Practices and views on fetal heart monitoring:A structured observation and interview study

Objective: To assess and explain deviations from recommended practice in National Institute for Clinical Excellence (NICE) guidelines in relation to fetal heart monitoring. Design: Qualitative study. Setting: Large teaching hospital in the UK. Sample: Sixty-six hours of observation of 25 labours and interviews with 20 midwives of varying grades. Methods: Structured observations of labour and semistructured interviews with midwives. Interviews were undertaken using a prompt guide, audiotaped, and transcribed verbatim. Analysis was based on the constant comparative method, assisted by QSR N5 software. Main outcome measures: Deviations from recommended practice in relation to fetal monitoring and insights into why these occur. Results: All babies involved in the study were safely delivered, but 243 deviations from recommended practice in relation to NICE guidelines on fetal monitoring were identified, with the majority (80%) of these occurring in relation to documentation. Other deviations from recommended practice included indications for use of electronic fetal heart monitoring and conduct of fetal heart monitoring. There is evidence of difficulties with availability and maintenance of equipment, and some deficits in staff knowledge and skill. Differing orientations towards fetal monitoring were reported by midwives, which were likely to have impacts on practice. The initiation, management, and interpretation of fetal heart monitoring is complex and distributed across time, space, and professional boundaries, and practices in relation to fetal heart monitoring need to be understood within an organisational and social context. Conclusion: Some deviations from best practice guidelines may be rectified through straightforward interventions including improved systems for managing equipment and training. Other deviations from recommended practice need to be understood as the outcomes of complex processes that are likely to defy easy resolution. © RCOG 2006.

Factor analysis and discriminant validity:a brief review of some practical issues

Growth in availability and ability of modern statistical software has resulted in greater numbers of research techniques being applied across the marketing discipline. However, with such advances come concerns that techniques may be misinterpreted by researchers. This issue is critical since misinterpretation could cause erroneous findings. This paper investigates some assumptions regarding: 1) the assessment of discriminant validity; and 2) what confirmatory factor analysis accomplishes. Examples that address these points are presented, and some procedural remedies are suggested based upon the literature. This paper is, therefore, primarily concerned with the development of measurement theory and practice. If advances in theory development are not based upon sound methodological practice, we as researchers could be basing our work upon shaky foundations.

Improved supercontinuum generation by dispersion tuning and dual wavelength pumping

Supercontinuum generation in ultra-long Raman fibre laser cavities is compared for a range of fibre dispersions in the anomalous and normal regimes. For normal dispersion improved performance and efficiency is achieved using dual wavelength pumping.

Simulation based knowledge elicitation:effect of visual representation and model parameters

Since much knowledge is tacit, eliciting knowledge is a common bottleneck during the development of knowledge-based systems. Visual interactive simulation (VIS) has been proposed as a means for eliciting experts’ decision-making by getting them to interact with a visual simulation of the real system in which they work. In order to explore the effectiveness and efficiency of VIS based knowledge elicitation, an experiment has been carried out with decision-makers in a Ford Motor Company engine assembly plant. The model properties under investigation were the level of visual representation (2-dimensional, 2½-dimensional and 3-dimensional) and the model parameter settings (unadjusted and adjusted to represent more uncommon and extreme situations). The conclusion from the experiment is that using a 2-dimensional representation with adjusted parameter settings provides the better simulation-based means for eliciting knowledge, at least for the case modelled.

Sustainable rural micro-enterprises through co- and tri-generation:review of concepts

Biomass production, conversion and utilization can be done locally with value addition to small farmers. However, new technical inputs are needed for profitable exploitation of biomass within the constraints related to land, water and skill availability and to provide higher quality of energy needed for rural industries. Trigeneration, which is generating energy simultaneously in three forms (electric power, heat for processing and refrigeration), helps in fully utilizing the stored energy in biomass and would be most appropriate for micro enterprises. This paper presents concepts in terms of trigeneration systems feasible for rural areas.

