Within the last decade, the importance of flexibility and efficiency has increased in the manufacturing sector. The rising level of uncertainty in consumer preferences has caused many organizations to aggressively search for cost reductions and other sources of competitive advantage. This fact has resulted in an increased implementation of advanced manufacturing technologies (AMT). A number of studies propose that the implementation of AMT must be accompanied by a shift in supporting organizational practices to realize the greatest performance enhancement. As yet, the complementarities between organizational policies and AMT have not been determined. Using assumptions about complementarities in manufacturing made by Milgrom and Roberts (1995) in conjunction with a comprehensive AMT survey (Survey of Advanced Technology in Canadian Manufacturing-1998) a model of manufacturing plant productivity was developed. Constrained regression analysis reveals that the use of AMT, as well as various organizational policies, depends both on the size of the plant as well as the industry in which it operates. Factor analysis of the over 70 variables found that regardless of the nature of the variable (business strategy, source of implementation support, AMT, etc. ), all design elements factored together. The factor analysis also shows that large firms who use AMT also have many design technologies. This result differs for smaller firms where the use of AMT is highly correlated with perceived benefits of the technology and a large number of sources of implementation support. The analysis also supports the distinction of high technology (highly innovative) industries and low technology (low levels of innovation) industries since electronics, chemicals and automotive have a large percentage of plants with all of the model factors whereas the textile, non-metal and lumber industries have very few plants with all of the model factors. The results show that there are important differences that should be considered when creating policies to encourage innovation and the use of AMT for the various manufacturing industries and plant sizes.

Purpose of the research<p>This paper presents an analysis of, and recommendations for, the training and accreditation of healthcare workers in Canada<p>The significant cost of education and healthcare, as well as the current and ongoing national shortage of healthcare professionals, warrants a critical look at the educational training requirements of healthcare workers in Canada. This topic includes reviewing the historical background of training for a variety of healthcare professionals in Western cultures, the common philosophy of education trends for these workers, and the future directions for various professions, focusing specifically on Medical Radiation Technologists in Canada.<p>Methods used <p>The methodology applied to this research is that of critical analysis, utilizing the following critical skills as proposed by philosopher Bertrand Russell: (i) the ability to form an opinion for oneself (tasks of recognizing, listening and questioning), (ii) the ability to find an impartial solution (dealing with biases and detachment for beliefs, judging on merit of issues), and (iii) the ability to identify and question assumptions (emphasis on judgment, critical reflection and constructive rather than destructive doubt)(Hare, 2001, pp8-9). Recommendations regarding pre-service and continuing educational training for Medical Radiation Technologists in Canada will be proposed.<p>Tied to any investigation of healthcare workers is a critical assessment of the healthcare system, as the needs of the community that is served by these professionals must be identified and successfully met. The literature review includes national statistics and summaries of health and lifestyle trends, as well as the trends for the education and training of healthcare workers.<p>Results obtained/Significance of findings<p>Reflective, critical assessment of the training and future trends of healthcare workers reveals that healthcare has undergone two major changes in focus: (1) healthcare as a business and (2) the holistic interdisciplinary trend of patient care.<p>After investigating the trends of health care professionals training, and even though the arguments for degree as entry-to-practice are very strong on many levels, I dont feel that I can conclude that the degree is the only option. If diploma training can adequately provide the basic theory and skills needed, additional skills and training, when required for a particular task, should be, and currently are, made available to the individual.

Methylglyoxal (MG), a metabolite of glucose, causes non-enzymatic glycation of proteins to form irreversible advanced glycation end products (AGEs). Increased MG production, which in turn gives rise to AGEs, has been linked to the development of complications in diabetes. However, the role of MG and AGEs in hypertension has not been investigated widely. The previous study from our laboratory showed that the cellular levels of MG and MG-induced AGE formation are significantly higher in cultured aortic smooth muscle cells from spontaneously hypertensive rats (SHR) than those from normotensive Wistar-Kyoto rats (WKY). Using immunofluorescence staining with specific monoclonal antibodies against MG-induced AGEs, the present studies show a strong association of MG and its AGE products (Nå-carboxyethyl-lysine and Nå-carboxymethyl-lysine) with hypertension in SHR. The blood pressure of SHR was not different from that of WKY rats at 5 wks of age. From 8 wks onwards, blood pressure was significantly elevated compared to age-matched WKY rats. Importantly, this increase in blood pressure coincided with an elevated MG level in plasma and aorta of SHR in an age-dependent fashion compared to age-matched WKY rats, although no difference was observed in blood glucose levels between these two strains. Our data showed an increased MG level in plasma and aorta, but not in kidney or heart, in SHR at an early age of 8 wks, suggesting, in addition to diabetes/hyperglycemic or hyperlipidemic conditions, the accumulation of MG in blood vessel walls plays an important role in the development of hypertension or its complications even in the absence of diabetes. Moreover, we observed increased blood pressure and vascular remodeling in Sprague Dawley rats which had been treated to increase endogenous MG and related AGEs. After inhibiting MG and MG-induced AGE generation in SHR, hypertension development in this genetic hypertension model was delayed and vascular remodeling was reversed. Our data indicate that increased MG and AGE formation may play an important role in the development of hypertension.

