The 2015 IWGDF guidance documents on prevention and management of foot problems in diabetes: Development of an evidence-based global consensus

Foot problems complicating diabetes are a source of major patient suffering and societal costs. Investing in evidence-based, internationally appropriate diabetic foot care guidance is likely among the most cost-effective forms of healthcare expenditure, provided it is goal-focused and properly implemented. The International Working Group on the Diabetic Foot (IWGDF) has been publishing and updating international Practical Guidelines since 1999. The 2015 updates are based on systematic reviews of the literature, and recommendations are formulated using the Grading of Recommendations Assessment Development and Evaluation system. As such, we changed the name from 'Practical Guidelines' to 'Guidance'. In this article we describe the development of the 2015 IWGDF Guidance documents on prevention and management of foot problems in diabetes. This Guidance consists of five documents, prepared by five working groups of international experts. These documents provide guidance related to foot complications in persons with diabetes on: prevention; footwear and offloading; peripheral artery disease; infections; and, wound healing interventions. Based on these five documents, the IWGDF Editorial Board produced a summary guidance for daily practice. The resultant of this process, after reviewed by the Editorial Board and by international IWGDF members of all documents, is an evidence-based global consensus on prevention and management of foot problems in diabetes. Plans are already under way to implement this Guidance. We believe that following the recommendations of the 2015 IWGDF Guidance will almost certainly result in improved management of foot problems in persons with diabetes and a subsequent worldwide reduction in the tragedies caused by these foot problems.

The Hot Topic Community: Videoconferencing to reduce the professional isolation of teachers in rural Western Australia

Access to quality professional learning and the opportunity to collaborate with other educators can be limited for teachers in rural and remote areas of Western Australia. A recognised need to enhance the skills of rural teaching professionals and encourage teachers in small communities to join collegial networks was established by the members of several professional organisations. A working group consisting of representatives from the Australian College of Educators-WA (ACE-WA), the Rural and Remote Education Advisory Council (RREAC), the Society for the Provision of Education in Rural Australia (SPERA) and the School of Isolated and Distance Education (SIDE) provided teachers in rural areas with the opportunity to reduce professional isolation through the provision of relevant, convenient, and cost effective in-service education. Through a videoconferencing system, accessed within the Western Australian Telecentre Network and other educational organisations, the audience connected and participated with the presenter and studio based audience for two Hot Topics Seminars in 2008. This paper reports on the challenges and successes encountered by the working group and the findings of the research conducted throughout 2008.

Augmenting process elicitation with visual priming: An empirical exploration of user behaviour and modelling outcomes

Business process models have become an effective way of examining business practices to identify areas for improvement. While common information gathering approaches are generally efficacious, they can be quite time consuming and have the risk of developing inaccuracies when information is forgotten or incorrectly interpreted by analysts. In this study, the potential of a role-playing approach to process elicitation and specification has been examined. This method allows stakeholders to enter a virtual world and role-play actions similarly to how they would in reality. As actions are completed, a model is automatically developed, removing the need for stakeholders to learn and understand a modelling grammar. An empirical investigation comparing both the modelling outputs and participant behaviour of this virtual world role-play elicitor with an S-BPM process modelling tool found that while the modelling approaches of the two groups varied greatly, the virtual world elicitor may not only improve both the number of individual process task steps remembered and the correctness of task ordering, but also provide a reduction in the time required for stakeholders to model a process view.

In-training assessment - Its potential in enhancing clinical teaching

Context In-training assessment (ITA) has established its place alongside formative and summative assessment at both the undergraduate and postgraduate level. In this paper the authors aimed to identify those characteristics of ITA that could enhance clinical teaching. Methods A literature review and discussions by an expert working group at the Ninth Cambridge Conference identified the aspects of ITA that could enhance clinical teaching. Results The features of ITA identified included defining the specific benefits to the learner, teacher and institution, and highlighting the patient as the context for ITA and clinical teaching. The ‘mapping’ of a learner’s progress towards the clinical teaching objectives by using multiple assessments over time, by multiple observers in both a systematic and opportunistic way correlates with the incremental nature of reaching clinical competence. Conclusions The importance of ITA based on both direct and indirect evidence of what the learner actually does in the real clinical setting is emphasized. Particular attention is given to addressing concerns in the more controversial areas of assessor training, ratings and documentation for ITA. Areas for future research are also identified.

