1000 resultados para Approaches


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As a result of growing evidence regarding the effects of environmental characteristics on the health and wellbeing of people in healthcare facilities (HCFs), more emphasis is being placed on, and more attention being paid to, the consequences of design choices in HCFs. Therefore, we have critically reviewed the implications of key indoor physical design parameters, in relation to their potential impact on human health and wellbeing. In addition, we discussed these findings within the context of the relevant guidelines and standards for the design of HCFs. A total of 810 abstracts, which met the inclusion criteria, were identified through a Pubmed search, and these covered journal articles, guidelines, books, reports and monographs in the studied area. Of these, 231 full publications were selected for this review. According to the literature, the most beneficial design elements were: single-bed patient rooms, safe and easily cleaned surface materials, sound-absorbing ceiling tiles, adequate and sufficient ventilation, thermal comfort, natural daylight, control over temperature and lighting, views, exposure and access to nature, and appropriate equipment, tools and furniture. The effects of some design elements, such as lighting (e.g. artificial lighting levels) and layout (e.g. decentralized versus centralized nurses’ stations), on staff and patients vary, and “the best design practice” for each HCF should always be formulated in co-operation with different user groups and a multi-professional design team. The relevant guidelines and standards should also be considered in future design, construction and renovations, in order to produce more favourable physical indoor environments in HCFs.

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Contractors have to bid competitively for most of their work and at the same time deal with the risks and uncertainties connected with bid submission. This article examines the factors involved in tender pricing and how they interrelate. From this, a conceptual model of contractors’ pricing strategy is developed.

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The robust and diversely useful isoindoline nitroxide, 5-carboxy-1,1,3,3-tetramethylisoindolin-2-yloxyl (1; CTMIO), has previously been synthesised in low-to-moderate yields from phthalic anhydride (3). Recent interest in its biological potential as a potent antioxidant and in other areas has seen an increased demand for its production. Herein, three new synthetic routes to CTMIO are presented and their efficiencies assessed. Two routes, via the nitrile 9 and the formyl compound 11, derive from 5-bromo-1,1,3,3-tetramethylisoindoline (6). The third approach starts from the readily accessible starting material, 4-methylphthalic anhydride (12), and proceeds by a methylarene oxidation with potassium permanganate. The three new approaches yield CTMIO in comparable overall yields (16–18 %); however, the synthetic efficiency is most improved when employing the nitrile intermediate 9.

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CSR is increasingly an essential issue for business enterprises. It is a company and multidimensional organizational ...

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Health information systems are being implemented in countries by governments and regional health authorities in an effort to modernize healthcare. With these changes, there has emerged a demand by healthcare organizations for nurses graduating from college and university programs to have acquired nursing informatics competencies that would allow them to work in clinical practice settings (e.g. hospitals, clinics, home care etc). In this paper we examine the methods employed by two different countries in developing national level nursing informatics competencies expected of undergraduate nurses prior to graduation (i.e. Australia, Canada). This work contributes to the literature by describing the science and methods of nursing informatics competency development at a national level.

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This study used next generation sequencing technologies to investigate growth in a cultured crustacean. The objective was to identify and characterise specific gene loci that contribute important phenotypic variation to growth as well as to develop a large set of SNP markers in candidate genes for assessing correlations between specific mutations and individual growth performance. The genomic dataset generated provides a fundamental resource for application in future crustacean stock improvement programs. Ultimately, the data can be applied to development of culture lines with improved growth performance.

