Yes / The World Health Organization (WHO) recommends 100% blood should be from voluntary non-remunerated donors (VNRD) yet the majority of blood donations (75%) in Barbados are family/replacement donations. Increasing VNRD is paramount to achieving a safe, reliable blood supply and understanding the population is a strategy suggested by the WHO to inform donor recruitment and education. To obtain information to devise strategies for a voluntary donor mobilization campaign in Barbados. Methods: Participants in Barbados (n=429) completed a self-administered questionnaire in 2014. The questionnaire comprised 31 questions including demographics (age, sex, highest educational attainment) and blood donation-related knowledge, attitudes and practices. Analysis of variance, t-test and linear regression were used to analyse data. Results: Fifty-three per cent (n=219) of participants had previously donated blood; only 23.9% of these had donated within the past two years and almost half were family/replacement donors only. Knowledge deficits included blood donation requirements, deferral factors and maximum yearly donations. Most participants (79%) were willing to donate with more information. Participants with higher educational attainment and previous donors had higher total knowledge and attitude scores (p<0.01). Single, female, and younger participants were less likely to donate blood (p<0.05). Conclusion: Barbados can likely increase voluntary blood donation rates by addressing knowledge deficits through education campaigns and increasing awareness of the need for donation.

Medial Oxford unicompartmental knee replacement (UKR) is an established and successful treatment for patients with antero-medial knee osteoarthritis. However, following the operation some patients have pain which compromises their functional outcome. The aims of this thesis were to determine the incidence of pain, to identify the patient, disease and surgical risk factors associated with this pain and to try and understand why it occurs. The clinical studies were performed using patients operated on by experienced surgeons. The incidence of post-operative severe pain was 3% at six weeks and 2% at one year and the incidence remained unchanged at subsequent follow ups. The overall incidence of pain has reduced over the years. In patients who had UKR between 1998 and 2001, the incidence of severe pain was 5%; this reduced to 2.3% for the period between 2008 and 2011. As the indications have not changed, the improvement is probably due to modifications in the surgical technique and due to improvements in instrumentation. Patients with severe pain at the final follow up had a worse neuropathic pain score, and the patients with possible pre-operative neuropathic pain achieved significantly worse outcome. To explore the effect of disease severity on outcome, matched cohorts of patients with partial thickness cartilage loss (PTCL), bone-on-bone and bone loss were compared. All those with bone-on-bone and bone loss did well, whereas 20% of those with PTCL did not benefit from the surgery; 7% had severe pain and 17% had pain related complications. Although component and leg alignment, and component overhang have a profound effect on the outcome of total knee replacement (TKR), their effect on the outcome of the Oxford UKR are not known. It was found that malalignment in the coronal or sagittal planes of the femoral component within ±10° and of the tibial component within ±5° did not compromise the outcome. Leg alignment was not related to outcome even though 18% were in 5° varus and 8% were in 10° varus. In contrast, tibial component overhang ≥3 mm compromised the outcome and 21% of these patients continue to suffer from pain. The presence of radiolucent lines (RLL) following a joint replacement is usually deemed to be indicative, or predictive, of loosening. 63% of Oxford UKRs were found to have RLL under the tibial component. No correlation was found between RLL and outcome, particularly pain. It has been suggested that post-operative pain, which is commonly antero-medial over the proximal tibia, may be related to bone overload. This was explored using the finite element (FE) analysis. Following implantation of the Oxford UKR, the strains in the antero-medial region doubled. Various implantation, loading and alignment variables were studied and the findings correlated with the clinical studies, suggesting that high strain is an important cause of pain. With time, the bone will remodel, so the strains will decrease but individual differences in the remodeling threshold may explain resolution of symptoms in some, but not in all, patients. In conclusion, this work has shown that following the Oxford UKR, pain is a rare but important complication. The chance of pain can be decreased by operating only on patients with bone-on-bone arthritis and taking care with the surgical technique. Bone overload is likely to be an important cause of pain, and further modification to the implant or technique, such as achieving fixation of the tibial component vertical wall to bone, may further decrease the incidence of pain.

