3,488 research outputs found

    The Entrenched Political Limitations of Australian Refugee Policy: A Case Study of the Australian Labor Party (2007-2013)

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    This thesis deconstructs Australia’s asylum and refugee policy trajectory under the Labor government between 2007 and 2013. For a short time after the 2007 election, in accordance with its promise to abolish the LNP’s Pacific Solution, Labor began to unwind certain policy structures of externalisation and deterrence that had been in place since the introduction of mandatory detention in 1992. By 2013 however, the ALP had declared that asylum seekers arriving by boat had no prospect of resettlement in Australia. This thesis analyses the political strategy of the ALP in rhetoric, policy choices and policy justifications to derive lessons from Labor’s mitigated challenge to the deterrence/externalisation paradigm. Critical Discourse Analysis is used to examine the political strategies of lead actors, particularly the ALP and the LNP, and to reconcile these strategies with policy outcomes such as irregular arrivals, detention figures, deaths at sea and compliance with obligations under international law. A central argument of this thesis is that Labor’s attempt to sustainably depart from the dominant externalisation paradigm was impaired, not by a lack of commitment to its stated program of reform, but rather by entrenched political limitations of the Australian context. These limitations include the LNP’s rigid partisanship and lack of policy compromise, the deep-rooted nature of mandatory detention, and the Australian public’s historical and continued support for controlled migration. A precise and detailed analysis of the impact of these limitations on Labor’s proposed reform fills a gap in academic knowledge about the political influences on policy action in Australian asylum and refugee policy. I contend that these limitations must be effectively engaged with in any attempt to reform the Australian asylum and refugee policy space

    Report of the International Narcotics Control Board for 2022.

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    Infections and the Guillain-Barre Syndrome:from endemic to pandemic

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    Screening, risk stratification, and management of atrial fibrillation

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    Atrial fibrillation (AF), the most common sustained arrhythmia, is associated with high morbidity and mortality. Major improvements have been made in the diagnosis and management of AF in the past two decades. However, important questions pertaining to the screening, prognosis, risk stratification, and management of AF remain unanswered. This thesis presents original studies addressing knowledge gaps in these aspects of AF. In Chapter 2, using a large cohort of individuals from the UK Biobank, we investigated the association between lung function and incident AF. We observed that reduced ventilatory function was associated with increased risk of AF independently of age, sex, smoking, and several other known AF risk factors. This suggests that individuals with substantial reduction of their lung function might represent an appropriate population for targeted AF screening and ventilatory parameters might improve AF risk prediction. Chapter 3 assesses data related to implantable cardiac monitors (ICM). The first section reports AF diagnostic yield in a real-world cohort of patients receiving prolonged cardiac monitoring with ICM for stroke and unexplained syncope. It indicates that patients with stroke or transient ischemic attack (TIA) have a higher rate of AF detection compared with patients with unexplained syncope. However, this real-world study shows AF detection rates following stroke significantly lower than what has been previously reported. The second section of this chapter summarizes data on AF detection rates across different rhythm monitoring strategies (non-invasive and ICM) in patients with cryptogenic stroke (CS) or embolic stroke of undetermined source (ESUS). It shows that the yield of ICM increases with the duration of monitoring; more than a quarter of patients with CS or ESUS will be diagnosed with AF during follow-up. About one in seven patients have AF detected within a month of mobile cardiac outpatient telemetry, suggesting that a non-invasive rhythm monitoring strategy should be considered before invasive monitoring. Chapters 4 and 5 address risk stratification in patients with AF. Chapter 4 has two sections. The first section is a meta-analysis that comprehensively summarizes data from prospective cohort studies on clinical predictors of stroke in anticoagulant-naïve patients with AF. It shows that although weighted similarly in most risk stratification schemes such as the CHA2DS2-VASc score, the absolute risk of stroke attributable to hypertension, diabetes, vascular disease, and heart failure may not be the same in individual patients. Furthermore, it shows that female sex seems not to be universally associated with stroke or systemic embolism, suggesting that the decision to initiate oral anticoagulation should not be made on the sole basis of female sex as currently recommended by some scientific societies. By compiling evidence from various studies, the second section of this chapter demonstrates that some anatomic and functional cardiac imaging parameters are associated with stroke in patients with AF and therefore, might improve stroke risk stratification in these patients. Chapter 5 presents two systematic reviews and meta-analysis which show that AF and carotid artery disease frequently co-exist, with about one in ten patients with AF who has carotid stenosis, and vice versa; and non-stenotic carotid disease being much more frequent. Moreover, there is an association between carotid atherosclerosis and the risk of stroke in patients with AF, suggesting that the incorporation of carotid atherosclerosis and characteristics of carotid plaques into scoring systems might improve stroke prediction in patients with AF. Taking this further, the last section of this chapter investigates the potential added value of high-risk carotid plaques on stroke risk stratification compared to the classical CHA₂DS₂-VASc score in a prospective cohort of patients with AF. It shows a low prevalence (5.5%) of moderate to severe carotid stenosis (≥ 50%), whereas one in three participants have carotid plaques considered vulnerable or high-risk. Neither the degree of carotid stenosis nor the presence of vulnerable plaques is associated with incident ischemic stroke, suggesting that carotid disease is probably not an important cause of ischemic stroke in this group of patients with AF and therefore, vulnerable carotid plaques might not improve stroke risk stratification in patients with AF. Chapter 6 presents two pooled analyses of data on the prognostic impact of AF on acute coronary syndromes (ACS) and acute pulmonary embolism (aPE). The first section of the chapter shows that AF is common in patients with ACS (one in nine) and that it (especially newly diagnosed AF) is associated with poor short-term and long-term outcomes including re-infarction, heart failure, stroke, acute kidney injury, heart failure, major bleeding, and death. Likewise, the second section of the chapter demonstrates that AF is frequent in patients with aPE (one in eight) and is associated with increased short-term and long-term mortality. Considering this strong prognostic impact of AF in patients with ACS and aPE, its incorporation into risk stratification schemes for these patients should be considered. Furthermore, considering the significant incidence of AF in patients with ACS and aPE, studies are needed to determine the appropriate rhythm monitoring strategies in these patients. Chapters 7-9 focus on sex differences in the management of AF. Chapter 7 analyses data from 142 randomized controlled trials (RCTs) of AF published in top tiers cardiovascular journals and shows that despite recent progress, females remain substantially less represented in RCTs of AF. This raises concern about the generalizability of these trials and the validity of the evidence guiding the treatment of females. Furthermore, primary outcomes are infrequently reported by sex in these RCTs of AF. Considering established benefit of risk factor modification on outcomes in patients with AF, Chapter 8 assesses sex differences in weight-loss, cardiorespiratory fitness gain, and progression and recurrence of AF in patients undergoing aggressive risk factor modification. It shows that despite sex differences in some baseline characteristics, the benefits of weight-loss and fitness gain were favourable for both males and females. However, improvement in fitness had a much greater benefit for total arrhythmia freedom for females, whereas there was a trend towards more common regression from persistent to paroxysmal AF in males. These findings reinforce the need to address lifestyle risk factors to minimize arrhythmia recurrence and reduce symptom severity for all individuals. Finally, Chapter 9 investigates the impact of sex on the clinical profile, utilization of rhythm control therapies, in-hospital mortality, length of stay (LOS), and cost of hospitalization in patients admitted for AF in the United States. It shows similarities and disparities in risk factors for mortality between males and females, and that unlike what has been reported in several previous studies, although women had a relatively higher mortality rate, after risk adjustment, female sex was not a predictor of mortality.Thesis (Ph.D.) -- University of Adelaide, Adelaide Medical School, 02

