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.

Investigation of the neural correlates of recognition memory using magnetoencephalography

Neuroimaging literature has identified several regions involved in encoding and recognition processes. A review of the literature illustrated considerable variations in the precise location and mechanisms of these processes, and it was these variations that were investigated in the studies in this thesis. Magnetoencephalography (MEG) was used as the neuroimaging tool and a preliminary study identified Synthetic Aperture Magnetometry (SAM) and not a traditional dipole fitting technique, as an appropriate tool for identifying the multiple cortical regions involved in recognition memory. It has been suggested that there is hemispheric asymmetry in encoding and recognition processes. There are two main hypotheses: the first suggesting that there is task-specificity, the second that this specificity is determined by stimulus modality. A series of experiments was completed with two main aims: first to produce consistent and complementary recognition memory data with MEG, and second to determine whether there exists any hemispheric asymmetry in recognition memory. The results obtained from five experiments demonstrated activation of prefrontal and middle temporal structures, which were consistent with those reported in previous neuroimaging studies. It was suggested that this diverse activation may be explained by the involvement of a semantic network during recognition memory processes. In support of this, a subsequent study involving a semantic encoding task demonstrated that category-specific differences in cortical activation also existed in the recognition memory phase. Controlling for the involvement of such semantic processes produced predominantly bilateral activation. It was suggested that the apparent hemispheric asymmetry findings reported in the literature may be due to the 'coarse' temporal analysis available with earlier imaging techniques, which over-simplified the networks reported by being unable to recognise the early complex processes associated with semantic processing which these MEG studies were able to identify. The importance of frequency-specific activations, specifically theta synchronisation and alpha desynchronisation, in memory processes was also investigated.

Case based design of knitwear

In the developed world we are surrounded by man-made objects, but most people give little thought to the complex processes needed for their design. The design of hand knitting is complex because much of the domain knowledge is tacit. The objective of this thesis is to devise a methodology to help designers to work within design constraints, whilst facilitating creativity. A hybrid solution including computer aided design (CAD) and case based reasoning (CBR) is proposed. The CAD system creates designs using domain-specific rules and these designs are employed for initial seeding of the case base and the management of constraints. CBR reuses the designer's previous experience. The key aspects in the CBR system are measuring the similarity of cases and adapting past solutions to the current problem. Similarity is measured by asking the user to rank the importance of features; the ranks are then used to calculate weights for an algorithm which compares the specifications of designs. A novel adaptation operator called rule difference replay (RDR) is created. When the specifications to a new design is presented, the CAD program uses it to construct a design constituting an approximate solution. The most similar design from the case-base is then retrieved and RDR replays the changes previously made to the retrieved design on the new solution. A measure of solution similarity that can validate subjective success scores is created. Specification similarity can be used as a guide whether to invoke CBR, in a hybrid CAD-CBR system. If the newly resulted design is suffciently similar to a previous design, then CBR is invoked; otherwise CAD is used. The application of RDR to knitwear design has demonstrated the flexibility to overcome deficiencies in rules that try to automate creativity, and has the potential to be applied to other domains such as interior design.

The Fuzzy-Neuro Classifier for Decision Support

This paper aims at development of procedures and algorithms for application of artificial intelligence tools to acquire process and analyze various types of knowledge. The proposed environment integrates techniques of knowledge and decision process modeling such as neural networks and fuzzy logic-based reasoning methods. The problem of an identification of complex processes with the use of neuro-fuzzy systems is solved. The proposed classifier has been successfully applied for building one decision support systems for solving managerial problem.

