Hyponatremia is common in preterm infants. The causes are usually related to the inability of the premature kidneys to excrete a given water load, excessive sodium losses, or inadequate sodium intake. Here, we present a case of severe hyponatremia in an extreme preterm infant, associated with the use of aminophylline. Aminophylline was administered intravenously on day 1 for the treatment of apnea of prematurity. On day 3, the patient developed hyponatremia which was not responsive to sodium replacement and fluid restriction. Due to concerns of aminophylline‑induced hyponatremia, aminophylline was discontinued on day 6, and within 48 h of discontinuation, serum sodium normalized without the need for sodium supplementation. The purpose of the case report is to present a rare complication associated with aminophylline use and to shed light on potential deleterious effects associated with drug shortages.

Yes

Student Number : 0218517V - MSc dissertation - School of Geography, Archaeology and Environmental Studies - Faculty of Science / Rapid population growth, combined with an expanding economy and tourist industry has lead to a water resource crisis in the United Arab Emirates. The water crisis includes serious difficulties in meeting basic needs, particularly in the agricultural sector, which is a dominating water consumer in the country. All economic sectors are finding it increasingly difficult meeting their water needs, which is primarily manifested by the natural scarcity of water recourses, depletion of groundwater, low efficiency of water use and low coverage of water and sanitation services. This dissertation presents a vision for a comprehensive Earth Information System that goes beyond the limited collection of, say, meteorological data, but seeks to create a national database of past, present and future data of the many related earth system components of both natural and human origin, all of which play a role in defining the hydrologic cycle, and ultimately, the state of water resources. This system is being motivated by the fact that most of the water resource assessments in the UAE cannot take advantage of such datasets because the data are either not collected, too fragmented, or are not part of a national archive that is accessible to the research community and the general public. This system will be developed at the highest level of the national government, through the Office of His Highness the President and the office of the Department of Water Resource Studies which will seek to provide improved water resource assessment using modern database and analytical methods, that will support the development of better studies and new, modern institutional networks and authorities.

Research Doctorate - Doctor of Philosophy / This thesis explores the barriers that are preventing large numbers of permanent resident overseas-trained doctors (PROTDs) from working as general practitioners (GPs) in rural New South Wales (NSW). It focuses specifically on doctors from non-English speaking backgrounds who are permanent residents of Australia or Australian citizens, and who migrated to Australia for reasons other than employment. This thesis explores the views and perceptions of PROTDs and does not specifically consider the views of other stakeholders. Archival, qualitative and quantitative research techniques have been used to determine the suitability of the policies and practices governing the appointment and registration of PROTDs in NSW, and to identify any policy changes required. This research demonstrates that the policies governing medical registration in NSW have frequently been driven by political factors, and have, at times, been used to control the size of the medical workforce. As a consequence of these policies, many PROTDs have been prevented from working as a doctor in NSW. Of particular concern is the lack of training or clinical experience available to PROTDs and their difficulties preparing for, and passing, the Australian Medical Council (AMC) examinations. The lack of accurate information regarding the requirements and opportunities for medical practice in NSW is also a major problem. PROTDs in NSW are unable to get the training and support they need to meet the requirements for medical registration in NSW and are rapidly losing their confidence, and their clinical skills. Not all PROTDs are going to have, or be able to acquire, the skills and knowledge required for general practice in rural NSW. However the need for additional doctors is sufficiently great to warrant a proactive approach from governments and relevant agencies. In the seven years it has taken to complete this research, most of the discriminatory aspects of the assessment and registration of PROTDs in NSW have been removed. However the legacy of previous policies and practices remains and a large number of PROTDs remain out of the medical workforce.