    A geo-informatics approach to sustainability assessments of floatovoltaic technology in South African agricultural applications

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    South African project engineers recently pioneered the first agricultural floating solar photovoltaic tech nology systems in the Western Cape wine region. This effort prepared our country for an imminent large scale diffusion of this exciting new climate solver technology. However, hydro-embedded photovoltaic sys tems interact with environmentally sensitive underlying aquatic ecosystems, causing multiple project as sessment uncertainties (energy, land, air, water) compared to ground-mounted photovoltaics. The dissimi lar behaviour of floatovoltaic technologies delivers a broader and more diversified range of technical advan tages, environmental offset benefits, and economic co-benefits, causing analytical modelling imperfections and tooling mismatches in conventional analytical project assessment techniques. As a universal interna tional real-world problem of significance, the literature review identified critical knowledge and methodology gaps as the primary causes of modelling deficiencies and assessment uncertainties. By following a design thinking methodology, the thesis views the sustainability assessment and modelling problem through a geo graphical information systems lens, thus seeing an academic research opportunity to fill critical knowledge gaps through new theory formulation and geographical knowledge creation. To this end, this philosophi cal investigation proposes a novel object-oriented systems-thinking and climate modelling methodology to study the real-world geospatial behaviour of functioning floatovoltaic systems from a dynamical system thinking perspective. As an empirical feedback-driven object-process methodology, it inspired the thesis to create new knowledge by postulating a new multi-disciplinary sustainability theory to holistically characterise agricultural floatovoltaic projects through ecosystems-based quantitative sustainability profiling criteria. The study breaks new ground at the frontiers of energy geo-informatics by conceptualising a holistic theoretical framework designed for the theoretical characterisation of floatovoltaic technology ecosystem operations in terms of the technical energy, environmental and economic (3E) domain responses. It campaigns for a fully coupled model in ensemble analysis that advances the state-of-the-art by appropriating the 3E theo retical framework as underpinning computer program logic blueprint to synthesise the posited theory in a digital twin simulation. Driven by real-world geo-sensor data, this geospatial digital twin can mimic the geo dynamical behaviour of floatovoltaics through discrete-time computer simulations in real-time and lifetime digital project enactment exercises. The results show that the theoretical 3E framing enables project due diligence and environmental impact assessment reporting as it uniquely incorporates balanced scorecard performance metrics, such as the water-energy-land-food resource impacts, environmental offset benefits and financial feasibility of floatovoltaics. Embedded in a geoinformatics decision-support platform, the 3E theory, framework and model enable numerical project decision-supporting through an analytical hierarchy process. The experimental results obtained with the digital twin model and decision support system show that the desktop-based parametric floatovoltaic synthesis toolset can uniquely characterise the broad and diverse spectrum of performance benefits of floatovoltaics in a 3E sustainability profile. The model uniquely predicts important impact aspects of the technology’s land, air and water preservation qualities, quantifying these impacts in terms of the water, energy, land and food nexus parameters. The proposed GIS model can quantitatively predict most FPV technology unknowns, thus solving a contemporary real-world prob lem that currently jeopardises floating PV project licensing and approvals. Overall, the posited theoretical framework, methodology model, and reported results provide an improved understanding of floating PV renewable energy systems and their real-world behaviour. Amidst a rapidly growing international interest in floatovoltaic solutions, the research advances fresh philosophical ideas with novel theoretical principles that may have far-reaching implications for developing electronic, photovoltaic performance models worldwide.GeographyPh. D. (Geography