Una sociedad legalista: Abogados, procuradores de causas y la creación de una cultura legal colonial en Lima y Potosí, 1540–1670

This study deals with the formation, reproduction, and the role in litigation of two branches of the legal profession, lawyers and procurators. They were the experts in charge of civil, criminal, and ecclesiastical litigation during the Old Regime. While the lawyers provided erudite legal advice, procurators oriented and drove the procedure as legal representatives of their clients. The European legal revolutions of the twelfth and thirteenth centuries forged a new legal culture in which the lawsuit was reputed to be the best way to settle disputes. Likewise, that legal culture conferred an important place to specialists as legal facilitators of the contending parties. When Castilians exported their legal system to the New World, they spread a complex and bureaucratic framework, contributing to the reproduction of a class of experts in urban spaces. Lima and Potosi, two urban centers created in the sixteenth century, quickly became significant ‘legal cities’. This dissertation explores how the legal markets of these cities operated, the careers of their specialists, their professional options, social images regarding them, and litigation costs. This study examines the careers of 267 facilitators and demonstrates that they constituted a class of distinctive legal professionals. Legal culture embodies the representation and use of law. The closeness of specialists with litigants, in particular of procurators familiarized the parties with litigation and its complex processes. These specialists forged dominant legal discourses and manipulated juridical order. Litigants were not passive agents of their specialists. Caciques and members of the Hispanicized communities appropriated the law in a visible way as the growing litigiousness illustrates. Colonial law (of a pluralistic basis) was an arena of assertion and discussion of rights by different social actors, encomenderos, leading citizens, widows, native chieftains, artisans, and commoners. This study concludes that this struggle and manipulation served to legitimate the role of those legal experts and gave birth to a complex legalistic society in the Andes under Spanish Habsburg rule.

Unidades geoambientais e áreas de preservação permanente como instrumentos de auxílio para o planejamento ambiental - o caso da via costeira de Natal-RN

Brazilian law provides a series of rules and policies which regulate space use and occupancy as well as guide environmental planning. Among those are the Permanent Preservation Areas (PPAs) which purpose is to ensure the preservation of elements that are essential to maintain the environmental function and landscape. Another important instrument identifier of spaces are geoenvironmental units, which are synthesis elements grouping areas of similar characteristics and can be used for the analysis of risk, fragility and potential use of spaces. The geoenvironmental units are defined by more complex processes (information integration), focusing not only on individual elements, but being determined from a systemic analysis. Is It possible to identify and delineate APPs from the identification and determination of geoenvironmental units? The aim of this study was to evaluate the potential of geoenvironmental units in the process of identification and delineation of APPs a see how much of the study area, the area by the Coast line in Natal/RN, is still good for occupation. It was used the physiognomic method, in which the limits of the units are plotted on a synthetic document (aerial photographs), valuing aspects of relief in a range of detail by the analysis of systemic categories (element, structure, function and interaction), observed. The methodology used allowed the identification and delineation of eleven geoenvironmental units and, from these, it was possible to identify and delineate four out of the five PPAs occurring in the study area. Only a small space of 1.2 ha of the study area is not considered APP by law. Thus, the occupation of the unoccupied area by the Coast line is not feasible from a legal standpoint. The geoenvironmental units as well as the identified and delineated APPs in the area by the Coast line are spaces which preservation is guaranteed by law in various scopes and are necessary to maintain the environmental functions of the area. The planning for the use and occupation of the area should involve the recovery of degraded areas and the creation of elements that make possible the use as well as attract the community, as provided in the initial planning, by ensuring the public utility and social interest in the Project.

Data to Decision in a Dynamic Ocean: Robust Species Distribution Models and Spatial Decision Frameworks

Human use of the oceans is increasingly in conflict with conservation of endangered species. Methods for managing the spatial and temporal placement of industries such as military, fishing, transportation and offshore energy, have historically been post hoc; i.e. the time and place of human activity is often already determined before assessment of environmental impacts. In this dissertation, I build robust species distribution models in two case study areas, US Atlantic (Best et al. 2012) and British Columbia (Best et al. 2015), predicting presence and abundance respectively, from scientific surveys. These models are then applied to novel decision frameworks for preemptively suggesting optimal placement of human activities in space and time to minimize ecological impacts: siting for offshore wind energy development, and routing ships to minimize risk of striking whales. Both decision frameworks relate the tradeoff between conservation risk and industry profit with synchronized variable and map views as online spatial decision support systems.

