The implausibility of ‘usual care’ in an open system: sedation and weaning practices in Paediatric Intensive Care Units (PICUs) in the United Kingdom (UK).

Background
The power of the randomised controlled trial depends upon its capacity to operate in a closed system whereby the intervention is the only causal force acting upon the experimental group and absent in the control group, permitting a valid assessment of intervention efficacy. Conversely, clinical arenas are open systems where factors relating to context, resources, interpretation and actions of individuals will affect implementation and effectiveness of interventions. Consequently, the comparator (usual care) can be difficult to define and variable in multi-centre trials. Hence outcomes cannot be understood without considering usual care and factors that may affect implementation and impact on the intervention.

Methods
Using a fieldwork approach, we describe PICU context, ‘usual’ practice in sedation and weaning from mechanical ventilation, and factors affecting implementation prior to designing a trial involving a sedation and ventilation weaning intervention. We collected data from 23 UK PICUs between June and November 2014 using observation, individual and multi-disciplinary group interviews with staff.

Results
Pain and sedation practices were broadly similar in terms of drug usage and assessment tools. Sedation protocols linking assessment to appropriate titration of sedatives and sedation holds were rarely used (9 % and 4 % of PICUs respectively). Ventilator weaning was primarily a medical-led process with 39 % of PICUs engaging senior nurses in the process: weaning protocols were rarely used (9 % of PICUs). Weaning methods were variably based on clinician preference. No formal criteria or use of spontaneous breathing trials were used to test weaning readiness. Seventeen PICUs (74 %) had prior engagement in multi-centre trials, but limited research nurse availability. Barriers to previous trial implementation were intervention complexity, lack of belief in the evidence and inadequate training. Facilitating factors were senior staff buy-in and dedicated research nurse provision.

Conclusions
We examined and identified contextual and organisational factors that may impact on the implementation of our intervention. We found usual practice relating to sedation, analgesia and ventilator weaning broadly similar, yet distinctively different from our proposed intervention, providing assurance in our ability to evaluate intervention effects. The data will enable us to develop an implementation plan; considering these factors we can more fully understand their impact on study outcomes.

Conflito de interesse: a nova posição da CVM

O parágrafo primeiro do artigo 115 da Lei n. 6.404/76 dispõe que o acionista não poderá votar, entre outras, quando possuir interesse conflitante com o da companhia. Contudo, a legislação não estabelece o critério de avaliação do conflito, restando à doutrina e à jurisprudência fazê-lo. Dessa maneira surgiram os critérios formal e substancial. A Comissão de Valores Mobiliários – CVM, autarquia responsável pela regulação e fiscalização das sociedades anônimas, já adotou ambos os critérios e nos autos do Caso Tractebel consolidou seu novo entendimento, qual seja, pela adoção do critério formal de verificação do conflito. Assim, esse trabalho tem como objetivo analisar jurisprudências anteriores ao Caso Tractebel para entender a argumentação utilizada em cada um desses casos para, ao final, analisar a argumentação trazida pela CVM para fundamentar seu novo entendimento.

O controle social do judiciário: a experiência do Observatório da Justiça e Cidadania no Estado do Rio Grande do Norte

This dissertation deals with the possibility of build an effective social control of the judiciary Brazilians. The theme was bounded by a cut geographic and secular: the experience of the Center of Justice and Citizenship in the state of Rio Grande do Norte (OJC/RN), which begins formally in august 2003. The research approach and leave of experience in judicial practice and policy specific substrates to theorize about the subject. We collected documents about cases, the judicial diagnoses, reports, news material, in addition to lifting bibliographic. Therefore, it is working with about notions of a democratic state of right in the light of the Brazilian Constitution of 1988, in order to contextualize the insertion of the judicial system, by the prospect of legitimacy, which is considered by a look formal and material. It is a brief analysis of the system of official control of the judiciary (internal and external), is emphasizing its shortcomings functional and its corporate character, which suffers from poor conformation democratic. Then there is a discussion about the need to establish the social control of the judiciary, through the prism of relations of power that are locked in the judiciary, the lack of formal criteria for the guarantee of obtaining the correct judgment (laws, precedents and conscience of the judge), the problems of impunity and justice class, and from the examination of some cases, as the body of search. From this conjuncture, prepares to be an outline of shapes and the limits of social control, consonant the proposal erected in certain sectors of organized civil society, represented by the movement s social OJC. In the end, considerations are made on the legitimacy and constitutionality of OJC

Denominal Verbs in Brazilian Portuguese: distinguishing between diachronic and synchronic structures within Distributed Morphology approach

