Suchergebnisse

Wireless Internet has been available since the late 1990's, but has only recently emerged as a powerful tool for access in communities and cities at large. However, this has not gone unnoticed by parties that perceive a potential threat to the established order of Internet players. As the clash of interests grows, governments have been getting involved through policy and regulation to help bring balance to the social and economic issues. In this paper, the author attempts to put these issues in to a clearer perspective by summarizing the landscape as it pertains to wireless Internet access from the North American perspective.

With the Ontario healthcare system under strain the use of resources—particularly emergency medical services (EMS) is an increasing focus. Recent work has identified long-term care facilities as high users of EMS despite access to health-related support outside of the hospital. However, such insights are not available for home care. A retrospective review of administrative records of EMS calls drawn from over 6 million visits by home care providers found relatively low call rates: 8.4 calls per 100 000 personal support visits, 4.1 calls per 100 000 for rehabilitation providers, and 0.9 calls per 100 000 for nurses. The majority (85%) of calls resulted in transport to the hospital; the notable exception was fall-related events, and of these falls, a third (32%) were treated at home. Classification of reported physical symptoms suggests opportunities for leveraging in-home clinical specialists to avoid hospital transport where possible and preserve EMS capacity to respond to the most urgent and severe events.

BackgroundWe set out to define the relative prevalence and common presentations of the various aetiologies of headache within an ambulant HIV‐seropositive adult population in Kampala, Uganda.MethodsWe conducted a prospective study of adult HIV‐1‐seropositive ambulatory patients consecutively presenting with new onset headaches. Patients were classified as focal‐febrile, focal‐afebrile, non‐focal‐febrile or non‐focal‐afebrile, depending on presence or absence of fever and localizing neurological signs. Further management followed along a pre‐defined diagnostic algorithm to an endpoint of a diagnosis. We assessed outcomes during four months of follow up.ResultsOne hundred and eighty patients were enrolled (72% women). Most subjects presented at WHO clinical stages III and IV of HIV disease, with a median Karnofsky performance rating of 70% (IQR 60‐80).The most common diagnoses were cryptococcal meningitis (28%, n = 50) and bacterial sinusitis (31%, n = 56). Less frequent diagnoses included cerebral toxoplasmosis (4%, n = 7), and tuberculous meningitis (4%, n = 7). Thirty‐two (18%) had other diagnoses (malaria, bacteraemia, etc.). No aetiology could be elucidated in 28 persons (15%). Overall mortality was 13.3% (24 of 180) after four months of follow up. Those without an established headache aetiology had good clinical outcomes, with only one death (4% mortality), and 86% were ambulatory at four months.ConclusionIn an African HIV‐infected ambulatory population presenting with new onset headache, aetiology was found in at least 70%. Cryptococcal meningitis and sinusitis accounted for more than half of the cases.

An increasing number of clients are requesting green building design due to its potential to provide high-sustainability performance, monetary savings and health benefits to occupants. However, the practice of designing green building projects to meet overarching sustainability criteria is complex, with issues of poor information exchange synthesis. The building information modelling (BIM) process was created to ensure that the cumbersome green building data is exchanged accurately and in a coordinated manner. However, the implementation of the BIM process in green building design practices remains underexplored in the literature and industry practice. Therefore, this study aims to identify the best practices in BIM process implementation in the early stages of green building design. A quantitative research method was adopted; a questionnaire was used to survey 180 architects working in various construction firms in Malaysia. The questionnaire data was analysed using factor analysis to narrow down the long list of factors (best practices) into a small number of components. The results highlighted the best approaches in BIM process implementation in green building design practices: (1) Selection of a well-trained and competent design team, (2) Use of software with high interoperability to ensure exchange of accurate information, (3) Development of a standard method for BIM process implementation in green building design and (4) Timely identification of critical decision points. The research outcome will enlighten construction professionals on the best practices in implementing the BIM process in green building design, thereby allowing them to deliver building projects with high-sustainability performance.