870 resultados para Federal aid to energy development


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Like many other Caribbean countries, Grenada, Saint Lucia and Saint Vincent and the Grenadines are almost entirely dependent on imported petroleum as their primary source of energy. In this regard, many countries in the subregion have taken a strategic approach to long-term planning in the energy sector towards creating higher levels of efficiency on both the demand and supply sides as well as promoting diversification in the energy mix. Within this context, this study was conducted to present mechanisms to improve energy efficiency (EE) in the transport sector in Grenada, Saint Lucia and Saint Vincent and the Grenadines. For each country, the report presents a brief description of current trends in energy consumption generally as well as energy issues in the transport sector and programmes, initiatives and regulatory mechanisms currently in place that are contributing to energy efficiency in the sector.

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With their accession to the European Union, twelve new countries - Romania among them - (re)entered the international community of international donors. In the history of development aid this can be seen as a unique event: it is for the first time in history that such a large number of countries become international donors, with such short notice and in such a particular context that sees some scholars announcing the ‘death’ of development. But in spite of what might be claimed regarding the ‘end’ of the development era, development discourse seems to be rather vigorous and in good health: it is able to extert an undeniable force of attraction over the twelve countries that, in a matter of years, have already convinced themselves of its validity and adhered to its main tenets. This thesis collects evidence for improving our understanding of this process that sees the co-optation of twelve new countries to the dominant theory and practice of development cooperation. The evidence collected seems to show that one of the tools employed by the promoters of this co-optation process is that of constructing the ‘new’ Member States as ‘new’, inexpert donors that need to learn from the ‘old’ ones. By taking a case-study approach, this thesis gathers data that suggests that conceiving of the ‘twelve’ as ‘new’ donors is both historically inaccurate and value-ladden. On one hand, Romania’s case-study illustrates how in the (socialist) past at least one in the group of the twelve was particularly conversant in the discourse of international development. On the other hand, the process of co-optation, while being presented as a knowledgeproducing process, can also be seen as an ignorance-producing procedure: Romania, along with its fellow new Member States, takes the opportunity of ‘building its capacity’ and ‘raising its awareness’ of development cooperation along the line drawn by the European Union, but at the same time it seems to un-learn and ‘lower’ its awareness of development experience in the (socialist) past. This is one possible reading of this thesis. At a different level, this thesis can also be seen as an attempt to account of almost five decades of international development discourse in one specific country – Romania – in three different socio-political contexts: the socialist years (up to the year 1989), the ‘transition years’ (from 1989 to the pre-accession years) and the membership to the European Union. In this second reading, the thesis seeks to illustrate how – contrary to widespread beliefs – before 1989 Romania’s international development discourse was particularly vivid: in the most varied national and international settings President Ceausescu unfolded an extensive discursive activity on issues pertaining to international development; generous media coverage of affairs concerning the developing countries and their fight for development was the rule rather than the exception; the political leadership wanted the Romanians not only to be familiarized with (or ‘aware of’ to use current terminology) matters of underdevelopment, but also to prove a sense of solidarity with these countries, as well as a sense of pride for the relations of ‘mutual help’ that were being built with them; finally, international development was object of academic attention and the Romanian scholars were able not only to reflect on major developments, but could also formulate critical positions towards the practices of development aid. Very little remains of all this during the transition years, while in the present those who are engaged in matters pertaining to international development do so with a view of building Romania as an EU-compliant donor.

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This Thesis aims at building and discussing mathematical models applications focused on Energy problems, both on the thermal and electrical side. The objective is to show how mathematical programming techniques developed within Operational Research can give useful answers in the Energy Sector, how they can provide tools to support decision making processes of Companies operating in the Energy production and distribution and how they can be successfully used to make simulations and sensitivity analyses to better understand the state of the art and convenience of a particular technology by comparing it with the available alternatives. The first part discusses the fundamental mathematical background followed by a comprehensive literature review about mathematical modelling in the Energy Sector. The second part presents mathematical models for the District Heating strategic network design and incremental network design. The objective is the selection of an optimal set of new users to be connected to an existing thermal network, maximizing revenues, minimizing infrastructure and operational costs and taking into account the main technical requirements of the real world application. Results on real and randomly generated benchmark networks are discussed with particular attention to instances characterized by big networks dimensions. The third part is devoted to the development of linear programming models for optimal battery operation in off-grid solar power schemes, with consideration of battery degradation. The key contribution of this work is the inclusion of battery degradation costs in the optimisation models. As available data on relating degradation costs to the nature of charge/discharge cycles are limited, we concentrate on investigating the sensitivity of operational patterns to the degradation cost structure. The objective is to investigate the combination of battery costs and performance at which such systems become economic. We also investigate how the system design should change when battery degradation is taken into account.

