Does video feedback analysis improve CPR performance in phase 5 medical students?

Background The use of simulation in medical education is increasing, with students taught and assessed using simulated patients and manikins. Medical students at Queen���s University of Belfast are taught advanced life support cardiopulmonary resuscitation as part of the undergraduate curriculum. Teaching and feedback in these skills have been developed in Queen���s University with high-fidelity manikins. This study aimed to evaluate the effectiveness of video compared to verbal feedback in assessment of student cardiopulmonary resuscitation performance Methods Final year students participated in this study using a high-fidelity manikin, in the Clinical Skills Centre, Queen���s University Belfast. Cohort A received verbal feedback only on their performance and cohort B received video feedback only. Video analysis using ���StudioCode��� software was distributed to students. Each group returned for a second scenario and evaluation 4 weeks later. An assessment tool was created for performance assessment, which included individual skill and global score evaluation. Results One hundred thirty eight final year medical students completed the study. 62 % were female and the mean age was 23.9 years. Students having video feedback had significantly greater improvement in overall scores compared to those receiving verbal feedback (p���=���0.006, 95 % CI: 2.8���15.8). Individual skills, including ventilation quality and global score were significantly better with video feedback (p���=���0.002 and p���<���0.001, respectively) when compared with cohort A. There was a positive change in overall score for cohort B from session one to session two (p���<���0.001, 95 % CI: 6.3���15.8) indicating video feedback significantly benefited skill retention. In addition, using video feedback showed a significant improvement in the global score (p���<���0.001, 95 % CI: 3.3���7.2) and drug administration timing (p���=���0.004, 95 % CI: 0.7���3.8) of cohort B participants, from session one to session two. Conclusions There is increased use of simulation in medicine but a paucity of published data comparing feedback methods in cardiopulmonary resuscitation training. Our study shows the use of video feedback when teaching cardiopulmonary resuscitation is more effective than verbal feedback, and enhances skill retention. This is one of the first studies to demonstrate the benefit of video feedback in cardiopulmonary resuscitation teaching.

Resili��ncia, Coping e Autocompaix��o em Cuidadores Formais da Rede Nacional de Cuidados Continuados Integrados