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Energy efficiency of buildings is attracting significant attention from the research community as the world is moving towards sustainable buildings design. Energy efficient approaches are measures or ways to improve the energy performance and energy efficiency of buildings. This study surveyed various energy-efficient approaches for commercial building and identifies Envelope Thermal Transfer Value (ETTV) and Green applications (Living wall, Green facade and Green roof) as most important and effective methods. An in-depth investigation was carried out on these energy-efficient approaches. It has been found that no ETTV model has been developed for sub-tropical climate of Australia. Moreover, existing ETTV equations developed for other countries do not take roof heat gain into consideration. Furthermore, the relationship of ETTV and different Green applications have not been investigated extensively in any literature, and the energy performance of commercial buildings in the presence of Living wall, Green facade and Green roof has not been investigated in the sub-tropical climate of Australia. The study has been conducted in two phases. First, the study develops the new formulation, coefficient and bench mark value of ETTV in the presence of external shading devices. In the new formulation, roof heat gain has been included in the integrated heat gain model made of ETTV. In the 2nd stage, the study presents the relationship of thermal and energy performance of (a) Living wall and ETTV (b) Green facade and ETTV (c) Combination of Living wall, Green facade and ETTV (d) Combination of Living wall, Green Roof and ETTV in new formulations. Finally, the study demonstrates the amount of energy that can be saved annually from different combinations of Green applications, i.e., Living wall, Green facade; combination of Living wall and Green facade; combination of Living wall and Green roof. The estimations are supported by experimental values obtained from extensive experiments of Living walls and Green roofs.

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Literacy studies have begun to examine the spatial dimension of literacy practices in a way that foregrounds space, and that considers space as constitutive to human relations and practices. This chapter provides an introduction to spatial literacy research, providing a guide to key theorists, themes, and studies that have shaped historical and new developments in spatial approaches to literacy practice and pedagogy. It begins by reconceptualising socio-spatial approaches to literacy research and defines terms. Intersections with related social theories are examined, with an emphasis on critical approaches and the politics of space. It clarifies the relationship between socio-spatial and socio-cultural paradigms, revisiting the spatial in seminal socio-cultural research. It covers new ground,including networks, flows, and deterritorialisation of literacy practice. The chapter concludes with challenges and recommendations for future language research and educational practice.

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BACKGROUND: The treatment for deep surgical site infection (SSI) following primary total hip arthroplasty (THA) varies internationally and it is at present unclear which treatment approaches are used in Australia. The aim of this study is to identify current treatment approaches in Queensland, Australia, show success rates and quantify the costs of different treatments. METHODS: Data for patients undergoing primary THA and treatment for infection between January 2006 and December 2009 in Queensland hospitals were extracted from routinely used hospital databases. Records were linked with pathology information to confirm positive organisms. Diagnosis and treatment of infection was determined using ICD-10-AM and ACHI codes, respectively. Treatment costs were estimated based on AR-DRG cost accounting codes assigned to each patient hospital episode. RESULTS: A total of n=114 patients with deep surgical site infection were identified. The majority of patients (74%) were first treated with debridement, antibiotics and implant retention (DAIR), which was successful in eradicating the infection in 60.3% of patients with an average cost of $13,187. The remaining first treatments were 1-stage revision, successful in 89.7% with average costs of $27,006, and 2-stage revisions, successful in 92.9% of cases with average costs of $42,772. Multiple treatments following 'failed DAIR' cost on average $29,560, for failed 1-stage revision were $24,357, for failed 2-stage revision were $70,381 and were $23,805 for excision arthroplasty. CONCLUSIONS: As treatment costs in Australia are high primary prevention is important and the economics of competing treatment choices should be carefully considered. These currently vary greatly across international settings.

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Despite growing recognition of creativity's importance for young people, the creativity of adolescents remains a neglected field of study. Hence, grounded theory research was conducted with 20 adolescents from two Australian schools regarding their self-reported experiences of creativity in diverse domains. Four approaches to the creative process – adaptation, transfer, synthesis, and genesis – emerged from the research. These approaches used by students across a range of domains contribute to the literature in two key ways: (a) explaining how adolescents engage in the creative process, theorised from adolescent creators’ self-reports of their experiences and (b) confirms hybrid theories that recognise that creativity has elements of both domain-generality and domain-specificity. The findings have educational implications for both students and teachers. For students, enhancing metacognitive awareness of their preferred approaches to creativity was reported as a valuable experience in itself, and might also enable adolescents to expand their creativity through experimenting with other ways of engaging in the creative process. For teachers, using these understandings to underpin their pedagogies can promote metacognitive awareness and experimentation, and also provide teachers with a framework for assessing students’ creative processes.