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This dissertation focuses on Project HOPE, an American medical aid agency, and its work in Tunisia. More specifically this is a study of the implementation strategies of those HOPE sponsored projects and programs designed to solve the problems of high morbidity and infant mortality rates due to environmentally related diarrheal and enteric diseases. Several environmental health programs and projects developed in cooperation with Tunisian counterparts are described and analyzed. These include (1) a paramedical manpower training program; (2) a national hospital sanitation and infection control program; (3) a community sewage disposal project; (4) a well reconstruction project; and (5) a solid-waste disposal project for a hospital.^ After independence, Tunisia, like many developing countries, encountered several difficulties which hindered progress toward solving basic environmental health problems and prompted a request for aid. This study discusses the need for all who work in development programs to recognize and assess those difficulties or constraints which affect the program planning process, including those latent cultural and political constraints which not only exist within the host country but within the aid agency as well. For example, failure to recognize cultural differences may adversely affect the attitudes of the host staff towards their work and towards the aid agency and its task. These factors, therefore, play a significant role in influencing program development decisions and must be taken into account in order to maximize the probability of successful outcomes.^ In 1969 Project HOPE was asked by the Tunisian government to assist the Ministry of Health in solving its health manpower problems. HOPE responded with several programs, one of which concerned the training of public health nurses, sanitary technicians, and aids at Tunisia's school of public health in Nabeul. The outcome of that program as well as the strategies used in its development are analyzed. Also, certain questions are addressed such as, what should the indicators of success be, and when is the time right to phase out?^ Another HOPE program analyzed involved hospital sanitation and infection control. Certain generic aspects of basic hospital sanitation procedures were documented and presented in the form of a process model which was later used as a "microplan" in setting up similar programs in other Tunisian hospitals. In this study the details of the "microplan" are discussed. The development of a nation-wide program without any further need of external assistance illustrated the success of HOPE's implementation strategies.^ Finally, although it is known that the high incidence of enteric disease in developing countries is due to poor environmental sanitation and poor hygiene practices, efforts by aid agencies to correct these conditions have often resulted in failure. Project HOPE's strategy was to maximize limited resources by using a systems approach to program development and by becoming actively involved in the design and implementation of environmental health projects utilizing "appropriate" technology. Three innovative projects and their implementation strategies (including technical specifications) are described.^ It is advocated that if aid agencies are to make any progress in helping developing countries basic sanitation problems, they must take an interdisciplinary approach to progrm development and play an active role in helping counterparts seek and identify appropriate technologies which are socially and economically acceptable. ^