Introdu����o: Na literatura internacional e nacional verifica-se a inexist��ncia de estudos sobre os correlatos psicol��gicos de cuidadores formais, como a resili��ncia e o coping. Apesar de se reconhecer a import��ncia de uma presta����o de cuidados mais compassivos e humanizados, mais uma vez, n��o existem estudos nesta ��rea. Este facto estende-se aos cuidadores formais que trabalham com pessoas em situa����o de depend��ncia, na Rede Nacional de Cuidados Continuados Integrados. Assim, foram nossos objetivos: caraterizar os cuidadores formais de algumas Unidades de Cuidados Continuados (UCC) da RNCCI em vari��veis sociodemogr��ficas e profissionais; analisar os seus n��veis de resili��ncia, coping e autocompaix��o; verificar se existem associa����es significativas entre estas vari��veis e com as vari��veis sociodemogr��ficas e profissionais. Metodologia: 78 cuidadores formais (sexo feminino, n = 76; 97,4%), com uma m��dia de idades de 35,45 anos (DP = 9,0) forneceram o seu consentimento informado para preencherem um question��rio sociodemogr��fico e profissional, a Escala de Avalia����o Global da Resili��ncia, o Brief COPE e a Self Compassion Scale (SELFCS). Resultados: Os cuidadores revelaram um n��vel m��dio de resili��ncia (total). A dimens��o de coping com m��dia mais elevada foi o Coping ativo e a com m��dia mais baixa foi o Uso de subst��ncias. Na SELFCS a dimens��o com m��dia mais elevada foi o Calor/compreens��o e a com m��dia mais baixa foi o Isolamento. No geral, a pontua����o total de resili��ncia correlacionou-se de forma positiva com as dimens��es positivas da autocompaix��o (SELFCS) e de forma negativa com as dimens��es negativas desta escala. As dimens��es mais positivas de coping correlacionaram-se de forma positiva com as dimens��es positivas de autocompaix��o e as mais negativas de coping com as dimens��es negativas de autocompaix��o. Quanto maior a idade dos cuidadores menor o n��vel de Suporte Emocional e maior o n��vel de Religi��o e Mindfulness. Mais horas de trabalho associaram-se a menor resili��ncia e a maior n��vel de Suporte Emocional Discuss��o: Este estudo revelou, ainda que numa amostra reduzida, que os cuidadores formais das UCC parecem revelar n��veis equilibrados em correlatos psicol��gicos importantes quando se ���cuida��� de outra pessoa. Por��m, as UCC devem preocupar-se em fomentar, junto dos cuidadores, n��veis mais elevados de resili��ncia, estrat��gias mais positivas de coping e a compaix��o auto e h��tero dirigida, para assegurar um ���cuidar��� mais pleno quer para os profissionais, quer para aqueles que s��o cuidados. / Introduction: In the international and national literature, we verified the inexistence of studies about psychological correlates of formal caregivers, such as resilience and coping. Although the importance of more humanized and compassive care is recognized, again, there are no studies in this area. This is also verified regarding formal caregivers that work with people in a dependence situation, as in the National Network of Continuous Care. Our aims were to characterize the formal caregivers from some units of the National Network of Continuous Care in sociodemographic and professional variables; analyze these professionals levels of resilience, coping and self-compassion; verify if there are significant associations between these variables and with the sociodemographic and professional variables. Methodology: 78 formal caregivers (female, n = 76; 97,4%), with an mean age of 35,45 years (SD = 9,0) provided their informed consent to fill in a professional and sociodemographic questionnaire, the Global Resiliency Evaluation Scale, the Brief COPE and the Self Compassion Scale (SELFCS). Results: The caregivers showed a medium level of resilience. The coping dimension with the highest mean was Active coping and the dimension with the lowest mean was Substance Use. Regarding SELFCS the dimension with the highest mean was Warmth, contrasting with Isolation, the dimension with the lowest mean. Overall, the total score of resilience was positively correlated with self-compassion positive dimensions (SELFCS) and negatively correlated with the negative dimensions of this scale. The most positive dimensions of coping were positively correlated with the positive dimensions of self-compassion and the most negative dimensions of coping were correlated with the negative dimensions of self-compassion. Older caregivers showed lower use of Emotional support and higher level of Religion and Mindfulness use. More daily hours of work were associated with less resilience and higher Emotional Support. Discussion: This study revealed, although in a small sample, that Continuous Care Units (CCU) formal caregivers seem to have balanced levels of psychological correlates that are important while caring for others. However, the CCU should promote, in the caregivers higher levels of resilience, coping and self-compassion, to ensure a better care, simultaneously the professionals and patients.

ADVERTISEMENT ALLOCATION AND TRUST MECHANISMS DESIGN IN SOCIAL NETWORKS

Social network sites (SNS), such as Facebook, Google+ and Twitter, have attracted hundreds of millions of users daily since their appearance. Within SNS, users connect to each other, express their identity, disseminate information and form cooperation by interacting with their connected peers. The increasing popularity and ubiquity of SNS usage and the invaluable user behaviors and connections give birth to many applications and business models. We look into several important problems within the social network ecosystem. The first one is the SNS advertisement allocation problem. The other two are related to trust mechanisms design in social network setting, including local trust inference and global trust evaluation. In SNS advertising, we study the problem of advertisement allocation from the ad platform's angle, and discuss its differences with the advertising model in the search engine setting. By leveraging the connection between social networks and hyperbolic geometry, we propose to solve the problem via approximation using hyperbolic embedding and convex optimization. A hyperbolic embedding method, \hcm, is designed for the SNS ad allocation problem, and several components are introduced to realize the optimization formulation. We show the advantages of our new approach in solving the problem compared to the baseline integer programming (IP) formulation. In studying the problem of trust mechanisms in social networks, we consider the existence of distrust (i.e. negative trust) relationships, and differentiate between the concept of local trust and global trust in social network setting. In the problem of local trust inference, we propose a 2-D trust model. Based on the model, we develop a semiring-based trust inference framework. In global trust evaluation, we consider a general setting with conflicting opinions, and propose a consensus-based approach to solve the complex problem in signed trust networks.

