866 resultados para nutritional management


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The decentralisation reform in Indonesia has mandated the Central Government to transfer some functions and responsibilities to local governments including the transfer of human resources, assets and budgets. Local governments became giant asset holders almost overnight and most were ill prepared to handle these transformations. Assets were transferred without analysing local government need, ability or capability to manage the assets and no local government was provided with an asset management framework. Therefore, the aim of this research is to develop a Public Asset Management Framework for provincial governments in Indonesia, especially for infrastructure and real property assets. This framework will enable provincial governments to develop integrated asset management procedures throughout asset‘s lifecycle. Achieving the research aim means answering the following three research questions; 1) How do provincial governments in Indonesia currently manage their public assets? 2) What factors influence the provincial governments in managing these public assets? 3) How is a Public Asset Management Framework developed that is specific for the Indonesian provincial governments‘ situation? This research applied case studies approach after a literature review; document retrieval, interviews and observations were collated. Data was collected in June 2009 (preliminary data collection) and January to July 2010 in the major eastern Indonesian provinces. Once the public asset management framework was developed, a focus group was used to verify the framework. Results are threefold and indicate that Indonesian provincial governments need to improve the effectiveness and efficiency of current practice of public asset management in order to improve public service quality. The second result shows that the 5 major concerns that influence the local government public asset management processes are asset identification and inventory systems, public asset holding, asset guidance and legal arrangements, asset management efficiency and effectiveness, and, human resources and their organisational arrangements. The framework was then applied to assets already transferred to local governments and so included a system of asset identification and a needs analysis to classify the importance of these assets to local governments, their functions and responsibilities in delivering public services. Assets that support local government functions and responsibilities will then be managed using suitable asset lifecycle processes. Those categorised as surplus assets should be disposed. Additionally functions and responsibilities that do not need an asset solution should be performed directly by local governments. These processes must be measured using performance measurement indicators. All these stages should be guided and regulated with sufficient laws and regulations. Constant improvements to the quality and quantity of human resources hold an important role in successful public asset management processes. This research focuses on developing countries, and contributes toward the knowledge of a Public Asset Management Framework at local government level, particularly Indonesia. The framework provides local governments a foundation to improve their effectiveness and efficiency in managing public assets, which could lead to improved public service quality. This framework will ensure that the best decisions are made throughout asset decision ownership and provide a better asset life cycle process, leading to selection of the most appropriate asset, improve its acquisition and delivery process, optimise asset performance, and provide an appropriate disposal program.

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The polyphagous moth Helicoverpa armigera (Hübner) is one of the world's most important agricultural pests. A number of existing approaches and future designs for management of H. armigera rely on the assumption that moths do not exhibit either genetically and/or non-genetically based variation for host plant utilization. We review recent empirical evidence demonstrating that both these forms of variation influence host plant use in this moth. The significance of this variation in H. armigera in relation to current and future pest management strategies is examined. We provide recommendations on future research needs and directions for sustainable management of H. armigera, under a framework that includes consideration of intra-specific variation for host use relevant in this and other similar pest species.

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Ramp metering is an effective motorway control tool beneficial for mainline traffic, but the long on-ramp queues created interfere with surface traffic profoundly. This study deals with the conflict between mainline benefits and thecosts of on-ramp and surface traffic. A novel local on-ramp queue management strategy with mainline speed recovery is proposed. Microscopic simulation is used to test the new strategy and compare it with other strategies. Simulation results reveal that the ramp metering with queue management strategy provides a good balance between the mainline and on-ramp performances.

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Property is an important factor in all businesses production in order to function. Nourse (1990) quoted ¡°some businesses are real estate, all businesses use real estate¡±. In recent years, the management of property assets has become the focus of many organisations, including the non-real estate businesses. Good asset management is concerned with the effective utilisation of a property owner.s assets. It is the management process of ensuring that the portfolio of properties held meets the overall requirements of the users. In short, it is the process of identifying the user.s requirement and the rationalisation of property holdings to match that requirement best, followed by a monitoring and ongoing review of practice. In Malaysia, federal agencies and local authorities are among the largest property asset owners. Recently the federal government has released a Total Asset Management Manual (TAMM). It is at the preliminary stage of implementation. This thesis will study the international practices of asset management of public sector assets and assess the effectiveness of TAMM. This research will focus on current international practices for the effective management of public sector property assets. The current application in Malaysia will be highlighted, to determine the awareness and understanding of the current practices to the recently released TAMM. This research is an exploratory research. The basis of this research relies on the combination of qualitative and quantitative approach, whereby the qualitative approach focuses on the international practices and its application to the management of public sector property assets. Questionnaires survey will be conducted among the Malaysian public property assets managers and users in the quantitative approach to gauge the collective opinion on the current practices of TAMM and its implementation