    Anuário científico da Escola Superior de Tecnologia da Saúde de Lisboa - 2021

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    É com grande prazer que apresentamos a mais recente edição (a 11.ª) do Anuário Científico da Escola Superior de Tecnologia da Saúde de Lisboa. Como instituição de ensino superior, temos o compromisso de promover e incentivar a pesquisa científica em todas as áreas do conhecimento que contemplam a nossa missão. Esta publicação tem como objetivo divulgar toda a produção científica desenvolvida pelos Professores, Investigadores, Estudantes e Pessoal não Docente da ESTeSL durante 2021. Este Anuário é, assim, o reflexo do trabalho árduo e dedicado da nossa comunidade, que se empenhou na produção de conteúdo científico de elevada qualidade e partilhada com a Sociedade na forma de livros, capítulos de livros, artigos publicados em revistas nacionais e internacionais, resumos de comunicações orais e pósteres, bem como resultado dos trabalhos de 1º e 2º ciclo. Com isto, o conteúdo desta publicação abrange uma ampla variedade de tópicos, desde temas mais fundamentais até estudos de aplicação prática em contextos específicos de Saúde, refletindo desta forma a pluralidade e diversidade de áreas que definem, e tornam única, a ESTeSL. Acreditamos que a investigação e pesquisa científica é um eixo fundamental para o desenvolvimento da sociedade e é por isso que incentivamos os nossos estudantes a envolverem-se em atividades de pesquisa e prática baseada na evidência desde o início dos seus estudos na ESTeSL. Esta publicação é um exemplo do sucesso desses esforços, sendo a maior de sempre, o que faz com que estejamos muito orgulhosos em partilhar os resultados e descobertas dos nossos investigadores com a comunidade científica e o público em geral. Esperamos que este Anuário inspire e motive outros estudantes, profissionais de saúde, professores e outros colaboradores a continuarem a explorar novas ideias e contribuir para o avanço da ciência e da tecnologia no corpo de conhecimento próprio das áreas que compõe a ESTeSL. Agradecemos a todos os envolvidos na produção deste anuário e desejamos uma leitura inspiradora e agradável.info:eu-repo/semantics/publishedVersio

    Exploring crowdsourced self-care techniques: a study on Parkinson’s disease

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    Living with Parkinson’s Disease introduces a range of significant challenges into one’s daily life. While medical interventions exist to overcome some of these challenges, patient self-care techniques often form an essential complement to the treatments recommended by medical doctors. Knowledge on these self-care techniques often originates from those living with Parkinson’s themselves or their close caregivers, as they have the knowledge and experience required to assess self-care techniques. This so-called ‘patient knowledge’ is usually exchanged in peer meetings or discussion forums. Although vital to the Parkinson’s Disease community, this information is often difficult to access due to its unstructured format and the difficulty of navigating through online forums. We present an online tool that allows for contributing, assessing, and finally discovering Parkinson’s Disease self-care techniques. The custom discovery tool was populated with self-care knowledge by over 300 people with Parkinson’s and dozens of their carers, spanning areas such as daily well-being and using assistive equipment. Then, we invited patients to explore the discover features in a smaller scale trial. While well-received, our deployment highlighted several challenges that we further discuss in this paper. Overall, our study contributes to crowdsourced digital health solutions and provides both design and research implications to this challenging domain with a vulnerable user group
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