957 resultados para Goma 7-Step Pathway


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Taiwan is a rapidly changing society, facing many challenges. In this state of flux, it is important to step back and see the big picture. The NewFutures 2000 conference, which commemorated fifty years of the of Tamkang University, in TamShui (the northernmost tip), Taiwan (Republic of China) and was held on 5–7 November 2000, gave Taiwanese an opportunity to gain just such a perspective. The ostensible aim of the conference was to explore ‘transformations in education, culture and technology’. But numerous perspectives and academic approaches were explored; predictions, normative visions, probable futures, alternative futures, ethical futures, epistemological re-constructions, studies and deconstruction’s of images of the future, myth and worldview—all received attention, sometimes overwhelming the participants with contradictory and overbearing ideas. [introduction]

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Abstract Purpose: To determine how high and low contrast visual acuities are affected by blur caused by crossed-cylinder lenses. Method: Crossed-cylinder lenses of power zero (no added lens), +0.12 DS/-0.25 DC, +0.25 DS/-0.50 DC and +0.37/-0.75 DC were placed over the correcting lenses of the right eyes of eight subjects. Negative cylinder axes used were 15-180 degrees in 15 degree step for the two higher crossed-cylinders and 30-180 degrees in 30 degree steps for the lowest crossed cylinder. Targets were single lines of letters based on the Bailey-Lovie chart. Successively smaller lines were read until the subject could not read any of the letters correctly. Two contrasts were used: high (100%) and low (10%). The screen luminance of 100 cd/m2, together with the room lighting, gave pupil sizes of 4.5 to 6 mm. Results: High contrast visual acuities were better than low contrast visual acuities by 0.1 to 0.2 log unit (1 to 2 chart lines) for the no added lens condition. Based on comparing the average of visual acuities for the 0.75 D crossed-cylinder with the best visual acuity for a given contrast and subject, the rates of change of visual acuity per unit blur strength were similar for high contrast (0.34± 0.05 logMAR/D) and low contrast (0.37± 0.09 logMAR/D). There were considerable asymmetry effects, with the average loss in visual acuity across the two contrasts and the 0.50D/0.75 D crossed-cylinders doubling between the 165± and 60± negative cylinder axes. The loss of visual acuity with 0.75 D crossed-cylinders was approximately twice times that occurring for defocus of the same blur strength. Conclusion: Small levels of crossed-cylinder blur (≤0.75D) produce losses in visual acuity that are dependent on the cylinder axis. 0.75 D crossed-cylinders produce losses in visual acuity that are twice those produced by defocus of the same blur strength.

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Purpose. To devise and validate artist-rendered grading scales for contact lens complications Methods. Each of eight tissue complications of contact lens wear (listed under 'Results') was painted by a skilled ophthalmic artist (Terry R. Tarrant) in five grades of severity: 0 (normal), 1 (trace), 2 (mild), 3 (moderate) and 4 (severe). A representative slit lamp photograph of a tissue response of each of the eight complications was shown to 404 contact lens practitioners who had never before used clinical grading scales. The practitioners were asked to grade each tissue response to the nearest 0.1 grade unit by interpolation. Results. The standard deviation (± s.d.) of the 404 responses for each tissue complication is tabulated below:_ing_ 0.5 Endothelial pplymegethisjij-4 0.7 Epithelial microcysts 0.5 Endothelial blebs_ 0.4 Stromal edema_onjunctiva! hyperemia 0.4 Stromal neovascularization 0.4 Papillary conjunctivitis 0.5 The frequency distributions and best-fit normal curves were also plotted. The precision of grading (s.d. x 2) ranged from 0.8 to 1.4, with a mean precision of 1.0. Conclusions. Grading scales afford contact lens practitioners with a method of quantifying the severity of adverse tissue responses to contact lens wear. It is noteworthy that the statistically verified precision of grading (1.0 scale unit) concurs precisely with the essential design feature of the grading scales that each grading step of 1.0 corresponds to clinically significant difference in severity. Thus, as a general rule, a difference or change in grade of > 1.0 can be taken to be both clinically and statistically significant when using these grading scales. Trained observers are likely to achieve even greater grading precision. Supported by Hydron Limited.

