Appropriate indicators for injury control?

Indicators are valuable tools used to measure progress towards a desired health outcome. Increased awareness of the public health burden due to injury has lead to a concomitant interest in monitoring the impact of national initiatives that aim to reduce the size of the burden. Several injury indicators have now been proposed. This study examines the ability of each of the suggested indicators to reflect the nature and extent of the burden of non-fatal injury. A criterion validity, population-based, prospective cohort study was conducted in Brisbane, a sub-tropical Metropolitan City on the eastern seaboard of Australia, over a 12-month period between 1 January and 31 December 1998. Neither the presence of a long bone fracture nor the need for hospitalisation for 4 or more days were sensitive or specific indicators for 'serious' or major injury as defined by the 'Gold Standard' Injury Severity Score (ISS). Subsequent analysis, using other public health outcome measures demonstrated that the major component of the illness burden of injury was in fact due to 'minor' not serious injury. However, the suggested indicators demonstrated low sensitivity and specificity for these outcomes as well. The results of the study support the need to include at least all hospitalisations in any population-based measure of injury and not attempt to simplify the indicator to a more convenient measure aimed at identifying just those cases of,serious' injury.

Implications of missed opportunities for learning and assessment in design and technology education

Supporting student learning can be difficult, especially within open-ended or loosely structured activities, often seen as valuable for promoting student autonomy in many curriculum areas and contexts. This paper reports an investigation into the experiences of three teachers who implemented design and technology education ideas in their primary school classrooms for the first time. The teachers did not capitalise upon many of the opportunities for scaffolding their students' learning within the open-ended activities they implemented. Limitations of the teachers' conceptual and procedural knowledge of design and technology were elements that influenced their early experiences. The study has implications for professional developers planning programs in newly introduced areas of the curriculum to support teachers in supporting learning within open-ended and loosely structured problem solving activities. (C) 2001 Elsevier Science Ltd. All rights reserved.

Enhancing the immunogenicity and modulating the fine epitope recognition of antisera to a helical group A streptococcal peptide vaccine candidate from the M protein using lipid-core peptide technology

A conserved helical peptide vaccine candidate from the M protein of group A streptococci, p145, has been described. Minimal epitopes within p145 have been defined and an epitope recognized by protective antibodies, but not by autoreactive T cells, has been identified. When administered to mice, p145 has low immunogenicity. Many boosts of peptide are required to achieve a high antibody titre (> 12 800). To attempt to overcome this low immunogenicity, lipid-core peptide technology was employed. Lipid-core peptides (LCP) consist of an oligomeric polylysine core, with multiple copies of the peptide of choice, conjugated to a series of lipoamino acids, which acts as an anchor for the antigen. Seven different LCP constructs based on the p145 peptide sequence were synthesized (LCP1-->LCP7) and the immunogenicity of the compounds examined. The most immunogenic constructs contained the longest alkyl side-chains. The number of lipoamino acids in the constructs affected the immunogenicity and spacing between the alkyl side-chains increased immunogenicity. An increase in immunogenicity (enzyme-linked immunosorbent assay (ELISA) titres) of up to 100-fold was demonstrated using this technology and some constructs without adjuvant were more immunogenic than p145 administered with complete Freund's adjuvant (CFA). The fine specificity of the induced antibody response differed for the different constructs but one construct, LCP4, induced antibodies of identical fine specificity to those found in endemic human serum. Opsonic activity of LCP4 antisera was more than double that of p145 antisera. These data show the potential for LCP technology to both enhance immunogenicity of complex peptides and to focus the immune response towards or away from critical epitopes.

Aerosolization of protein solutions using thermal inkjet technology

Vapotronics Inc. is developing the thermal inkjet (TIJ) technology used extensively in the printer industry to create a digital aerosol inhaler for the inhalation of therapeutics for local and systemic delivery. The operation of thermal inkjet printers requires generation of high temperatures and vaporization of the liquid formulation to effect droplet ejection. A study was conducted to develop formulations that would permit the generation of aerosols of therapeutic proteins without damage to the inkjet system or degradation of the proteins. Two proteins, human growth hormone and insulin, were formulated and aerosolized. The aerosol was collected and subjected to assays to compare the physicochemical and biological activities of these proteins before and after aerosolization. In each case, there was no significant changes to the proteins as a result of the aerosolization, providing evidence that TIJ can be used for aerosolizing solutions of protein therapeutics.