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The feral pig, Sus scrofa, is a widespread and abundant invasive species in Australia. Feral pigs pose a significant threat to the environment, agricultural industry, and human health, and in far north Queensland they endanger World Heritage values of the Wet Tropics. Historical records document the first introduction of domestic pigs into Australia via European settlers in 1788 and subsequent introductions from Asia from 1827 onwards. Since this time, domestic pigs have been accidentally and deliberately released into the wild and significant feral pig populations have become established, resulting in the declaration of this species as a class 2 pest in Queensland. The overall objective of this study was to assess the population genetic structure of feral pigs in far north Queensland, in particular to enable delineation of demographically independent management units. The identification of ecologically meaningful management units using molecular techniques can assist in targeting feral pig control to bring about effective long-term management. Molecular genetic analysis was undertaken on 434 feral pigs from 35 localities between Tully and Innisfail. Seven polymorphic and unlinked microsatellite loci were screened and fixation indices (FST and analogues) and Bayesian clustering methods were used to identify population structure and management units in the study area. Sequencing of the hyper-variable mitochondrial control region (D-loop) of 35 feral pigs was also examined to identify pig ancestry. Three management units were identified in the study at a scale of 25 to 35 km. Even with the strong pattern of genetic structure identified in the study area, some evidence of long distance dispersal and/or translocation was found as a small number of individuals exhibited ancestry from a management unit outside of which they were sampled. Overall, gene flow in the study area was found to be influenced by environmental features such as topography and land use, but no distinct or obvious natural or anthropogenic geographic barriers were identified. Furthermore, strong evidence was found for non-random mating between pigs of European and Asian breeds indicating that feral pig ancestry influences their population genetic structure. Phylogenetic analysis revealed two distinct mitochondrial DNA clades, representing Asian domestic pig breeds and European breeds. A significant finding was that pigs of Asian origin living in Innisfail and south Tully were not mating randomly with European breed pigs populating the nearby Mission Beach area. Feral pig control should be implemented in each of the management units identified in this study. The control should be coordinated across properties within each management unit to prevent re-colonisation from adjacent localities. The adjacent rainforest and National Park Estates, as well as the rainforest-crop boundary should be included in a simultaneous control operation for greater success.

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In 2010, six Threshold Learning Outcomes (TLOs) for law were developed by the Australian Learning and Teaching Council's Discipline Scholars: Law. The final of these outcomes, TLO 6, concerns self-management. This thesis examines strategies for implementing self-management in Australian legal education by first contextualising the development of TLO 6 in light of other relevant national and international developments in higher education, and secondly, analysing this learning outcome through the lens of Self-Determination Theory (SDT), an influential branch of educational psychology. It is argued that the central concept of autonomous self-regulation in SDT provides insights into factors that are relevant to law students’ capacities for long-term self-management, which is reinforced by analysis of the literature on law students’ distress. Accordingly, curriculum design that supports students’ autonomy may simultaneously promote students’ self-management capacities. The discussion of theoretical and practical perspectives on autonomy supportive curriculum design in this thesis thus illuminates potential pedagogical approaches for the implementation of TLO 6 in Australian legal curricula.