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The two minerals borickyite and delvauxite CaFe3+4(PO4,SO4)2(OH)8•4-6H2O have the same formula. Are the minerals identical or different? The minerals borickyite and delvauxite have been characterised by Raman spectroscopy. The minerals are related to the minerals diadochite and destinezite. Both minerals are amorphous. Delvauxite appears to vary in crystallinity from amorphous to semi-crystalline. The minerals are often X-ray non-diffracting. The minerals are found in soils and may be described as ‘colloidal’ minerals. Vibrational spectroscopy enables an assessment of the molecular structure of borickyite and delvauxite. Bands are assigned to phosphate and sulphate stretching and bending modes. Multiple water bending and stretching modes imply that non-equivalent water molecules in the structure exist with different hydrogen bond strengths. The two minerals show differing spectra and must be considered as different minerals.

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Precise identification of the time when a change in a hospital outcome has occurred enables clinical experts to search for a potential special cause more effectively. In this paper, we develop change point estimation methods for survival time of a clinical procedure in the presence of patient mix in a Bayesian framework. We apply Bayesian hierarchical models to formulate the change point where there exists a step change in the mean survival time of patients who underwent cardiac surgery. The data are right censored since the monitoring is conducted over a limited follow-up period. We capture the effect of risk factors prior to the surgery using a Weibull accelerated failure time regression model. Markov Chain Monte Carlo is used to obtain posterior distributions of the change point parameters including location and magnitude of changes and also corresponding probabilistic intervals and inferences. The performance of the Bayesian estimator is investigated through simulations and the result shows that precise estimates can be obtained when they are used in conjunction with the risk-adjusted survival time CUSUM control charts for different magnitude scenarios. The proposed estimator shows a better performance where a longer follow-up period, censoring time, is applied. In comparison with the alternative built-in CUSUM estimator, more accurate and precise estimates are obtained by the Bayesian estimator. These superiorities are enhanced when probability quantification, flexibility and generalizability of the Bayesian change point detection model are also considered.

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This report provides an overview of findings of qualitative research comprising three case studies undertaken as a part of the retrospective analysis component of Sustainable Built Environment National Research Centre (SBEnrc) Project 2.7 Leveraging R&D investment for the Australian Built Environment. These case studies (see Parts 2, 3 and 4 of this suite of reports) were undertaken to illustrate the nature of past R&D investments in Australia. This was done to complement: (i) the audit and analysis of past R&D investment undertaken by Thomas Barlow (2011); and (ii) the Construction 2030 roadmap being developed by Swinburne University of Technology and Professor Göran Roos from VTT Technical Research Centre of Finland. These documents will be the basis for the final phase of the present project - developing policy guidelines for future R&D investment in the Australian built environment. Refer also Parts 1, 2 and 3 for detail findings.

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This report discusses findings of a case study into "CADD, BIM and IPD" undertaken as a part of the retrospective analysis component of Sustainable Built Environment National Research Centre (SBEnrc) Project 2.7 Leveraging R&D investment for the Australian Built Environment. This case study investigated the evolution that has taken place in the Queensland Department of Public Works Division of Project Services during the last 20 years from: the initial implementation of computer aided design and documentation(CADD); to the experimentation with building information modelling (BIM) from the mid 2000’s; embedding integrated practice (IP); to current steps towards integrated project delivery (IPD) with the integration of contractors in the design/delivery process. This case study should be read in conjunction with Part 1 of this suite of reports.

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This report discusses findings of a case study into "Road Construction Safety" undertaken as a part of the retrospective analysis component of Sustainable Built Environment National Research Centre (SBEnrc) Project 2.7 Leveraging R&D investment for the Australian Built Environment. The Queensland Department of Transport and Main Roads (QTMR) has taken a leadership role in developing a safer working environment for road construction workers. In the past decades, a range of initiatives have been introduced to contribute to improved performance in this area. Several initiatives have been undertaken by QTMR as part of their overarching commitment to safety. Three such initiatives form the basis for this case study investigation, in order to better illustrate the nature of R&D investment and its impact on day-to-day operations and the supply chain. These are the development and implementation of: (i) the Mechanical Traffic Aid: (ii) the Thermal Imaging Camera; and (iii) the Trailer-based CCTV (camera). This case study should be read in conjunction with Part 1 of this suite of reports.