Self-awareness and psychosocial functioning following acquired brain injury: An evaluation of a group support programme

This study investigated a group support programme designed to improve self-awareness deficits and psychosocial functioning in a group of chronic patients (N = 21) with acquired brain injury (ABI). The participants were on average 8.6 years (range: 1-36 years) post-injury and were seen at the Brain Injury Association of Queensland, Australia. The assessment of participants involved two standardised measures of intellectual self-awareness with collateral reports from relatives. The present study introduced a new measure called the Self-Regulation Skills Interview (SRSI) which assessed higher levels of self awareness and self-regulation skills. Psychosocial functioning was assessed using a standardised self-report measure. At baseline the group had a relatively high level of intellectual self-awareness regarding their deficits, a low to moderate level of self-regulation skills, and significant psychosocial impairment. The participants were involved in a 16-week group programme which involved components of cognitive rehabilitation, cognitive-behavioural therapy, and social skills training. A post-intervention assessment indicated that participants had significantly improved levels of self-regulation skills and psychosocial functioning. A 6-month follow-up assessment indicated that overall, participants had maintained the gains made during the programme. The important role of self-regulation skills is emphasised as the principle factor contributing to the maintenance of the gains observed.

Long-Term Pharmacotherapy for Obesity in Elderly Patients A Retrospective Evaluation of Medical Records from a Specialized Obesity Outpatient Clinic

Background: Obesity is a serious chronic disease and the prevalence of this condition is increasing among the elderly. Although the benefits of weight loss to improve control of associated diseases are well known in young adults, they are not in older patients. The use of anti-obesity drugs to promote weight loss is widespread in Brazil and other countries, and obesity specialists frequently prescribe medicines in doses and for durations previously unreported in the literature. Sibutramine, orlistat and amfepramone (diethylpropion) have been evaluated in clinical trials of more than 2 years` duration in adults, demonstrating safety and efficacy, but long-term studies in obesity treatment are absent for other drugs. The efficacy and safety of obesity pharmacotherapy among the elderly is unknown. Objective: To describe the experience of obesity pharmacotherapy in the elderly in a specialized obesity care setting in Brazil, with a focus on efficacy and safety. Methods: A retrospective evaluation was conducted on medical charts from an outpatient clinic of a specialized tertiary centre for the treatment of obesity. We included patients who had had at least one consultation between January and December 2007, were aged >= 60 years at the beginning of the treatment, had had at least 6 months of follow-up and had received a prescription of at least one potential weight-loss drug. Diagnoses reported on medical records were documented. Age, weight, height and body mass index (BMI) were recorded at admission, after 6, 12, 18 and 24 months, and at the last available visit. The medicines prescribed, together with the dose, duration of use, adverse effects and reasons for discontinuation, were documented. Results: The group consisted of 44 women (86%) and 7 men (14%), with a mean +/- SD age of 65.2 +/- 4.5 years, weight of 95.3 +/- 12.5 kg and BMI of 38.5 +/- 4.3 kg/m(2). The mean +/- SD time of follow-up was 39.3 +/- 26.4 months, and the mean weight loss was 6.65 kg (p < 0.01). After the first 6 months, the mean +/- SD weight loss was 5.7 +/- 3.8 kg (p < 0.0001). A smaller weight loss was seen between the 6th and 12th months, with no statistically significant change in weight thereafter. A weight loss of >= 5% was achieved by 64.71%, 63.64%, 62.16% and 69.70% in the 6th, 12th, 18th and 24th months, respectively, and a weight loss of >= 10% was achieved by 17.65%, 34.09%, 32.43% and 39.39% in the 6th, 12th, 18th and 24th months, respectively. The medicines prescribed were sibutramine, orlistat, fluoxetine, sertraline, topiramate, fenproporex, mazindol and amfepramone, alone or in combinations, concomitantly or sequentially. The reasons for discontinuation were lack of response (n = 13), loss of response (development of tolerance) [n= 11], lack of adherence (n = 14) and adverse effects (n= 14). One episode of atrial flutter occurred in a patient taking fenproporex. The weight-loss medications were generally well tolerated, and only transient adverse events were reported. Conclusions: Long-term pharmacotherapy for obesity was effective and well tolerated by this group of elderly patients.

Cognitive functioning in subjects with recent-onset psychosis from a low-middle-income environment: Multiple-domain deficits and longitudinal evaluation

Cognitive deficits are a key feature of recent-onset psychosis, but there is no consensus on whether such deficits are generalized or confined to specific domains. Besides, it is unclear whether cognitive deficits: a) are found in psychotic patients in samples from outside high-income countries; and b) whether they progress uniformly over time in schizophrenia and affective psychoses. We applied 12 tests organized into eight cognitive domains, comparing psychosis patients (n = 56, time from initial contact = 677.95+/-183.27 days) versus healthy controls (n = 70) recruited from the same area of Sao Paulo, Brazil. Longitudinal comparisons (digit span and verbal fluency) were conducted between a previous assessment of the subjects carried out at their psychosis onset, and the current follow-up evaluation. Psychosis patients differed significantly from controls on five domains, most prominently on verbal memory. Cognitive deficits remained detectable in separate comparisons of the schizophrenia subgroup and, to a lesser extent, the affective psychosis subjects against controls. Longitudinal comparisons indicated significant improvement in schizophrenia, affective psychoses, and control subjects, with no significant group-by-time interactions. Our results reinforce the view that there are generalized cognitive deficits in association with recent-onset psychoses, particularly of non-affective nature, which persist over time. (C) 2009 Elsevier Ireland Ltd. All rights reserved.