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Esta Tesis surgió ante la intensidad y verosimilitud de varias señales o “warnings” asociadas a políticas dirigidas a reducir el peso del petróleo en el sector energético, tanto por razones económicas, como geopolíticas, como ambientales. Como tal Tesis se consolidó al ir incorporando elementos novedosos pero esenciales en el mundo petrolífero, particularmente las “tecnologías habilitantes”, tanto de incidencia directa, como el “fracking” como indirecta, del cual es un gran ejemplo el Vehículo Eléctrico (puro). La Tesis se definió y estructuró para elaborar una serie de indagaciones y disquisiciones, que comportaran un conjunto de conclusiones que fueran útiles para las corporaciones energéticas. También para la comprensión de la propia evolución del sector y de sus prestaciones técnicas y económicas, de cara a dar el servicio que los usuarios finales piden. Dentro de las tareas analíticas y reflexivas de la Tesis, se acuñaron ciertos términos conceptuales para explicar más certeramente la realidad del sector, y tal es el caso del “Investment burden”, que pondera la inversión específica (€/W) requerida por una instalación, con la duración del período de construcción y los riesgos tanto tangibles como regulatorios. Junto a ello la Tesis propone una herramienta de estudio y prognosis, denominada “Market integrated energy efficiency”, especialmente aplicable a dicotomías. Tal es el caso del coche térmico, versus coche eléctrico. El objetivo es optimizar una determinada actividad energética, o la productividad total del sector. Esta Tesis propone varias innovaciones, que se pueden agrupar en dos niveles: el primero dentro del campo de la Energía, y el segundo dentro del campo de las corporaciones, y de manera especial de las corporaciones del sector hidrocarburos. A nivel corporativo, la adaptación a la nueva realidad será función directa de la capacidad de cada corporación para desarrollar y/o comprar las tecnologías que permitan mantener o aumentar cuota de mercado. Las conclusiones de la Tesis apuntan a tres opciones principalmente para un replanteamiento corporativo: - Diversificación energética - Desplazamiento geográfico - Beneficiándose de posibles nuevos nichos tecnológicos, como son: • En upstream: Recuperación estimulada de petróleo mediante uso de energías renovables • En downstream: Aditivos orientados a reducir emisiones • En gestión del cambio: Almacenamiento energético con fines operativos Algunas políticas energéticas siguen la tendencia de crecimiento cero de algunos países de la OCDE. No obstante, la realidad mundial es muy diferente a la de esos países. Por ejemplo, según diversas estimaciones (basadas en bancos de datos solventes, referenciados en la Tesis) el número de vehículos aumentará desde aproximadamente mil millones en la actualidad hasta el doble en 2035; mientras que la producción de petróleo sólo aumentará de 95 a 145 millones de barriles al día. Un aumento del 50% frente a un aumento del 100%. Esto generará un curioso desajuste, que se empezará a sentir en unos pocos años. Las empresas y corporaciones del sector hidrocarburos pueden perder el monopolio que atesoran actualmente en el sector transporte frente a todas las demás fuentes energéticas. Esa pérdida puede quedar compensada por una mejor gestión de todas sus capacidades y una participación más integrada en el mundo de la energía, buscando sinergias donde hasta ahora no había sino distanciamiento. Los productos petrolíferos pueden alimentar cualquier tipo de maquina térmica, como las turbinas Brayton, o alimentar reformadores para la producción masiva de H2 para su posterior uso en pilas combustible. El almacenamiento de productos derivados del petróleo no es ningún reto ni plantea problema alguno; y sin embargo este almacenamiento es la llave para resolver muchos problemas. Es posible que el comercio de petróleo se haga menos volátil debido a los efectos asociados al almacenamiento; pero lo que es seguro es que la eficiencia energética de los usos de ese petróleo será más elevada. La Tesis partía de ciertas amenazas sobre el futuro del petróleo, pero tras el análisis realizado se puede vislumbrar un futuro prometedor en la fusión de políticas medioambientales coercitivas y las nuevas tecnologías emergentes del actual portafolio de oportunidades técnicas. ABSTRACT This Thesis rises from the force and the credibility of a number of warning signs linked to policies aimed at reducing the role of petroleum in the energy industry due to economical, geopolitical and environmental drives. As such Thesis, it grew up based on aggregating new but essentials elements into the petroleum sector. This is the case of “enabling technologies” that have a direct impact on the petroleum industry (such as fracking), or an indirect but deep impact (such as the full electrical vehicle). The Thesis was defined and structured in such a way that could convey useful conclusions for energy corporations through a series of inquiries and treatises. In addition to this, the Thesis also aims at understating la evolution of the energy industry and its capabilities both technical and economical, towards delivering the services required by end users. Within the analytical task performed in the Thesis, new terms were coined. They depict concepts that aid at explaining the facts of the energy industry. This is the case for “Investment burden”, it weights the specific capital investment (€/W) required to build a facility with the time that takes to build it, as well as other tangible risks as those posed by regulation. In addition to this, the Thesis puts forward an application designed for reviewing and predicting: the so called “Market integrated energy efficiency”, especially well-suited for dichotomies, very appealing for the case of the thermal car versus the electric car. The aim is to optimize energy related activity; or even the overall productivity of the system. The innovations proposed in this Thesis can be classified in two tiers. Tier one, within the energy sector; and tier two, related to Energy Corporation in general, but with oil and gas corporations at heart. From a corporate level, the adaptation to new energy era will be linked with the corporation capability to develop or acquire those technologies that will yield to retaining or enhancing market share. The Thesis highlights three options for corporate evolution: - diversification within Energy - geographic displacement - profiting new technologies relevant to important niches of work for the future, as: o Upstream: enhanced oil recovery using renewable energy sources (for upstream companies in the petroleum business) o Downstream: additives for reducing combustion emissions o Management of Change: operational energy storage Some energy policies tend to follow the zero-growth of some OECD countries, but the real thing could be very different. For instance, and according to estimates the number of vehicles in use will grow from 1 billion to more than double this figure 2035; but oil production will only grow from 95 million barrel/day to 145 (a 50% rise of versus an intensification of over a 100%). Hydrocarbon Corporation can lose the monopoly they currently hold over the supply of energy to transportation. This lose can be mitigated through an enhanced used of their capabilities and a higher degree of integration in the world of energy, exploring for synergies in those places were gaps were present. Petroleum products can be used to feed any type of thermal machine, as Brayton turbines, or steam reformers to produce H2 to be exploited in fuel cells. Storing petroleum products does not present any problem, but very many problems can be solved with them. Petroleum trading will likely be less volatile because of the smoothing effects of distributed storage, and indeed the efficiency in petroleum consumption will be much higher. The Thesis kicked off with a menace on the future of petroleum. However, at the end of the analysis, a bright future can be foreseen in the merging between highly demanding environmental policies and the relevant technologies of the currently emerging technical portfolio.