Sequencing batch reactor technology: the key to a BP refinery (Bulwer Island) upgraded environmental protection system - a low cost lagoon based retro-fit

BP Refinery (Bulwer Island) Ltd (BP) located on the eastern Australian coast is currently undergoing a major expansion as a part of the Queensland Clean Fuels Project. The associated wastewater treatment plant upgrade will provide a better quality of treated effluent than is currently possible with the existing infrastructure, and which will be of a sufficiently high standard to meet not only the requirements of imposed environmental legislation but also BP's environmental objectives. A number of challenges were faced when considering the upgrade, particularly; cost constraints and limited plot space, highly variable wastewater, toxicity issues, and limited available hydraulic head. Sequencing Batch Reactor (SBR) Technology was chosen for the lagoon upgrade based on the following; SBR technology allowed a retro-fit of the existing earthen lagoon without the need for any additional substantial concrete structures, a dual lagoon system allowed partial treatment of wastewaters during construction, SBRs give substantial process flexibility, SBRs have the ability to easily modify process parameters without any physical modifications, and significant cost benefits. This paper presents the background to this application, an outline of laboratory studies carried out on the wastewater and details the full scale design issues and methods for providing a cost effective, efficient treatment system using the existing lagoon system.

Estimation of body fatness from body mass index and bioelectrical impedance: comparison of New Zealand European, Maori and Pacific Island children

Objective: To compare percentage body fat (%BF) for a given body mass index (BMI) among New Zealand European, Maori and Pacific Island children. To develop prediction equations based on bioimpedance measurements for the estimation of fat-free mass (FFM) appropriate to children in these three ethnic groups. Design: Cross-sectional study. Purposive sampling of schoolchildren aimed at recruiting three children of each sex and ethnicity for each year of age. Double cross-validation of FFM prediction equations developed by multiple regression. Setting: Local schools in Auckland. Subjects: Healthy European, Maori and Pacific Island children (n = 172, 83 M, 89 F, mean age 9.4 +/- 2.8(s. d.), range 5 - 14 y). Measurements: Height, weight, age, sex and ethnicity were recorded. FFM was derived from measurements of total body water by deuterium dilution and resistance and reactance were measured by bioimpedance analysis. Results: For fixed BMI, the Maori and Pacific Island girls averaged 3.7% lower % BF than European girls. For boys a similar relation was not found since BMI did not significantly influence % BF of European boys ( P = 0.18). Based on bioimpedance measurements a single prediction equation was developed for all children: FFM (kg) = 0.622 height (cm)(2)/ resistance +0.234 weight (kg)+1.166, R-2 = 0.96, s. e. e. = 2.44 kg. Ethnicity, age and sex were not significant predictors. Conclusions: A robust equation for estimation of FFM in New Zealand European, Maori and Pacific Island children in the 5 - 14 y age range that is more suitable than BMI for the determination of body fatness in field studies has been developed. Sponsorship: Maurice and Phyllis Paykel Trust, Auckland University of Technology Contestable Grants Fund and the Ministry of Health.

Narrating the guillotine: Punishment technology as myth and symbol

The work of Michel Foucault sees modern penal technology its ann expression of power that operates through and is motivated by a dry instrumental reason. This article draws upon Durkheim and Bakhtin to advance a radically alternative approach. It is suggested that such technology is invested with sacred and profane symbolism and is understood via emotionally charged, dramatically compelling narrative frames. Tensions between official and unauthorized discourses can be understood through a center/periphery model of culture. In an extended case study of the guillotine, it is shown dial the apparatus was initially legitimated as an expression of a sacred revolutionary code. Such a discourse was subsequently destabilized by popular medical debates that raised the specter of pain after decapitation. While inconclusive, these new motifs mobilized Gothic and grotesque themes that confronted the rationalist aesthetics of the guillotine. A situation of Bakhtinian hetoroglossia eventuated. Uncertainty, the uncanny and fable entered a discursive field of increasing complexity.

Prediction of multilayer adsorption and capillary condensation phenomena in cylindrical mesopores

MCM-41 periodic mesoporous silicates with a high degree of structural ordering are synthesized and used as model adsorbents to study the isotherm prediction of nitrogen adsorption. The nitrogen adsorption isotherm at 77 K for a macroporous silica is measured and used in high-resolution alpha(s)-plot comparative analysis to determine the external surface area, total surface area and primary mesopore volume of the MCM-41 materials. Adsorption equilibrium data of nitrogen on the different pore size MCM-41 samples (pore diameters from 2.40 to 4.92 nm) are also obtained. Based on the Broekhoff and de Boer' thermodynamic analysis, the nitrogen adsorption isotherms for the different pore size MCM-41 samples are interpreted using a novel strategy, in which the parameters of an empirical expression, used to represent the potential of interaction between the adsorbate and adsorbent, are obtained by fitting only the multilayer region prior to capillary condensation for C-16 MCM-41. Subsequently the entire isotherm, including the phase transition, is predicted for all the different pore size MCM-41 samples without any fitting. The results show that the prediction of multilayer adsorption and total adsorbed amount are in good agreement with the experimental isotherms. The predictions of the relative pressure corresponding to capillary equilibrium (coexistence) transition agree remarkably with experimental data on the adsorption branch even for hysteretic isotherms, confirming that this is the branch appropriate for pore size distribution analysis. The impact of pore radius on the adsorption film thickness and capillary coexistence pressure is also investigated, and found to agree with the experimental data. (C) 2003 Elsevier Inc. All rights reserved.