Recent work on argument structure has shown that there must be a synchronic relation between nouns and derived verbs that can be treated in structural terms. However, a simple phonological/morphological identity or diachronic derivation between a verb and a noun cannot guarantee that there is a denominal structure in a synchronic approach. In this paper we observe the phenomenon of Denominal Verbs in Brazilian Portuguese and argue for a distinction between etymological and synchronic morphological derivation. The objectives of this paper are 1) to identify synchronic and formal criteria to define which diachronic Denominal Verbs can also be considered denominal under a synchronic analysis; and 2) to detect in which cases the label "denominal" can be justifiably abandoned. Based on results of argument structure tests submitted to the judgments of native speakers, it was possible to classify the supposed homogenous Denominal Verbs class into three major groups: Real Denominal Verbs, Root-derived Verbs, and Ambiguous Verbs. In a Distributed Morphology approach, it was possible to explain the distinction between these groups based on the ideia of phases in words and the locality of restriction in the interpretation of roots.

La cooperación entre editores y bibliotecarios como estrategia institucional para la gestión de revistas científicas

El desarrollo sostenido de edición de revistas científicas ha abierto un campo de análisis y aplicación de conocimientos específicos para los bibliotecarios. El trabajo en cooperación con los editores enriquece a ambos actores pues, mientras los bibliotecarios conocen los estándares de normalización de la información y difusión del conocimiento científico, los editores se centran en las tareas académicas -pertinencia temática, relación con autores y evaluadores, revisión por pares. Los indicadores de evaluación de revistas científicas, tanto regionales como internacionales, se han afianzado en las últimas décadas a partir de acuerdos interinstitucionales y de la aceptación de los propios editores, aplicándose criterios de gestión y criterios formales de edición y evaluación. En este contexto, los editores necesitan un apoyo especializado que los acompañe en el proceso de desarrollo científico y técnico para conseguir que sus revistas se inserten en los principales núcleos de publicaciones científicas de cada disciplina. En este trabajo se presenta la experiencia de la Coordinación del Área de Publicaciones, en la Biblioteca de la Facultad de Humanidades y Ciencias de la Educación de la Universidad Nacional de La Plata, que edita actualmente más de 20 revistas

La cooperación entre editores y bibliotecarios como estrategia institucional para la gestión de revistas científicas

El desarrollo sostenido de edición de revistas científicas ha abierto un campo de análisis y aplicación de conocimientos específicos para los bibliotecarios. El trabajo en cooperación con los editores enriquece a ambos actores pues, mientras los bibliotecarios conocen los estándares de normalización de la información y difusión del conocimiento científico, los editores se centran en las tareas académicas -pertinencia temática, relación con autores y evaluadores, revisión por pares. Los indicadores de evaluación de revistas científicas, tanto regionales como internacionales, se han afianzado en las últimas décadas a partir de acuerdos interinstitucionales y de la aceptación de los propios editores, aplicándose criterios de gestión y criterios formales de edición y evaluación. En este contexto, los editores necesitan un apoyo especializado que los acompañe en el proceso de desarrollo científico y técnico para conseguir que sus revistas se inserten en los principales núcleos de publicaciones científicas de cada disciplina. En este trabajo se presenta la experiencia de la Coordinación del Área de Publicaciones, en la Biblioteca de la Facultad de Humanidades y Ciencias de la Educación de la Universidad Nacional de La Plata, que edita actualmente más de 20 revistas

La cooperación entre editores y bibliotecarios como estrategia institucional para la gestión de revistas científicas

El desarrollo sostenido de edición de revistas científicas ha abierto un campo de análisis y aplicación de conocimientos específicos para los bibliotecarios. El trabajo en cooperación con los editores enriquece a ambos actores pues, mientras los bibliotecarios conocen los estándares de normalización de la información y difusión del conocimiento científico, los editores se centran en las tareas académicas -pertinencia temática, relación con autores y evaluadores, revisión por pares. Los indicadores de evaluación de revistas científicas, tanto regionales como internacionales, se han afianzado en las últimas décadas a partir de acuerdos interinstitucionales y de la aceptación de los propios editores, aplicándose criterios de gestión y criterios formales de edición y evaluación. En este contexto, los editores necesitan un apoyo especializado que los acompañe en el proceso de desarrollo científico y técnico para conseguir que sus revistas se inserten en los principales núcleos de publicaciones científicas de cada disciplina. En este trabajo se presenta la experiencia de la Coordinación del Área de Publicaciones, en la Biblioteca de la Facultad de Humanidades y Ciencias de la Educación de la Universidad Nacional de La Plata, que edita actualmente más de 20 revistas

La deformación del tipo Construcción de bóvedas no-canónicas en España (siglos XVI-XVIII)