This dissertation explores the role of the regulations regarding seniority with respect to employee layoffs. The main focus of this inquiry is to explore the degree to which the regulations protect the groups of employees for which it is intended. The main area of interest is § 22 of the law regarding employment protection concerning protections for employees with long periods of employment and older workers. It contains an examination of the regulatory framework and an empirical survey of how these regulations were applied at a number of workplaces. The survey consists of thirty workplaces and illustrates how the protectionist purpose of the legislation can be minimized or enhanced as a result of the different decisions made by employers or labor unions and the deliberations behind the decisions. The empirical survey also roughly shows the outcome of the application of these regulations with respect to the surveyed groups at the workplaces. / digitalisering@umu

Research Doctorate - Doctor of Philosophy / This thesis explores the barriers that are preventing large numbers of permanent resident overseas-trained doctors (PROTDs) from working as general practitioners (GPs) in rural New South Wales (NSW). It focuses specifically on doctors from non-English speaking backgrounds who are permanent residents of Australia or Australian citizens, and who migrated to Australia for reasons other than employment. This thesis explores the views and perceptions of PROTDs and does not specifically consider the views of other stakeholders. Archival, qualitative and quantitative research techniques have been used to determine the suitability of the policies and practices governing the appointment and registration of PROTDs in NSW, and to identify any policy changes required. This research demonstrates that the policies governing medical registration in NSW have frequently been driven by political factors, and have, at times, been used to control the size of the medical workforce. As a consequence of these policies, many PROTDs have been prevented from working as a doctor in NSW. Of particular concern is the lack of training or clinical experience available to PROTDs and their difficulties preparing for, and passing, the Australian Medical Council (AMC) examinations. The lack of accurate information regarding the requirements and opportunities for medical practice in NSW is also a major problem. PROTDs in NSW are unable to get the training and support they need to meet the requirements for medical registration in NSW and are rapidly losing their confidence, and their clinical skills. Not all PROTDs are going to have, or be able to acquire, the skills and knowledge required for general practice in rural NSW. However the need for additional doctors is sufficiently great to warrant a proactive approach from governments and relevant agencies. In the seven years it has taken to complete this research, most of the discriminatory aspects of the assessment and registration of PROTDs in NSW have been removed. However the legacy of previous policies and practices remains and a large number of PROTDs remain out of the medical workforce.

Masters of Commerce / Information and Communication Technology is a mixed set of technological tools and resources used to create and manage information. It involves technologies such as radio, television, video, DVD, telephone (both fixed line and mobile phones), satellite systems, computer (network hardware and software) as well as the tools and services associated with these technologies. ICT is increasingly seen as a major enabler of efficiencies and a catalyst for innovations. With adequate skills to effectively use ICT, it can also prove to be a foundation upon which sustainable socio-economic developments can be built. The problem in South Africa, however, is that of a severe shortage of technical skills in the ICT sector. The paradox is that despite the efforts at national, provincial and organisational levels to redress the shortage of skills, the problem persists. The aim of this study thus, was to understand the magnitude of skills shortages in under-developed areas of the Eastern Cape, so as to inform corrective measures. The Actor Network Theory (ANT) was used mainly as an analytical framework to analyse the problem of e-Skills shortages in South Africa. ANT helped in framing the context of the problem. It offered useful lenses of viewing the e-Skills development phenomenon as a network of stakeholders (actors), subjects (actants), processes and a determinant of information flows within the e-Skills development network. The study was mostly descriptive (and partly explanatory), seeking to clarify the status quo, the causes, and ultimately, to explore appropriate solutions. The interpretive approach was followed to conduct qualitative research. In this instance, a purposive sampling method was used to draw participants mainly from un/employed grade 12 (grade 12) graduates of 26 participants, consisting of 18 to 35 years of age. Participants were also drawn from high-level management in the training and development organisations and local employers of ICT graduates of Centane and Butterworth villages in the Eastern Cape. Content analysis technique was used to analyse and interpret data. Findings do reflect a severe lack of basic ICT skills, with causal factors varying from a lack of awareness about ICT careers, to a lack of access to ICT tools, with the majority of the affected grade 12 graduates neither being employed nor doing any tertiary studies. It is therefore recommended for the government to revisit the e-Skills policy and its implementation structures in rural areas. The Department of Education (DoE) in the Eastern Cape should also create educational networks that will provide remote schools with low cost, but high performance Internet access. A re-look into the general quality of education in rural areas is also urgent.