Tecnologia assistiva e computacional : contribuições para o atendimento educacional especializado e desafios na formação de professores

Neste trabalho, analisamos aspectos relacionados a como a tecnologia computacional é utilizada no Atendimento Educacional Especializado (AEE) e como se deu a formação de professores para utilizar esses recursos. Para tanto, delimitamos os seguintes objetivos específicos: investigar a utilização da tecnologia assistiva (TA) computacional no âmbito das salas de recursos multifuncionais (SRM); problematizar as tensões, dificuldades e possibilidades relacionadas à TA com ênfase na tecnologia computacional para o AEE; analisar a formação do professor de educação especial para o AEE tendo como recurso a TA com ênfase na tecnologia computacional, visando à mediação dos processos de aprendizagem. O aporte teórico deste trabalho foi a abordagem histórico-cultural, tomando por referência os estudos de Vigotski e seus colaboradores. Trata-se de uma pesquisa qualitativa que fez uso de diferentes instrumentos metodológicos como, os grupos focais, o questionário online e a entrevista semiestruturada. Para desenvolvê-lo, realizamos a coleta de dados em diferentes contextos, começando pelos grupos focais da pesquisa inaugural do Oneesp, que serviram como dispositivo para esta pesquisa, seguida da aplicação de um questionário aos professores participantes da pesquisa-formação desenvolvida como um desdobramento no estado do Espírito Santo da pesquisa inaugural do Oneesp pelos integrantes do Oeeesp e da aplicação in loco de entrevistas semiestruturadas com professores de educação especial, de uma SRM do Tipo II. Foram oitenta e nove professores participantes na pesquisa do Oneesp, trinta professores na pesquisa-formação do Oeeesp e dois professores para aplicação da entrevista semiestruturada in loco, respectivamente. Esses dois professores participaram tanto da pesquisa do Oneesp como da pesquisa do Oeeesp. Analisamos esses três momentos, dos quais emergiram os apontamentos que nos proporcionaram pensar, com base nas narrativas orais e escritas dos professores: sua formação para uso da TA computacional; seu entendimento sobre sua formação para este fim; seus anseios por uma formação mais direcionada; a forma como utilizam a tecnologia na sala de recursos; seus entendimentos sobre as dificuldades e possibilidades relacionadas a TA com ênfase na tecnologia computacional para o AEE. Após essas análises, concluímos que poucos professores que atuam nas SRM tiveram uma formação que possibilitasse a aplicação das tecnologias computacionais em sua mediação pedagógica, aliando teoria e prática, com momentos de formação que privilegiassem os momentos presenciais e em laboratórios, onde possam interagir com os computadores e suas ferramentas simbólicas. Sem essa familiaridade com os recursos computacionais, os professores acabam sentindo-se inseguros para utilizá-los, deixando de potencializar, pela via desses recursos, os processos de ensinoaprendizagem do aluno com deficiência. Faz-se necessário um investimento nesse tipo de formação e, mais do que isso, que se viabilize para os professores que atuam ou que pretendem atuar nas SRM. A partir de uma formação apropriada é possível fazer com que os professores utilizem os recursos computacionais como mediadores dos processos de ensino-aprendizagem de seus alunos.

Information and Technology Implementation Issues in AAL Solutions

With the population ageing effect, the technological developments, and pressure to reduce the cost with healthcare, are reunited the conditions for the development of Ambient Assisted Living (AAL) solutions. This work is a revision of the current state of the art. Its aim is the characterization of the AAL solutions, within the AAL4ALL scope. Therefore, it is presented features, scenarios and projects, referring the limitations and the opportunities for the future developments of prototypes using high level information and technology in AAL environments. Moreover, it is presented guidelines of operation, exposing the conceptual approach, and the discussion and conclusion, which present recommendations and current AAL4ALL project positions in terms of concepts and technologies.

Ambient assisted living technology: comparative perspectives of users and caregivers

Developed societies are currently facing severe demographic changes: the world population is ageing at an unprecedented rate. This demographic trend will be also followed by an increase of people with physical limitations. New challenges are being raised to the traditional health care systems, not only in Portugal, but also in all other European states. There is an urgent need to find solutions that allow extending the time people can live in their preferred environment by increasing their autonomy, self-confidence and mobility. AAL4ALL is a project currently being developed in cooperation with 34 Portuguese interdisciplinary partners, from industry to academia, R&D and social disciplines, which employs a novel conceptual approach through the development of an ecosystem of products and services for Ambient Assisted Living (AAL) associated to a business model and validated through large scale trial. This paper presents a comparative perspective of the needs and attitudes towards technology of the AAL users and caregivers identified in the analysis of a set of three different surveys: a users survey targeted at the Portuguese seniors and pre-seniors; an informal caregivers survey targeted at the family, friends and neighbours who provide care without any financial compensation; and a formal caregivers survey targeted at physicians, nurses,psychologists, social workers, and direct-care workers providing care to elders. The first results indicate that AAL solutions must be affordable,user friendly and have a true perceived benefit to their users.