The activity of pH membrane disruptive pseudopeptides and their subcellular fate in mammalian cells cultured in-vitro

This thesis describes investigations upon pseudopeptides which were conducted to improve our understanding of the fate of synthetic macromolecules in cells and to develop approaches to influence that fate. The low uptake of molecules across the external cellular membrane is the principal barrier against effective delivery of therapeutic products to within the cell structure. In nature, disruption of this membrane by amphiphilic peptides plays a central role in the pathogenesis by bacterial and toxin infections. These amphiphilic peptides contain both hydrophobic and weakly charged hydrophilic amino acid residues and upon activation they become integrated into the lipid bilayers of the extracellular or endosomal membranes. The architectures of the pseudopeptides described here were designed to display similar pH dependent membrane rupturing activity to that of peptides derived from the influenza virus hemagglutinin HA-2. This HA protein promotes fusion of the influenza virus envelope with the cell endosome membrane due to a change in conformation in response to the acidic pH of the endosome lumen (pH 5.0-6.0). The pseudopeptides were obtained by the copolymerisation of L-lysine and L-lysine ethyl-ester with various dicarboxylic acid moieties. In this way a linear polyamide comprising of alternating pendant carboxylic acids and pendant hydrophobic moieties was made. At physiological pH (pH 7.4), electrostatic repulsion of pendant anionic carboxyl groups along the polymer backbone is sufficient to overcome the intramolecular association of the hydrophobic groups resulting in an extended conformation. At low pH (typically pH 4.8) loss of charge results in increased intramolecular hydrophobic association and the polymer chain collapses to a compact conformation, leading to precipitation of the polymer. Consequently, a conformation dependent functional property could be made to respond to small changes in the environmental pH. Pseudopepides were investigated for their cytoxicity towards a well known cell line, namely C26 (colorectal adenocarcinoma) and were shown through the use of a cell viability assay, MTT (3-(4,5-dimethylthiazol-2-yl)-2,5 diphenyltetrazolium bromide) to be well tolerated by C26 cells over a range of concentrations (2-500,μg/ml) at physiological pH (pH 7.4). A modified version of a shorter 30-minute coupled enzymatic assay, the LDH (lactate dehydrogenase) assay was used to evaluate the ability of the pseudopeptides to disrupt the membrane of two different cell lines (COS-1; African green monkey, kidney and A2780; human ovarian carcinoma) at low pH (pH 5.5). The cell membrane disruption property of the pseudopeptides was successfully demonstrated for COS-I and A2780 cell lines at this pH (pH 5.5). A variety of cell lines were chosen owing to limited availability and to compare the cytotoxic action of these pH responsive psudopeptides towards normal and tumorogenic cell lines. To investigate the intracellular delivery of one of the pseudopeptides, poly (L-lysine iso-phthalamide) and its subcellular location, a Cy3 bisamine fluorophore was conjugated into its backbone, at ratios of dye:lysine of 1:20, 1:30, 1:40, 1:60 and 1:80. Native polyacrylacrylamide gel electrophoresis (PAGE) and high voltage paper electrophoresis (HVPE) studies of the polydyes were conducted and provided evidence that that the Cy3 bisamine fluorophore was conjugated into the backbone of the polymer, poly (L-lysine iso-phthalamide). The subcellular fate of the fluorescentlylabelled "polydye" (hereafter PD20) was monitored by laser scanning confocal microscopy (LSCM) in CHO (Chinese hamster ovary) cells cultured in-vitro at various pH values (pH 7.4 and 5.0). LSCM images depicting time-dependent internalisation of PD20 indicated that PD20 traversed the extracellular membrane of CHO cells cultured in-vitro within ten minutes and migrated towards the endosomal regions where the pH is in the region of 5.0 to 6.0. Nuclear localisation of PD20 was demonstrated in a subpopulation of CHO cells. A further study was completed in CHO and HepG2 (hepatocellular carcinoma) cells cultured in-vitro using a lower molecular weight polymer to demonstrate that the molecular weight of "polydye" could be tailored to attain nuclear trafficking in cells. Prospective use of this technology encompasses a method of delivering a payload into a living cell based upon the hypercoiling nature of the pseudopeptides studied in this thesis and has led to a patent application (GB0228525.2; 20(2).

Functionalisation of polymers: reactive processing, structure and performance characteristics