For siting offshore wind energy development (OWED) in the U.S. Atlantic (chapter 4), bird density maps are combined across species with weights of OWED sensitivity to collision and displacement and 10 km2 sites are compared against OWED profitability based on average annual wind speed at 90m hub heights and distance to transmission grid. A spatial decision support system enables toggling between the map and tradeoff plot views by site. A selected site can be inspected for sensitivity to a cetaceans throughout the year, so as to capture months of the year which minimize episodic impacts of pre-operational activities such as seismic airgun surveying and pile driving.

Routing ships to avoid whale strikes (chapter 5) can be similarly viewed as a tradeoff, but is a different problem spatially. A cumulative cost surface is generated from density surface maps and conservation status of cetaceans, before applying as a resistance surface to calculate least-cost routes between start and end locations, i.e. ports and entrance locations to study areas. Varying a multiplier to the cost surface enables calculation of multiple routes with different costs to conservation of cetaceans versus cost to transportation industry, measured as distance. Similar to the siting chapter, a spatial decisions support system enables toggling between the map and tradeoff plot view of proposed routes. The user can also input arbitrary start and end locations to calculate the tradeoff on the fly.

Essential to the input of these decision frameworks are distributions of the species. The two preceding chapters comprise species distribution models from two case study areas, U.S. Atlantic (chapter 2) and British Columbia (chapter 3), predicting presence and density, respectively. Although density is preferred to estimate potential biological removal, per Marine Mammal Protection Act requirements in the U.S., all the necessary parameters, especially distance and angle of observation, are less readily available across publicly mined datasets.

In the case of predicting cetacean presence in the U.S. Atlantic (chapter 2), I extracted datasets from the online OBIS-SEAMAP geo-database, and integrated scientific surveys conducted by ship (n=36) and aircraft (n=16), weighting a Generalized Additive Model by minutes surveyed within space-time grid cells to harmonize effort between the two survey platforms. For each of 16 cetacean species guilds, I predicted the probability of occurrence from static environmental variables (water depth, distance to shore, distance to continental shelf break) and time-varying conditions (monthly sea-surface temperature). To generate maps of presence vs. absence, Receiver Operator Characteristic (ROC) curves were used to define the optimal threshold that minimizes false positive and false negative error rates. I integrated model outputs, including tables (species in guilds, input surveys) and plots (fit of environmental variables, ROC curve), into an online spatial decision support system, allowing for easy navigation of models by taxon, region, season, and data provider.

For predicting cetacean density within the inner waters of British Columbia (chapter 3), I calculated density from systematic, line-transect marine mammal surveys over multiple years and seasons (summer 2004, 2005, 2008, and spring/autumn 2007) conducted by Raincoast Conservation Foundation. Abundance estimates were calculated using two different methods: Conventional Distance Sampling (CDS) and Density Surface Modelling (DSM). CDS generates a single density estimate for each stratum, whereas DSM explicitly models spatial variation and offers potential for greater precision by incorporating environmental predictors. Although DSM yields a more relevant product for the purposes of marine spatial planning, CDS has proven to be useful in cases where there are fewer observations available for seasonal and inter-annual comparison, particularly for the scarcely observed elephant seal. Abundance estimates are provided on a stratum-specific basis. Steller sea lions and harbour seals are further differentiated by ‘hauled out’ and ‘in water’. This analysis updates previous estimates (Williams & Thomas 2007) by including additional years of effort, providing greater spatial precision with the DSM method over CDS, novel reporting for spring and autumn seasons (rather than summer alone), and providing new abundance estimates for Steller sea lion and northern elephant seal. In addition to providing a baseline of marine mammal abundance and distribution, against which future changes can be compared, this information offers the opportunity to assess the risks posed to marine mammals by existing and emerging threats, such as fisheries bycatch, ship strikes, and increased oil spill and ocean noise issues associated with increases of container ship and oil tanker traffic in British Columbia’s continental shelf waters.