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Climate change is predicted to increase the frequency and severity of extreme weather events which pose significant challenges to the ability of government and other relief agencies to plan for, cope with and respond to disasters. Consequently, it is important that communities in climate sensitive and potential disaster prone areas strengthen their resilience to natural disasters in order to expeditiously recover from potential disruptions and damage caused by disasters. Building self reliance and, particularly in the immediate aftermath of a disaster, can facilitate short-term and long-term community recovery. To build stronger and more resilient communities, it is essential to have a better understanding of their current resilience capabilities by assessing areas of strength, risks and vulnerabilities so that their strengths can be enhanced and the risks and vulnerability can be appropriately addressed and mitigated through capacity building programs. While a number of conceptual frameworks currently exist to assess the resilience level of communities to disasters, they have tended to differ on their emphasis, scope and definition of what constitutes community resilience and how community resilience can be most effectively and accurately assessed. These limitations are attributed to the common approach of viewing community resilience through a mono-disciplinary lens. To overcome this, this paper proposes an integrated conceptual framework that takes into account the complex interplay of environmental, social, governance, infrastructure and economic attributes associated with community resilience. The framework can be operationalised using a range of resilience indicators to suit the nature of a disaster and the specific characteristics of a study region.

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Climate change is expected to increase earth’s temperatures and consequently result in more frequent extreme weather events such as cyclones, storms, droughts and floods and rising global sea levels. This phenomenon will affect all assets. This paper discusses the impact of climate change and its consequences on public buildings. Public building management encompasses the building life cycle from planning, procurement, operation, repair and maintenance and building disposal. This paper recommends climate change adaptation strategies to be integrated into public building management. The roles and responsibilities of asset managers and users are discussed within the framework of planning and implementation of public building management and the integration of climate change adaptation strategies. A key point is that climate change can induce premature obsolescence of public buildings and services, which will increase the maintenance and refurbishment costs. This in turn will affect the life cycle cost of the building. Furthermore, a business continuity plan is essential for public building management in the context of disasters. The paper also highlights the significant role that the occupants of public buildings can play in the development and implementation of climate change adaptation strategies.

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Business process management systems (BPMS) belong to a class of enterprise information systems that are characterized by the dependence on explicitly modeled process logic. Through the process logic, it is relatively easy to manage explicitly the routing and allocation of work items along a business process through the system. Inspired by the DeLone and McLean framework, we theorize that these process-aware system features are important attributes of system quality, which in turn will elevate key user evaluations such as perceived usefulness, and usage satisfaction. We examine this theoretical model using data collected from four different, mostly mature BPM system projects. Our findings validate the importance of input quality as well as allocation and routing attributes as antecedents of system quality, which, in turn, determines both usefulness and satisfaction with the system. We further demonstrate how service quality and workflow dependency are significant precursors to perceived usefulness. Our results suggest the appropriateness of a multi-dimensional conception of system quality for future research, and provide important design-oriented advice for the design and configuration of BPMSs.

