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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.

Accelerated warming of high latitude systems of the northern hemisphere is expected to cause significant changes to the hydro-ecology of Arctic lakes. To record comprehensive and meaningful baseline hydrological, limnological, and ecological conditions to which future change can be compared, all available environmental information generated on Noell Lake, NWT was compiled and synthesized. Data included: physical and geographical characteristics (bathymetric and drainage basin attributes); general regional climatology; water quality (nutrients, major anions/cations, dissolved oxygen, dissolved organic carbon); biological composition (fish community, macrophyte, phytoplankton, epiphyton and epipelon surveys) and seasonal patterns in primary productivity (as measured by chlorophyll-a (Chl-a)). A field-monitoring study was conducted from September 2010 to July 2013 assessing the application, reliability, and quality control/quality assurance of a newly developed automated buoy-based Arctic Lake Monitoring System (ALMS). The ALMS continuously measured a range of lake limnological and water quality parameters under both open-water and under-ice conditions. Overall, the ALMS provided a usable, uninterrupted record of changes in measured environmental, hydrological, and limnological parameters in both the epilimnion and hypolimnion. Noell Lake was determined to be spatially homogeneous with respect to the limnological measurements taken and, thus, the data recorded by the instrument arrays were determined to be representative of the lake as a whole. In addition to the measurements made by environmental sensors mounted on the buoy and mooring components, an augmentary array of in-situ sampling campaigns and controlled experiments were conducted to produce a continuous and comprehensive description of daily and seasonal changes to the hydrological and limnological conditions of Noell Lake. The continuous data series confirmed that Noell Lake is dimictic, with mixing events occurring in August and June, and hypoxic oxygen conditions occurring in March. Nutrient limitation experiments revealed that autotrophic productivity in Noell Lake was nitrogen-limited. Compiling data from existing literature involved >700 northern, high-latitude lakes; patterns in temporal and latitudinal changes in Arctic lake primary productivity (as measured by open-water, epilimnion Chl-a) and geochemistry were assessed. The key hypothesis tested was whether Arctic lakes are showing increased primary productivity (i.e., “greening”), through time and by latitude, similar to that documented for Arctic terrestrial systems. In general, significant decreases in lake Chl-a was observed in Arctic and sub-Arctic lakes over a ≈50 year time span. Separation of lakes by latitudinal bands revealed that trends in the lower Arctic region (60.00-69.99 Degrees North) showed a significant decreasing time trend, while high Arctic lakes displayed no trends. Corresponding temporal trends of total phosphorous (TP), total nitrogen (TN), and dissolved organic carbon (DOC) differed depending on the latitude of the lakes. Re-evaluation of the original northern-lake productivity models developed by Flanagan et al. (2003) through the use of the new, independent datasets (>700 lakes) as well as the addition of other environmental variables (DOC, dissolved inorganic carbon, lake depth, conductivity, and ice-cover) showed that the original models were valid and the most parsimonious in predicting variation in algal biomass in northern latitude lakes. Only measures of dissolved nutrients (TP, TN) and latitude are required to predict autotrophic water column productivity. / Graduate

Space-time coded systems developed in the last ten years have been designed primarily using linear modulation. Non-linear continuous phase modulation has desirable constant envelope properties and considerable potential in space-time coded systems. The work in this thesis is focussed on developing and analysing an integrated space-time coded continuous phase modulated (STC-CPM) system. The coding of the space-time encoder and the modulation is incorporated into a single trellis encoder. This allows state combining, which leads to complexity reduction due to the reduced number of states. Design criteria for STC-CPM are summarized and the Euclidean distance is shown to be important for code design. The integrated STC-CPM system design enables systematic spacetime code searches that find optimal space-time codes, to be easily implemented. Optimal rate-1/2 and rate-2/3 space-time codes are found by maximizing the system's minimum squared Euclidean distance. These codes can provide high throughput and good coding gains over un-optimized full rank codes, such as delay diversity, in a quasi-static flat fading environment. Performance bounds are developed using a union bound argument and the pairwise error probability. Approximations of the bounds are evaluated. These truncated upper bounds predict the slopes of the simulated performance curves at low error rates.

The production of bio-ethanol from lignocellulosic material requires a more efficient process to be feasible and compete with products from fossil fuels. There is a need to rapidly and nondestructively be able to determine key components during fermentation. Raman spectroscopy is a technique, which can be used to monitor the fermentation process in real-time and provide information about key components which can be accessed immediately, thus facilitating process control. A continuous system with membrane cell recycling was set up and fermentations were performed using Saccharomyces cerevisiae ATCC 96581. Fermentations were performed to test for optimal dilution rates and operating times, the effect of different sugar concentrations in the media feed, and which position in the system was optimal for Raman data collection. Raman data and aliquot samples for HPLC validation were continuously collected throughout the fermentations. Raman data was analysed with PLS models to obtain component concentrations, for which RMSE was calculated in order to compare to HPLC validation set. Fermentations were performed with synthetic glucose media as well as with poplar hydrolysate. It was shown that the continuous system with membrane cell recycling could achieve a glucose-to-ethanol conversion of between 75-100%. The process could be sufficiently monitored by Raman spectroscopy, and predicted concentrations were within the range of the validation set in most cases. However, the error of prediction varied between the different fermentations.

On presente une generalisation d'un resultat de Wallin ainsi qu'une caracterisation des ensembles compacts polaires dans un espace de Brelot. Ces resultats se generalisent a un produit de n espaces de Brelot en demontrant la continuite des fonctions multireduites. On en deduit qu'un ensemble localement n polaire est un ensemble in polaire. Des resultats semblebles ont lieu pour une sous-classe des ensembles pluripolaires dans un domaine hyperconvexe et borne de C('n).

The construction of the generalized continuous wavelet transform (GCWT) on Hilbert spaces is a special case of the coherent state transform construction, where the coherent state system arises as an orbit of an admissible vector under a strongly continuous unitary representation of a locally compact group. In this thesis we extend this construction to the setting of Hilbert C*-modules. In particular, we define a coherent state transform and a GCWT on Hilbert modules. This construction gives a reconstruction formula and a resolution of the identity formula analogous to those found in the Hilbert space setting. Moreover, the existing theory of standard normalized tight frames in finite countably generated Hilbert modules can be viewed as a discrete case of this construction We also show that the image space of the coherent state transform on Hilbert module is a reproducing kernel Hilbert module. We discuss the kernel and the intertwining property of the group coherent state transform.

Thesis (M.S.)--Oregon Graduate Center, 1981.

University, Diss., 2006--Frankfurt (Main). / Zsfassung in dt. und engl. Sprache.

Thesis (M. Sc.)--University of Hong Kong, 2007.