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Treatment of acute ischemic stroke is highly time dependent, which relies heavily on each hospital’s ability and capacity. Designated stroke centers have been established across Canada, but there is still a divide between urban and rural hospitals. This study aims to understand the similarities and differences in their stroke treatment process workflow, incorporation of best practices and data collection.
Methods:
Interviews were conducted with clinicians in stroke centers across Canada to identify similarities and differences between provinces and hospital treatment capability. Semi-structured interviews were completed from September 15 to November 3, 2023, with clinicians and stroke coordinators using snowball and purposive sampling techniques. The interviews were analyzed using thematic analysis.
Results:
Fourteen participants were interviewed with representatives from four primary stroke centers and three comprehensive stroke centers across five provinces. Five primary themes were identified: 1) management of resources, 2) standardization of tasks, 3) data collection, 4) tool integration into workflow and 5) teamwork and experience. Participants in primary centers described limited resources to follow the patient through the entire treatment process, reliance on pre-notification times to prospectively search necessary patient information, using software to aid in calculating National Institute of Health Stroke Scale and being more cautious toward treating thrombolytics. Both center types discussed challenges with complete and accurate data collection.
Conclusions:
The overall stroke treatment process and information required across primary and comprehensive centers are similar. However, differences occur in the process due to limitations in resources, pre-arrival notification time, completeness and accuracy of data collected and comfort in treating with thrombolytics.
This article presents a systematic literature review of publications from 2014 to 2021 using “archaeological site” and “climate change” as keywords, in addition to several terms representing forms of stakeholder engagement. Articles were thematically coded to explore trends at the intersection of climate change, archaeology, and local and Traditional stakeholders. Results show that nearly half of the selected publications did not include local and Traditional stakeholder engagement in studies related to climate adaptation planning for archaeological sites. Synthesis of the results with insights gained from other literature on decolonizing archaeology showed that potential reasons for this gap include (1) the academic publishing culture, (2) archaeology as a predominantly Western discipline, and (3) increasingly available tools for climate change adaptation planning for archaeological sites. This article calls on the academic community to consider holistic stewardship using a landscape approach and to use climate change adaptation planning to elevate local and Traditional stakeholder input and values.
The need for a new economy is great and the obstacles are many: growing inequalities within and between nations and regions, new complicity between corporations and non-democratic political regimes and failure of workers worldwide to make common cause. There are alternative models, indicating that a more egalitarian approach does not necessarily reduce living standards. Environmental degradation cannot be addressed by a technological fix: the threat to our long-term survival is pre-figured in the impact of climate change and corporate rapacity on the land and sea resources of the indigenous minorities who live as humanity has lived for most of its existence. A 10-point plan for a follow-up to the United Nations’ Millennium Development Goals is suggested, but it will work only if solidarity networks can be built across divides of ascribed race, religion and nominal income levels, to express the will of the people in place of the government representatives who are prepared to gamble the future of humanity for corporate profit and power.
With the expanding adoption of technology and intelligent applications in every aspect of our life, energy, resource, data, and product management are all improving. So, modern management has recently surged to cope with modern societies. Numerous optimization approaches and algorithms are used to effectively optimize the literature while taking into account its many restrictions. With their dependability and superior solution quality for overcoming the numerous barriers to generation, distribution, integration, and management, nature-inspired meta-heuristic optimization algorithms have stood out among these methods. Hence, this article aims to review the application of nature-inspired optimization algorithms to modern management. Besides, the created clusters introduce the top authors in this field. The results showed that nature-inspired optimization algorithms contribute significantly to cost, resource, and energy efficiency. The genetic algorithm is also the most important and widely used method in the previous literature.
Obesity is a risk factor for various diseases and can affect the disease course. Studies have shown detrimental effects of obesity on patients affected with SARS-CoV-2 including increased hospitalization and more severe disease. This study aims to investigate the effects of obesity on symptom duration in patients with COVID-19, and also explore the possibility of using BMI as a predictor of symptom duration in outpatient settings.
