598 resultados para concurrent evidence


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Transportation disadvantaged groups, in the previous studies, are defined as those who are low income earners, family dependent, limited access to private motor vehicles and public transport services, and also those who oblige to spend relatively more time and money on their trips. Additionally those disable, young and elderly are considered among the natural groups of transportation disadvantaged. Although in general terms this definition seems correct, it is not specific enough to become a common universal definition that could apply to all urban contexts. This paper investigates whether travel difficulty perceptions vary and so does the definition of transportation disadvantaged in socio-culturally different urban contexts. For this investigation the paper undertakes a series of statistical analysis in the case study of Yamaga, Japan, and compares the findings with a previous case study, where the same methodology, hypothesis, and assumptions were utilized in a culturally and demographically different settlement of Aydin, Turkey. After comparing the findings observed in Aydin with the statistical analysis results of Yamaga, this paper reveals that there can be no explicitly detailed universal definition of transportation disadvantaged. The paper concludes by stating characteristics of transportation disadvantage is not globally identical, and policies and solutions that work in a locality may not show the same results in another socio-cultural context.

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Dystrobrevin binding protein 1 (DTNBP1), or dysbindin, is thought to be critical in regulating the glutamatergic system. While the dopamine pathway is known to be important in the aetiology of schizophrenia, it seems likely that glutamatergic dysfunction can lead to the development of schizophrenia. DTNBP1 is widely expressed in brain, levels are reduced in brains of schizophrenia patients and a DTNBP1 polymorphism has been associated with reduced brain expression. Despite numerous genetic studies no DTNBP1 polymorphism has been strongly implicated in schizophrenia aetiology. Using a haplotype block-based gene-tagging approach we genotyped 13 SNPs in DTNBP1 to investigate possible associations with DTNBP1 and schizophrenia. Four polymorphisms were found to be significantly associated with schizophrenia. The strongest association was found with an A/C SNP in intron 7 (rs9370822). Homozygotes for the C allele of rs9370822 were more than two and a half times as likely to have schizophrenia compared to controls. The other polymorphisms showed much weaker association and are less likely to be biologically significant. These results suggest that DTNBP1 is a good candidate for schizophrenia risk and rs9370822 is either functionally important or in disequilibrium with a functional SNP, although our observations should be viewed with caution until they are independently replicated.

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Evidence based practice (EBP) has been accepted as a process to assist health professionals in clinical decision making to improve patient outcomes. It requires applying skills in a prescribed sequence to critique existing practices. Many countries, including Australia, require nurses to demonstrate competencies in EBP skills to be registered. In the last ten years, this has lead to universities incorporating EBP in undergraduate nursing degree courses. The literature reports many challenges including students’ difficulties in critically appraising research evidence, and their need for both simplification of the process and extensive support. The purpose of our study was to investigate the effectiveness of a standalone introductory EBP subject for a diverse group of third-year undergraduates, based on a novel but challenging approach to assessment. Despite many changes made in the second iteration of the subject, most students’ perceptions of the subject’s difficulty remained unchanged. This research aligns with the issues identified in the literature and has wider applicability to the teaching of rapidly changing disciplines, where evidence-driven consumers have easy access to information and expect up-to-date practices.

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A review of the literature related to issues involved in irrigation induced agricultural development (IIAD) reveals that: (1) the magnitude, sensitivity and distribution of social welfare of IIAD is not fully analysed; (2) the impacts of excessive pesticide use on farmers’ health are not adequately explained; (3) no analysis estimates the relationship between farm level efficiency and overuse of agro-chemical inputs under imperfect markets; and (4) the method of incorporating groundwater extraction costs is misleading. This PhD thesis investigates these issues by using primary data, along with secondary data from Sri Lanka. The overall findings of the thesis can be summarised as follows. First, the thesis demonstrates that Sri Lanka has gained a positive welfare change as a result of introducing new irrigation technology. The change in the consumer surplus is Rs.48,236 million, while the change in the producer surplus is Rs. 14,274 millions between 1970 and 2006. The results also show that the long run benefits and costs of IIAD depend critically on the magnitude of the expansion of the irrigated area, as well as the competition faced by traditional farmers (agricultural crowding out effects). The traditional sector’s ability to compete with the modern sector depends on productivity improvements, reducing production costs and future structural changes (spillover effects). Second, the thesis findings on pesticides used for agriculture show that, on average, a farmer incurs a cost of approximately Rs. 590 to 800 per month during a typical cultivation period due to exposure to pesticides. It is shown that the value of average loss in earnings per farmer for the ‘hospitalised’ sample is Rs. 475 per month, while it is approximately Rs. 345 per month for the ‘general’ farmers group during a typical cultivation season. However, the average willingness to pay (WTP) to avoid exposure to pesticides is approximately Rs. 950 and Rs. 620 for ‘hospitalised’ and ‘general’ farmers’ samples respectively. The estimated percentage contribution for WTP due to health costs, lost earnings, mitigating expenditure, and disutility are 29, 50, 5 and 16 per cent respectively for hospitalised farmers, while they are 32, 55, 8 and 5 per cent respectively for ‘general’ farmers. It is also shown that given market imperfections for most agricultural inputs, farmers are overusing pesticides with the expectation of higher future returns. This has led to an increase in inefficiency in farming practices which is not understood by the farmers. Third, it is found that various groundwater depletion studies in the economics literature have provided misleading optimal water extraction quantity levels. This is due to a failure to incorporate all production costs in the relevant models. It is only by incorporating quality changes to quantity deterioration, that it is possible to derive socially optimal levels. Empirical results clearly show that the benefits per hectare per month considering both the avoidance costs of deepening agro-wells by five feet from the existing average, as well as the avoidance costs of maintaining the water salinity level at 1.8 (mmhos/Cm), is approximately Rs. 4,350 for farmers in the Anuradhapura district and Rs. 5,600 for farmers in the Matale district.