Personal health data - Privacy policy harmonization and global enforcement

This workshop is jointly organized by EFMI Working Groups Security, Safety and Ethics and Personal Portable Devices in cooperation with IMIA Working Group "Security in Health Information Systems". In contemporary healthcare and personal health management the collection and use of personal health information takes place in different contexts and jurisdictions. Global use of health data is also expanding. The approach taken by different experts, health service providers, data subjects and secondary users in understanding privacy and the privacy expectations others may have is strongly context dependent. To make eHealth, global healthcare, mHealth and personal health management successful and to enable fair secondary use of personal health data, it is necessary to find a practical and functional balance between privacy expectations of stakeholder groups. The workshop will highlight these privacy concerns by presenting different cases and approaches. Workshop participants will analyse stakeholder privacy expectations that take place in different real-life contexts such as portable health devices and personal health records, and develop a mechanism to balance them in such a way that global protection of health data and its meaningful use is realized simultaneously. Based on the results of the workshop, initial requirements for a global healthcare information certification framework will be developed.

The struggle for protection of environmental refugees: who's responsibility? Discourses from the United Nations and Non-governmental organizations

This thesis identifies, examines and problematizes some of the discourses that have so far come to light on the issue of protection for environmental refugees. By analyzing the discourses produced by the United Nations Office of the High Commissioner for Refugees (UNHCR) and two non-governmental organizations - the Environmental Justice Foundation (EJF) and Equity and Justice Working Group Bangladesh (EquityBD), I examine the struggling discourses that have emerged about how protection for environmental refugees has been interpreted. To do this, I rely on Ernesto Laclau and Chantal Mouffe's theory and method of discourse analysis. The results show that responsibilization is the main point of struggle in the discussions on the protection of environmental refugees. As a floating signifier, it was utilized by the discourses produced by the UNCHR and the selected NGOs in contingent ways and with different political objectives. The UNHCR discourse responsibilized both the environmental refugees for their own protection and the individual states. The EJF and EquityBD, by contrast, allocated responsibility for the protection of environmental refugees to the international community. These contingent understandings of responsibilization necessitated different justifications. While the EJF discourse relied on humanitarianism for the assistance of environmental refugees, the EquityBD discourse constructed a rights based, more permanent solution. The humanitarian based discourse of the EJF was found to be inextricably linked with the neoliberal discourse produced by the UNHCR. Both these discourses encouraged environmental refugees to stay in their homelands, undermining the politics of protection. Another way in which protection was undermined was by UNHCR's discourse on securitization. In this context, climate change induced displacement became threat to developed countries, the global economy and transnational classes. The struggling discourses about who/what has been allocated responsibility for the protection of environmental refugees also meant that identities of the displaced be constructed in specific ways. While the UNHCR discourse constructed as voluntary migrants and predators, the EJF and EquityBD discourses portrayed them as victims. However, even though the EJF discourse constructed them as victims, their reliance on humanitarianism could also be interpreted as a way of giving the environmental refugee a predator like identity. These discourses on responsibilization and identity formation clashed with each other in the aim of achieving a hegemonic position in discussions and debates about the protection of environmental refugees.

The struggle for protection of environmental refugees: who's responsibility? Discourses from the United Nations and Non-governmental organizations

This thesis identifies, examines and problematizes some of the discourses that have so far come to light on the issue of protection for environmental refugees. By analyzing the discourses produced by the United Nations Office of the High Commissioner for Refugees (UNHCR) and two non-governmental organizations - the Environmental Justice Foundation (EJF) and Equity and Justice Working Group Bangladesh (EquityBD), I examine the struggling discourses that have emerged about how protection for environmental refugees has been interpreted. To do this, I rely on Ernesto Laclau and Chantal Mouffe's theory and method of discourse analysis. The results show that responsibilization is the main point of struggle in the discussions on the protection of environmental refugees. As a floating signifier, it was utilized by the discourses produced by the UNCHR and the selected NGOs in contingent ways and with different political objectives. The UNHCR discourse responsibilized both the environmental refugees for their own protection and the individual states. The EJF and EquityBD, by contrast, allocated responsibility for the protection of environmental refugees to the international community. These contingent understandings of responsibilization necessitated different justifications. While the EJF discourse relied on humanitarianism for the assistance of environmental refugees, the EquityBD discourse constructed a rights based, more permanent solution. The humanitarian based discourse of the EJF was found to be inextricably linked with the neoliberal discourse produced by the UNHCR. Both these discourses encouraged environmental refugees to stay in their homelands, undermining the politics of protection. Another way in which protection was undermined was by UNHCR's discourse on securitization. In this context, climate change induced displacement became threat to developed countries, the global economy and transnational classes. The struggling discourses about who/what has been allocated responsibility for the protection of environmental refugees also meant that identities of the displaced be constructed in specific ways. While the UNHCR discourse constructed as voluntary migrants and predators, the EJF and EquityBD discourses portrayed them as victims. However, even though the EJF discourse constructed them as victims, their reliance on humanitarianism could also be interpreted as a way of giving the environmental refugee a predator like identity. These discourses on responsibilization and identity formation clashed with each other in the aim of achieving a hegemonic position in discussions and debates about the protection of environmental refugees.

