Antecedents of sustainable management support for IT-related initiatives

Having IT-related capabilities is not enough to secure value from the IT resources and survive in today’s competitive environment. IT resources evolve dynamically and organisations must sustain their existing capabilities to continue to leverage value from their IT resources. Organisations’ IT-related management capabilities are an important source of their competitive advantage. We suggest that organisations can sustain these capabilities through appropriate considerations of resources at the technology-use level. This study suggests that an appropriate organisational design relating to decision rights and work environment, and a congruent reward system can create a dynamic IT-usage environment. This environment will be a vital source of knowledge that could help organisations to sustain their IT-related management capabilities. Analysis of data collected from a field survey demonstrates that this dynamic IT-usage environment, a result of the synergy between complementary factors, helps organisations to sustain their IT-related management capabilities. This study adds an important dimension to understanding why some organisations continue to perform better with their IT resources than others. For practice, this study suggests that organisations need to consider a comprehensive approach to what constitutes their valuable resources.

Improvisation in interactive music systems

This project investigates machine listening and improvisation in interactive music systems with the goal of improvising musically appropriate accompaniment to an audio stream in real-time. The input audio may be from a live musical ensemble, or playback of a recording for use by a DJ. I present a collection of robust techniques for machine listening in the context of Western popular dance music genres, and strategies of improvisation to allow for intuitive and musically salient interaction in live performance. The findings are embodied in a computational agent – the Jambot – capable of real-time musical improvisation in an ensemble setting. Conceptually the agent’s functionality is split into three domains: reception, analysis and generation. The project has resulted in novel techniques for addressing a range of issues in each of these domains. In the reception domain I present a novel suite of onset detection algorithms for real-time detection and classification of percussive onsets. This suite achieves reasonable discrimination between the kick, snare and hi-hat attacks of a standard drum-kit, with sufficiently low-latency to allow perceptually simultaneous triggering of accompaniment notes. The onset detection algorithms are designed to operate in the context of complex polyphonic audio. In the analysis domain I present novel beat-tracking and metre-induction algorithms that operate in real-time and are responsive to change in a live setting. I also present a novel analytic model of rhythm, based on musically salient features. This model informs the generation process, affording intuitive parametric control and allowing for the creation of a broad range of interesting rhythms. In the generation domain I present a novel improvisatory architecture drawing on theories of music perception, which provides a mechanism for the real-time generation of complementary accompaniment in an ensemble setting. All of these innovations have been combined into a computational agent – the Jambot, which is capable of producing improvised percussive musical accompaniment to an audio stream in real-time. I situate the architectural philosophy of the Jambot within contemporary debate regarding the nature of cognition and artificial intelligence, and argue for an approach to algorithmic improvisation that privileges the minimisation of cognitive dissonance in human-computer interaction. This thesis contains extensive written discussions of the Jambot and its component algorithms, along with some comparative analyses of aspects of its operation and aesthetic evaluations of its output. The accompanying CD contains the Jambot software, along with video documentation of experiments and performances conducted during the project.

Antecedents of sustainable management support for IT related initiatives

Having IT-related capabilities is not enough to secure value from IT resources and survive in today’s competitive environment. IT resources evolve dynamically and firms must sustain their existing capabilities to continue to leverage value from their IT resources. Firm’s human resources are an important IT-related capability, and an important source of their competitive advantage. Using a field survey, this study demonstrates that a dynamic end-user environment, a result of a coordinated change in complementary factors can help sustain firms’ IT-related management capabilities. These factors include an appropriate organizational design to decision rights and work environment and a congruent reward system. This study adds an important dimension in understanding why some firms continue to perform better with their IT resources than others. For practice, this study suggests that a comprehensive approach to what constitutes valuable organizational resources is necessary.

Sourcing and evaluating IT business value in emerging economies : the case of the South Pacific Island Countries

Information Technology (IT) is an important resource that facilitates growth and development in both the developed and emerging economies. The increasing forces of globalization are creating a wider digital divide between the developed and emerging economies. The smaller emerging economies are the most venerable. Intense competition for IT resources means that these emerging economies would need to acquire a deeper understanding of how to source and evaluate their IT-related efforts. This effort would put these economies in a better position to source funding from various stakeholders. This research presents a complementary approach to securing better IT-related business value in organizations in the South Pacific Island countries – a case of emerging economies. Analysis of data collected from six South Pacific Island countries suggests that organizations that invest in IT and related complementaries are able to better their business processes. The data also suggest that improved business processes lead to overall business processes improvements.

Particle wave

“Particle Wave” is comprised of six lenticular panels hung in an even, horizontal sequence. Each panel alternates between two solid colour fields as you move past it. There are six colours in total, with each colour represented twice in the spectrum. From left to right, the panels move through yellow, orange, magenta, violet, blue, green and back to yellow. The work’s title refers to the two competing theories of light, which can be understood as either paradoxical or complementary. Like these theories, the experience of viewing the work catches us in a double bind. While we can orient ourselves to see solid colour fields one by one, we are never able to fully capture them all at once. In fact, it is only through our continual movement, and the subsequent transitioning of visible colours that we register the complete spectrum. Through this viewing experience, “Particle Wave” actively engages with our peripheral vision and the transitory nature of perception. It plays with the fundamental pleasures of colour and vision, and the uneasy seduction of being unable to grasp multiple phenomena simultaneously.