An evaluation of the genotoxic and cytotoxic effects of the anti-obesity drugs sibutramine and fenproporex

Anti-obesity medications deserve special considerations at the present time due to an increasing number of overweight and obese people who require these therapeutic alternatives. Obesity is positively associated with several chronic illnesses, including cancer. In this work, we evaluated the possible genotoxic and/or cytotoxic actions of two drugs, sibutramine and fenproporex, in the doses of 10, 20 and 40 mg/kg body weight (bw), administered intraperitoneally in male Swiss mice. The genotoxic effect was analyzed by comet assay and micronucleus test. We found that both drugs increased the frequency of genotoxic damage in Swiss mice, but did not present cytotoxic activities towards the polychromatic erythrocytes of the bone marrow of these animals.

A soft computing approach to kidney diseases evaluation

Kidney renal failure means that one���s kidney have unexpectedly stopped functioning, i.e., once chronic disease is exposed, the presence or degree of kidney dysfunction and its progression must be assessed, and the underlying syndrome has to be diagnosed. Although the patient���s history and physical examination may denote good practice, some key information has to be obtained from valuation of the glomerular filtration rate, and the analysis of serum biomarkers. Indeed, chronic kidney sickness depicts anomalous kidney function and/or its makeup, i.e., there is evidence that treatment may avoid or delay its progression, either by reducing and prevent the development of some associated complications, namely hypertension, obesity, diabetes mellitus, and cardiovascular complications. Acute kidney injury appears abruptly, with a rapid deterioration of the renal function, but is often reversible if it is recognized early and treated promptly. In both situations, i.e., acute kidney injury and chronic kidney disease, an early intervention can significantly improve the prognosis.The assessment of these pathologies is therefore mandatory, although it is hard to do it with traditional methodologies and existing tools for problem solving. Hence, in this work, we will focus on the development of a hybrid decision support system, in terms of its knowledge representation and reasoning procedures based on Logic Programming, that will allow one to consider incomplete, unknown, and even contradictory information, complemented with an approach to computing centered on Artificial Neural Networks, in order to weigh the Degree-of-Confidence that one has on such a happening. The present study involved 558 patients with an age average of 51.7 years and the chronic kidney disease was observed in 175 cases. The dataset comprise twenty four variables, grouped into five main categories. The proposed model showed a good performance in the diagnosis of chronic kidney disease, since the sensitivity and the specificity exhibited values range between 93.1 and 94.9 and 91.9���94.2 %, respectively.

A critical evaluation of methods for the reconstruction of tissue-specific models

Under the framework of constraint based modeling, genome-scale metabolic models (GSMMs) have been used for several tasks, such as metabolic engineering and phenotype prediction. More recently, their application in health related research has spanned drug discovery, biomarker identification and host-pathogen interactions, targeting diseases such as cancer, Alzheimer, obesity or diabetes. In the last years, the development of novel techniques for genome sequencing and other high-throughput methods, together with advances in Bioinformatics, allowed the reconstruction of GSMMs for human cells. Considering the diversity of cell types and tissues present in the human body, it is imperative to develop tissue-specific metabolic models. Methods to automatically generate these models, based on generic human metabolic models and a plethora of omics data, have been proposed. However, their results have not yet been adequately and critically evaluated and compared. This work presents a survey of the most important tissue or cell type specific metabolic model reconstruction methods, which use literature, transcriptomics, proteomics and metabolomics data, together with a global template model. As a case study, we analyzed the consistency between several omics data sources and reconstructed distinct metabolic models of hepatocytes using different methods and data sources as inputs. The results show that omics data sources have a poor overlapping and, in some cases, are even contradictory. Additionally, the hepatocyte metabolic models generated are in many cases not able to perform metabolic functions known to be present in the liver tissue. We conclude that reliable methods for a priori omics data integration are required to support the reconstruction of complex models of human cells.

