Improving outcome of childhood bacterial meningitis by simplified treatment : Experience from Angola

Background Acute bacterial meningitis (BM) continues to be an important cause of childhood mortality and morbidity, especially in developing countries. Prognostic scales and the identification of risk factors for adverse outcome both aid in assessing disease severity. New antimicrobial agents or adjunctive treatments - except for oral glycerol - have essentially failed to improve BM prognosis. A retrospective observational analysis found paracetamol beneficial in adult bacteraemic patients, and some experts recommend slow β-lactam infusion. We examined these treatments in a prospective, double-blind, placebo-controlled clinical trial. Patients and methods A retrospective analysis included 555 children treated for BM in 2004 in the infectious disease ward of the Paediatric Hospital of Luanda, Angola. Our prospective study randomised 723 children into four groups, to receive a combination of cefotaxime infusion or boluses every 6 hours for the first 24 hours and oral paracetamol or placebo for 48 hours. The primary endpoints were 1) death or severe neurological sequelae (SeNeSe), and 2) deafness. Results In the retrospective study, the mortality of children with blood transfusion was 23% (30 of 128) vs. without blood transfusion 39% (109 of 282; p=0.004). In the prospective study, 272 (38%) of the children died. Of those 451 surviving, 68 (15%) showed SeNeSe, and 12% (45 of 374) were deaf. Whereas no difference between treatment groups was observable in primary endpoints, the early mortality in the infusion-paracetamol group was lower, with the difference (Fisher s exact test) from the other groups at 24, 48, and 72 hours being significant (p=0.041, 0.0005, and 0.005, respectively). Prognostic factors for adverse outcomes were impaired consciousness, dyspnoea, seizures, delayed presentation, and absence of electricity at home (Simple Luanda Scale, SLS); the Bayesian Luanda Scale (BLS) also included abnormally low or high blood glucose. Conclusions New studies concerning the possible beneficial effect of blood transfusion, and concerning longer treatment with cefotaxime infusion and oral paracetamol, and a study to validate our simple prognostic scales are warranted.

Psychologically-Based and Content-Oriented Experience in Entertainment Virtual Environments

In daily life, rich experiences evolve in every environmental and social interaction. Because experience has a strong impact on how people behave, scholars in different fields are interested in understanding what constitutes an experience. Yet even if interest in conscious experience is on the increase, there is no consensus on how such experience should be studied. Whatever approach is taken, the subjective and psychologically multidimensional nature of experience should be respected. This study endeavours to understand and evaluate conscious experiences. First I intro-duce a theoretical approach to psychologically-based and content-oriented experience. In the experiential cycle presented here, classical psychology and orienting-environmental content are connected. This generic approach is applicable to any human-environment interaction. Here I apply the approach to entertainment virtual environments (VEs) such as digital games and develop a framework with the potential for studying experiences in VEs. The development of the methodological framework included subjective and objective data from experiences in the Cave Automatic Virtual Environment (CAVE) and with numerous digital games (N=2,414). The final framework consisted of fifteen factor-analytically formed subcomponents of the sense of presence, involvement and flow. Together, these show the multidimensional experiential profile of VEs. The results present general experiential laws of VEs and show that the interface of a VE is related to (physical) presence, which psychologically means attention, perception and the cognitively evaluated realness and spatiality of the VE. The narrative of the VE elicits (social) presence and involvement and affects emotional outcomes. Psychologically, these outcomes are related to social cognition, motivation and emotion. The mechanics of a VE affect the cognitive evaluations and emotional outcomes related to flow. In addition, at the very least, user background, prior experience and use context affect the experiential variation. VEs are part of many peoples lives and many different outcomes are related to them, such as enjoyment, learning and addiction, depending on who is making the evalua-tion. This makes VEs societally important and psychologically fruitful to study. The approach and framework presented here contribute to our understanding of experiences in general and VEs in particular. The research can provide VE developers with a state-of-the art method (www.eveqgp.fi) that can be utilized whenever new product and service concepts are designed, prototyped and tested.