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Human immunodeficiency virus (HIV) that leads to acquired immune deficiency syndrome (AIDs) reduces immune function, resulting in opportunistic infections and later death. Use of antiretroviral therapy (ART) increases chances of survival, however, with some concerns regarding fat re-distribution (lipodystrophy) which may encompass subcutaneous fat loss (lipoatrophy) and/or fat accumulation (lipohypertrophy), in the same individual. This problem has been linked to Antiretroviral drugs (ARVs), majorly, in the class of protease inhibitors (PIs), in addition to older age and being female. An additional concern is that the problem exists together with the metabolic syndrome, even when nutritional status/ body composition, and lipodystrophy/metabolic syndrome are unclear in Uganda where the use of ARVs is on the increase. In line with the literature, the overall aim of the study was to assess physical characteristics of HIV-infected patients using a comprehensive anthropometric protocol and to predict body composition based on these measurements and other standardised techniques. The other aim was to establish the existence of lipodystrophy, the metabolic syndrome, andassociated risk factors. Thus, three studies were conducted on 211 (88 ART-naïve) HIV-infected, 15-49 year-old women, using a cross-sectional approach, together with a qualitative study of secondary information on patient HIV and medication status. In addition, face-to-face interviews were used to extract information concerning morphological experiences and life style. The study revealed that participants were on average 34.1±7.65 years old, had lived 4.63±4.78 years with HIV infection and had spent 2.8±1.9 years receiving ARVs. Only 8.1% of participants were receiving PIs and 26% of those receiving ART had ever changed drug regimen, 15.5% of whom changed drugs due to lipodystrophy. Study 1 hypothesised that the mean nutritional status and predicted percent body fat values of study participants was within acceptable ranges; different for participants receiving ARVs and the HIV-infected ART-naïve participants and that percent body fat estimated by anthropometric measures (BMI and skinfold thickness) and the BIA technique was not different from that predicted by the deuterium oxide dilution technique. Using the Body Mass Index (BMI), 7.1% of patients were underweight (<18.5 kg/m2) and 46.4% were overweight/obese (≥25.0 kg/m2). Based on waist circumference (WC), approximately 40% of the cohort was characterized as centrally obese. Moreover, the deuterium dilution technique showed that there was no between-group difference in the total body water (TBW), fat mass (FM) and fat-free mass (FFM). However, the technique was the only approach to predict a between-group difference in percent body fat (p = .045), but, with a very small effect (0.021). Older age (β = 0.430, se = 0.089, p = .000), time spent receiving ARVs (β = 0.972, se = 0.089, p = .006), time with the infection (β = 0.551, se = 0.089, p = .000) and receiving ARVs (β = 2.940, se = 1.441, p = .043) were independently associated with percent body fat. Older age was the greatest single predictor of body fat. Furthermore, BMI gave better information than weight alone could; in that, mean percentage body fat per unit BMI (N = 192) was significantly higher in patients receiving treatment (1.11±0.31) vs. the exposed group (0.99±0.38, p = .025). For the assessment of obesity, percent fat measures did not greatly alter the accuracy of BMI as a measure for classifying individuals into the broad categories of underweight, normal and overweight. Briefly, Study 1 revealed that there were more overweight/obese participants than in the general Ugandan population, the problem was associated with ART status and that BMI broader classification categories were maintained when compared with the gold standard technique. Study 2 hypothesized that the presence of lipodystrophy in participants receiving ARVs was not different from that of HIV-infected ART-naïve participants. Results showed that 112 (53.1%) patients had experienced at least one morphological alteration including lipohypertrophy (7.6%), lipoatrophy (10.9%), and mixed alterations (34.6%). The majority of these subjects (90%) were receiving ARVs; in fact, all patients receiving PIs reported lipodystrophy. Period spent receiving ARVs (t209 = 6.739, p = .000), being on ART (χ2 = 94.482, p = .000), receiving PIs (Fisher’s exact χ2 = 113.591, p = .000), recent T4 count (CD4 counts) (t207 = 3.694, p = .000), time with HIV (t125 = 1.915, p = .045), as well as older age (t209 = 2.013, p = .045) were independently associated with lipodystrophy. Receiving ARVs was the greatest predictor of lipodystrophy (p = .000). In other analysis, aside from skinfolds at the subscapular (p = .004), there were no differences with the rest of the skinfold sites and the circumferences between participants with lipodystrophy and those without the problem. Similarly, there was no difference in Waist: Hip ratio (WHR) (p = .186) and Waist: Height ratio (WHtR) (p = .257) among participants with lipodystrophy and those without the problem. Further examination showed that none of the 4.1% patients receiving stavudine (d4T) did experience lipoatrophy. However, 17.9% of patients receiving EFV, a non-nucleoside reverse transcriptase inhibitor (NNRTI) had lipoatrophy. Study 2 findings showed that presence of lipodystrophy in participants receiving ARVs was in fact far higher than that of HIV-infected ART-naïve participants. A final hypothesis was that the prevalence of the metabolic syndrome in participants receiving ARVs was not different from that of HIV-infected ART-naïve participants. Moreover, data showed that many patients (69.2%) lived with at least one feature of the metabolic syndrome based on International Diabetic Federation (IDF, 2006) definition. However, there was no single anthropometric predictor of components of the syndrome, thus, the best anthropometric predictor varied as the component varied. The metabolic syndrome was diagnosed in 15.2% of the subjects, lower than commonly reported in this population, and was similar between the medicated and the exposed groups (χ 21 = 0.018, p = .893). Moreover, the syndrome was associated with older age (p = .031) and percent body fat (p = .012). In addition, participants with the syndrome were heavier according to BMI (p = .000), larger at the waist (p = .000) and abdomen (p = .000), and were at central obesity risk even when hip circumference (p = .000) and height (p = .000) were accounted for. In spite of those associations, results showed that the period with disease (p = .13), CD4 counts (p = .836), receiving ART (p = .442) or PIs (p = .678) were not associated with the metabolic syndrome. While the prevalence of the syndrome was highest amongst the older, larger and fatter participants, WC was the best predictor of the metabolic syndrome (p = .001). Another novel finding was that participants with the metabolic syndrome had greater arm muscle circumference (AMC) (p = .000) and arm muscle area (AMA) (p = .000), but the former was most influential. Accordingly, the easiest and cheapest indicator to assess risk in this study sample was WC should routine laboratory services not be feasible. In addition, the final study illustrated that the prevalence of the metabolic syndrome in participants receiving ARVs was not different from that of HIV-infected ART-naïve participants.