Una bóveda no canónica es una bóveda que se adapta a una forma distinta de aquella para la que ha sido inicialmente concebida. Bóvedas raras, anormales, no convencionales, habitualmente consideradas excepciones o casos particulares, resultan ser más frecuentes de lo inicialmente esperado. El interés por este tipo de bóvedas surge a raíz de una investigación inicial sobre las bóvedas empleadas para cubrir espacios de planta anular, como en el caso de las girolas de las iglesias. Sin embargo, el problema de la bóveda anular no puede ser abordado directamente, sino como parte de una investigación más general sobre bóvedas que se deforman para adaptarse a una situación anómala. El análisis de las posibilidades que un determinado tipo de bóveda brinda para resolver el abovedamiento de espacios de planta irregular, trascendiendo el problema de la planta anular, es lo que da origen a esta investigación. La cuestión de las bóvedas deformadas forma parte de un contexto mayor, el de la deformación en arquitectura abovedada. Ante una contradicción, la deformación de la bóveda es sólo una de las posibles opciones que esta arquitectura ofrece para resolver un problema de deformación. La tesis se estructura en dos partes: en la primera parte se analizan los conceptos de forma y deformación en el contexto de la arquitectura abovedada con objeto de sentar las bases para una teoría de las bóvedas no canónicas. El objetivo es establecer un punto de partida para la investigación en un campo que todavía no había sido abordado. En la segunda parte se analizan tres tipos de bóveda desde la perspectiva de las bóvedas no canónicas, a partir de un estudio de casos de bóvedas en España entre los siglos XVI y XVIII. El estudio de la deformación en arquitectura abovedada se centra en el problema de la girola, por tratarse de un caso generalizado de deformación, directamente relacionado con el problema de las bóvedas irregulares y cuyo estudio, llamativamente, no había sido llevado a cabo hasta la fecha. Se propone una primera aproximación al problema de la girola, desde un punto de vista puramente morfológico, al margen de consideraciones históricas. En el caso de las bóvedas deformadas, el análisis se centra en tres tipos de bóveda: la bóveda de crucería, la bóveda de arista y la bóveda baída. Estos tres tipos de bóveda, aunque basadas en criterios formales distintos, están íntimamente relacionados entre sí. Por un lado permiten resolver el mismo problema –planta cuadrada delimitada por arcos–, por otro lado es posible establecer una relación formal entre la bóveda de arista y la bóveda baída a través de la bóveda de crucería. El estudio de casos recogido en la segunda parte de la tesis se fundamenta en dos líneas de investigación, la primera sobre soluciones teóricas de bóvedas no convencionales propuestas en los manuscritos y tratados de cantería, y la segunda sobre bóvedas efectivamente construidas, tratado de establecer una comparación entre teoría y práctica, confrontando el grado de relación entre ambas. Sin embargo este doble análisis sólo se ha podido llevar a cabo en contadas ocasiones. Constatamos que las bóvedas no canónicas reflejadas en los tratados son pocas y apenas se han llevado a la práctica, mientras que las soluciones construidas no responden a modelos teóricos propuestos, manifestando un divorcio entre teoría y práctica. El estudio de estas bóvedas permite poner en cuestión la definición tradicional que relaciona los conceptos de ‘bóveda’ y ‘superficie’. Al iniciar el trabajo nos encontramos con un modelo teórico extremadamente rígido que deja fuera un gran número de bóvedas, obligando a agruparlas bajo el término «no canónicas». El trabajo realizado pone en evidencia lo limitado del modelo. El problema no está en la presencia de bóvedas anómalas, que no se adaptan al modelo tradicionalmente propuesto, sino en la extrema rigidez del modelo. ABSTRACT A non canonical vault is a vault adapted to a different form from that for which was originally conceived. These rare, abnormal, unconventional vaults are usually considered as exceptions or special cases. However they prove to be more frequent than it was initially expected. Interest in this type of vaults arises from an initial research on the vaults used to roof annular spaces, such as ambulatories. Nevertheless, the annular vault question cannot be addressed directly, but as a part of a broader research on distorted vaults; a research on vaults deformed to conform an anomalous layout. The analysis of the possibilities that a particular type of vault provides to solve the vaulting of an irregular layout, beyond the problem of the annular plan is the origin of this research. The argument of deformed vaults is part of a greater context, the context of deformation in vaulted architecture. Facing a contradiction, deforming a vault is just one of the options that vaulted architecture offers to solve a problem of deformation. This dissertation is organised in two parts: in the first part we analyse the concepts of form and deformation in the context of vaulted architecture in order to lay the foundations for a non canonical vaults theory. The objective is to establish a starting point for future research in a field that has not been addressed yet. In the second part, we analyse three types of vault from the perspective of non canonical vaults, based on a case study of Spanish vaults between the 16th and 18th Centuries. The analysis of deformation in vaulted architecture focuses on the question of the ambulatory, because it is a generalized example of deformation, directly related to the problem of irregular vaults. Remarkably, the analysis of these spaces had not been conducted to date. We propose a first approach to the question of the ambulatory, from a purely morphological point of view, setting aside historical considerations. The analysis of deformed vaults focuses on three types of vault: the groin vault, the ribbed vault and the sail vault. These three types of vault, although based on different formal criteria, are closely related between them. On the one hand, they allow to solve the same problem –a square perimeter limited by arcs-; on the other hand, it is possible to establish a formal relationship between the groin vault and the sail vault through the ribbed vault. The case study presented in the second part of this dissertation is based on two research lines: theoretical non conventional vaults solutions proposed on stonecutting treatises; and currently built vaults. The aim of this double analysis was to establish a comparison between theory and practice, comparing the degree of relationship between them. Nevertheless, this double analysis has only been carried out on rare occasions. It is noted that non canonical vaults reflected in treaties are few and hardly been employed, while the built solutions do not meet proposed theoretical models, expressing a divorce between theory and practice. The analysis of these vaults allows us to question the traditional definition that connects the concepts of 'vault' and 'surface'. When we began this research, we found an extremely rigid theoretical model that leaved out many vaults, forcing to group them under the term of «non canonical vaults». This research evidences the limitations of the model. The problem is not the presence of abnormal vaults, which cannot adapt to the traditional model, but in the very high stiffness of the model.

