825 resultados para critical issues


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Objective Despite ‘hospital resilience’ gaining prominence in recent years, it remains poorly defined. This article aims to define hospital resilience, build a preliminary conceptual framework and highlight possible approaches to measurement. Methods Searches were conducted of the commonly used health databases to identify relevant literature and reports. Search terms included ‘resilience and framework or model’ or ‘evaluation or assess or measure and hospital and disaster or emergency or mass casualty and resilience or capacity or preparedness or response or safety’. Articles were retrieved that focussed on disaster resilience frameworks and the evaluation of various hospital capacities. Result A total of 1480 potentially eligible publications were retrieved initially but the final analysis was conducted on 47 articles, which appeared to contribute to the study objectives. Four disaster resilience frameworks and 11 evaluation instruments of hospital disaster capacity were included. Discussion and conclusion Hospital resilience is a comprehensive concept derived from existing disaster resilience frameworks. It has four key domains: hospital safety; disaster preparedness and resources; continuity of essential medical services; recovery and adaptation. These domains were categorised according to four criteria, namely, robustness, redundancy, resourcefulness and rapidity. A conceptual understanding of hospital resilience is essential for an intellectual basis for an integrated approach to system development. This article (1) defines hospital resilience; (2) constructs conceptual framework (including key domains); (3) proposes comprehensive measures for possible inclusion in an evaluation instrument, and; (4) develops a matrix of critical issues to enhance hospital resilience to cope with future disasters.

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This document calls on governments, civil society and in particular educators to prioritize processes that develop and strengthen education for sustainable development (ESD). The world has changed since the UN World Summit on Sustainable Development in 2002. While there have been significant initiatives and progress has been made, the scale of effort is still overshadowed by the scope of the problem. For instance, human-induced climate change is creating a long-lasting ecological crisis with severe economic and social consequences. Recently the global economic crisis has drawn attention to the problem of borrowing from resources that do not exist. Poverty, conflict and social injustice remain critical issues on the global agenda. A renewed sense of commitment to the UN Decade of Education for Sustainable Development 2005-2014 is required. Formal, informal and non-formal education and learning processes for sustainability must be strengthened and prioritized. This document supports and builds on the concepts and values that are put forward within UNESCO’s International Implementation Scheme for Education for Sustainable Development and in the Earth Charter. The purpose of ESD is to reorient education in order to contribute to a sustainable future for the common good of present and future generations. ESD recognizes the interdependence of environmental, social and economic perspectives and the dependence of humanity on a healthy biosphere. Participation and involvement are necessary components of ESD, with an emphasis on empowerment and agency for active citizenship, human rights and societal change. Re-orientation is necessary at all levels and in all phases of education, and encompasses community learning, thus making ESD a wider process challenging the form and purpose of education itself.

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This chapter reviews almost a decade of research and writing undertaken by the authors into ethical dilemmas faced by leaders in a number of different operational contexts, including schools, universities and the public sector. The importance of this body of work is emphasised by one of our research participants who argued that ethical dilemmas were the 'bread and butter' of what leaders do. The chapter comprises four main sections. The first section overviews key theoretical aspects as background to the chapter, including relevant discussions about ethics and ethical decision-making. The second section synthesises the research findings from our work in the three contexts noted above, drawing out a set of learnings that contribute to better understandings of the nature, complexities and challenges of ethical dilemmas. This section is followed by a discussion of an explanatory conceptual model of ethical dilemmas that was developed initially from the literature and confirmed by our research. The model reminds us of some of the critical issues at play in ethical dilemmas, and some of the consequences and implications for organisational culture building they can generate. By way of a short scenario, the final section provides a theory-to-practice illustration of an ethical dilemma in action. A set of recommendations, drawn from the ideas of school leaders who have worked with this and similar dilemmas, is offered as a way forward to better understanding and resolution of such dilemmas so prevalent in our schools today.

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Three case studies are presented to show low-temperature plasma-specific effects in the solution of (i) effective control of nucleation and growth; (ii) environmental friendliness; and (iii) energy efficiency critical issues in semiconducting nanowire growth. The first case (related to (i) and (iii)) shows that in catalytic growth of Si nanowires, plasma-specific effects lead to a substantial increase in growth rates, decrease of the minimum nanowire thickness, and much faster nanowire nucleation at the same growth temperatures. For nucleation and growth of nanowires of the same thickness, much lower temperatures are required. In the second example (related to (ii)), we produce Si nanowire networks with controllable nanowire thickness, length, and area density without any catalyst or external supply of Si building material. This case is an environmentally-friendly alternative to the commonly used Si microfabrication based on a highly-toxic silane precursor gas. The third example is related to (iii) and demonstrates that ZnO nanowires can be synthesized in plasma-enhanced CVD at significantly lower process temperatures than in similar neutral gas-based processes and without compromising structural quality and performance of the nanowires. Our results are relevant to the development of next-generation nanoelectronic, optoelectronic, energy conversion and sensing devices based on semiconducting nanowires.