Elevated Blood Pressure and Obesity in Childhood: A Cross-Sectional Evaluation of 4,609 Schoolchildren

Background: The incidence of obesity in children is increasing worldwide, primarily in urbanized, high-income countries, and hypertension development is a detrimental effect of this phenomenon. Objective: In this cross-sectional study, we evaluated the prevalence of excess weight and its association with high blood pressure (BP) in schoolchildren. Methods: Here 4,609 male and female children, aged 6 to 11 years, from 24 public and private schools in Maringa, Brazil, were evaluated. Nutritional status was assessed by body mass index (BMI) according to cutoff points adjusted for sex and age. Blood pressure (BP) levels above 90th percentile for gender, age and height percentile were considered elevated. Results: The prevalence of excess weight among the schoolchildren was 24.5%; 16.9% were overweight, and 7.6% were obese. Sex and socioeconomic characteristics were not associated with elevated BP. In all age groups, systolic and diastolic BP correlated with BMI and waist and hip measurements, but not with waist-hip ratio. The prevalence of elevated BP was 11.2% in eutrophic children, 20.6% in overweight children [odds ratio (OR), 1.99; 95% confidence interval (CI), 1.61-2.45], and 39.7% in obese children (OR, 5.4; 95% CI, 4.23-6.89). Conclusion: Obese and overweight children had a higher prevalence of elevated BP than normal-weight children. Our data confirm that the growing worldwide epidemic of excess weight and elevated BP in schoolchildren may also be ongoing in Brazil.

Long term global evaluation of a national AIDS prevention strategy: the case of Switzerland.

OBJECTIVES: The Swiss Aids prevention strategy has been subject to a continuous process of evaluation for the past 12 years. This paper describes the conceptual approach, methodology, results obtained and contribution to policy-making of that evaluation.��DESIGN: The evaluation is on-going, global with respect to all components of the strategy, and utilization-focused. Each successive phase of the evaluation has included 10-20 studies centred either on aspects of process, of outcome or of environmental context. Findings are synthesized at the end of each phase. METHODS: Both quantitative and qualitative methods are used. Studies generally have one of three functions within the overall evaluation: assessment of trends through surveys or other types of repeated studies; evaluation of specific areas through a series of studies from different viewpoints; in-depth investigation or rapid assessment through one-off studies. Various methods of triangulation are used to validate findings. RESULTS: The evaluation has allowed for: the observation of behavioural change in different populations; the availability of scientific data in controversial fields such as drug-use policy; an understanding of the diversity of public appropriation of prevention messages. Recommendations are regularly formulated and have been used by policy-makers and field workers for strategy development. CONCLUSIONS: The global approach adopted corresponds well to the evaluation requirements of an integrated long-term prevention strategy. Cost is low relative to the extent of information provided. Such an evaluation cannot however address the question of causal relationship between the strategy and observed changes. The evaluation has contributed to the development of a culture of evaluation in Swiss AIDS prevention more generally.

Evaluation of the susceptibility of pathogenic Candida species to fluconazole. Fluconazole Global Susceptibility Study Group.

A fluconazole 25 microg disk diffusion test was used to test 2230 consecutively isolated Candida strains from 42 different hospital laboratories in 23 countries. Ninety seven percent of 1634 Candida albicans isolates and 83.4% of 596 non-Candida albicans isolates were susceptible to fluconazole, applying the proposed breakpoints (&gt; or = 26 mm for susceptible strains and 18-25 mm for dose-dependent susceptible strains). This is the first hospital laboratory study to evaluate a large number and wide range of sequential Candida isolates from patients with all types of hospital infections. The fluconazole disk diffusion test appears to be a low-cost, reproducible, and accurate means of assessing the in vitro susceptibility of Candida isolates.

Energy gap in the aetiology of body weight gain and obesity: a challenging concept with a complex evaluation and pitfalls.

