The first goal of this investigation was to undertake a non-equivalent quasi-experimental design to test the effect of a total Quality management (TQM) approach to improve the appropriateness of clinical laboratory test utilisation in the management of early acute myocardial infarction (AMI). The study was conducted at 2 public hospitals in Sydney over a 30 month period, and in 2 stages- pre and post TQM intervention. Using specifically a Continuous Quality Improvement (CQI) FOCUS-PDCA model, a multidisciplinary team was empowered to make appropriate changes in order to improve a variety of problem areas that affected the total pathology service. Improvement was directed at the total system of pathology testing, not just test ordering. It was observed that the introduction of a TQM environment had provided a more committed, integrated and motivated clinical care effort towards improving the appropriateness of test ordering. Such team efforts were accompanied by demonstrated customer satisfaction at various aspects of the laboratory service and further benefits to patient care. Patient care benefited greatly from the highly significant changes towards more appropriate timing of blood collections for cardiac enzyme testing. Other improvements included overall improvements to the turnaround time of test results, reductions in specimen delivery delays, more appropriate use of clinical laboratory tests, a streamlined distribution of printed reports and marked improvements in communication between staff involved in the process of test ordering. Of major importance was the finding that CQI strategies resulted in substantial savings of 23.0% of the overall cost of pathology services. Adoption of the TQM approach appears to be a strategy worthy of exploration by laboratory directors and health administrators interested in improving patient care while at the same time reducing expenditure. / Doctor of Philosophy (PhD)

With the obvious evolution and acceleration of smart grid, it is crucial for its success to rely on a solid transmission protocol among its peripherals due to its real time streaming. TCP is the well known traditional transport protocol used for a reliable transmission, and is a major player for smart grid. However, it lacks a fault tolerance transmission method that overcomes potential failures which may mitigate smart grid progress and in its turn decrease its reliability. We propose that smart grid operators utilize SCTP as the principle transport protocol for their smart grid communications, by using the two very significant characteristics offered by SCTP multi-homing and multi-streaming respectively. Thus, we argue that they can override two major obstacles caused by TCP Head of Line Blocking (HLB) and the inability of handling automatically two or more paths to a final destination. Although SCTP resembles TCP in many aspects, SCTP can definitely play a dominant role in many current and future applications due to its key features that do not exist in TCP. We have used ns2.34 simulator as the tool whom we relied on to investigate whether or not smart grid may benefit over TCP by the two SCTP features, and have analyzed the output of simulated results by using other analytical tools. As we obtain results, we argue that smart grid operators should rely on SCTP as a feasible transmission protocol instead of TCP.

Background: Mexican-American women are a burgeoning population and are at increased risk for heart disease. However, there are no studies published yet describing acute myocardial infarction (AMI) symptoms unique to this Hispanic subgroup. Aims: Guided by vulnerability theory, the aims were to describe Mexican-American women's perceptions of the AMI symptom experience and to measure their self-reported acute and prodromal MI symptoms. Methods: A convenience sample of eight Mexican-American women mean age 63 years (range 41-78 years) with recent AMI from the U.S.-Mexico border region participated in a semi-structured interview and completed the McSweeney Acute and Prodromal Myocardial Infarction Symptom Survey (MAPMISS). Qualitative description was used to analyze codes from interview data and descriptive statistics to analyze the MAPMISS responses. Results: Mexican-American women's symptom experience was incongruent with what they knew to be symptoms of a heart attack. They attributed AMI symptoms to non-cardiac causes and did not think they were having an MI. Women self-managed symptoms and delayed seeking health care until symptoms became severe. "Asphyxiatia" (asphyxiating) and "menos fuerza" (less strength) were the most commonly described symptoms in the interviews. On the MAPMISS, Mexican-American women reported a mean of 11.25 (range 5-22) acute and 8.75 (range 0-17) prodromal symptoms. Sleep disturbance and weakness and nausea were the most frequently reported prodromal and acute symptoms, respectively, as measured by MAPMISS. Prodromal leg pain was reported with more frequency than prodromal general chest pain. Conclusions: Delays in seeking health services by Mexican-American women in the U.S.-Mexico border region reflect (1) the difference in their actual MI symptoms compared to preconceived ideas of a heart attack, (2) different terms used to describe their MI symptoms, and (3) not initiating healthcare services themselves. These findings can be used to inform Mexican-American women and healthcare providers in the U.S.-Mexico border region about the unique experiences of Mexican-American women. The findings that participants were not able to recognize or attribute their AMI symptoms suggest that heart health education should be tailored to Mexican-American women and targeted to Mexican-American families and communities.