Starting with marine animal observations at specific coordinates and times, I combine these data with environmental data, often satellite derived, to produce seascape predictions generalizable in space and time. These habitat-based models enable prediction of encounter rates and, in the case of density surface models, abundance that can then be applied to management scenarios. Specific human activities, OWED and shipping, are then compared within a tradeoff decision support framework, enabling interchangeable map and tradeoff plot views. These products make complex processes transparent for gaming conservation, industry and stakeholders towards optimal marine spatial management, fundamental to the tenets of marine spatial planning, ecosystem-based management and dynamic ocean management.

Reputation performance: a portfolio selection approach

This paper introduces a normative view on corporate reputation strategic management. Reputation performance is conceptualised as the outcome of complex processes and social interactions and the lack of a holistic reputation performance management framework is identified. In an attempt to fill this gap, a portfolio-based approach is put forward. Drawing on the foundations of modern portfolio theory we create a portfolio-based reputation management algorithmic model where reputation components and priorities are weighted by decision makers and shape organisational change in an attempt to formulate a corporate reputation strategy. The rationale of this paper is based on the foundational consideration of organisations as choosing he optimal strategy by seeking to maximise their reputation performance while maintaining organisational stability and minimising organisational risk.

Understandings of transnational families in debates on Migration and development

International migration sets in motion a range of significant transnational processes that connect countries and people. How migration interacts with development and how policies might promote and enhance such interactions have, since the turn of the millennium, gained attention on the international agenda. The recognition that transnational practices connect migrants and their families across sending and receiving societies forms part of this debate. The ways in which policy debate employs and understands transnational family ties nevertheless remain underexplored. This article sets out to discern the understandings of the family in two (often intermingled) debates concerned with transnational interactions: The largely state and policydriven discourse on the potential benefits of migration on economic development, and the largely academic transnational family literature focusing on issues of care and the micro-politics of gender and generation. Emphasizing the relation between diverse migration-development dynamics and specific family positions, we ask whether an analytical point of departure in respective transnational motherhood, fatherhood or childhood is linked to emphasizing certain outcomes. We conclude by sketching important strands of inclusions and exclusions of family matters in policy discourse and suggest ways to better integrate a transnational family perspective in global migration-development policy.

‘Potentially inappropriate or specifically appropriate?’ Qualitative evaluation of general practitioners views on prescribing, polypharmacy and potentially inappropriate prescribing in older people

Background: Potentially inappropriate prescribing (PIP) is common in older people in primary care, as evidenced by a significant body of quantitative research. However, relatively few qualitative studies have investigated the phenomenon of PIP and its underlying processes from the perspective of general practitioners (GPs). The aim of this paper is to explore qualitatively, GP perspectives regarding prescribing and PIP in older primary care patients.

Method: Semi-structured qualitative interviews were conducted with GPs participating in a randomised controlled trial (RCT) of an intervention to decrease PIP in older patients (≥70 years) in Ireland. Interviews were conducted with GP participants (both intervention and control) from the OPTI-SCRIPT cluster RCT as part of the trial process evaluation between January and July 2013. Interviews were conducted by one interviewer and audio recorded. Interviews were transcribed verbatim and a thematic analysis was conducted.

Results: Seventeen semi-structured interviews were conducted (13 male; 4 female). Three main, inter-related themes emerged (complex prescribing environment, paternalistic doctor-patient relationship, and relevance of PIP concept). Patient complexity (e.g. polypharmacy, multimorbidity), as well as prescriber complexity (e.g. multiple prescribers, poor communication, restricted autonomy) were all identified as factors contributing to a complex prescribing environment where PIP could occur, as was a paternalistic-doctor patient relationship. The concept of PIP was perceived to be of variable usefulness to GPs and the criteria to measure it may be at odds with the complex processes of prescribing for this patient population.

Conclusions: Several inter-related factors contributing to the occurrence of PIP were identified, some of which may be amenable to intervention. Improvement strategies focused on improved management of polypharmacy and multimorbidity, and communication across primary and secondary care could result in substantial improvements in PIP.