This descriptive phenomenology had two purposes: first, to explore the experience of making decisions for women with advanced cancer; and second, to explore the experience for significant others and health care team members as women made their decisions. A plethora of research exists on making decisions during the cancer experience, including research regarding: 1) decision-making styles; 2) factors or determinants which play a role in decision making; 3) information: needs, seeking behaviours, and utilization; and 4) decision support technologies. However, a gap exists in the literature regarding the experience of making decisions. Conversational interviews were conducted with five women and three relevant others for each woman: her primary nurse, her oncologist, and one significant other. Women were also provided with the opportunity to journal in a diary or email their memories of decisions and the surrounding experience. Van Manens (1990) phenomenology guided the analysis of data. For the women, analysis centered on the four existentials of lived time, lived other, lived space, and lived body, revealing four themes of the lived experience of making decisions: 1) control, 2) influence, 3) normalcy, and 4) vulnerability. Phenomenological analysis on data from the significant others revealed three themes: 1) what used to be, 2) power shift, and 3) life on hold. Themes for the health care teams experience as women made decisions were: 1) emotional detachment, 2) discomfort, and 3) acquiescing. Understanding the perspectives from these lived experiences will assist the health care team to support women, and their significant others, through the experience of making decisions.

The constant matrix multiplication is one of the key operations in many applications including digital signal processing, communication, and coding. In general, constant matrix multiplication can be expressed as bit-level Boolean functions. Then, common subexpression elimination (CSE) can be used to reduce the area cost of realizing these bit-level functions by finding the shared common factors among these bit-level equations. The proposed circuit generator performs logic reduction on the input Boolean functions and produces the simplified Verilog HDL codes as output. Then the simplified code is fed into Synopsys Design Compiler for further logic minimization and technology mapping to generate gate-level netlists. In this thesis, we present ten different CSE algorithms for logic reduction of the bit-level Boolean functions. The comparisons include both the architecture-level technology-independent results and the Synopsys synthesized technology-dependent results. According to the experiments, we observe that our CSE can effectively reduce the area cost. We also apply the CSE to the design of the Advanced Encryption Standard (AES) in cryptography.

(<特集>悪性脳腫瘍の病態と治療) (<SPECIAL ISSUE>Pathology and Treatment of Malignant Brain Tumors)

Thesis (D. Min.)--Denver Conservative Baptist Seminary, 1996. / Includes bibliographical references (leaves 215-224).

Introduction: Child maltreatment continues to be a significant public health concern in civilian and military communities alike. Child maltreatment has profound short and long term negative effects on children and families and is tremendously costly to society. There are several correlates of child maltreatment unique to the military family: deployment of the active duty service member and living in an overseas duty locations.Rationale: The high rate of deployments within the Marine Corps military community in Japan makes these children particularly vulnerable to child maltreatment. Many forms of child maltreatment are most significant in school aged children, and nearly all maltreated children display recognizable signs and symptoms including physical, emotional, and behavioral characteristics, but also academic difficulties which can be best detected by the educator or other school personnel. Thus, the importance of improving school personnel's knowledge regarding the recognition and response of child maltreatment is especially important. Department of Defense Dependent Schools (DoDDS) teachers, school professionals, and staff with direct student contact spend a significant amount of time with military children and are in a prime position to recognize and respond to at-risk and maltreated children.Purpose/Objective: The purpose of this study was to pilot a web-based child maltreatment tutorial for DoDDS teachers, school professionals and support staff with direct student contact within the Marine Corps community in Japan. The goal was to determine whether these professionals would gain information about child maltreatment in general and specific to the military families in Japan.Methods: Thirty-three eligible school personnel within the DoDDS school district in Japan participated in the study. A pre-test /post-test design was used to determine the effectiveness of the tutorial in increasing participant knowledge of risk factors, signs and symptoms, and reporting procedures for child maltreatment.Results: Findings indicated that participants' post-test scores were significantly higher than pre-test scores (p <0.001). The majority of participants indicated that they liked the format and self-paced nature of the tutorial.Conclusions: This exploratory study demonstrated the effectiveness of a web-based tutorial to disseminate information about child maltreatment in military families.