Methods:
Patients diagnosed with COVID-19 between June and October 2020, who had no other comorbidities, and were planned to receive treatment in the outpatient setting were enrolled in the study. Duration of the symptoms was determined based on participants’ self-report of their symptoms. Linear regression was used to create predictive models based on participants’ BMI, age, sex, disease presentation, and their self-reported symptom duration.
Results:
A total of 210 patients were included in the final analysis. Patients with higher BMI had significantly longer symptom duration. Linear regression models showed highest correlation between BMI and symptom duration compared to other covariates.
Conclusion:
Low error in predictions and high coverage of data variability showed BMI can be used as a predictive factor for symptom duration in COVID-19 patients treated in outpatient settings.
Based on the findings of the empirical chapters, Chapter 6 recapitulates the impacts that rich mineral resources generate on the state–capital–labor triad in China. It analyzes in detail the Chinese state’s coping strategies to mitigate the resource curse at local levels. Moreover, it explains why the Chinese state is able and willing to take the observed strategies to contain the resource curse. The key lies in the Chinese Communist Party-state’s strong capacity to penetrate into the economy and the society and also in its top-down monitoring and tight control of the local agents. In the end, this chapter critically evaluates the successes and pitfalls of the China model of resource management.
Access to natural resources and the allocation of revenue generated by resource exploitation is at the core of many conflicts and plays an important role in many others.Yet natural resources can also be a key factor in promoting a durable peace. This chapter explores the puzzle of whether and how to address natural resource ownership, management, and revenue allocation in a manner that promotes durable peace. This chapter reviews the peace processes related to conflicts in Papua New Guinea and Bougainville, Indonesia and Aceh, Iraq and Kurdistan, the Philippines and Bangsamoro, Sierra Leone, Sudan and South Sudan, Sudan and Darfur, and Yemen to understand if and when parties broach the subject of natural resources in the peace process, and how they then decide upon matters such as the ownership, management, and revenue allocation.
Eradication of alien invasive species in the soil with steam as an alternative to chemical fumigation may allow contaminated soil to be reused. We have investigated steam disinfestation of soil to combat invasive plant species in three experiments including different temperatures and exposure durations using a prototype stationary soil-steaming device. The experiments included effects on seed germination of bigleaf lupine (Lupinus polyphyllus Lindl.), ornamental jewelweed (Impatiens glandulifera Royle), and wild oat (Avena fatua L.; one population from Poland and one from Norway), as well as effects on sprouting rhizome fragments of Canada goldenrod (Solidago canadensis L.) and Bohemian knotweed (Reynoutria x bohemica Chrtek & Chrtková). In Experiment 1, we tested four different soil temperatures of 64, 75, 79, and 98 C with an exposure duration of 90 s. In Experiments 2 and 3, we tested exposure durations of 30, 90, and 180 s and 90, 180, and 540 s, respectively, at 98 C. Seed pretreatment of 14 d cooling for L. polyphyllus and I. glandulifera, no seed pretreatment and 12-h moistening for A. fatua populations, and 5- and 10-cm cutting size for R. x bohemica were applied. Our results showed germination/sprouting was inhibited at 75 C for I. glandulifera (for 90 s) and 98 C for the other species; however, longer exposure duration was needed for L. polyphyllus. While 30 s at 98 C was enough to kill A. fatua seeds and S. canadensis and R. x bohemica rhizome fragments, 180-s exposure duration was needed to kill L. polyphyllus seeds. The results showed promising control levels of invasive plant propagules in contaminated soil by steaming, supporting the steam treatment method as a potential way of disinfecting soil to prevent dispersal of invasive species.