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When you have completed this chapter you will be able to: • recognise the scope and impact of chronic pain in Australia • discuss the relevance of a biopsychosocial model of chronic pain for persons with chronic illness and disability • identify key components of pain assessment • acknowledge the central role the person with chronic pain takes in the management of their health • identify a range of therapies available for the management of chronic pain

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Aims and objectives. To examine Chinese cancer patients’ fatigue self-management, including the types of self-management behaviours used, their confidence in using these behaviours, the degree of relief obtained and the factors associated with patients’ use of fatigue self-management behaviours. Background. Fatigue places significant burden on patients with cancer undergoing chemotherapy. While some studies have explored fatigue self-management in Western settings, very few studies have explored self-management behaviours in China. Design. Cross-sectional self- and/or interviewer-administered survey. Methods. A total of 271 participants with self-reported fatigue in the past week were recruited from a specialist cancer hospital in south-east China. Participants completed measures assessing the use of fatigue self-management behaviours, corresponding self-efficacy, perceived relief levels plus items assessing demographic characteristics, fatigue experiences, distress and social support. Results. A mean of 4_94 (_2_07; range 1–10) fatigue self-management behaviours was reported. Most behaviours were rated as providing moderate relief and were implemented with moderate self-efficacy. Regression analyses identified that having more support from one’s neighbourhood and better functional status predicted the use of a greater number of self-management behaviours. Separate regression analyses identified that greater neighbourhood support predicted greater relief from ‘activity enhancement behaviours’ and that better functional status predicted greater relief from ‘rest and sleep behaviours’. Higher self-efficacy scores predicted greater relief from corresponding behaviours. Conclusions. A range of fatigue self-management behaviours were initiated by Chinese patients with cancer. Individual, condition and environmental factors were found to influence engagement in and relief from fatigue self-managementbehaviours. Relevance to clinical practice. Findings highlight the need for nurses to explore patients’ use of fatigue self-management behaviours and the effectiveness of these behaviours in reducing fatigue. Interventions that improve patients’ self-efficacy and neighbourhood supports have the potential to improve outcomes from fatigue self-management behaviours.

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Jakarta, Indonesia’s chronic housing shortage poses multiple challenges for contemporary policy-makers. While it may be in the city’s interest to increase the availability of housing, there is limited land to do so. Market pressures, in tandem with government’s desire for housing availability, demand consideration of even marginal lands, such as those within floodplains, for development. Increasingly, planning for a flood resilient Jakarta is complicated by a number of factors, including: the city is highly urbanized and land use data is limited; flood management is technically complex, creating potential barriers to engagement for both decision-makers and the public; inherent uncertainty exists throughout modelling efforts, central to management; and risk and liability for infrastructure investments is unclear. These obstacles require localized watershed-level participatory planning to address risks of flooding where possible and reduce the likelihood that informal settlements occur in areas of extreme risk. This paper presents a preliminary scoping study for determination of an effective participatory planning method to encourage more resilient development. First, the scoping study provides background relevant to the challenges faced in planning for contemporary Jakarta. Second, the study examines the current use of decision-support tools, such as Geographic Information Systems (GIS), in planning for Jakarta. Existing capacity in the use of GIS allows for consideration of the use of an emerging method of community consultation - Multi-Criteria Decision-Making (MCDM) support systems infused with geospatial information - to aid in engagement with the public and improve decision-making outcomes. While these methods have been used in Australia to promote stakeholder engagement in urban intensification, the planned research will be an early introduction of the method to Indonesia. As a consequence of this intervention, it is expected that planning activities will result in a more resilient city, capable of engaging with disaster risk management in a more effective manner.