"Pitää kuitenkin lähentyä sitä vangin roolia, vaikka ite ois toista mieltä" : Diskurssianalyyttinen tutkimus toiseuden rakentumisesta vankilaopetuksessa

The focus of this discourse analytical study was to review the meanings which prison education and its participants are given in the formal educational policy and to find out whether these meanings are agreed by the prison students. The intrestes of this thesis were to examine what kind of social and individual promises are related to the prison education and what kind of subject positions are possible to the prison students. The thesis was also interested in the meanings of education in different contexts. The aim of this study was to examine prison education especially for women. This thesis was based on Michel Foucault s ideas of power and the view of this study was directly critical. The prison education was seen as normalizing governance which tends to prepare its subjects to the normal. In this process of differentiating the normal and the abnormal the subjects of prison education are reconstructed as the others . The three research questions of this thesis were: how and what kind of prison education is reconstructed firstly in the strategy of prison education and secondly in the interviews. Thirdly it was questioned how and what kind of meanings gender receive in the discourse of prison education. The main data was consisted by the Finnish Criminal Sanctions Agency s document The Strategy of the Prison education for years 2008 2012 and the three interviews of women who participated to prison education. The interviews were made for this thesis in Autumn 2010. Two other Finnish Criminal Sanctions Agency s documents Prisoners in education (2007) and Visible women (2008) - the report of the working group on female prisoners were also used as subtext materials. The methods of critical and realistic discourse analysis and rhetorical analysis were applied in the analysis. The results of the thesis support the outlook of prison education as a form of normalizing governance which reconstruct the others position for the prison students. Prison education was seen supportive for personal life control and for integrating to the society. The participants of prison education repeated the official discourses in their accounts which is a signal of internalized governance. The interviewees also used different types of anti-discourses when forming implications of prison education.

A Physical Model for Inception and Propagation of Upward Lightning Leader from a 1200 kV AC Power Transmission Line

UHV power transmission lines have high probability of shielding failure due to their higher height, larger exposure area and high operating voltage. Lightning upward leader inception and propagation is an integral part of lightning shielding failure analysis and need to be studied in detail. In this paper a model for lightning attachment has been proposed based on the present knowledge of lightning physics. Leader inception is modeled based on the corona charge present near the conductor region and the propagation model is based on the correlation between the lightning induced voltage on the conductor and the drop along the upward leader channel. The inception model developed is compared with previous inception models and the results obtained using the present and previous models are comparable. Lightning striking distances (final jump) for various return stroke current were computed for different conductor heights. The computed striking distance values showed good correlation with the values calculated using the equation proposed by the IEEE working group for the applicable conductor heights of up to 8 m. The model is applied to a 1200 kV AC power transmission line and inception of the upward leader is analyzed for this configuration.

Segregating Discourse Segments from Engineering Documents for Knowledge Acquisition

The broader goal of the research being described here is to automatically acquire diagnostic knowledge from documents in the domain of manual and mechanical assembly of aircraft structures. These documents are treated as a discourse used by experts to communicate with others. It therefore becomes possible to use discourse analysis to enable machine understanding of the text. The research challenge addressed in the paper is to identify documents or sections of documents that are potential sources of knowledge. In a subsequent step, domain knowledge will be extracted from these segments. The segmentation task requires partitioning the document into relevant segments and understanding the context of each segment. In discourse analysis, the division of a discourse into various segments is achieved through certain indicative clauses called cue phrases that indicate changes in the discourse context. However, in formal documents such language may not be used. Hence the use of a domain specific ontology and an assembly process model is proposed to segregate chunks of the text based on a local context. Elements of the ontology/model, and their related terms serve as indicators of current context for a segment and changes in context between segments. Local contexts are aggregated for increasingly larger segments to identify if the document (or portions of it) pertains to the topic of interest, namely, assembly. Knowledge acquired through such processes enables acquisition and reuse of knowledge during any part of the lifecycle of a product.