The excavation of the Qin wooden documents from Well No. 1 at Liye 里耶, Hunan province has significantly reshaped our knowledge of Qin history. This article examines a multi-slip manuscript from Liye on the Qin management of human resources in a newly conquered area, Qianling County. The manuscript is the best example of the multi-layered structure of a Qin administrative document; it also sheds new light on the difficulties the Qin encountered in resource management during the early years of unification. The manuscript shows that the responsible officials in Qianling County had failed to engage tuli 徒隸 (laborer-servants)—a major labor source in the Qin—in agricultural production, which appears to have deviated from the Qin strategy of managing human resources. To minimize the harmfulness that this deviation might cause, the Qin heavily relied upon a system of supervision and punishment. This article offers a contextualized study of the manuscript with an analysis of the related Qin excavated sources.
The objective of this study was to assess the current breaking point of crisis surge capacity of trauma services in Qatar and to develop a mitigation plan.
Methods:
The study utilized real-time data from the National Trauma Registry. Data was explored cumulatively by weeks, months and a year’s interval and all trauma admissions within this time frame were considered as 1 ‘Disaster Incident.’
Results:
A total of 2479 trauma patients were included in the study over 1 year. The mean age of patients was 31.5 ± 15.9 and 84% were males. The number of patients who sustained severe trauma which necessitated Level 1 activation was 16%. The emergency medical services (EMS) surge attained crisis of operational capacity at 5 months of disaster incident for priority 1 cases. Bed capacity at the floor was the first to reach operational crisis followed by the ICU and operating room. The gap in the surge for surgical interventions was specific to the specialty and surgery type which reached operational crisis at 3 months.
Conclusion:
The study highlights the surge capacity and capability of the healthcare system at a Level 1 trauma center. The identified gaps in surge capacity require several key components of healthcare resources to be addressed across the continuum of care.
The chapter examines three distinct issues related to the sharing of resources in conflict settlements: revenue sharing, shared access to and use of a resource (e.g. water); and shared management arrangements. It draws lessons from how these issues have been handled in federal and devolved governance regimes. It distinguishes between how resource provisions may relate to ending a conflict on the one hand and to promoting longer-term development on the other hand. In finds that relatively few conflict settlements include meaningful provisions on these three aspects of resource sharing. The sharing of revenues, or of access to a resource, is easier to resolve than sharing of management, though there can still be important engagement of local and regional communities and governments in the decision-making process. Moreover, there are established guidelines on good resource and revenue management, including in devolved contexts, that should be considered in peace settlements.
In this paper, we compile estimates of cod size distributions based on zooarchaeological data and contemporary length-frequency data to look at variability in size composition through time across the North Pacific, from the northern Kuril Islands through the Aleutian Islands to southeast Alaska. The results suggest that a strong longitudinal trend in cod size has remained consistent over time, with the largest cod found to the west. We find that five of nine sites show that overall cod length and distribution of the largest fish remain relatively unchanged. Two sites where we find truncation of the length distributions—or loss of the largest fish—are places where the modern fisheries have the longest history and have been most intense, suggesting a potential for anthropogenic impacts on these local populations. We acknowledge two limitations in these data: (1) there are differences in selectivity between the ancient and modern fisheries; and (2) seasonal variability in fish availability was observed to be an important explanatory variable in the modern data set, but the season of harvest is poorly understood for the ancient collections. Therefore, while differences observed between the two data sets suggest possible anthropogenic influence on the size structure of Pacific cod, they are not conclusive.
In this chapter, we focus on how wireless communication resources (spectral, temporal, and power) can be optimized and managed in wireless networks that support UAVsWestart by analyzing a very unique problem related to wireless networks supported by hovering UAV base stations: Cell association in hover time constraints. We show how the presence of hover time constraints for the UAVs will drastically change the way in which cell association is performed. Then, we generalize the problem of cell association to a fully fledged 3D cellular system that integrates both UAV base stations and UAV user equipment. Subsequently, we investigate the problem of spectrum and cache management in a wireless network supported by UAV base stations that are able to access both licensed and unlicensed spectrum resources.