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The objective of this paper is to provide an analysis of the potential and obstacles to the development of geothermal energy resources in Colorado. Geothermal energy is the only renewable resource that can provide base-load electricity. While Colorado has significant geothermal energy potential, there are no such power plants. Layers of federal and state laws and regulations represent one barrier to further geothermal development. Transmission constraints represent another major barrier. High exploration and construction costs along with high-risk profiles for geothermal projects form another major barrier. Perceived barriers such as misunderstanding the impacts, risks, and benefits of geothermal energy hinder further development. Recommendations are provided to help overcome these obstacles.

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For many years the European Union has been improving the efficient use of energy resources and yet the demand for energy in the EU continues to increase. When Europe belonged to one of the world’s key energy markets with relatively easy access to energy resources, growing energy needs were not seen as a source of concern. Today, however, as the competition for energy resources is intensifying and the global position of the EU energy market is being challenged by growing economies in the developing countries, above all China and India, the EU needs to adopt bold policies to guarantee the sustainable supply of energy. This report argues the EU needs to develop a fully-fledged external energy policy; i.e. a common, coherent, strategic approach that build bridges between the interests and needs of the EU integrated energy market on the one hand and supplier countries on the other. The EU’s external energy policy has two main objectives. The first one is to ensure a sustainable, stable and cost-effective energy supply. The second is to promote energy market integration and regulatory convergence with neighbouring countries (often but not always this supports the achievement of the first objective). However, in order to improve its effectiveness, the EU’s external energy policy needs to be seen in a broader economic and political context. Any progress in energy cooperation with third countries is contingent upon the EU’s general stance and offer to those countries.

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The Energy Conservation Act (20 ILCS 1115) was signed into law in September 1979. The law requires that the Department provide technical assistance in the development of thermal efficiency standards and lighting efficiency standards to units of local government, upon request by such unit. The law also states that the Department shall provide technical assistance in the development of a program for energy efficiency in procurement to units of local government, upon request by such unit. The Technical Assistance Programs provided under the law are supported by funds provided to the State pursuant to federal acts that provide funds for energy conservation efforts through the use of building codes.

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sect. 1. Old-age pensions, federal old-age benefits, aid to dependent children, maternal and child welfare, aid to crippled children, vocational rehabilitation, aid to the blind, public health, unemployment compensation.--sect. 2. Unemployment compensation, federal old-age benefits.

