Surgical programme at Royal Alexandra Hospital, Sydney, for Papua New Guinea children with congenital heart disease, 1978-1994

Objective : To report the history of the Royal Alexandra Hospital for Children (RAHC) Papua New Guinea (PNG) cardiac surgical programme and describe the selection, preoperative clinical features and postoperative outcome of children with congenital heart disease managed by the programme. Methods : Details for each of the PNG cardiac patients admitted to RAHC following selection by visiting cardiologists between 1978 and 1994 were entered into a database, and analysed and interpreted. Results : A congenital heart defect was confirmed in 165 of the 170 children selected. The male to female ratio was 1:1 and the mean age on admission to RAHC was 5.5 years. Almost all of the children for whom data were available (98%) had a weight for age and 41% had a height for age less than the 3rd centile. One-sixth had delayed milestones. A large number were tachypnoeic, in heart failure, or had pulmonary hypertension on admission. Ventricular septal defect and tetralogy of Fallot were the commonest defects, and lesions such as aortic stenosis, coarctation of the aorta and transposition of the great arteries were absent or rare. Thirty-one (19%) of the children selected initially did not receive surgery because of pulmonary hypertension, or because the lesions did not fall within the programme guidelines for operation. One hundred and twenty-nine children had corrective and four had palliative procedures. Half of the operated children had postoperative complications. Eight children died, all following open-heart procedures, giving a case fatality rate of 6%. Preoperative tachypnoea, hepatomegaly, cardiac failure and pulmonary hypertension were strongly associated with poor outcome. Conclusions : The programme was an arduous exercise for all organizations concerned, but achieved comparatively good short-term outcomes. The experience gained should assist in planning for similar programmes.

NEW Solutions: An Australian health promotion programme for people with mental illness

The prevalence of people who are overweight or obese is continuing to rise. This is a key risk indicator of preventable morbidity and mortality resulting from many diseases. The increase in the number of obese people is associated with dietary practices and a reduction in physical activity. There is a need to implement strategies for the reduction of obesity in at-risk groups. People with a mental illness are at high risk of many physical illnesses related to behavioural factors, which include poor diet and lack of exercise. Health promotion programmes need to be incorporated into mental-health services to improve the general health and wellbeing of people with a mental illness. An Australian psychiatric rehabilitation service developed and implemented a health promotion programme, NEW Solutions, which aimed to address issues related to weight gain, dietary practice and physical inactivity.

Total energy expenditure and body composition changes following peripheral blood stem cell transplantation and participation in an exercise programme

The purpose of this investigation was to assess changes in total energy expenditure (TEE), body weight (BW) and body composition following a peripheral blood stem cell transplant and following participation in a 3-month duration, moderate-intensity, mixed-type exercise programme. The doubly labelled and singly labelled water methods were used to measure TEE and total body water (TBW). Body weight and TBW were then used to calculate percentage body fat (%BF), and fat and fat-free mass (FFM). TEE and body composition measures were assessed pretransplant (PI), immediately post-transplant (PII) and 3 months post-PII (PIII). Following PII, 12 patients were divided equally into a control group (CG) or exercise intervention group (EG). While there was no change in TEE between pre- and post-transplant, BW (P

EWASTEU Programme: proposals to minimise the problem of e‑waste

Hoje em dia muitos dos equipamentos elétricos e eletrónicos que compramos ficam obsoletos num curto espaço de tempo por causa dos rápidos avanços tecnológicos neste campo. Equipamentos como computadores, telemóveis e equipamentos elétricos e eletrónicos de pequeno e grande porte são transformados em lixo eletrónico e muitos deles são despejados no lixo comum. Para alterar este cenário, a União Europeia publicou diretivas neste domínio com o intuito de controlar o crescimento do lixo eletrónico e reduzir o seu impacto. Neste contexto, a Universidade de Yaşar (Turquia) submeteu à União Europeia um projeto (EWASTEU) com o objetivo de fornecer uma visão do que está acontecer com o equipamento transformado em lixo eletrónico e de apresentar algumas propostas para minimizar este problema. Uma das principais questões a ser respondida será a adequação das diretivas europeias.

Payment for performance in the Family Health Programme: lessons from the UK Quality and Outcomes Framework

OBJECTIVE: Payment for performance financial incentive schemes reward doctors based on the quality and the outcomes of their treatment. In Brazil, the Ministry of Health is looking to scale up its use in public hospitals and some municipalities are developing payment for performance schemes even for the Family Health Programme. In this article the Quality and Outcomes Framework used in the UK since 2004 is discussed, as well as its experience to elaborate some important lessons that Brazilian municipalities should consider before embarking on payment for performance scheme in primary care settings.

