Evaluation of the problem posed by in-place pollutants in Baltimore Harbor and recommendation of corrective action.

Mode of access: Internet.

The problem posed by exam choice on the comparability of results in the Finnish matriculation examination

The article focuses on the upper secondary matriculation examination in Finland as a school leaving and university entrance examination. The presented research addresses the question of whether increased choice of the subject-specific examinations has the potential to undermine the comparability of examination results and to direct students’ choices not only in the examination but already beforehand at school. The authors refer to Finland’s tradition of more than 160 years of a national examination connecting the academic track of upper secondary schools with universities. The authors explain the Finnish system by describing the adoption of a course-based (vs. class- or year-based) curriculum for the three-year upper secondary education and the subsequent reforms in the matriculation examination. This increases students’ choices considerably with regard to the subject-specific exams included in the examination (a minimum of four). As a result, high-achieving students compete against each other in the more demanding subjects while the less able share the same normal distribution of grades in the less demanding subjects. As a consequence, students tend to strategic exam-planning, which in turn affects their study choices at school, often to the detriment of the more demanding subjects and, subsequently, of students’ career opportunities, endangering the traditional national objective of an all-round pre-academic upper secondary education. This contribution provides an overview of Finnish upper secondary education and of the matriculation examination (cf. Klein, 2013) while studying three separate but related issues by using data from several years of Finnish matriculation results: the relation of the matriculation examination and the curriculum; the problems of comparability vis-à-vis university entry due to the increased choice within the examination; the relations between students’ examination choices and their course selection and achievement during upper secondary school. (DIPF/Orig.)

Diarrhoea risk factors in enterally tube fed critically ill patients : a retrospective audit

Objective: Diarrhoea in the enterally tube fed (ETF) intensive care unit (ICU) patient is a multifactorial problem. Diarrhoeal aetiologies in this patient cohort remain debatable; however, the consequences of diarrhoea have been well established and include electrolyte imbalance, dehydration, bacterial translocation, peri anal wound contamination and sleep deprivation. This study examined the incidence of diarrhoea and explored factors contributing to the development of diarrhoea in the ETF, critically ill, adult patient. ---------- Method: After institutional ethical review and approval, a single centre medical chart audit was undertaken to examine the incidence of diarrhoea in ETF, critically ill patients. Retrospective, non-probability sequential sampling was used of all emergency admission adult ICU patients who met the inclusion/exclusion criteria. ---------- Results: Fifty patients were audited. Faecal frequency, consistency and quantity were considered important criteria in defining ETF diarrhoea. The incidence of diarrhoea was 78%. Total patient diarrhoea days (r = 0.422; p = 0.02) and total diarrhoea frequency (r = 0.313; p = 0.027) increased when the patient was ETF for longer periods of time. Increased severity of illness, peripheral oxygen saturation (Sp02), glucose control, albumin and white cell count were found to be statistically significant factors for the development of diarrhoea. ---------- Conclusion: Diarrhoea in ETF critically ill patients is multi-factorial. The early identification of diarrhoea risk factors and the development of a diarrhoea risk management algorithm is recommended.

Probiotics and diarrhoea management in enterally tube fed critically ill patients : what is the evidence?

Objective: The aim of this literature review is to identify the role of probiotics in the management of enteral tube feeding (ETF) diarrhoea in critically ill patients.---------- Background: Diarrhoea is a common gastrointestinal problem seen in ETF patients. The incidence of diarrhoea in tube fed patients varies from 2% to 68% across all patients. Despite extensive investigation, the pathogenesis surrounding ETF diarrhoea remains unclear. Evidence to support probiotics to manage ETF diarrhoea in critically ill patients remains sparse.---------- Method: Literature on ETF diarrhoea and probiotics in critically ill, adult patients was reviewed from 1980 to 2010. The Cochrane Library, Pubmed, Science Direct, Medline and the Cumulative Index of Nursing and Allied Health Literature (CINAHL) electronic databases were searched using specific inclusion/exclusion criteria. Key search terms used were: enteral nutrition, diarrhoea, critical illness, probiotics, probiotic species and randomised clinical control trial (RCT).---------- Results: Four RCT papers were identified with two reporting full studies, one reporting a pilot RCT and one conference abstract reporting an RCT pilot study. A trend towards a reduction in diarrhoea incidence was observed in the probiotic groups. However, mortality associated with probiotic use in some severely and critically ill patients must caution the clinician against its use.---------- Conclusion: Evidence to support probiotic use in the management of ETF diarrhoea in critically ill patients remains unclear. This paper argues that probiotics should not be administered to critically ill patients until further research has been conducted to examine the causal relationship between probiotics and mortality, irrespective of the patient's disease state or projected prophylactic benefit of probiotic administration.

Constitutional legitimacy : an international ill and gap in the literature?

The central argument of this work is that “democratic constitutional legitimacy”[2] probably does not currently exist in the politics of any country internationally. This inherent problem in constitutionalism is an endemic governance problem most citizenries should be dealing with, only that we are not in a large extent doing so and haven’t been historically. This position was ascertained using a form of Beck and Grande’s (2010) cosmopolitan methodology in my doctoral thesis (which we shall return to). It is argued that every constitution is in need of considerable rethinking so as to bring its statutes in line with the interests of the plurality of individuals it oversees. Finally, this work attempts to show that research in this area of democratic constitutional legitimacy is lacking in the literature as only a few scholars presently engage the issue (namely Simone Chambers).