With the obvious evolution and acceleration of smart grid, it is crucial for its success to rely on a solid transmission protocol among its peripherals due to its real time streaming. TCP is the well known traditional transport protocol used for a reliable transmission, and is a major player for smart grid. However, it lacks a fault tolerance transmission method that overcomes potential failures which may mitigate smart grid progress and in its turn decrease its reliability. We propose that smart grid operators utilize SCTP as the principle transport protocol for their smart grid communications, by using the two very significant characteristics offered by SCTP multi-homing and multi-streaming respectively. Thus, we argue that they can override two major obstacles caused by TCP Head of Line Blocking (HLB) and the inability of handling automatically two or more paths to a final destination. Although SCTP resembles TCP in many aspects, SCTP can definitely play a dominant role in many current and future applications due to its key features that do not exist in TCP. We have used ns2.34 simulator as the tool whom we relied on to investigate whether or not smart grid may benefit over TCP by the two SCTP features, and have analyzed the output of simulated results by using other analytical tools. As we obtain results, we argue that smart grid operators should rely on SCTP as a feasible transmission protocol instead of TCP.

No description available.

Within a few years of the end of World War Two Christianity had spread to every Taiwanese aboriginal group. Nowadays a variety of Christian churches play an important role in aboriginal society. This study is about conversion to Christianity and its aftermath in an aboriginal village. Fieldwork was conducted among the Ami (one of the nine Taiwanese aboriginal groups), in Iwan, a village on the eastern coastal of Taiwan. In this study the individual interests of social actors are emphasised. I suggest that not only political leaders had special motives (i.e. to pursue political power) in conversion, but also ordinary people had their own interests too (i.e. to pursue a better life in the future). In this sense we might say that the meanings, functions, purposes and aims imputed to religion by converts are arrived at through local dialogues. Religious conversion happened against a historical background of long and sustained contact with colonising immigrants (e.g. Japanese and Chinese). During colonial rule. Ami social life expanded radically and mass conversion took place, in the 1950s, when a common dissatisfaction with life was felt. I argue that relative deprivation was an important factor in this conversion and it became significant because of the emphasis put on it by local political leaders. The adoption of different Christian churches is best understood from the perspective of internal political relations and the careers of political leaders. In general I argue that through the articulations of prominent Ami leaders various external phenomena have been integrated into Ami life and successful articulations have also helped certain political leaders to pursue or maintain their authority.

This diploma thesis is about costumes from Maupassant' s novel "Milacek", following up its dramatisation from Zdenek Kaloc. In introduction, I explain the reasons why I have decided for this topic nowadays. Theoretical part describes the content of the novel and the circumstances of the origin of the novel. Then life of G. De Maupassant is briefly explained and his novel is compared to his own life experience. After that follows the listing of selected drama and film adaptations. After that, the novel Bell ami is compared to other literature work from different authors. Analytical part describes mainly the work with the text of the novel, its dramatization and explains the inspiration for the costumes. Then there are reflections on possible principles of staging and relation to present social issues and problems. This part of the thesis ends with the description of the solution of individual costumes. In the conclusion, there is a summary of the goals of the thesis and the explanation of the adaptiation of the dramatization.