Moral och moralutveckling är ett komplext område som kan vara viktigt att belysa i socialt arbete, då det visat sig att ungdomar med ett normbrytande beteende ofta har en lägre moralnivå än andra ungdomar. Det kan därför hävdas att det finns ett behov av moralfrämjande insatser inom ramen för behandling. Studiens syfte är att undersöka moralutveckling och ställa detta mot behandlingsprogrammet Aggression Replacement Training för att se hur de moralbildande komponenterna är tänkta att främja normbrytande ungdomars moralutveckling. Ett vidare syfte är att undersöka hur moralteorier och ART kan förstås ur ett genusperspektiv. I Studien används scoping samt en riktad innehållsanalys för att tematisera manual, forskning och litteratur. Resultatet visar att ART:s syfte med moralträning är att ungdomar ska ledas framåt i sin moralutveckling och nå en medvetenhet kring ömsesidigt beroende mellan individ och samhälle. Behandlingsutfallet påverkas av en kombination av olika faktorer, inom och utanför behandlingsprogrammets ramar. Det är oklart huruvida det finns ett behov av att anpassa behandling utefter kön, dock kan det hävdas att det utifrån ett genusperspektiv krävs individanpassning. Diskussionen belyser att det kan finnas ett behov av att göra en distinktion mellan moraliskt resonerande och moraliskt handlande, samt så diskuteras genusperspektivets betydelse i relation till könsroller och socialisering. / Morality and moral development are complex topics that may be important to social work, as it has been found that adolescents with antisocial behavior often has a lower moral level than other juveniles. It can therefore be argued that there is a need for moral interventions when different interventions are organized. The purpose of this study is to explore moral development in relation to the treatment program Aggression Replacement Training, how the components in moral skill training are meant to promote moral development in juvenile delinquents. A further aim is to examine how moral theories and ART can be understood from a gender perspective. Methods used in this study are scoping and directed content analysis. The results show that ART:s aim with moral training is to lead juveniles forward in their moral development. A combination of factors, both within and outside the treatment program affects the treatment outcome. Whether there is a need to adjust treatment to sex is unclear, thus it can be argued that there from a gender perspective may exist a need for more personalized treatment. The discussion illuminates a need to make a distinction between moral reasoning and moral action in treatment. Furthermore the discussion considers gender perspective in relation to gender role and socialization.

Diss. (sammanfattning) Umeå : Univ., 2005. / Härtill 4 uppsatser.

Cache replacement policies can play a pivotal role in the overall performance of a system by preserving data locality and thus limiting the o -chip accesses. In a shared memory system, a cache coherence protocol is necessary to ensure correctness of data computations by maintaining the state of entries in the cache. In this work we attempt to build and investigate the effect of cache replacement policies using the information provided by cache coherence protocol states. The cache coherence protocol states give us an idea about the state of entry with respect to other cores in the system. State based analysis of SPLASH-2 and PARSEC benchmark suites show that this information hints us towards the locality patterns of cache blocks, which can be used to prioritize the order of replacement of a cache states in a replacement policy. We model ten di erent cache state based replacement policies, three having xed priorities and seven whose priorities vary dynamically over the most recently used state. We compare these policies against the standard replacement policies (LRU, FIFO and Random) in terms of system performance and ease of implementation. We develop our simulation framework using the Multi2Sim simulator, where we model cache state based replacement policies. We simulate SPLASH-2 and PARSEC benchmark suites over a variety of con gurations, where we vary the number of cores, associatively for each level of cache, private/shared L2 cache. We characterize the programs to find out critical components for performance. For an 8-core system we observe that the best case among these state based replacement policies shows marginal improvements in IPC over the Random and FIFO policies, falling slightly short of LRU. We design the state based replacement policies using a smaller cache (CSL-cache), which is used to store the state information of the blocks in the main cache. The CSL cache communicates with the controller to provide the replacement entry. The complexity associated with the system is equal to FIFO and is independent of the associatively of the cache.