The main aim of this work was to study the effect of two comonomers, trimethylolpropane trimethacrylate (TRIS) and divinylbenzene (DVB) on the nature and efficiency of grafting of two different monomers, glycidyl methacrylate (GMA) and maleic anhydride (MA) on polypropylene (P) and on natural rubber (NR) using reactive processing methods. Four different peroxides, benzoyl peroxide (BPO), dicumyl peroxide (DCP), 2,5-dimethyl-2,5-bis-(tert-butyl peroxy) hexane (t-101), and 1,1-di(tert-butylperoxy)-3,3,5-trimethyl cyclohexene (T-29B90) were examined as free radical initiators. An appropriate methodology was established and chemical composition and reactive processing parameters were examined and optimised. It was found that in the absence of the coagents DVB and TRIS, the grafting degree of GMA and MA increased with increasing peroxide concentration, but the level of grafting was low and the homopolymerisaton of GMA and the crosslinking of NR or chain scission of PP were identified as the main side reactions that competed with the desired grafting reaction in the polymers. At high concentrations of the peroxide T-101 (>0.02 mr) cross linking of NR and chain scission of PP became dominant and unacceptable. An attempt to add a reactive coagent, e.g. TRIS during grafting of GMA on natural rubber resulted in excessive crosslinking because of the very high reactivity of this comonomer with the C=C of the rubber. Therefore, the use of any multifunctional and highly reactive coagent such as TRIS, could not be applied in the grafting of GAM onto natural rubber. In the case of PP, however, the use of TRIS and DVB was shown to greatly enhance the grafting degree and reduce the chain scission with very little extent of monomer homopolymerisation taking place. The results showed that the grafting degree was increased with increasing GMA and MA concentrations. It was also found that T-101 was a suitable peroxide to initiate the grafting reaction of these monomers on NR and PP and the optimum temperature for this peroxide was =160°C. A very preliminary work was also conducted on the use of the functionalised-PP (f-PP) in the absence and presence of the two comonomers (f-PP-DVB or f-PP-TRIS) for the purpose of compatibilising PP-PBT blends through reactive blending. Examination of the morphology of the blends suggested that an effective compatibilisation has been achieved when using f-PP-DVB and f-PP-TRIS, however more work is required in this area.

Development of techniques to predict production line efficiency

This industrial based research project was undertaken for British Leyland and arose as a result of poor system efficiency on the Maxi and Marina vehicle body build lines. The major factors in the deterioration of system efficiency were identified as: a) The introduction of a 'Gateline' system of vehicle body build. b) The degeneration of a newly introduced measured daywork payment scheme. By relating the conclusions of past work on payment systems to the situation at Cowley, it was concluded that a combination of poor industrial relations and a lack of managerial control had caused the measured daywork scheme to degenerate into a straightforward payment for time at work. This ellminated the monetary incentive to achieve schedule with the consequence that both inefficiency and operating costs increased. To analyse further the cause of inefficiency, a study of Marina gateline stoppage logs was carried out. This revealed that poor system efficiency on the gateline was caused more by the nature of its design than poor reliability on individual items of' plant. The consideration given to system efficiency at the design stage was found to be negligible, the main obstacles being: a) A lack of understanding pertaining to the influence of certain design factors on the efficiency of a production line. b) The absence of data and techniques to predict system efficiency at the design stage. To remedy this situation, a computer simulation study of' the design factors was carried out from which relationships with system efficiency were established and empirical efficiency equations developed. Sets of tables were compiled from the equations and efficiency data relevant to vehicle body building established from the gateline stoppage logs. Computer simulation, the equations and the tables,when used in conjunction. with good efficiency data, are shown to be accurate methods of predicting production line system.efficiency.

A combination of cyclone and vert techniques for the management of construction projects

Many planning and control tools, especially network analysis, have been developed in the last four decades. The majority of them were created in military organization to solve the problem of planning and controlling research and development projects. The original version of the network model (i.e. C.P.M/PERT) was transplanted to the construction industry without the consideration of the special nature and environment of construction projects. It suited the purpose of setting up targets and defining objectives, but it failed in satisfying the requirement of detailed planning and control at the site level. Several analytical and heuristic rules based methods were designed and combined with the structure of C.P.M. to eliminate its deficiencies. None of them provides a complete solution to the problem of resource, time and cost control. VERT was designed to deal with new ventures. It is suitable for project evaluation at the development stage. CYCLONE, on the other hand, is concerned with the design and micro-analysis of the production process. This work introduces an extensive critical review of the available planning techniques and addresses the problem of planning for site operation and control. Based on the outline of the nature of site control, this research developed a simulation based network model which combines part of the logics of both VERT and CYCLONE. Several new nodes were designed to model the availability and flow of resources, the overhead and operating cost and special nodes for evaluating time and cost. A large software package is written to handle the input, the simulation process and the output of the model. This package is designed to be used on any microcomputer using MS-DOS operating system. Data from real life projects were used to demonstrate the capability of the technique. Finally, a set of conclusions are drawn regarding the features and limitations of the proposed model, and recommendations for future work are outlined at the end of this thesis.