Low-resource environments, such as those found in humanitarian crises, pose significant challenges to the provision of proper medical treatment. While the lack of training of health providers to such settings has been well-acknowledged in literature, there has yet to be any scientific evidence for this phenomenon.
Methods:
This pilot study utilized a randomized crossover experimental design to examine the effects of high- versus low-resource simulated scenarios of a resuscitation of a critically ill obstetric patient on a medical doctors’ performance and inter-personal skills. Ten senior residents (fifth-year post-graduate) of the Maggiore Hospital School of Medicine (Novara, NO, Italy) were included in the study.
Results:
Overall performance score for the high-resource setting was 5.2, as opposed to only 2.3 for the low-resource setting. The mean effect size for the overall score was 2.9 (95% CI, 1.7–4.0; P <.001). The results suggest a significant decrease in both technical (medical) and non-technical skills, such as leadership, problem solving, situation awareness, resource utilization, and communication in the low-resource environment setting. The latter finding is of special important since it was yet to be reported.
Conclusions:
This pilot study suggests that untrained physicians in low-resource environments may experience a considerable setback not only to their professional performance, but also to their interpersonal skills, when deployed ill-prepared to humanitarian missions. Consequently, this may endanger the health of local populations.
This chapter falls into these related parts. The first deals with research: why it is different today than before, why a library is no longer essential, as well as the training of faculty members to become good researchers. Strong, relevant research is a key driver for marketing, and the Dean/President typically would play a key role here, above all by communicating effectively key research findings. The Dean/President is typically also critical in finding a reasonable balance when it comes to how much resources that is spent on research verses on marketing.
This chapter surveys a range of extant textual records (wooden tablets, jar labels, and ostraca) from the Great Oasis related to the management of water wells and of crop distribution. It looks first at the longstanding practice of documenting the condition of the wells in the oasis, before focusing on late antique evidence from both the Dakhla and Kargha oases concerned with the disbursement of these goods and on the individuals responsible for generating the records, primarily literate administrators and members of the military.
In the scholarly literature on the oases, we find a variety of assertions about the cities of the Kharga and Dakhla oases: that one was the capital at a particular period, that one did or did not have civic status at some date. On close examination, most of these statements turn out to be based on slender or no evidence, and in many cases we find that we know much less than has been supposed about the administrative organization of the Great Oasis. In what follows, we look more closely at the available evidence for both Kharga and Dakhla, tracing the history of Hibis – often supposed to be the capital of the whole oasis – and then of the two major towns of the Dakhla Oasis, Mothis (modern-day Mut) and Trimithis. We will try as well to see what we can of their interrelationship and of the overall administrative structure.
The purpose of this paper is to analyse the performance of two similar small businesses in seeking resource consent to expand their operations. The proposed developments are examples of locally unwanted land use. Why did one project proceed as planned, and the other project experience expensive delays? The different outcomes are examined from three perspectives: stakeholder theory, the NIMBY phenomena and the legislative framework. The paper then suggests approaches to address the growing problem of community resistance that can threaten small business development. The paper contributes to the literature by providing new insights into the complex relationship between stakeholder theory, the NIMBY phenomena and the legislative framework.
Small-scale fishers working in the West African Bijagós Archipelago are predominantly regional in-migrants, often living in isolated fishing camps (or economic enclaves) where capture, processing and trading activities occur. This paper explores the factors driving the fishing camp formation, relations with non-camp communities and interactions with prominent authority groups. One camp, presented here in the context of an anthropological case study, lost access to Ancopado beach during the designation of Orango National Park. Following violent evictions, migrant fishers shifted their efforts into less-observed waters, introducing challenging power negotiations with indigenous Bijagós islanders and fisheries authorities. Fishing persists inside the marine protected area, indicative of non-compliance by small-scale fishers who continue to resist a weak resource management agenda. The implications of this situation are discussed in terms of human rights to fish.