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The future power grid will effectively utilize renewable energy resources and distributed generation to respond to energy demand while incorporating information technology and communication infrastructure for their optimum operation. This dissertation contributes to the development of real-time techniques, for wide-area monitoring and secure real-time control and operation of hybrid power systems. ^ To handle the increased level of real-time data exchange, this dissertation develops a supervisory control and data acquisition (SCADA) system that is equipped with a state estimation scheme from the real-time data. This system is verified on a specially developed laboratory-based test bed facility, as a hardware and software platform, to emulate the actual scenarios of a real hybrid power system with the highest level of similarities and capabilities to practical utility systems. It includes phasor measurements at hundreds of measurement points on the system. These measurements were obtained from especially developed laboratory based Phasor Measurement Unit (PMU) that is utilized in addition to existing commercially based PMU’s. The developed PMU was used in conjunction with the interconnected system along with the commercial PMU’s. The tested studies included a new technique for detecting the partially islanded micro grids in addition to several real-time techniques for synchronization and parameter identifications of hybrid systems. ^ Moreover, due to numerous integration of renewable energy resources through DC microgrids, this dissertation performs several practical cases for improvement of interoperability of such systems. Moreover, increased number of small and dispersed generating stations and their need to connect fast and properly into the AC grids, urged this work to explore the challenges that arise in synchronization of generators to the grid and through introduction of a Dynamic Brake system to improve the process of connecting distributed generators to the power grid.^ Real time operation and control requires data communication security. A research effort in this dissertation was developed based on Trusted Sensing Base (TSB) process for data communication security. The innovative TSB approach improves the security aspect of the power grid as a cyber-physical system. It is based on available GPS synchronization technology and provides protection against confidentiality attacks in critical power system infrastructures. ^

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A guide for students and families looking to obtain state and federal financial aid. Information includes: FAFSA filing deadlines, the steps necessary to complete the FAFSA and Iowa Financial Aid Application, how to accept financial aid awards and the common myths that families have about financial aid. (Item: IC-HAFF)

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Worldwide, the current pattern of urban development is unsustainable and metropolitan planning and development strategies deliver poor environmental outcomes in relation to energy production. As a result, an increasing number of governments and private sector development companies are initiating projects that aim to deliver enhanced environmental outcomes rather than a ‘business as usual’ approach. This paper will summarise the findings from a study that explored the link between building orientation and energy efficiencies in sub-tropical and tropical climates. The study used a new thermal modelling software tool developed by CSIRO that responds more accurately to residential heating and cooling energy performance in those climate zones. This software tool responds to industry criticisms regarding cold climate modelling systems that do not make sufficient allowance for natural ventilation. The study examined a range of low, medium and high-density dwelling types and investigated the impact of orientation, insulation, ventilation and shading devices on energy efficiencies. This paper will examine the findings from the medium and high-density case study developments as these are relevant to residential developments in many South East Asian countries, such as Singapore, Hong Kong and Malaysia. Finally, the paper will explore the potential benefits that medium and high-density residential developments have in the development of ‘solar cities’ and ‘solar suburbs’.

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The epidemic of obesity is impacting an increasing proportion of children, adolescents and adults with a common feature being low levels of physical activity (PA). Despite having more knowledge than ever before about the benefits of PA for health and the growth and development of youngsters, we are only paying lip-service to the development of motor skills in children. Fun, enjoyment and basic skills are the essential underpinnings of meaningful participation in PA. A concurrent problem is the reported increase in sitting time with the most common sedentary behaviors being TV viewing and other screen-based games. Limitations of time have contributed to a displacement of active behaviors with inactive pursuits, which has contributed to reductions in activity energy expenditure. To redress the energy imbalance in overweight and obese children, we urgently need out-of-the-box multisectoral solutions. There is little to be gained from a shame and blame mentality where individuals, their parents, teachers and other groups are singled out as causes of the problem. Such an approach does little more than shift attention from the main game of prevention and management of the condition, which requires a concerted, whole-of-government approach (in each country). The failure to support and encourage all young people to participate in regular PA will increase the chance that our children will live shorter and less healthy lives than their parents. In short, we need novel environmental approaches to foster a systematic increase in PA. This paper provides examples of opportunities and challenges for PA strategies to prevent obesity with a particular emphasis on the school and home settings.