The concept of energy gap(s) is useful for understanding the consequence of a small daily, weekly, or monthly positive energy balance and the inconspicuous shift in weight gain ultimately leading to overweight and obesity. Energy gap is a dynamic concept: an initial positive energy gap incurred via an increase in energy intake (or a decrease in physical activity) is not constant, may fade out with time if the initial conditions are maintained, and depends on the 'efficiency' with which the readjustment of the energy imbalance gap occurs with time. The metabolic response to an energy imbalance gap and the magnitude of the energy gap(s) can be estimated by at least two methods, i.e. i) assessment by longitudinal overfeeding studies, imposing (by design) an initial positive energy imbalance gap; ii) retrospective assessment based on epidemiological surveys, whereby the accumulated endogenous energy storage per unit of time is calculated from the change in body weight and body composition. In order to illustrate the difficulty of accurately assessing an energy gap we have used, as an illustrative example, a recent epidemiological study which tracked changes in total energy intake (estimated by gross food availability) and body weight over 3 decades in the US, combined with total energy expenditure prediction from body weight using doubly labelled water data. At the population level, the study attempted to assess the cause of the energy gap purported to be entirely due to increased food intake. Based on an estimate of change in energy intake judged to be more reliable (i.e. in the same study population) and together with calculations of simple energetic indices, our analysis suggests that conclusions about the fundamental causes of obesity development in a population (excess intake vs. low physical activity or both) is clouded by a high level of uncertainty.

Production scheduling tools' evaluation in a global telecommunications and electronics company

Tutkimuksen p����tavoite on arvioida, ovatko nelj�� ohjelmistovaihtoehtoa riitt��vi�� tuotannon aikataulutuksen ty��kaluja ja mik�� ty��kaluista sopii toimeksiantajayritykselle. Alatavoitteena on kuvata tuotannon aikataulutuksen nyky- ja tahtotila prosessimallinnuksen avulla, selvitt���� ty��kalun k��ytt��j��tarpeet ja m����ritell�� priorisoidut valintakriteerit ty��kalulle.Tutkimuksen teoriaosuudessa tutkitaan tuotannon aikataulutuksen logiikkaa ja haasteita. Ty��ss�� tarkastellaan aikataulutusohjelmiston valintaa rinnakkain prosessinmallinnuksen kanssa. Aikataulutusohjelmistovaihtoehdot ja metodit k��ytt��j��tarpeiden selvitt��miseksi k��yd����n l��pi. Empiriaosuudessa selvitet����n tutkimuksen suhde toimeksiantajayrityksen strategiaan. K��ytt��j��tarpeet selvitet����n haastattelujen avulla jaanalysoidaan QFD matriisin avulla. Toimeksiantajayrityksen tuotannon aikataulutuksen nyky- ja tahtotilaprosessit mallinnetaan, jotta ohjelmistojen sopivuutta, aikataulutusprosessia tukevana ty��kaluna voidaan arvioida.Tutkimustuloksena ovatpriorisoidut valintakriteerit aikataulutusty��kalulle eli k��ytt��j��tarpeista johdetut t��rkeimm��t toiminnalliset ominaisuudet, j��rjestelm��toimittaja-arvio sek�� suositukset jatkotoimenpiteist�� ja lis��tutkimuksesta.

Climate change and global responsibility - the role of energy consumption, GDP and CO2 emissions

Climate change is one of the biggest challenges faced by this generation. Despite being the single most important environmental challenge facing the planet and despite over two decades of international climate negotiations, global greenhouse gas (GHG) emissions continue to rise. By the middle of this century, GHGs must be reduced by as much as 40-70% if dangerous climate change is to be avoided. In the Kyoto Protocol no quantitative emission limitation and reduction commitments were placed on the developing countries. For the planning of the future commitments period and possible participation of developing countries, information of the functioning of the energy systems, CO2 emissions development in different sectors, energy use and technological development in developing countries is essential. In addition to the per capita emissions, the efficiency of the energy system in relation to GHG emissions is crucial for the decision of future long-term burden sharing between countries. Country���s future development of CO2 emissions can be defined by the estimated CO2 intensity of the future and the estimated GDP growth. The changes in CO2 intensity depend on several factors, but generally developed countries��� intensity has been increasing in the industrialization phase and decreasing when their economy shifts more towards the system dominated by the service sector. The level of the CO2 intensity depends by a large extent on the production structure and the energy sources that are used. Currently one of the most urgent issues regarding global climate change is to decide the future of the Kyoto Protocol. Negotiations on this topic have already been initiated, with the aim of being finalised by the 2015. This thesis provides insights into the various approaches that can be used to characterise the concept of comparable efforts for developing countries in a future international climate agreement. The thesis examines the post-Kyoto burden sharing questions for developing countries using the contraction and convergence model, which is one approach that has been proposed to allocate commitments regarding future GHG emissions mitigation. This new approach is a practical tool for the evaluation of the Kyoto climate policy process and global climate change negotiations from the perspective of the developing countries.