The aim of this thesis was to investigate how to construct a system to measure load in a mobile unicompartmental knee replacement (UKR) bearing. In vivo loads have been measured in a total knee replacement (TKR), but with TKR the kinematics are different from those of the normal knee, whereas they are close to normal in a mobile UKR, so the loads measured by an instrumented UKR would be more representative of the normal knee. On the principle of measuring compression of an object under load, the load may be estimated. Compression measurement using a capacitive sensor was the optimal solution to measure load, based on life expectancy of the sensor and bearing integrity. A capacitive sensor within a polyethylene (UHMWPE) bearing has not been used before. The visco-elastic and temperature dependent properties of UHMWPE were determined with experiments. UHMWPE had an approximately linear response after ten minutes of applying a constant load. A temperature sensor should be used in vivo to compensate for temperature effects acting on the elastic modulus of UHMWPE. Finite element modelling demonstrated that positioning the sensor under the centre of the bearing concavity resulted in the largest capacitive change. The influence of various dimensional parameters on sensor output was simulated, and the conclusion was that the sensor only needs to be calibrated once. An electronic module inserted into a bearing had less than 5 % influence on bearing compression. Capacitive sensors were made from polyimide, using standard production methods, and embedded within a UKR bearing using the standard compression moulding process. The embedded sensor had a second order low pass frequency response, with a corner frequency of 9 Hz, twice the frequency required for typical functional loading such as gait. Physiological load signals, gait and step up/down, were applied to the bearing. The capacitance to load response was approximately linear. Load was estimated using a linear method and a dynamic method. The linear method performed best, with an accuracy of force estimation better than 90 %. In vitro tests were performed using a commercially available transceiver, two stan- dard antennas and a custom antenna, designed to be incorporated in the bearing. Wireless communication between an implanted custom antenna and an external an- tenna was shown to be feasible. Experiments were also performed that demonstrate that inductive powering of the bearing was feasible. In addition to load measurement, a proposal for dynamic measurement of the orien- tation angles of both the tibia and the femur was made. Power and volume calculations showed that it is possible to place an electronic module within the bearing. This thesis has not only demonstrated that it is feasible to make an instrumented bearing for UKR but has also provided a basic design for manufacturing.

nÃo hà / The reduction of the tax burden has been one of the main tools used by the Brazilian states in order to benefit companies established in their territories, with the objective of protecting the local market and especially the generation of employment. The Government of CearÃ, imbued with this purpose, promoted the reduction of the tax burden applied to the segments of Wholesale and Retail Footwear, using the systematic replacement tax with a aggregate of 55%, which is on average 24% lower that the rate of Additives practiced by such segments. In this work, through empirical tests, we will attest if the benefit granted promoted the extension of the tax base as a way to compensate the reduction of the tax burden. / A reduÃÃo da carga tributÃria tem sido um dos principais instrumentos utilizados pelos Estados brasileiros como forma de beneficiar empresas estabelecidas em seus territÃrios, tendo como objetivo proteger o mercado local e principalmente a geraÃÃo de emprego. O Governo Cearense, imbuÃdo desse propÃsito, promoveu a reduÃÃo da carga tributÃria aplicada aos segmentos de ComÃrcio Atacadista e Varejista de CalÃados, utilizando para tanto a sistemÃtica da substituiÃÃo tributÃria com uma agregaÃÃo de 55%, que à em mÃdia 24% menor que a Taxa de Adicionamento mÃdia praticada por tais segmentos. Nesse trabalho, atravÃs de testes empÃricos, iremos atestar se o benefÃcio concedido promoveu o alargamento da base tributÃria como forma de compensar a reduÃÃo da carga tributÃria.

No description available.