Organic wastes like sewage sludge and dairy manure were subjected to microwave enhanced advanced oxidation process ( MW/H₂0₂-AOP). The MW/H₂O₂-AOP was developed to release nutrients like phosphorus and nitrogen in the soluble form from the organic waste; these nutrients could be further recovered and reused. In the past, this process has been successfully applied to a series of organic waste for the purpose of solubilizing nutrients. The objectives of this research were to: (1) improve the MW/H₂0₂-AOP in terms of nutrient release by determining the different factors that influence the treatment, (2) define the factors affecting the process in their order of significance and (3) check the efficacy of the process on various waste. In the MW/H₂0₂-AOP, the role of mixing was verified, using municipal sewage sludge (aerobic and anaerobic). It was speculated that mixing the samples during the process would facilitate uniform heating and thus promote more nutrient release. At a microwave temperature of 80 °C, heating time of 5 minutes and hydrogen peroxide dosage of 1 mL per 1% of total solids, the results showed that mixed samples gave a higher nutrient solubilization compared to the unmixed. Subsequently, mixing and solids concentration were incorporated in a screening design with the other proven important factors viz., microwave temperature and hydrogen peroxide dosage. The results showed that microwave temperature and hydrogen peroxide dosage were the most significant factors for the release of orthophosphate, ammonia and soluble chemical oxygen demand. Preliminary experiments treating anaerobic sludge using MW/H₂O₂-AOP showed a decrease in orthophosphate concentration below the initial untreated value while for ammonia and volatile fatty acids the concentrations remained same as the initial. In this case, the set microwave temperature was 80 °C with 5 minutes heating and hydrogen peroxide dosage of 1 mL per 1% total solids at pH 7. To investigate this behavior, anaerobic sludge was treated at two pH conditions (7.8 and 4) at microwave temperatures ranging from 80 to 160 °C with hydrogen peroxide dosage of lmL per 1% total solids for 5 minutes. The results showed that acid addition helped in the destruction of sludge solids and release of nutrients. TheMW/H₂0₂-AOP was used to treat separated solid dairy manure. Solid dairy manure with total solids 1.6% was subjected to microwave temperature of 120 °C for 10 minutes with a hydrogen peroxide dosage of 2 mL per 1% total solids at three pH conditions (3.5, 7.3 and 12). Only at pH 3.5, substantial quantity of orthophosphate, ammonia, soluble chemical oxygen demands and volatile fatty acids could be released. Further, a screening experiment was designed including microwave temperature, hydrogen peroxide dosage and heating time, to determine the factors most affecting nutrient solubilization from solid dairy manure. Hydrogen peroxide dosage and temperature were important factors in orthophosphate release while microwave temperature and heating time were important in the release of ammonia and volatile fatty acids. The results clearly define the efficacy of the MW/H₂0₂-AOP on various organic waste as well as the conditions under which the treatment can be optimized.

Dissertation submitted in fulfilment of the requirements for the Degree of Master of Technology: Emergency Medical Care, Durban University of Technology, 2011. / South African Advanced Life Support (ALS) providers follow an autonomous practice model of care. This advanced role profile is characterized by clinical skill competence and autonomous decision making whilst demonstrating a high level of awareness of their own ethical attitudes, values and beliefs. It is through a professional commitment that ALS providers deliver an advanced evidence based practice that should be maintained constantly within a dynamic environment. Continuous Professional Development (CPD) is seen as an instrument for this. CPD should also serve as a means to acquire professional excellence and going beyond the boundaries of meeting the base level standard with the aim of providing the finest quality of care in the interest of patient safety. Purpose of the research The purpose of this research is to identify gaps in the professional development of out-of-hospital ALS providers trained in South Africa by assessing frequency of performance of ALS clinical skills, by determining perceived level of competence and predictors of confidence, and by sourcing information on attendance of CPD activities and training needs. vi Methodology This study used a quantitative non-experimental design. Data was attained from an e-mail based descriptive survey that was limited to a precise and concise questionnaire. The data from 140 (N) ALS providers was subjected to a descriptive statistical analysis using the PASW statistics version 18.0 to systematically show patterns and trends. Frequency distributions were generated to describe data categories. Bivariate analysis was conducted using Chi-square and Pearson correlation tests. Results Results indicated that ALS providers performed clinical skills infrequently. Of the total number of respondents 140 (N), the average ALS clinical skills performance was 6 (4.8%) daily. In the 2-6 times a week category 8 (6.4%) ALS clinical skills were performed. ALS clinical skills performance in the once a week category showed an average of 7 (5.6%) and the once a month category, an average of 17 (13.7%) ALS skills were performed. An average of 31 (25%) ALS skills were performed in the once in six months category whilst an average of 54 (43.5%) were performed in the greater than six months category. CPD activities that are appropriate to ensuring the maintenance of competence for these clinical skills were not adequately undertaken. Medical updates were mostly attended by ALS providers, 52 (42.9%) whilst CPD events that addressed clinical skills, was mostly limited vii to the ACLS course 42 (34.7%). The needs assessment for CPD showed that 56 (53%) of respondents expressed a need for paediatric and obstetric simulated skill sessions, whilst 43 (40.9%) requested clinical skills workshops and 39 (37.1%) expressed a need for clinical practice in theatre and coronary care units. Conclusions and recommendations This study shows that ALS clinical skill competence is maintained by frequent practice and appropriateness of CPD activities. The infrequent performance of ALS skills coupled with the lack of appropriate and diverse CPD activity attendance results in poor maintenance of competence. The loss of competence can be related to poor reported levels of confidence which consequently places patient safety at risk. To safeguard against medical error and ensure patient safety, it is strongly recommended that CPD audits be undertaken on all ALS providers for appropriate CPD compliance related to clinical skills performance. In addition to a clinical skills audit, it is recommended that a national clinical skills registry be established with the intention of facilitating clinical skill surveillance, to determine a notifiable, high risk skill set. To safeguard against knowledge and clinical skill attrition and loss of competence, the delivery of CPD activities should be assessed for effectiveness and appropriateness.