Computer speech synthesis: its status and prospects.

Computer speech synthesis has reached a high level of performance, with increasingly sophisticated models of linguistic structure, low error rates in text analysis, and high intelligibility in synthesis from phonemic input. Mass market applications are beginning to appear. However, the results are still not good enough for the ubiquitous application that such technology will eventually have. A number of alternative directions of current research aim at the ultimate goal of fully natural synthetic speech. One especially promising trend is the systematic optimization of large synthesis systems with respect to formal criteria of evaluation. Speech recognition has progressed rapidly in the past decade through such approaches, and it seems likely that their application in synthesis will produce similar improvements.

CONDICIONES INICIALES PARA UNA POLÍTICA DE DESARROLLO Y DEL MEDIO AMBIENTE. Un enfoque a partir de los derechos concretos a la vida

Resumen En este ensayo se pretende analizar, críticamente, un aspecto que consideramos crucial en toda propuesta de desarrollo, ya sea que éste se entienda como “desarrollo económico”, como “desarrollo humano sostenible”, o como desarrollo a secas: los criterios formales de decisión y sus correspondientes marcos categoriales. Estos criterios se insertan necesariamente en un sistema de coordinación del trabajo social, y condicionan los fines y las metas de la acción. Además, lo hacemos teniendo especialmente en cuenta aquellos rasgos estructurales del subdesarrollo capitalista que creemos necesario enfrentar y superar en toda propuesta de desarrollo: el desempleo, las desigualdades sociales y regionales, la exclusión social y la destrucción del medio ambiente. El análisis presupone una imagen del ser humano que concibe a éste como un sujeto de derechos concretos a la vida, imagen que parte del trabajo humano en el conjunto de la división social del trabajo, y por tanto, de un sujeto en comunidad. Adjudica al ser humano determinados derechos a la vida que tienen que impregnar a la sociedad entera para que pueda ser realmente una sociedad libre.   Abstract This paper attempts analyze, in a critical way, a crucial issue concerning every development proposal: the formal criteria of decision and their respective theoretical frameworks, either we talk about economic development, human development or just development. These criteria are necessarily inserted in a social labor coordination system and they determine those ends and goals of the human action. Moreover, we emphasize those structural features from capitalist underdeveloped countries that are urgent to face and overcome: unemployment, social and regional inequalities, social exclusion and environment destruction. Analysis we do presupposes the human being conceived as a person with concrete rights of live, as from the human labor in the whole of social labor division, and therefore, as a person in a community. Every society, in order to be a free society, must to assign these concrete rights of live to every human being.

Pathways for developing a 'smart' workforce : does the achievement of formal workplace qualifications encourage participation in higher education?