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Introduction The purpose of this study was to develop, implement and evaluate the impact of an educational intervention, comprising an innovative model of clinical decisionmaking and educational delivery strategy for facilitating nursing students‘ learning and development of competence in paediatric physical assessment practices. Background of the study Nursing students have an undergraduate education that aims to produce graduates of a generalist nature who demonstrate entry level competence for providing nursing care in a variety of health settings. Consistent with population morbidity and health care roles, paediatric nursing concepts typically form a comparatively small part of undergraduate curricula and students‘ exposure to paediatric physical assessment concepts and principles are brief. However, the nursing shortage has changed traditional nursing employment patterns and new graduates form the majority of the recruitment pool for paediatric nursing speciality staff. Paediatric nursing is a popular career choice for graduates and anecdotal evidence suggests that nursing students who select a clinical placement in their final year intend to seek employment in paediatrics upon graduation. Although concepts of paediatric nursing are included within undergraduate curriculum, students‘ ability to develop the required habits of mind to practice in what is still regarded as a speciality area of practice is somewhat limited. One of the areas of practice where this particularly impacts is in paediatric nursing physical assessment. Physical assessment is a fundamental component of nursing practice and competence in this area of practice is central to nursing students‘ development of clinical capability for practice as a registered nurse. Timely recognition of physiologic deterioration of patients is a key outcome of nurses‘ competent use of physical assessment strategies, regardless of the practice context. In paediatric nursing contexts children‘s physical assessment practices must specifically accommodate the child‘s different physiological composition, function and pattern of clinical deterioration (Hockenberry & Barrera, 2007). Thus, to effectively manage physical assessment of patients within the paediatric practice setting nursing students need to integrate paediatric nursing theory into their practice. This requires significant information processing and it is in this process where students are frequently challenged. The provision of rules or models can guide practice and assist novice-level nurses to develop their capabilities (Benner, 1984; Benner, Hooper-Kyriakidis & Stannard, 1999). Nursing practice models are cognitive tools that represent simplified patterns of expert analysis employing concepts that suit the limited reasoning of the inexperienced, and can represent the =rules‘ referred to by Benner (1984). Without a practice model of physical assessment students are likely to be uncertain about how to proceed with data collection, the interpretation of paediatric clinical findings and the appraisal of findings. These circumstances can result in ad hoc and unreliable nursing physical assessment that forms a poor basis for nursing decisions. The educational intervention developed as part of this study sought to resolve this problem and support nursing students‘ development of competence in paediatric physical assessment. Methods This study utilised the Context Input Process Product (CIPP) Model by Stufflebeam (2004) as the theoretical framework that underpinned the research design and evaluation methodology. Each of the four elements in the CIPP model were utilised to guide discrete stages of this study. The Context element informed design of the clinical decision-making process, the Paediatric Nursing Physical Assessment model. The Input element was utilised in appraising relevant literature, identifying an appropriate instructional methodology to facilitate learning and educational intervention delivery to undergraduate nursing students, and development of program content (the CD-ROM kit). Study One employed the Process element and used expert panel approaches to review and refine instructional methods, identifying potential barriers to obtaining an effective evaluation outcome. The Product element guided design and implementation of Study Two, which was conducted in two phases. Phase One employed a quasiexperimental between-subjects methodology to evaluate the impact of the educational intervention on nursing students‘ clinical performance and selfappraisal of practices in paediatric physical assessment. Phase Two employed a thematic analysis and explored the experiences and perspectives of a sample subgroup of nursing students who used the PNPA CD-ROM kit as preparation for paediatric clinical placement. Results Results from the Process review in Study One indicated that the prototype CDROM kit containing the PNPA model met the predetermined benchmarks for face validity and the impact evaluation instrumentation had adequate content validity in comparison with predetermined benchmarks. In the first phase of Study Two the educational intervention did not result in statistically significant differences in measures of student performance or self-appraisal of practice. However, in Phase Two qualitative commentary from students, and from the expert panel who reviewed the prototype CD-ROM kit (Study One, Phase One), strongly endorsed the quality of the intervention and its potential for supporting learning. This raises questions regarding transfer of learning and it is likely that, within this study, several factors have influenced students‘ transfer of learning from the educational intervention to the clinical practice environment, where outcomes were measured. Conclusion In summary, the educational intervention employed in this study provides insights into the potential e-learning approaches offer for delivering authentic learning experiences to undergraduate nursing students. Findings in this study raise important questions regarding possible pedagogical influences on learning outcomes, issues within the transfer of theory to practice and factors that may have influenced findings within the context of this study. This study makes a unique contribution to nursing education, specifically with respect to progressing an understanding of the challenges faced in employing instructive methods to impact upon nursing students‘ development of competence. The important contribution transfer of learning processes make to students‘ transition into the professional practice context and to their development of competence within the context of speciality practice is also highlighted. This study contributes to a greater awareness of the complexity of translating theoretical learning at undergraduate level into clinical practice, particularly within speciality contexts.