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We show that when a soft polymer like Poly(3-hexyl-thiophene) wraps multiwall nanotubes by coiling around the main axis, a localized deformation of the nanotube structure is observed. High resolution transmission electron microscopy shows that radial compressions of about 4% can take place, and could possibly lead to larger interlayer distance between the nanotube inner walls and reduce the innermost nanotube radius. The mechanical stress due to the polymer presence was confirmed by Raman spectroscopic observation of a gradual upshift of the carbon nanotube G-band when the polymer content in the composites was progressively increased. Vibrational spectroscopy also indicates that charge transfer from the polymer to the nanotubes is responsible for a peak frequency relative downshift for high P3HT-content samples. Continuously acquired transmission electron microscopy images at rising temperature show the MWCNT elastic compression and relaxation due to polymer rearrangement on the nanotube surface.

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There has been increasing international efforts to ensure that health care policies are evidence based. One area where there is a lack of ‘effectiveness’ evidence is in the use of end-of-life care pathways (EOLCP) (1). Despite the lack of evidence supporting the efficacy of the EOCLP, their use has been endorsed in the recent national palliative care strategy document in the UK (2). In addition, a publication endorsed by the Australian Government (titled: Supporting Australians to live well at the End of Life- National Palliative Care Strategy 2010) (3), recommended a national roll out of EOLCP across all sectors (primary, acute and aged care) in Australia. According to this document, it is a measure of “appropriateness” and “effectiveness” for promoting quality end-of-life care.

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As organizations reach higher levels of Business Process Management maturity, they tend to accumulate large collections of process models. These repositories may contain thousands of activities and be managed by different stakeholders with varying skills and responsibilities. However, while being of great value, these repositories induce high management costs. Thus, it becomes essential to keep track of the various model versions as they may mutually overlap, supersede one another and evolve over time. We propose an innovative versioning model, and associated storage structure, specifically designed to maximize sharing across process models and process model versions, reduce conflicts in concurrent edits and automatically handle controlled change propagation. The focal point of this technique is to version single process model fragments, rather than entire process models. Indeed empirical evidence shows that real-life process model repositories have numerous duplicate fragments. Experiments on two industrial datasets confirm the usefulness of our technique.

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The ability to differentiate from competitors through the selection of unique offerings is an important cornerstone of competitive performance. Developing unique products and services to offer in the marketplace is not only important for established firms, but also an important strategic choice for young firms (Baum and Haveman, 1997). Unlike large and established firms, young firms tend to have less access to adequate resources, well-developed sources of information, contact networks, and considerable experience and management know-how. That is, these firms differ significantly in their attributes and performance from larger and well-established firms (c.f. Miller and Chen, 1994). Although young firms are disadvantaged by the paucity of resources in putting together its unique product offering(s), they develop different pathways in advancing their assortment of capabilities that enables them to stay ahead of competitors.

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Analysis of either footprints or footwear impressions which have been recovered from a crime scene is a well known and well accepted part of forensic investigation. When this evidence is obtained by investigating officers, comparative analysis to a suspect’s evidence may be undertaken. This can be done either by the detectives or in some cases, podiatrists with experience in forensic analysis. Frequently asked questions of a podiatrist include; “What additional information should be collected from a suspect (for the purposes of comparison), and how should it be collected?” This paper explores the answers to these and related questions based on 20 years of practical experience in the field of crime scene analysis as it relates to podiatry and forensics. Elements of normal and abnormal foot function are explored and used to explain the high degree of variability in wear patterns produced by the interaction of the foot and footwear. Based on this understanding the potential for identifying unique features of the user and correlating this to footwear evidence becomes apparent. Standard protocols adopted by podiatrists allow for more precise, reliable, and valid results to be obtained from their analysis. Complex data sets are now being obtained by investigating officers and, in collaboration with the podiatrist; higher quality conclusions are being achieved. This presentation details the results of investigations which have used standard protocols to collect and analyse footwear and suspects of recent major crimes.

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Commentary on : Carey JV. Literature review : should antipyretic therapies routinely be administered to patients with [corrected] fever? J Clin Nurs 2010;19:2377–93.

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This paper, which is abstracted from a larger study into the acquisition and exercise of nephrology nursing expertise, aims to explore the role of knowledge in expert practice. Using grounded theory methodology, the study involved 17 registered nurses who were practicing in a metropolitan renal unit in New South Wales, Australia. Concurrent data collection and analysis was undertaken, incorporating participants' observations and interviews. Having extensive nephrology nursing knowledge was a striking characteristic of a nursing expert. Expert nurses clearly relied on and utilized extensive nephrology nursing knowledge to practice. Of importance for nursing, the results of this study indicate that domain-specific knowledge is a crucial feature of expert practice.