Advance pricing arrangements : an Australian Tax Office success or a legislative failure?

Australia’s domestic income tax legislation and double tax agreements contain transfer pricing rules which are designed to counter the underpayment of tax by businesses engaged in international dealings between related parties. The current legislation and agreements require that related party transactions take place at a value which reflects an arm’s length price, that is, a price which would be charged between unrelated parties. For a host of reasons, it is increasingly difficult for multinational entities to demonstrate that they are transferring goods and services at a price which is reflective of the behaviour of independent parties, thereby making it difficult to demonstrate compliance with the relevant legislation. Further, where an Australian business undertakes cross-border related party transactions there is the risk of an audit by the Australian Tax Office (ATO). If a business wishes to avoid the risk of an audit, and any ensuing penalties, there is one option: an advance pricing arrangement (APA). An APA is an agreement whereby the future transfer pricing methodology to be used to determine the arm’s length price is agreed to by the taxpayer and the relevant tax authority or authorities. The ATO views the APA process as an important part of its international tax strategy and believes that there are complementary benefits provided to both the taxpayer and the ATO. The ATO promotes the APA process on the basis of creating greater certainty for all parties while reducing compliance costs and the risk of audit and penalty. While the ATO regards the APA system as a success, it may be argued that the implementation of such a system is simply a practical solution to an ongoing problem of an inherent failure in both the legislation and ATO interpretation and application of this legislation to provide certainty to the taxpayer. This paper investigates the use of APAs as a solution to the problem of transfer pricing and considers whether they are the success the ATO claims. It is argued that there is no doubt that APAs provide a valuable practical tool for multinational entities facing the challenges of the taxation of global trading under the current transfer pricing regime. It does not, however, provide a long term solution. Rather, the long term solution may be in the form of legislative amendment.

The composition of sugarcane juices dervied from burnt cane and whole green cane crop

There has been substantial interest within the Australian sugar industry in product diversification as a means to reduce its exposure to fluctuating raw sugar prices and in order to increase its commercial viability. In particular, the industry is looking at fibrous residues from sugarcane harvesting (trash) and from sugarcane milling (bagasse) for cogeneration and the production of biocommodities, as these are complementary to the core process of sugar production. A means of producing surplus residue (biomass) is to process whole sugarcane crop. In this paper, the composition of different juices derived from different harvesting methods, viz. burnt cane with all trash extracted (BE), green cane with half of the trash extracted (GE), and green cane (whole sugarcane crop) with trash unextracted (GU), were investigated and the results and comparison presented. The determination of electrical conductivity, inorganic composition, and organic acids indicate that both GU and GE cane juice contain a higher proportion of soluble inorganic ions and ionisable organic acids, compared to BE cane juice. It is important to note that there are considerably higher levels of Na ions and citric acid, but relatively low P levels in the GU samples. A higher level of reducing sugars was analysed in the GU samples than the BE samples due to the higher proportion of impurities found naturally in sugarcane tops and leaves. The purity of the first expressed juice (FEJ) of GU cane was on average higher than that of FEJ of BE cane. Results also show that GU juices appear to contain higher levels of proteins and polysaccharides, with no significant difference in starch levels.

The duplicitous nature of inflammation in wound repair

Skin plays a key role in protecting the body from the onslaught of pathogens and toxins we meet during our lifetime; thus, out of necessity, we have developed a rapid repair mechanism that quickly plugs any holes in this vital organ. Upon injury, a series of highly coordinated overlapping events, that include inflammatory, proliferation and maturation phases, result in the hasty closure of the wound and restoration of skin integrity. Over the past decade it has become clear that a number of immune cells that regulate the inflammatory phase, whilst important for removal of invading pathogens, are not necessary for repair and in fact may be responsible for the subsequent scar formation that seems to have resulted from having such a rapid repair process. The magnitude and length of inflammation in the wound not only appears to dictate the extent of scar formation but also in some cases may even prevent wound closure. In this review we will explore the two sides of inflammation in wound healing and review current and future drug therapies that target inflammation to modulate the healing outcome.

Developing safer passengers through a school-based injury prevention program

Motor vehicle crashes are a leading cause of death among young people. Fourteen percent of adolescents aged 13-14 report passenger-related injuries within three months. Intervention programs typically focus on young drivers and overlook passengers as potential protective influences. Graduated Driver Licensing restricts passenger numbers, and this study focuses on a complementary school-based intervention to increase passengers’ personal- and peer-protective behavior. The aim of this research was to assess the impact of the curriculum-based injury prevention program, Skills for Preventing Injury in Youth (SPIY), on passenger-related risk-taking and injuries, and intentions to intervene in friends’ risky road behavior. SPIY was implemented in Grade 8 Health classes and evaluated using survey and focus group data from 843 students across 10 Australian secondary schools. Intervention students reported less passenger-related risk-taking six months following the program. Their intention to protect friends from underage driving also increased. The results of this study show that a comprehensive, school-based program targeting individual and social changes can increase adolescent passenger safety.