Staffing turnover created a challenge for the women’s services department of a hospital in the southern United States, potentially compromising care for women and infants during childbirth. The gap in practice was the lack of a structured nurse orientation/residency program for nurses new to perinatal nursing, which requires specific competencies not learned at the prelicensure level of education. The guiding practice-focused question was whether a multidisciplinary team could develop a formal evidence-based perinatal nurse residency program that would meet the needs of on-boarding and support for the new nursing hires at this facility. A team of experienced nurses, which included two nurses from labor and delivery, high risk antepartum, mother baby, and assistant nurse manager developed a comprehensive program, which included defined competencies, didactic materials, detailed simulations, and evaluation tools. A multidisciplinary team of six nurses, and the assistant nurse manager achieved consensus on the quality and comprehensive nature of the program plan using the Appraisal of Guidelines for Research and Evaluation Instrument II assessment tool. The implications of this project to bring about positive social change include the potential for improved nursing care for patients during childbirth as a result of increased nurse knowledge and mentoring support. Improved retention might also contribute to stable teamwork and peer support. This project has the potential to improve both physical and psychological outcomes for women and infants in the perinatal period.

An existing simulation model of the Weber Basin (GRES Model) was used as a basis for creating an equivalent model on the Water Evaluation and Planning (WEAP) system. The GRES Model was developed by the Utah Division of Water Resources (UDWR) and simulates the historical water allocation from 1950 to 2006. Using the GRES Model and additional information obtained from UDWR staff, two different WEAP models were created. The two models differed only in how water is transmitted to the service areas. End-of-month reservoir storage and other outputs from the GRES Model were compared to the two WEAP models. The two models turn out to be almost equal. The simplest version of the two WEAP models was selected and named the WEAP Weber Basin Model. The WEAP Weber Basin Model is basically a historical simulation of water allocation in the Weber Basin and shows that the storage level in most reservoirs, except Causey, does not reach the buffer zone. This result indicates the historical water security of the basin and also the security in the foreseable future. The WEAP Weber Basin Model was also modified. Two scenarios consider demand growth (i) with, and (ii) without applying water conservation. These modifications were applied to one of the service areas which serves purely municipal and indusrial demands. The inflow to the system was populated by randomly reshuffling the historical flows. This is assuming that the historical flows will repeat in a random order in the future. Hence the inflows to the streams in 2006 were assigned the historical inflows of 1968 and so on. The result from the WEAP Weber Basin Model without conservation (with growth) shows that most of the reservoirs, with the exception of Pinveview and Willard Reservoirs, do begin to draw from the buffer zone towards the end of the simulation period. Different storage carryover policies tested show that the reliability of the system decreases while its resilience increases when more and more of the water in the buffer zone is carried over between time steps. Applying conservation seems to reduce the shortages created when different storage carryover policies were implemented compred to the model that did not apply conservation.

BACKGROUND: Nationally, 85% of general surgery graduates pursue fellowships reducing the incoming general surgical workforce with a predicted shortage of 41,000 general surgeons by 2025. In recent studies, the lack of confidence appears to be a major factor contributing to resident decision to pursue fellowship. The aim of the study was to determine if a hybrid academic/community program contributes to early autonomy and the decision to pursue fellowship in general surgery graduates. METHODS: We evaluated the level of confidence, level of autonomy, and decision to pursue fellowship at a hybrid academic/community program that historically graduates 70% of their residents into general surgery practice through an anonymous survey. Participants responded using Likert scales along with simple polar questions. RESULTS: Most current residents (90%) reported, upon graduation, that they feel very confident (45%) or fairly confident (45%) performing major cases independently. Most attendings (64%) reported that during their third year of residency, they began performing the majority (more than 75%) of their major cases as surgeon junior while current residents (55%) reported they were performing the majority as a second-year resident. Fifty-five percent of residents felt that confidence played a role in the decision to pursue fellowship. Thirty-three percent of our current chief residents and only 34% of the total general surgery residents plan to pursue fellowships. Conclusions: Our study showed that our residents appear to have earlier levels of autonomy than that experienced by our practicing surgeons when they were residents. Confidence continues to play a role in the decision to pursue fellowship and overall our residents are confident in technical skills at graduation. Our unique program continues to graduate the majority of our surgical residents into successful general surgery practice.