The elderly population worldwide has an increasing expectation of wellbeing and life expectancy. The monitoring of the majority of elderly people on an individual basis, in a medical sense, will not be a viable proposition in the future due to the projected numbers of individuals requiring such activity. The expectation is that the infrastructure available will not be adequate to meet all the anticipated requirements and subsequently people will have to live at home with inadequate care. A new global objective that aims towards enhancing the quality of life of the elderly is being supported by extensive research. This research has been taking place in the field of ambient intelligence (AmI), considering factors including more comfort, improved health, enhanced security for the elderly, and facilitating the living in their homes longer. Prior research has shown a need for accelerated expansion in the ambient intelligence domain. To that end this work presents a novel learning technique for intelligent agents that can be used in Ambient Intelligent Environments (AIEs). The main objective of this work is to add knowledge to the AmI domain and to explore the practical applications within this research field. The added knowledge is accomplished through the development of an ambient intelligent health care environment that allows a practical assessment of the human well-being to take place. This is achieved by transforming the elderly living environment into an intelligent pseudo robot within which they reside to better understand the human wellbeing. The system developed aims to provide evidence that a level of automated care is both possible and practical. This care is for those with chronic physical or mental disabilities who have difficulty in their interactions with standardised living spaces. The novel integrated hardware and software architecture provides personalised environmental monitoring. It also provides control facilities based on the patient‘s physical and emotional wellness in their home. Entitled Health Adaptive Online Emotion Fuzzy Agent (HAOEFA), the system provides a non-invasive, self-learning, intelligent controlling system that constantly adapts to the requirements of an individual. The system has the ability to model and learn the user behaviour in order to control the environment on their behalf. This is achieved with respect to the changing environmental conditions as well as the user‘s health and emotional states being detected. A change of emotion can have a direct impact on the system‘s control taking place in the environment. Thus HAOEFA combines an emotion recognition system within a fuzzy logic learning and adaptation based controller. The emotion recogniser detects the occupant‘s emotions upon the changes of the physiological data being monitored. In addition to acting as an output to the occupant‘s physiological changes, the detected emotion also acts as input to the whole situation being observed by HAOEFA. This allows HAOEFA to control the Glam i-HomeCare on the user‘s behalf with respect to their emotional status. The system developed incorporates real-time, continuous adaptations to facilitate any changes to the occupant‘s behaviour within the environment. It also allows the rules to be adapted and extended online, assisting a life-long learning technique as the environmental conditions change and the user behaviour adjusts with it. HAOEFA uses the fuzzy c-means clustering methodology for extracting membership functions (MFs) before building its set of fuzzy rules. These MFs together with the rules base constitute a major part of the proposed system. It has the ability to learn and model the individual human behaviour with respect to their emotional status. Following the provided literature review and the presentation of Fuzzy logic MFs (see section 3.3). The thesis presents two chosen unobtrusive self-learning techniques that are used in the development of the intelligent fuzzy system. Each approach combines an emotion recogniser with a fuzzy logic learning and adaptation based technique for systems that can be used in AIEs. A comparison of two different MFs designs is contrasted showing the impact they have on the system learning ability. A number of carefully designed experiments were performed by volunteers in the Glam i-HomeCare test-bed at the University of South Wales to examine the system‘s ability to learn the occupant‘s behaviour with respect to their health and emotional states. The experimental procedures were performed twice by each volunteer, while maintaining the same behavioural actions to compare how much the design of fuzzy membership functions can impact the learning process and the number of rules created by the system. Besides evaluating both systems‘ emotion recognition accuracies and comparing them to one another for each occupant, the empirical outcomes show the potential of the approach in assisting the extension of independent living. The results demonstrate how the type-1 fuzzy system both learnt and adapted to each occupant‘s behaviour with respect to their health and emotional state whilst assessing multiple environmental conditions.

En este trabajo se analiza el estado del arte de los sistemas de medida orientados a los clientes de baja tensión en Chilectra S.A. y las tendencias de sistemas de medida avanzada en el mundo. Se realiza una evaluación técnica - económica de tres escenarios: Un sistema de lectura remota con corte y reposición del servicio y dos sistemas con diferentes opciones de tarifas y servicios adicionales. Se determinan los beneficios y costos que determinan la rentabilidad del proyecto. En base a los resultados de la evaluación, se desarrolla una propuesta mínima funcional de las características del sistema. Se analizan los riesgos del proyecto, así como las especificaciones que hoy rigen. Se presentan alternativas de sistemas de medida avanzada presentes en el mercado y se plantean políticas a seguir de modo de incrementar la viabilidad del proyecto.

The thesis processes the use of Montessori pedagogy in the Czech environment. The introductory chapters of this thesis describe the life and work of Marie Montessori, the fundamental anthropological thoughts and principles, and the development of Montessori approach. The thesis maps out by descriptive method the current institutions and primary schools which operates in the Czech environment. The following chapters contain case studies of two Montessori primary schools in Prague. The results of this thesis show that the approach of Marie Montessori is not just a rigid conception, but that it is still capable of development in the living process in school practice.