Corporate Brand Repositioning with CSR as the Differentiating Factor: A Study on Consumer Perceptions

Purpose – This research paper studies how the strategy of repositioning enables marketers to communicate CSR as their brand’s differentiating factor. It aims at understanding how consumer perceptions can be managed to generate brand value through corporate brand repositioning when CSR is the differentiating factor. The purpose of this paper is to answer the following research question: How can consumer perceptions be managed to generate brand value through corporate brand repositioning when CSR is the differentiating factor? The two research objectives were: 1. to build a model, which describes the different components of consumer perceptions involved in generation of brand value through repositioning when CSR is the differentiating factor, 2. to identify the most critical components in the context of the case company, IKEA for generation of brand value during the process of corporate brand repositioning Design/methodology/approach – This paper is based on the literature review covering the logic of brand value generation, repositioning strategy and consumer perceptions connected to CSR activities. A key concept of the positioning theory, the brand’s differentiating factor, was explored. Previous studies have concluded that desirability of the differentiating factor largely determines the level of brand value-creation for the target customers. The criterion of desirability is based on three dimensions: relevance, distinctiveness and believability. A model was built in terms of these desirability dimensions. This paper takes a case study approach where the predefined theoretical framework is tested using IKEA as the case company. When developing insights on the multifaceted nature of brand perceptions, personal interviews and individual probing are vital. They enable the interviewees to reflect on their feelings and perceptions with their own words. This is why the data collection was based on means-end type of questioning. Qualitative interviews were conducted with 12 consumers. Findings – The paper highlights five critical components that may determine whether IKEA will fail in its repositioning efforts. The majority of the critical components involved believability perceptions. Hence, according to the findings, establishing credibility and trustworthiness for the brand in the context of CSR seems primary. The most critical components identified of the believability aspect were: providing proof of responsible codes of conduct via conducting specific and concrete CSR actions, connecting the company’s products and the social cause, and building a linkage between the initial and new positioning while also weakening the old positioning. Originality/value – Marketers’ obligation is to prepare the company for future demands. Companies all over the globe have recognized the durable trend of responsibility and sustainability. Consumer´s worry about the environmental and social impact of modern lifestyles is growing. This is why Corporate Social Responsibility (CSR) provides brands an important source of differentiation and strength in the future. The strategy of repositioning enables marketers to communicate CSR as their brand’s differentiating factor. This study aimed at understanding how consumer perceptions can be managed to generate brand value through corporate brand repositioning when CSR is the differentiating factor.

Liminal Belonging: West African male asylum seekers’ narratives of the asylum experience whilst in Finland

The dominant discourses on the issue of asylum have placed it on a uniquely higher level of scrutiny as a politically very sensitive area for social research. Today, member states within the EU have implemented stricter policies to control new arrivals, whilst instituting statutory procedures to manage the existing asylum claims. In 2010, the number of applicants for asylum in Finland totalled 5988, out of which 1784 were given positive decisions. This thesis endeavour to highlight asylum seekers in the discourses about them by adding their voices to the discussions of them in contemporary Finland. Studies, which has concentrated on asylum seekers in Finland, uses the living conditions within asylum reception centres to assess the impacts of structural barriers on asylum seekers’ efforts to deal with the asylum process. By highlighting the impacts of the entire asylum process, which I believe starts from the country of origin; I focus on examining narratives of dealing with the experience of liminality whilst waiting for asylum, and then explore areas of possible participation within informal social networks for West African asylum seekers in Finland. The overall aim is to place the current research within the broader sociological discussion of ‘belonging’ for asylum seekers who are yet to be recognized as refugees, and who exist in a state of limbo. Methodologically, oral interviews, self-written autobiographical narratives, and ethnographic field work are qualitatively combined as data in this thesis for an empirical study of West African male asylum seekers in Finland. Narrative analysis is employed to analyze the data for this thesis. The ethnographic research data for the study began in May 2009 and ended in August of 2010. Altogether, ten interviews and four self-written narratives were collected as data. In total seven hours of audio recording were made, along eleven pages of hand-written autobiographical narratives. Field observation notes are employed in the study to provide contexts to the active interactional processes of interpretation throughout the analysis. Findings from the study suggest that within the experience of liminality, which surrounds the entire asylum process, participations within informal social networks are found to be important to the process of re-making place and the sense of belonging. My study shows that this is necessary to countering the experience of boredom, stress and social isolation, which permeate all aspects of life for West African asylum seekers, whilst they wait for asylum decisions in Finland.