The purpose of this paper is to investigate a public workforce education initiative in the context of State and agency policies designed to enhance employee capabilities to adapt to a volatile and changing environment. In particular, we are concerned with public employees’ experience of a higher educational pathway that resulted in their obtaining a Diploma level qualification. In addition to understanding the employees’ experience of this pathway we were interested in whether the experience contributed to their openness to the prospect of university level education. We conducted telephone interviews with a sample of participants from the program. Employees reported very positive experience of the program; in particular employees reported enhanced efficacy beliefs, a strong sense of achievement, and a feeling of recognition. This experience is explained by four main factors; (1) a program design that was well aligned with the employees learning needs, (2) strong support by organisational staff who delivered and assessed participants on capability criteria, (3) strong management support for employees’ participation, (4) an academic ceremony that provided participants with public recognition of their achievement by valued others. Participants’ motivation to participate was primarily intrinsic rather than extrinsic. Participants in the study reported that their experience in this educational pathway gave them the confidence to consider the possibility of university level education. The paper also discusses the practitioner-academic collaboration that led to the development of this paper.

Histories of user-generated content : between formal and informal media economies

Debates about user-generated content (UGC) often depend on a contrast with its normative opposite, the professionally produced content that is supported and sustained by commercial media businesses or public organisations. UGC is seen to appear within or in opposition to professional media, often as a disruptive, creative, change-making force. Our suggestion is to position UGC not in opposition to professional or "producer media", or in hybridised forms of subjective combination with it (the so-called "pro-sumer" or "pro-am" system), but in relation to different criteria, namely the formal and informal elements in media industries. In this article, we set out a framework for the comparative and historical analysis of UGC systems and their relations with other formal and informal media activity, illustrated with examples ranging from games to talkback radio. We also consider the policy implications that emerge from a historicised reading of UGC as a recurring dynamic within media industries, rather than a manifestation of consumer agency specific to digital cultures.

Formal methods for control synthesis in partially observed environments : application to autonomous robotic manipulation

Modern robots are increasingly expected to function in uncertain and dynamically challenging environments, often in proximity with humans. In addition, wide scale adoption of robots requires on-the-fly adaptability of software for diverse application. These requirements strongly suggest the need to adopt formal representations of high level goals and safety specifications, especially as temporal logic formulas. This approach allows for the use of formal verification techniques for controller synthesis that can give guarantees for safety and performance. Robots operating in unstructured environments also face limited sensing capability. Correctly inferring a robot's progress toward high level goal can be challenging.

This thesis develops new algorithms for synthesizing discrete controllers in partially known environments under specifications represented as linear temporal logic (LTL) formulas. It is inspired by recent developments in finite abstraction techniques for hybrid systems and motion planning problems. The robot and its environment is assumed to have a finite abstraction as a Partially Observable Markov Decision Process (POMDP), which is a powerful model class capable of representing a wide variety of problems. However, synthesizing controllers that satisfy LTL goals over POMDPs is a challenging problem which has received only limited attention.

This thesis proposes tractable, approximate algorithms for the control synthesis problem using Finite State Controllers (FSCs). The use of FSCs to control finite POMDPs allows for the closed system to be analyzed as finite global Markov chain. The thesis explicitly shows how transient and steady state behavior of the global Markov chains can be related to two different criteria with respect to satisfaction of LTL formulas. First, the maximization of the probability of LTL satisfaction is related to an optimization problem over a parametrization of the FSC. Analytic computation of gradients are derived which allows the use of first order optimization techniques.

The second criterion encourages rapid and frequent visits to a restricted set of states over infinite executions. It is formulated as a constrained optimization problem with a discounted long term reward objective by the novel utilization of a fundamental equation for Markov chains - the Poisson equation. A new constrained policy iteration technique is proposed to solve the resulting dynamic program, which also provides a way to escape local maxima.

The algorithms proposed in the thesis are applied to the task planning and execution challenges faced during the DARPA Autonomous Robotic Manipulation - Software challenge.

Improving the Accessibility of Lightweight Formal Verification Systems

In research areas involving mathematical rigor, there are numerous benefits to adopting a formal representation of models and arguments: reusability, automatic evaluation of examples, and verification of consistency and correctness. However, broad accessibility has not been a priority in the design of formal verification tools that can provide these benefits. We propose a few design criteria to address these issues: a simple, familiar, and conventional concrete syntax that is independent of any environment, application, or verification strategy, and the possibility of reducing workload and entry costs by employing features selectively. We demonstrate the feasibility of satisfying such criteria by presenting our own formal representation and verification system. Our system’s concrete syntax overlaps with English, LATEX and MediaWiki markup wherever possible, and its verifier relies on heuristic search techniques that make the formal authoring process more manageable and consistent with prevailing practices. We employ techniques and algorithms that ensure a simple, uniform, and flexible definition and design for the system, so that it easy to augment, extend, and improve.