Design of a doctorate programme on technology assessment: A sabbatical leave project

The work agenda includes the production of a report on different doctoral programmes on “Technology Assessment” in Europe, the US and Japan, in order to analyse collaborative post-graduation activities. Finally, the proposals on collaborative post-graduation programme between FCTUNL and ITAS-FZK will be organised by an ongoing discussion process with colleagues from ITAS.

Designing a technology assessment post-graduation programme: experiences, limits and needs

The post-graduation in the field of Technology Assessment (TA) is recent and that are several and different ways to be organised. Most experiences are related with the Masters diplom level (2nd cycle of graduation in high education). Just one in PhD level is explicit in the field of TA, and some other PhD courses include also TA topics in their programme structure. In this chapter we will analyse the problems related with the design of a post-graduation (MA, MSc or PhD) programme in the field of TA using as reference some international experiences. Hereby, the main conclusion seems to address labour market needs in the specialised knowledge of TA, of technology management or technology innovation. In this sense TA should be included as “minor” into post-graduation courses which may range from engineering disciplines to social sciences. As a graduation programme it can fill an expertise gap between technicians, engineers, scientists and the strategic decision makers or policy makers.

Designing a technology assessment post-graduation programme: experiences, limits and needs

IET Working Papers Series No. WPS09/2010

Development of Biomimetic Robots in the EPS Engineering Programme Capstone Project

This paper proposes the development of biologically inspired robots as the capstone project of the European Project Semester (EPS) framework. EPS is a one semester student centred international programme offered by a group of European engineering schools (EPS Providers) as part of their student exchange programme portfolio. EPS is organized around a central module (the EPS project) and a set of complementary supportive modules. Project proposals refer to open multidisciplinary real world problems. Its purpose is to expose students to problems of a greater dimension and complexity than those faced throughout the degree programme as well as to put them in contact with the socalled real world, in opposition to the academic world. Students are organized in teams, grouping individuals from diverse academic backgrounds and nationalities, and each team is fully responsible for conducting its project. EPS provides an integrated framework for undertaking capstone projects, which is focused on multicultural and multidisciplinary teamwork, communication, problem-solving, creativity, leadership, entrepreneurship, ethical reasoning and global contextual analysis. The design and development of biologically inspired robots allows the students to fulfil the previously described requirements and objectives and, as a result, we recommend the adoption of these projects within the EPS project capstone module for the benefit of engineering students.

Development of Biomimetic Robots in the EPS Engineering Programme Capstone Project

This paper presents the development of a fish-like robot called Bro-Fish. Bro-Fish aims to be an educational toy dedicated to teaching mechanics, programming and the physics of floating objects to youngsters. The underlying intention is to awaken the interest of children for technology, especially biomimetic (biologically inspired) approaches, in order to promote sustainability and raise the level of ecological awareness. The main focus of this project was to create a robot with carangiform locomotion and controllable swimming, providing the opportunity to customize parts and experiment with the physics of floating objects. Therefore, the locomotion principles of fishes and mechanisms developed in related projects were analysed. Inspired by this background knowledge, a prototype was designed and implemented. The main achievement is the new tail mechanism that propels the robot. The tail resembles the undulation motion of fish bodies and is actuated in an innovative way, triggered by an elegant movement of a rotating helicoidal. First experimental tests revealed the potential of the proposed methodology to effectively generate forward propulsion.

First Diabetic Retinopathy Prevalence Study in Portugal: RETINODIAB Study-Evaluation of the Screening Programme for Lisbon and Tagus Valley Region

BACKGROUND/AIMS: In Portugal, so far, there is no study or even accurate data on the prevalence of diabetic retinopathy (DR), based on a large representative sample and on a long-term follow-up. The objective of our study was to determine the prevalence of DR based on a national screening community-based programme. METHODS: A 5-year retrospective analysis of the RETINODIAB screening programme results was implemented in Lisbon and Tagus Valley area between July 2009 and October 2014. We estimated the prevalence of retinopathy for all patients with type 2 diabetes and studied the association between known risk factors and retinopathy emergence at their first screening. RESULTS: Throughout this period, from a total of 103 102 DR readable screening examinations, 52 739 corresponded to patients who attended RETINODIAB screening at entry. Globally, DR was detected in 8584 patients (16.3%). Of these, 5484 patients (10.4%) had mild non-proliferative (NP) DR, 1457 patients (2.8%) had moderate NPDR and 672 (1.3%) had severe NPDR. Finally, 971 patients (1.8%) had proliferative DR requiring urgent referral to an ophthalmologist. The presence of any DR, non-referable DR or referable DR was strongly associated with increasing duration of diabetes and earlier age at diagnosis. CONCLUSIONS: The prevalence rate of DR in our study (16.3%) was slightly lower than other published international data. The RETINODIAB network proved to be an effective screening programme as it improved DR screening in Lisbon and Tagus Valley surrounding area