Indigenous and foreign innovation efforts and drivers of technological upgrading:evidence from China

This paper explores the role of indigenous and foreign innovation efforts in technological upgrading in developing countries, taking into account sectoral specificities in technical change. Using a Chinese firm-level panel dataset covering 2001–05, the paper decomposes productivity growth into technical change and efficiency improvement and examines the impact of indigenous and foreign innovation efforts on these changes. Indigenous firms are found to be the leading force on the technological frontier in the low- and medium-technology industries, while foreign-invested firms enjoy a clear lead in the high-technology sector. Collective indigenous R&D activities at the industry level are found to be the major driver of technology upgrading of indigenous firms that push out the technology frontier. While foreign investment appears to contribute to static industry capabilities, R&D activities of foreign-invested firms have exerted a significant negative effect on the technical change of local firms over the sample period.

Entry, reforms complementarity and performance:a tale of two Indian manufacturing sectors

In this paper, we use plant-level data from two Indian industries, namely, electrical machinery and textiles, to examine the empirical relationship between structural reforms like abandonment of entry restrictions to the product market, competition and firm-level productivity and efficiency. These industries have faced different sets of policies since Independence but both were restricted in the adoption of technology and in the development of optimal scales of production. They also belonged to the first set of industries that benefited from the liberalization process started in the 1980s. Our results suggest that both the industries have improved their efficiency and scales of operation by the turn of the century. However, the process of adjustment seems to have been worked out more fully for electrical machinery. We also find evidence of spatial fragmentation of the market as late as 2000–2001. Gains in labour productivity were much more evident in states that either have a strong history of industrial activity or those that have experienced significant improvements in business environment since 1991.

How transition paths differ:enterprise performance in Russia and China

We use enterprise survey data to analyse and contrast the determinants of enterprise performance in China and Russia. We find that in China, enterprise growth and efficiency is associated with rapid increases in factor inputs, and with ownership to a lesser extent, but not greatly correlated with industry-specific or institutional factors. However, in Russia, enterprise growth is not associated with improvements in factor quantity (except for labor) or quality. The main determinants of company performance are instead demand and institutional factors at a regional level. The findings are robust across a variety of specifications.

QoS guarantee with adaptive transmit power and message rate control for DSRC vehicle network based road safety applications

Quality of services (QoS) support is critical for dedicated short range communications (DSRC) vehicle networks based collaborative road safety applications. In this paper we propose an adaptive power and message rate control method for DSRC vehicle networks at road intersections. The design objective is to provide high availability and low latency channels for high priority emergency safety applications while maximizing channel utilization for low priority routine safety applications. In this method an offline simulation based approach is used to find out the best possible configurations of transmit power and message rate for given numbers of vehicles in the network. The identified best configurations are then used online by roadside access points (AP) according to estimated number of vehicles. Simulation results show that this adaptive method significantly outperforms a fixed control method. © 2011 Springer-Verlag.

A stepwise fuzzy linear programming model with possibility and necessity relations

Linear programming (LP) is the most widely used optimization technique for solving real-life problems because of its simplicity and efficiency. Although conventional LP models require precise data, managers and decision makers dealing with real-world optimization problems often do not have access to exact values. Fuzzy sets have been used in the fuzzy LP (FLP) problems to deal with the imprecise data in the decision variables, objective function and/or the constraints. The imprecisions in the FLP problems could be related to (1) the decision variables; (2) the coefficients of the decision variables in the objective function; (3) the coefficients of the decision variables in the constraints; (4) the right-hand-side of the constraints; or (5) all of these parameters. In this paper, we develop a new stepwise FLP model where fuzzy numbers are considered for the coefficients of the decision variables in the objective function, the coefficients of the decision variables in the constraints and the right-hand-side of the constraints. In the first step, we use the possibility and necessity relations for fuzzy constraints without considering the fuzzy objective function. In the subsequent step, we extend our method to the fuzzy objective function. We use two numerical examples from the FLP literature for comparison purposes and to demonstrate the applicability of the proposed method and the computational efficiency of the procedures and algorithms. © 2013-IOS Press and the authors. All rights reserved.

Economic efficiency of smallholder maize producers in Western Kenya:a DEA meta-frontier analysis

Maize is the main staple food for most Kenyan households, and it predominates where smallholder, as well as large-scale, farming takes place. In the sugarcane growing areas of Western Kenya, there is pressure on farmers on whether to grow food crops, or grow sugarcane, which is the main cash crop. Further, with small and diminishing land sizes, the question of productivity and efficiency, both for cash and food crops is of great importance. This paper, therefore, uses a two-step estimation technique (DEA meta-frontier and Tobit Regression) to highlight the inefficiencies in maize cultivation, and their causes in Western Kenya.