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This report discusses findings of a case study into "Green Buildings" undertaken as a part of the retrospective analysis component of Sustainable Built Environment National Research Centre (SBEnrc) Project 2.7 Leveraging R&D investment for the Australian Built Environment. The Western Australian Government (WAG) has taken a leadership role for a number of decades in developing more environmentally responsive buildings. In the past decade, considerable initiatives have been introduced to contribute to: (i) greening the stock of government buildings; and (ii) providing leadership in the development of other non-residential buildings developed commercially. This role has been informed by global, national and internal initiatives and research in this area. This case study investigates: (i) the nature of this leadership; and (ii) the role of R&D policy development; and (iii) the dissemination and impact of outcomes in the broader industry. This case study should be read in conjunction with Part 1 of this suite of reports.

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The racemic title compound, C9H11NO4 . H2O, a tricyclic rearranged aminonorbornane dicarboxylic acid is a conformationally rigid analogue of glutamic acid and exists as an ammonium-carboxylate zwitterion, with the bridghead carboxylic acid group anti-related. In the crystal, intermolecular N-H...O and O-H...O hydrogen-bonding interactions involving the ammonium, carboxylic acid and water donor groups with both water and carboxyl O-atom acceptors give a three-dimensional framework structure.

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Flightless (Flii) is upregulated in response to wounding and has been shown to function in wound closure and scarring. In macrophages intracellular Flii negatively modulates TLR signalling and dampens cytokine production. We now show that Flii is constitutively secreted from macrophages and fibroblasts and is present in human plasma. Secretion from fibroblasts is upregulated in response to scratch wounding and LPS-activated macrophages also temporally upregulate their secretion of Flii. Using siRNA, wild-type and mutant proteins we show that Flii is secreted via a late endosomal/lysosomal pathway that is regulated by Rab7 and Stx11. Flii contains 11 leucine rich repeat (LRR) domains in its N-terminus that have nearly 50% similarity to those in the extracellular pathogen binding portion of Toll-like receptor 4 (TLR4). We show secreted Flii can also bind LPS and has the ability to alter macrophage activation. LPS activation of macrophages in Flii depleted conditioned media leads to enhanced macrophage activation and increased TNF secretion compared to cells activated in the presence of Flii. These results show secreted Flii binds to LPS and in doing so alters macrophage activation and cytokine secretion, suggesting that like the intracellular pool of Flii, secreted Flii also has the ability to alter inflammation.

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Aim: To explore the lived experience of post-traumatic stress disorder (PTSD) as described by individuals who have been involved in a motor vehicle accident (MVA) in Jordan. Background: Motor vehicle accident (MVA) survivors who develop post-traumatic stress disorder (PTSD) have become an important health issue. The World Health Organisation (WHO) states that trauma resulting from MVAs is a phenomenon of increasing concern, with death from injuries projected to rise from 5.1 million in 1990 to 8.4 million in 2020 particularly in developing countries such as Jordan (WHO, 2002). The impact of trauma from MVAs inevitably compromises the victim’s quality of life (WHO, 2002; Blanchard & Hickling, 2007) resulting in psychological and emotional distress, occupational disability, family disintegration, and socio-economic difficulty (Jordan Ministry of Health, 2005). The development of PTSD as a result of an MVA is not limited to the individual, but also extends to the family, friends, and the health care team involved in the person's care and rehabilitation. Design: A descriptive phenomenological approach was used for this study. Method: This study was conducted in an orthopaedic unit in Amera Basma Hospital in Irbid Jordan. Fifteen (15) participants were voluntary recruited through the process of purposeful sampling. Data was collected by face-to-face in depth-interviews. Interviews were digitally recorded and transcribed verbatim. The process of analysis was undertaken using Colaizzi’s (1978) eight step approach with the addition of two extra steps. Findings: The process of analysis identified seven themes explicated from the participants’ transcripts of interview. The seven themes were: 1. Feeling frustrated at a diminishing health status 2. Struggling to maintain a sense of independence 3. Harbouring feelings of not being able to recover 4. Feeling discriminated against and marginalised by society 5. Feeling ignored and neglected by health care professionals 6. Feeling abandoned by family, and 7. Moving toward acceptance through having faith in Allah. Conclusion: The findings of this study have the potential to make a significant contribution to extant knowledge on the topic which can inform future nursing practice, education, policy development, and research initiatives in Jordan and internationally.