Exploring critical literacy in Swedish education : Introductory notes

This article is an introductory note to The thematic section in this issue of Education Inquiry has its background in the need for research interpreting literacy from a critical perspective. Teaching literacy is not solely about technical reading skills but is also about understanding and the making of meaning. From that point of view, teaching must also consider the use of language, the context within which language is used, and issues of power. The thematic section includes five articles about critical literacy in Swedish education. The contributions were developed after a workshop conducted by Professor Hilary Janks, University of the Witwatersrand, Johannesburg. She introduces the framework of a critical literacy theory in the first article of the issue. Further, the contributions of Swedish scholars are united in their interest in applying a mode of critical literacy designed by Janks to different practices, sites and speech-events, for example policy documents, home reading, teaching and learning practices. The articles offer a wide perspective of critical literacy in education and further understanding of the complex processes in teaching.

Mechanochemical solvent-free synthesis of Sn-β Zeolite and Ag2O/TiO2 catalysts

Preparations of heterogeneous catalysts are usually complex processes that involve several procedures as precipitation, crystallization and hydrothermal treatments. This processes are really dependent by the operative conditions such as temperature, pH, concentration etc. Hence the resulting product is extremely affected by any possible variations in these parameters making this synthesis really fragile. With the aim to improve these operations has been decided to exploit a new possible strong environment-respectful process by mechanochemical treatment, which permits to carry out solvent free-solvent synthesis exploiting the Mixer Mill MM400 (Retsch) in order to have reproducible results. Two different systems have been studied in this kind of synthesis: a tin β -zeolite tested in a H-trasnfer reaction of cyclohexanone and a silver on titania catalyst used in the fluorination of 2,2 dimethyl glucaric acid. Each catalyst has been characterized by different techniques in order to understand the transformations involved in the mechanochemical treatment.

Análise da eficiência de indicadores da restauração ecológica em Mata Ripária no Cerrado, Planaltina - DF

Dissertação (mestrado)—Universidade de Brasília, Departamento de Engenharia Florestal, Programa de Pós-Graduação em Ciências Florestasi, 2015.

TAXONOMY, MORPHOLOGY, AND RNA-SEQ TRANSCRIPTOMICS OF THE CUBOZOAN ALATINA ALATA, AN EMERGING MODEL CNIDARIAN

Cnidarians are often considered simple animals, but the more than 13,000 estimated species (e.g., corals, hydroids and jellyfish) of the early diverging phylum exhibit a broad diversity of forms, functions and behaviors, some of which are demonstrably complex. In particular, cubozoans (box jellyfish) are cnidarians that have evolved a number of distinguishing features. Some cubozoan species possess complex mating behaviors or particularly potent stings, and all possess well-developed light sensation involving image-forming eyes. Like all cnidarians, cubozoans have specialized subcellular structures called nematocysts that are used in prey capture and defense. The objective of this study is to contribute to the development of the box jellyfish Alatina alata as a model cnidarian. This cubozoan species offers numerous advantages for investigating morphological and molecular traits underlying complex processes and coordinated behavior in free-living medusozoans (i.e., jellyfish), and more broadly throughout Metazoa. First, I provide an overview of Cnidaria with an emphasis on the current understanding of genes and proteins implicated in complex biological processes in a few select cnidarians. Second, to further develop resources for A. alata, I provide a formal redescription of this cubozoan and establish a neotype specimen voucher, which serve to stabilize the taxonomy of the species. Third, I generate the first functionally annotated transcriptome of adult and larval A. alata tissue and apply preliminary differential expression analyses to identify candidate genes implicated broadly in biological processes related to prey capture and defense, vision and the phototransduction pathway and sexual reproduction and gametogenesis. Fourth, to better understand venom diversity and mechanisms controlling venom synthesis in A. alata, I use bioinformatics to investigate gene candidates with dual roles in venom and digestion, and review the biology of prey capture and digestion in cubozoans. The morphological and molecular resources presented herein contribute to understanding the evolution of cubozoan characteristics and serve to facilitate further research on this emerging cubozoan model.

Identifying cancer-related microRNAs based on gene expression data

International audience