Trans digital storytelling : everyday activism, mutable identity and the problem of visibility

Mainstream representations of trans people typically run the gamut from victim to mentally ill and are almost always articulated by non-trans voices. The era of user-generated digital content and participatory culture has heralded unprecedented opportunities for trans people who wish to speak their own stories in public spaces. Digital Storytelling, as an easy accessible autobiographic audio-visual form, offers scope to play with multi-dimensional and ambiguous representations of identity that contest mainstream assumptions of what it is to be ‘male’ or ‘female’. Also, unlike mainstream media forms, online and viral distribution of Digital Stories offer potential to reach a wide range of audiences, which is appealing to activist oriented storytellers who wish to confront social prejudices. However, with these newfound possibilities come concerns regarding visibility and privacy, especially for storytellers who are all too aware of the risks of being ‘out’ as trans. This paper explores these issues from the perspective of three trans storytellers, with reference to the Digital Stories they have created and shared online and on DVD. These examplars are contextualised with some popular and scholarly perspectives on trans representation, in particular embodied and performed identity. It is contended that trans Digital Stories, while appearing in some ways to be quite conventional, actually challenge common notions of gender identity in ways that are both radical and transformative.

Enhancing opportunities to feed forward ; developing problem solving skills using web based scenarios

Universities often struggle to satisfy students’ need for feedback. This is an area where student satisfaction with courses of study can be low. Yet it is clear that one of the properties of good teaching is giving the highest quality feedback on student work. The term ‘feedback’ though is most commonly associated with summative assessment given by a teacher after work is completed. The student can often be a passive participant in the process. This paper looks at the implementation of a web based interactive scenario completed by students prior to summative assessment. It requires students to participate actively to develop and improve their legal problem solving skills. Traditional delivery of legal education focuses on print and an instructor who conveys the meaning of the written word to students. Today, mixed modes of teaching are often preferred and they can provide enhanced opportunities for feeding forward with greater emphasis on what students do. Web based activities allow for flexible delivery; they are accessible off campus, at a time that suits the student and may be completed by students at their own pace. This paper reports on an online interactive activity which provides valuable formative feedback necessary to allow for successful completion of a final problem solving assignment. It focuses on how the online activity feeds forward and contributes to the development of legal problem solving skills. Introduction to Law is a unit designed and introduced for completion by undergraduate students from faculties other than law but is focused most particularly on students enrolled in the Bachelor of Entertainment Industries degree, a joint initiative of the faculties of Creative Industries, Business and Law at the Queensland University of Technology in Australia. The final (and major) assessment for the unit is an assignment requiring students to explain the legal consequences of particular scenarios. A number of cost effective web based interactive scenarios have been developed to support the unit’s classroom activities. The tool commences with instruction on problem solving method. Students then view the stimulus which is a narrative produced in the form of a music video clip. A series of questions are posed which guide students through the process and they can compare their responses with sample answers provided. The activity clarifies the problem solving method and expectations for the summative assessment and allows students to practise the skill. The paper reports on the approach to teaching and learning taken in the unit including the design process and implementation of the activity. It includes an evaluation of the activity with respect to its effectiveness as a tool to feed forward and reflects on the implications for the teaching of law in higher education.

Drugs, labels and (p)ill-fitting boxes : ADHD and children who are hard to teach

In offering a critical review of the problem we call “ADHD” this paper progresses in three stages. The first two parts juxtapose the dominant voices emanating from the literature in medicine and psychology, highlighting some interdependency between these otherwise competing interest groups. In part three, the nature of the relationship between these groups and the institution of the school is considered, as is the role that the school may play in the psycho-pathologisation of fidgety, distractible, active children who prove hard to teach. In so doing, the author provides an insight as to why the problem we call “ADHD” has achieved celebrity status in Australia and what the effects of that may be for children who come to be described in these ways.

Statistical literacy in the elementary school: Opportunities for problem posing

This chapter addresses opportunities for problem posing in developing young children’s statistical literacy, with a focus on student-directed investigations. Although the notion of problem posing has broadened in recent years, there nevertheless remains limited research on how problem posing can be integrated within the regular mathematics curriculum, especially in the areas of statistics and probability. The chapter first reviews briefly aspects of problem posing that have featured in the literature over the years. Consideration is next given to the importance of developing children’s statistical literacy in which problem posing is an inherent feature. Some findings from a school playground investigation conducted in four, fourth-grade classes illustrate the different ways in which children posed investigative questions, how they made predictions about their outcomes and compared these with their findings, and the ways in which they chose to represent their findings.