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In 1972, the United Nations (UN) Conference on the Human Environment expressed a growing realization that economic and social progress needed to be balanced with a concern for the environment and the stewardship of natural resources. The hard-to-grasp concept of "sustainable development" was first defined as "development that meets the needs of the present without compromising the ability of future generations to meet their needs" (World Commission on Environment and Development [WESDJ, 1987, p. 43). This definition contains two concepts: first, "human needs," with priority given to the world's poor, and, second, the environment's limits for meeting the state of technological and social organization (WESD, 1987, p. 43). At the 2002 World Summit on Sustainable Development (UN, 2002a), the focus on environmental protection broadened to encompass social justice and the fight against poverty as key principles of development that is sustainable. Three interdependent and mutually reinforcing "pillars" were recognized: economic development, social development, and environmental protection. These pillars must be established at local, national, and global levels. The complexity and interrelationship of critical issues such as poverty, wasteful consumption, urban decay, population growth, gender inequality, health, conflict, and the violation of human rights are addressed in all three pillars (Pigozzi, 2003, p. 3). Following the concept of sustainable development, we argue that the challenge for developing countries in contemporary society is to meet the very real need for economic development and opportunities for income generation, while avoiding the unintended and unwanted consequences of economic development and globalization. These consequences include social exclusion, loss of cultural heritage, and environmental and ecological problems.

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The mining industry is highly suitable for the application of robotics and automation technology, since the work is arduous, dangerous, and often repetitive. This paper presents a broad overview of the issues involved in the development of a physically large and complex field robotic system—a 3500-tonne mining machine (dragline). Draglines are “walking cranes” used in open-pit coal mining to remove the material covering a coal seam. The critical issues of robust load position sensing, modeling of the dynamics of the electrical drive system and the swinging load, control strategies, the operator interface, and automation system architecture are addressed. An important aspect of this system is that it must work cooperatively with a human operator, seamlessly passing control back and forth in order to achieve the main aim—increased productivity.

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Significance Reactive oxygen species (ROS) such as superoxide, hydrogen peroxide, and peroxynitrite are generated ubiquitously by all mammalian cells and have been understood for many decades as inflicting cell damage and as causing cancer by oxidation and nitration of macromolecules, including DNA, RNA, proteins, and lipids. Recent Advances A current concept suggests that ROS can also promote cell signaling pathways triggered by growth factors and transcription factors that ultimately regulate cell proliferation, differentiation, and apoptosis, all of which are important hallmarks of tumor cell proliferation and angiogenesis. Moreover, an emerging concept indicates that ROS regulate the functions of immune cells that infiltrate the tumor environment and stimulate angiogenesis, such as macrophages and specific regulatory T cells. Critical Issues In this article, we highlight that the NADPH oxidase family of ROS-generating enzymes are the key sources of ROS and, thus, play an important role in redox signaling within tumor, endothelial, and immune cells thereby promoting tumor angiogenesis. Future Directions Knowledge of these intricate ROS signaling pathways and identification of the culprit NADPH oxidases is likely to reveal novel therapeutic opportunities to prevent angiogenesis that occurs during cancer and which is responsible for the revascularization after current antiangiogenic treatment.

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This book is an overview of key debates, research findings and theories in the area of sex and sexuality. Controversial issues are discussed in an informative and fair, balanced manner. With its sociological orientation, Perspectives in Human Sexuality employs a range of empirical and theoretical resources, including those which utilise scientific, medical, historical and ethical knowledge in order to elucidate the critical issues affecting contemporary life. This is the first textbook written especially for undergraduate students to offer a detailed and comprehensive introduction to sex and sexuality from an Australian and New Zealand perspective. This work examines issues such as sex and age, sex work and gay, lesbian and queer sex. Leading Australian and New Zealand authors in the field of sex and sexuality have contributed to the book. The book deals with sexuality from an Australasian perspective, addressing the specific concerns and interests of an Australasian audience, providing it with a unique standing in the current market.

