A multi-centre open-label randomised non-inferiority trial comparing watchful waiting to antibiotic treatment for acute otitis media without perforation in low-risk urban Aboriginal and Torres Strait Islander children (the WATCH trial): study protocol for a randomised controlled trial

Background Treatment guidelines recommend watchful waiting for children older than 2 years with acute otitis media (AOM) without perforation, unless they are at high risk of complications. The high prevalence of chronic suppurative otitis media (CSOM) in remote Aboriginal and Torres Strait Islander communities leads these children to be classified as high risk. Urban Aboriginal and Torres Strait Islander children are at lower risk of complications, but evidence to support the subsequent recommendation for watchful waiting in this population is lacking. Methods/Design This non-inferiority multi-centre randomised controlled trial will determine whether watchful waiting is non-inferior to immediate antibiotics for urban Aboriginal and Torres Strait Islander children with AOM without perforation. Children aged 2 − 16 years with AOM who are considered at low risk for complications will be recruited from six participating urban primary health care services across Australia. We will obtain informed consent from each participant or their guardian. The primary outcome is clinical resolution on day 7 (no pain, no fever of at least 38 °C, no bulging eardrum and no complications of AOM such as perforation or mastoiditis) as assessed by general practitioners or nurse practitioners. Participants and outcome assessors will not be blinded to treatment. With a sample size of 198 children in each arm, we have 80 % power to detect a non-inferiority margin of up to 10 % at a significance level of 5 %, assuming clinical improvement of at least 80 % in both groups. Allowing for a 20 % dropout rate, we aim to recruit 495 children. We will analyse both by intention-to-treat and per protocol. We will assess the cost- effectiveness of watchful waiting compared to immediate antibiotic prescription. We will also report on the implementation of the trial from the perspectives of parents/carers, health professionals and researchers. Discussion The trial will provide evidence for the safety and effectiveness of watchful waiting for the management of AOM in Aboriginal and Torres Strait Islander children living in urban settings who are considered to be at low risk of complications.

Women bashing: An urban Aboriginal perspective

ABORIGINAL people in urbanised Australia experience violence on a daily basis. This violence ranges from the psychological (the covert hostility of the corner shop, the denial of the Aboriginality of fair-skinned or urban Blacks) through to the physical brutality of the criminal justice system. For Aboriginal women and children this daily violence is not only public but also has a private, B1ack-on-B1ack dimension. The Aboriginal home may be some refuge from the slights of white Australia but this is cold comfort to women for whom being 'flogged up' by their partners is so ordinary an event as to be unremarkable.

Search Strategies for Multiple UAV Search and Destroy Missions

Multiple UAVs are deployed to carry out a search and destroy mission in a bounded region. The UAVs have limited sensor range and can carry limited resources which reduce with use. The UAVs perform a search task to detect targets. When a target is detected which requires different type and quantities of resources to completely destroy, then a team of UAVs called as a coalition is formed to attack the target. The coalition members have to modify their route to attack the target, in the process, the search task is affected, as search and destroy tasks are coupled. The performance of the mission is a function of the search and the task allocation strategies. Therefore, for a given task allocation strategy, we need to devise search strategies that are efficient. In this paper, we propose three different search strategies namely; random search strategy, lanes based search strategy and grid based search strategy and analyze their performance through Monte-Carlo simulations. The results show that the grid based search strategy performs the best but with high information overhead.

UAV Grouping and Coordination Tactics for Ground Attack Missions

Grouping and coordination tactics for ground attack missions by a heterogeneous mix of reconnaissance, enemy suppression, and attack unmanned aerial vehicles (UAVs) is presented. Dubins' paths are used to determine the optimal number of attack UAVs and their positional and heading freedoms, as functions of weapon seeker range and field of view. A generic battlefield scenario with layered defense is created and the tactics are evaluated on a Group Flyer simulation platform for both nominal and off-nominal conditions.

A History of the brazil : comprising its geography, commerce, colonizaton, aboriginal inhabitants

É uma tradução da Corographia brasilica... de Ayres de Cazal, acrescida de observações pessoais que o autor colheu durante sua viagem, conforme afirma no prefácio da própria obra. É um livro muito útil para estudo da sociedade pernambucana antes de 1817. A Corographia brasílica..., de Cazal, reveste-se de importância histórica por ter publicado, pela primeira vez, a carta de Pero Vaz de Caminha, segundo informa Borba de Moraes.

Advancing EDL technologies for future space missions : from ground testing facilities to ablative heatshields

Motivated by recent MSL results where the ablation rate of the PICA heatshield was over-predicted, and staying true to the objectives outlined in the NASA Space Technology Roadmaps and Priorities report, this work focuses on advancing EDL technologies for future space missions.

Due to the difficulties in performing flight tests in the hypervelocity regime, a new ground testing facility called the vertical expansion tunnel is proposed. The adverse effects from secondary diaphragm rupture in an expansion tunnel may be reduced or eliminated by orienting the tunnel vertically, matching the test gas pressure and the accelerator gas pressure, and initially separating the test gas from the accelerator gas by density stratification. If some sacrifice of the reservoir conditions can be made, the VET can be utilized in hypervelocity ground testing, without the problems associated with secondary diaphragm rupture.

The performance of different constraints for the Rate-Controlled Constrained-Equilibrium (RCCE) method is investigated in the context of modeling reacting flows characteristic to ground testing facilities, and re-entry conditions. The effectiveness of different constraints are isolated, and new constraints previously unmentioned in the literature are introduced. Three main benefits from the RCCE method were determined: 1) the reduction in number of equations that need to be solved to model a reacting flow; 2) the reduction in stiffness of the system of equations needed to be solved; and 3) the ability to tabulate chemical properties as a function of a constraint once, prior to running a simulation, along with the ability to use the same table for multiple simulations.

Finally, published physical properties of PICA are compiled, and the composition of the pyrolysis gases that form at high temperatures internal to a heatshield is investigated. A necessary link between the composition of the solid resin, and the composition of the pyrolysis gases created is provided. This link, combined with a detailed investigation into a reacting pyrolysis gas mixture, allows a much needed consistent, and thorough description of many of the physical phenomena occurring in a PICA heatshield, and their implications, to be presented.

Through the use of computational fluid mechanics and computational chemistry methods, significant contributions have been made to advancing ground testing facilities, computational methods for reacting flows, and ablation modeling.

Multi-objective optimization for multiphase orbital rendezvous missions

A multi-objective optimization approach was proposed for multiphase orbital rendezvous missions and validated by application to a representative numerical problem. By comparing the Pareto fronts obtained using the proposed method, the relationships between the three objectives considered are revealed, and the influences of other mission parameters, such as the sensors' field of view, can also be analyzed effectively. For multiphase orbital rendezvous missions, the tradeoff relationships between the total velocity increment and the trajectory robustness index as well as between the total velocity increment and the time of flight are obvious and clear. However, the tradeoff relationship between the time of flight and the trajectory robustness index is weak, especially for the four- and five-phase missions examined. The proposed approach could be used to reorganize a stable rendezvous profile for an engineering rendezvous mission, when there is a failure that prevents the completion of the nominal mission.