BACKGROUND:Anticoagulation with vitamin K antagonists such as warfarin has historically been used for the long term management of patients with thromboembolic disease. However, these agents have a slow onset of action which requires bridging therapy with heparin and its analogues, which are available only in parenteral route. To overcome these limitations, new oral anticoagulants such as factor Xa inhibitors and direct thrombin inhibitors have been developed. The aim of this article is to systematically review the phase 3 clinical trials of new oral anticoagulants in common medical conditions.METHODS:We searched PubMed (Medline) from January 2007 to February 2013 using "Oral anticoagulants", "New oral anticoagulants", "Randomized controlled trial", "Novel anticoagulants", "Apixaban", "Rivaroxaban", "Edoxaban", "Dabigatran etexilate", "Dabigatran" and a combination of the above terms. The available evidence from the phase 3 RCTs was summarized on the basis of individual drug and the medical conditions categorized into "atrial fibrillation", "acute coronary syndrome", "orthopedic surgery", "venous thromboembolism" and "medically ill patients".RESULTS:Apixaban, rivaroxaban and dabigatran have been found to be either non-inferior or superior to enoxaparin in prophylaxis of venous thromboembolism in knee and hip replacement with similar bleeding risk, superior to warfarin for stroke prevention in atrial fibrillation with significant reduction in the risk of major bleeding, non-inferior to aspirin for reducing cardiovascular death and stroke in acute coronary syndrome with significant increase in the risk of major bleed. Rivaroxaban and dabigatran are also superior to the conventional agents in the management of symptomatic venous thromboembolism. However, compared to enoxaparin, apixaban and rivaroxaban use lead to significantly increased bleeding risk in medically ill patients. Additional studies evaluating the specific reversal agents of these new drugs for the management of life-threatening bleeding or other adverse effects are necessary.CONCLUSION:Considering their pharmacological properties, their efficacy and bleeding complications, the new oral agents offer a net favourable clinical profile in orthopedic surgery, atrial fibrillation, acute coronary syndrome and increase the risk of bleeding in critically ill patients. Further studies are necessary to determine the long term safety and to identify the specific reversal agents of these new drugs.

Thesis (MBA)--Stellenbosch University, 2001. / ENGLISH ABSTRACT: The replacement of earthmoving machines forms a significant portion of the annual capital expenditure on South African mines. The decision on the timing of the replacement varies substantially between different operations, but frequently it is not based on any scientific study or analysis. The reason for this is that most textbooks propose complex calculations for the determination of an optimal replacement point, and subsequently the mathematical effort serves as a deterrent to those who are tasked with replacement evaluation. This study proposed a simple graphic method which is suitable for everyday use, and which can quickly be adapted when conditions change. The model furthermore makes provision for the analysis of the replacement of both the current machines (the so-called defenders) as well as an evaluation of potential replacement machines (the so-called challengers). In addition, the model also makes provision for the incorporation of non-cash factors, such as productivity and reliability. / AFRIKAANSE OPSOMMING: Die jaarlikse vervanging van grondversuiwing masjienerie maak 'n groot deel uit van die kapitaalplan van die meeste Suid-Afrikaanse myne. Die metode van besluitneming oor die presiese tydsberekening van die vervanging verskil ook tussen die verskillende organisasies, maar dit is selde gebaseer op 'n wetenskaplike analiese. Die rede hiervoor is dat die meeste handboeke komplekse wiskunde modelle voorstel vir die berekening van 'n optimate masjien vervangingspunt. The kompleksiteit gee daartoe aan dat baie nie kans sien om dit te probeer doen nie, en gevolging wegskram van enige analise. Hierdie studie projek stel 'n eenvoudige grafiese model voor vir allerdaagse gebruik, wat ook vinning gewysig kan word as toestande verander. The model maak ook voorsiening vir die analise van beide die huidige masjien (die sogenaamde verdediger) se optimale vervangingspunt, sowel as die evaluasie van potentiele nuwe masjiene (die sogenaamde aanvallers.) Die model maak verder ook voorsiening vir faktore wat nie normaalweg in geldwaarde beskryf word nie soos byvoorbeeld produktiwiteit en betroubaarheid.