A numerical study of variable coefficient elliptic Cauchy problem via projection method

In this paper, we investigate a numerical method for the solution of an inverse problem of recovering lacking data on some part of the boundary of a domain from the Cauchy data on other part for a variable coefficient elliptic Cauchy problem. In the process, the Cauchy problem is transformed into the problem of solving a compact linear operator equation. As a remedy to the ill-posedness of the problem, we use a projection method which allows regularization solely by discretization. The discretization level plays the role of regularization parameter in the case of projection method. The balancing principle is used for the choice of an appropriate discretization level. Several numerical examples show that the method produces a stable good approximate solution.

Two player game variant of the Erdos-Szekeres problem

The classical Erdos-Szekeres theorem states that a convex k-gon exists in every sufficiently large point set. This problem has been well studied and finding tight asymptotic bounds is considered a challenging open problem. Several variants of the Erdos-Szekeres problem have been posed and studied in the last two decades. The well studied variants include the empty convex k-gon problem, convex k-gon with specified number of interior points and the chromatic variant. In this paper, we introduce the following two player game variant of the Erdos-Szekeres problem: Consider a two player game where each player playing in alternate turns, place points in the plane. The objective of the game is to avoid the formation of the convex k-gon among the placed points. The game ends when a convex k-gon is formed and the player who placed the last point loses the game. In our paper we show a winning strategy for the player who plays second in the convex 5-gon game and the empty convex 5-gon game by considering convex layer configurations at each step. We prove that the game always ends in the 9th step by showing that the game reaches a specific set of configurations.

Distribution of Healthcare resources II.Study and Comparison of a Linear Programming Problem and its Dual. Resolution and Evaluation of a Practical Case and its Programming using Excel and Win QSB.

[EN]This research had as primary objective to model different types of problems using linear programming and apply different methods so as to find an adequate solution to them. To achieve this objective, a linear programming problem and its dual were studied and compared. For that, linear programming techniques were provided and an introduction of the duality theory was given, analyzing the dual problem and the duality theorems. Then, a general economic interpretation was given and different optimal dual variables like shadow prices were studied through the next practical case: An aesthetic surgery hospital wanted to organize its monthly waiting list of four types of surgeries to maximize its daily income. To solve this practical case, we modelled the linear programming problem following the relationships between the primal problem and its dual. Additionally, we solved the dual problem graphically, and then we found the optimal solution of the practical case posed through its dual, following the different theorems of the duality theory. Moreover, how Complementary Slackness can help to solve linear programming problems was studied. To facilitate the solution Solver application of Excel and Win QSB programme were used.

Using the interact system model to analyze computer mediated communication during a small group problem-solving task

The Interact System Model (ISM) developed by Fisher and Hawes (1971) for the analysis of face-to-face communication during small-group problem solving activities was used to study online communication. This tool proved to be of value in the analysis, but the conversation patterns reported by Fisher (1980) did not fully appear in the online environment. Participants displayed a habit of "being too polite" and not fully voicing their disagreements with ideas posed by others. Thus progress towards task completion was slow and incomplete.

A prospective clinical trial of a real-time polymerase chain reaction assay for the diagnosis of candidemia in nonneutropenic, critically ill adults

Background. Invasive Candida infection among nonneutropenic, critically ill adults is a clinical problem that has received increasing attention in recent years. Poor performance of extant diagnostic modalities has promoted risk-based, preemptive prescribing in view of the poor outcomes associated with inadequate or delayed antifungal therapy; this risks unnecessary overtreatment. A rapid, reliable diagnostic test could have a substantial impact on therapeutic practice in this patient population.

Methods. Three TaqMan-based real-time polymerase chain reaction assays were developed that are capable of detecting the main medically important Candida species, categorized according to the likelihood of fluconazole susceptibility. Assay 1 detected Candida albicans, Candida parapsilosis, Candida tropicalis, and Candida dubliniensis. Assays 2 and 3 detected Candida glabrata and Candida krusei, respectively. The clinical performance of these assays, applied to serum, was evaluated in a prospective trial of nonneutropenic adults in a single intensive care unit.

Results. In all, 527 specimens were obtained from 157 participants. All 3 assays were run in parallel for each specimen; they could be completed within 1 working day. Of these, 23 specimens were obtained from 23 participants categorized as having proven Candida infection at the time of sampling. If a single episode of Candida famata candidemia was excluded, the estimated clinical sensitivity, specificity, and positive and negative predictive values of the assays in this trial were 90.9%, 100%, 100% and 99.8%, respectively.

Conclusions. These data suggest that the described assays perform well in this population for enhancing the diagnosis of candidemia. The extent to which they may affect clinical outcomes, prescribing practice, and cost-effectiveness of care remains to be ascertained.

An integral equation method for a boundary value problem arising in unsteady water wave problems

In this paper we consider the 2D Dirichlet boundary value problem for Laplace’s equation in a non-locally perturbed half-plane, with data in the space of bounded and continuous functions. We show uniqueness of solution, using standard Phragmen-Lindelof arguments. The main result is to propose a boundary integral equation formulation, to prove equivalence with the boundary value problem, and to show that the integral equation is well posed by applying a recent partial generalisation of the Fredholm alternative in Arens et al [J. Int. Equ. Appl. 15 (2003) pp. 1-35]. This then leads to an existence proof for the boundary value problem. Keywords. Boundary integral equation method, Water waves, Laplace’s