Lessons from the northern hake long-term management plan: Could the economic assessment have accepted it?

An economic expert working group (STECF/SGBRE-07-05) was convened in 2007 for evaluating the potential economic consequences of a Long-Term Management Plan for the northern hake. Analyzing all the scenarios proposed by biological assessment, they found that keeping the F in the status quo level was the best policy in terms of net present values for both yield and profits. This result is counter intuitive because it may indicate that effort costs do no affect the economic reference points. However, it is well accepted that the inclusion of costs affects negatively the economic reference points. In this paper, applying a dynamic agestructured model to the northern hake, we show that the optimal fishing mortality that maximizes the net present value of profits is lower than Fmax.

Carne e bits : reflexões sobre a indiscernibilidade das fronteiras entre mentes e máquinas e os sistemas cognitivos híbridos

Faz reflexões sobre as várias formas de relação entre sujeitos e objetos-técnicos, com ênfase para a utilização dos computadores digitais e, particularmente, os softwares chamados agentes inteligentes. Analisa o espaço e suas mudanças qualitativas na atualidade, a partir do conceito do espaço como produção humana, analisando como as transformações em curso no ambiente afetam nossas subjetividades e, reciprocamente, como afetamos nossos ambientes. Discutidas as possibilidades de sobrevivência do homem nu nesses novos espaços, sem que esteja devidamente atualizado com as últimas novidades tecnológicas - próteses sensoriais e motoras. Perpassa a discussão sobre o pensamento que se utiliza do espaço como elemento constituinte do próprio pensamento e reflete sobre o espaço abstrato por excelência, os mundos virtuais. Discute o padrão de apropriação de artefatos pelo homem e seus efeitos na subjetividade, a manutenção do padrão de apropriação dos objetos-técnicos materiais em relação às formas de apropriação dos objetos-técnicos intangíveis (softwares). Traz reflexões sobre a possibilidade de autonomização completa dos agentes inteligentes e a sua instituição, ipso facto, como agentes - a chamada Inteligência Artificial.

PICES Press, Vol. 13, No. 1, January 2005

The state of PICES science - 2004 (pdf 0.7 MB) 2004 Wooster Award (pdf 0.2 MB) Micronekton – What are they and why are they important? (pdf 0.5 MB) Upscaling for a better understanding of climate links to ecosystems (pdf 0.1 MB) PICES Interns (pdf 0.1 MB) Report of the APN workshop on “Climate interactions and marine ecosystems” (pdf 0.6 MB) Photo highlights of PICES XIII (pdf 0.3 MB) Recent trends in waters of the subarctic NE Pacific – summer 2004 (pdf 0.1 MB) The state of the western North Pacific in the first half of 2004 (pdf 0.3 MB) The Bering Sea: Current status and recent events (pdf 0.1 MB) Study Group on Fisheries Ecosystem Responses to Recent Regime Shifts completes its mandate for the provision of scientific advice (pdf 0.1 MB) PICES Calendar (pdf 0.1 MB) The new PICES Working Group on Ecosystem-based management (pdf 0.05 MB) CO2 data integration activity for the North Pacific (pdf 0.2 MB) Carbon cycle changes in the North Pacific (pdf 0.8 MB) New and upcoming PICES publications (pdf 0.8 MB)

PICES Press, Vol. 8, No. 2, July 2000

Beyond El Nino Conference The status of the Bering Sea: June - December, 1999 The state of the western North Pacific in the second half of 1999 The state of the eastern North Pacific since autumn 1999 Project Argo Report of the ICES Zooplankton Ecology Working Group/PICES meeting Shark abundance increases in the Gulf of Alaska PICES Lower Trophic Level Modeling Workshop, Nemuro On the third meeting of the LMR-GOOS Panel Ocean Ecology of Juvenile Salmonids along the North American Coast