Optimizing Multimedia Experience in a Thin Client Environment for a Resource Constrained Processor

In this paper, we study how TCP and UDP flows interact with each other when the end system is a CPU resource constrained thin client. The problem addressed is twofold, 1) the throughput of TCP flows degrades severely in the presence of heavily loaded UDP flows 2) fairness and minimum QoS requirements of UDP are not maintained. First, we identify the factors affecting the TCP throughput by providing an in-depth analysis of end to end delay and packet loss variations. The results obtained from the first part leads us to our second contribution. We propose and study the use of an algorithm that ensures fairness across flows. The algorithm improves the performance of TCP flows in the presence of multiple UDP flows admitted under an admission algorithm and maintains the minimum QoS requirements of the UDP flows. The advantage of the algorithm is that it requires no changes to TCP/IP stack and control is achieved through receiver window control.

Operational experience on a grid connected 100 kWe biomass gasification power plant in Karnataka, India

The paper reports the operational experience from a 100 kWe gasification power plant connected to the grid in Karnataka. Biomass Energy for Rural India (BERI) is a program that implemented gasification based power generation with an installed capacity of 0.88 MWe distributed over three locations to meet the electrical energy needs in the district of Tumkur. The operation of one 100 kWe power plant was found unsatisfactory and not meeting the designed performance. The Indian Institute of Science, Bangalore, the technology developer, took the initiative to ensure the system operation, capacity building and prove the designed performance. The power plant connected to the grid consists of the IISc gasification system which includes reactor, cooling, cleaning system, fuel drier and water treatment system to meet the producer gas quality for an engine. The producer gas is used as a fuel in Cummins India Limited, GTA 855 G model, turbo charged engine and the power output is connected to the grid. The system has operated for over 1000 continuous hours, with only about 70 h of grid outages. The total biomass consumption for 1035 h of operation was 111 t at an average of 107 kg/h. Total energy generated was 80.6 MWh reducing over loot of CO(2) emissions. The overall specific fuel consumption was about 1.36 kg/kWh, amounting to an overall efficiency from biomass to electricity of about 18%. The present operations indicate that a maintenance schedule for the plant can be at the end of 1000 h. The results for another 1000 h of operation by the local team are also presented. (C) 2011 International Energy Initiative. Published by Elsevier Inc. All rights reserved.

Position control of DC motors with experience mapping based prediction controller

The paper presents a new controller inspired by the human experience based, voluntary body action control (dubbed motor control) learning mechanism. The controller is called Experience Mapping based Prediction Controller (EMPC). EMPC is designed with auto-learning features without the need for the plant model. The core of the controller is formed around the motor action prediction-control mechanism of humans based on past experiential learning with the ability to adapt to environmental changes intelligently. EMPC is utilized for high precision position control of DC motors. The simulation results are presented to show that accurate position control is achieved using EMPC for step and dynamic demands. The performance of EMPC is compared with conventional PD controller and MRAC based position controller under different system conditions. Position Control using EMPC is practically implemented and the results are presented.

EXPERIENCE OF OPERATING OPEN TOP BIOMASS GASIFIER USING A LOW DENSITY FUEL-COCONUT FRONDS

Use of fuel other than woody generally has been limited to rice husk and other residues are rarely tried as a fuel in a gasification system. With the availability of woody biomass in most countries like India, alternates fuels are being explored for sustainable supply of fuel. Use of agro residues has been explored after briquetting. There are few feedstock's like coconut fronts, maize cobs, etc, that might require lesser preprocessing steps compared to briquetting. The paper presents a detailed investigation into using coconut fronds as a fuel in an open top down draft gasification system. The fuel has ash content of 7% and was dried to moisture levels of 12 %. The average bulk density was found to be 230 kg/m3 with a fuel size particle of an average size 40 mm as compared to 350 kg/m3 for a standard wood pieces. A typical dry coconut fronds weighs about 2.5kgs and on an average 6 m long and 90 % of the frond is the petiole which is generally used as a fuel. The focus was also to compare the overall process with respect to operating with a typical woody biomass like subabul whose ash content is 1 %. The open top gasification system consists of a reactor, cooling and cleaning system along with water treatment. The performance parameters studied were the gas composition, tar and particulates in the clean gas, water quality and reactor pressure drop apart from other standard data collection of fuel flow rate, etc. The average gas composition was found to be CO 15 1.0 % H-2 16 +/- 1% CH4 0.5 +/- 0.1 % CO2 12.0 +/- 1.0 % and rest N2 compared to CO 19 +/- 1.0 % H-2 17 +/- 1.0 %, CH4 1 +/- 0.2 %, CO2 12 +/- 1.0 % and rest N2. The tar and particulate content in the clean gas has been found to be about 10 and 12 mg/m3 in both cases. The presence of high ash content material increased the pressure drop with coconut frond compared to woody biomass.