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This thesis introduced Bayesian statistics as an analysis technique to isolate resonant frequency information in in-cylinder pressure signals taken from internal combustion engines. Applications of these techniques are relevant to engine design (performance and noise), energy conservation (fuel consumption) and alternative fuel evaluation. The use of Bayesian statistics, over traditional techniques, allowed for a more in-depth investigation into previously difficult to isolate engine parameters on a cycle-by-cycle basis. Specifically, these techniques facilitated the determination of the start of pre-mixed and diffusion combustion and for the in-cylinder temperature profile to be resolved on individual consecutive engine cycles. Dr Bodisco further showed the utility of the Bayesian analysis techniques by applying them to in-cylinder pressure signals taken from a compression ignition engine run with fumigated ethanol.

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We have previously reported a preliminary taxonomy of patient error. However, approaches to managing patients' contribution to error have received little attention in the literature. This paper aims to assess how patients and primary care professionals perceive the relative importance of different patient errors as a threat to patient safety. It also attempts to suggest what these groups believe may be done to reduce the errors, and how. It addresses these aims through original research that extends the nominal group analysis used to generate the error taxonomy. Interviews were conducted with 11 purposively selected groups of patients and primary care professionals in Auckland, New Zealand, during late 2007. The total number of participants was 83, including 64 patients. Each group ranked the importance of possible patient errors identified through the nominal group exercise. Approaches to managing the most important errors were then discussed. There was considerable variation among the groups in the importance rankings of the errors. Our general inductive analysis of participants' suggestions revealed the content of four inter-related actions to manage patient error: Grow relationships; Enable patients and professionals to recognise and manage patient error; be Responsive to their shared capacity for change; and Motivate them to act together for patient safety. Cultivation of this GERM of safe care was suggested to benefit from 'individualised community care'. In this approach, primary care professionals individualise, in community spaces, population health messages about patient safety events. This approach may help to reduce patient error and the tension between personal and population health-care.

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Skin cancer is one of the most commonly occurring cancer types, with substantial social, physical, and financial burdens on both individuals and societies. Although the role of UV light in initiating skin cancer development has been well characterized, genetic studies continue to show that predisposing factors can influence an individual's susceptibility to skin cancer and response to treatment. In the future, it is hoped that genetic profiles, comprising a number of genetic markers collectively involved in skin cancer susceptibility and response to treatment or prognosis, will aid in more accurately informing practitioners' choices of treatment. Individualized treatment based on these profiles has the potential to increase the efficacy of treatments, saving both time and money for the patient by avoiding the need for extensive or repeated treatment. Increased treatment responses may in turn prevent recurrence of skin cancers, reducing the burden of this disease on society. Currently existing pharmacogenomic tests, such as those that assess variation in the metabolism of the anticancer drug fluorouracil, have the potential to reduce the toxic effects of anti-tumor drugs used in the treatment of non-melanoma skin cancer (NMSC) by determining individualized appropriate dosage. If the savings generated by reducing adverse events negate the costs of developing these tests, pharmacogenomic testing may increasingly inform personalized NMSC treatment.

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To date, available literature mainly discusses Twitter activity patterns in the context of individual case studies, while comparative research on a large number of communicative events, their dynamics and patterns is missing. By conducting a comparative study of more than forty different cases (covering topics such as elections, natural disasters, corporate crises, and televised events) we identify a number of distinct types of discussion which can be observed on Twitter. Drawing on a range of communicative metrics, we show that thematic and contextual factors influence the usage of different communicative tools available to Twitter users, such as original tweets, @replies, retweets, and URLs. Based on this first analysis of the overall metrics of Twitter discussions, we also demonstrate stable patterns in the use of Twitter in the context of major topics and events.

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This paper illustrates the use of finite element (FE) technique to investigate the behaviour of laminated glass (LG) panels under blast loads. Two and three dimensional (2D and 3D) modelling approaches available in LS-DYNA FE code to model LG panels are presented. Results from the FE analysis for mid-span deflection and principal stresses compared well with those from large deflection plate theory. The FE models are further validated using the results from a free field blast test on a LG panel. It is evident that both 2D and 3D LG models predict the experimental results with reasonable accuracy. The 3D LG models give slightly more accurate results but require considerably more computational time compared to the 2D LG models.