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This chapter charts the political transitions in the anti-trafficking agenda and rhetoric of the U.S. Government across three Presidential administrations through a detailed examination of the annual Trafficking in Persons reports released by the Office to Monitor and Combat Trafficking in Persons between 2001 and 2012. We argue that the transitions in language and focus reflect key tensions that have dominated trafficking discourse throughout the Clinton, Bush and Obama Presidencies. These fissures include debate over law enforcement versus rights-based frameworks, competing approaches on victim protection and identification, and ongoing disputes about the relationship between prostitution and human trafficking.

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Integration of biometrics is considered as an attractive solution for the issues associated with password based human authentication as well as for secure storage and release of cryptographic keys which is one of the critical issues associated with modern cryptography. However, the widespread popularity of bio-cryptographic solutions are somewhat restricted by the fuzziness associated with biometric measurements. Therefore, error control mechanisms must be adopted to make sure that fuzziness of biometric inputs can be sufficiently countered. In this paper, we have outlined such existing techniques used in bio-cryptography while explaining how they are deployed in different types of solutions. Finally, we have elaborated on the important facts to be considered when choosing appropriate error correction mechanisms for a particular biometric based solution.

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Purpose Health service quality is an important determinant for health service satisfaction and behavioral intentions. The purpose of this paper is to investigate requirements of e‐health services and to develop a measurement model to analyze the construct of “perceived e‐health service quality.” Design/methodology/approach The paper adapts the C‐OAR‐SE procedure for scale development by Rossiter. The focal aspect is the “physician‐patient relationship” which forms the core dyad in the healthcare service provision. Several in‐depth interviews were conducted in Switzerland; first with six patients (as raters), followed by two experts of the healthcare system (as judges). Based on the results and an extensive literature research, the classification of object and attributes is developed for this model. Findings The construct e‐health service quality can be described as an abstract formative object and is operationalized with 13 items: accessibility, competence, information, usability/user friendliness, security, system integration, trust, individualization, empathy, ethical conduct, degree of performance, reliability, and ability to respond. Research limitations/implications Limitations include the number of interviews with patients and experts as well as critical issues associated with C‐OAR‐SE. More empirical research is needed to confirm the quality indicators of e‐health services. Practical implications Health care providers can utilize the results for the evaluation of their service quality. Practitioners can use the hierarchical structure to measure service quality at different levels. The model provides a diagnostic tool to identify poor and/or excellent performance with regard to the e‐service delivery. Originality/value The paper contributes to knowledge with regard to the measurement of e‐health quality and improves the understanding of how customers evaluate the quality of e‐health services.

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Mentoring has been identified as an important career development activity for women managers. Over the last four decades, organisations world-wide have implemented formal mentoring programs for women and for members of minority groups in recognition of the personal and professional benefits mentoring provides, not only for persons who are mentored but also, for those who undertake the mentoring. This chapter reviews the literature on mentoring and the contribution it can make to the career development of women managers. It reviews several inter-related bodies of literature: women’s representation in management positions worldwide; theories and frameworks of mentoring; empirical research exploring the impact of mentoring relationships on women managers’ career development; current illustrations of formal programs offered to women managers in the public and private sectors; and some critical issues that continue to impact women managers in relation to mentoring relationships. The chapter concludes by making an argument for further research on gender and mentoring.

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Norfolk Island is an Australian external territory in Oceania. The significant road safety reforms in Australia from the 1970s onward bypassed the island, and most road safety ‘silver bullets’ adopted in other Australian jurisdictions were not introduced. While legislative amendments in 2010 introduced mandatory seat belt wearing for vehicle occupants on Norfolk Island, other critical issues face the community including drink driving by residents and visitors, occupant protection for vehicle passengers, and the provision of a more protective road environment. The release of the first Norfolk Island road safety strategy 2014-2016 proposed, inter alia: • a lower BAC of 0.05 and the introduction of compulsory driver alcohol and drug testing by police; • targeted enforcement of occupant protection for vehicle passengers, particularly for passengers riding on vehicle tray backs; • education interventions to challenge values held by some members of the community that support unsafe road use; • ensuring that driver information, training and testing is adequate for all drivers; • identification and rectification of hazardous roadside infrastructure, particularly barrier protection at “high drop locations” within the road network; and • developing a specification for vehicle standards for vehicles imported into Norfolk Island. Norfolk Island is engaging in a process of integration with the Australian community, and wider issues relating to funding and resources have impacted on the implementation of the road safety strategy. The response to the strategy will be discussed, particularly in terms of current attempts to address drink driving and the provision of a safer road environment.