Discussions in space : interactive urban screens for enhancing citizen engagement

Local governments struggle to engage time poor and seemingly apathetic citizens, as well as the city's young digital natives, the digital locals. Capturing the attention of this digitally literate community who are technology and socially savvy adds a new quality to the challenge of community engagement for urban planning. This project developed and tested a lightweight design intervention towards removing the hierarchy between those who plan the city and those who use it. The aim is to narrow this gap by enhancing people's experience of physical spaces with digital, civic technologies that are directly accessible within that space. The study's research informed the development of a public screen system called Discussions In Space (DIS). It facilitates a feedback platform about specific topics, e.g., a concrete urban planning project, and encourages direct, in-situ, real-time user responses via SMS and Twitter. The thesis presents the findings of deploying and integrating DIS in a wide range of public and urban environments, including the iconic urban screen at Federation Square in Melbourne, to explore the Human-Computer Interaction (HCI) related challenges and implications. It was also deployed in conjunction with a major urban planning project in Brisbane to explore the system's opportunities and challenges of better engaging with Australia's new digital locals. Finally, the merits of the short-texted and ephemeral data generated by the system were evaluated in three focus groups with professional urban planners. DIS offers additional benefits for civic participation as it gives voice to residents who otherwise would not be easily heard. It also promotes a positive attitude towards local governments and gathers complementary information that is different than that captured by more traditional public engagement tools.

Creating and evaluating IT-related business value in developing markets - Part 2

A deeper understanding on two aspects of use of IT resources in organisations is important to ensure sustainable investment in these IT resources. The first is how to leverage the IT resources to attain its maximum value. We discussed this aspect of use of IT resources in part 1 of this series. This discussion suggested a complementary approach as a first stage of IT business value creation, and dynamic capabilities approach to secure sustainable IT-related business value from the IT resources. The second important aspect of IT business value is where to evaluate IT-related business value in the organisations value chains. This understanding is important for organisations to ensure appropriate accountability of the investment and management of IT resources. We address this issue in this second part of the two part series.

Sourdough & other stories : a story told in parts (a mosaic novel and exegesis)

The mosaic novel - with its independent 'story-tiles' linking together to form a complete narrative - has the potential to act as a reflection on the periodic resurfacing of unconscious memories in the conscious lives of fictional characters. This project is an exploration of the mosaic text as a fictional analogue of involuntary memory. These concepts are investigated as they appear in traditional fairy tales and engaged with in this thesis's creative component, Sourdough and Other Stories (approximately 80,000 words), a mosaic novel comprising sixteen interconnected 'story-tiles'. Traditional fairy tales are non-reflective and conducive to forgetting (i.e. anti-memory); fairy tale characters are frequently portrayed as psychologically two-dimensional, in that there is no examination of the mental and emotional distress caused when children are stolen/ abandoned/ lost and when adults are exiled. Sourdough and Other Stories is a creative examination of, and attempted to remedy, this lack of psychological depth. This creative work is at once something more than a short story collection, and something that is not a traditional novel, but instead a culmination of two modes of writing. It employs the fairy tale form to explore James' 'thorns in the spirit' (1898, p.199) in fiction; the anxiety caused by separation from familial and community groups. The exegesis, A Story Told in Parts - Sourdough and Other Stories is a critical essay (approximately 20,000 words in length), a companion piece to the mosaic novel, which analyses how my research question proceeded from my creative work, and considers the theoretical underpinnings of the creative work and how it enacts the research question: 'Can a writer use the structural possibilities of the mosaic text to create a fictional work that is an analogue of an involuntary memory?' The cumulative effect of the creative and exegetical works should be that of a dialogue between the two components - each text informing the other and providing alternate but complementary lenses with which to view the research question.

Leveraging innovation for sustainable construction, proceedings of the CIB Task Group 58: Clients and Construction Innovation Workshop

This publication consists of a volume of papers presented at the workshop of the CIB Task Group 58: Clients and Construction Innovation, held on May 18- 19, 2009 at the University of Alberta in Edmonton, Canada. The workshop theme, “Leveraging Innovation for Sustainable Construction”, reflects a growing concern among clients for perspectives, approaches, and tools that will secure the practice of construction economically, socially, and environmentally. This collection encompasses some of the most incisive assessments of the challenges facing the construction industry today from a range of researchers and industry practitioners who are leading the way for tomorrow’s innovations. It provides a useful documentation of the ongoing conversation regarding innovation and sustainability issues and a foundation of knowledge for future research and development. The papers contained in this volume explore the workshop’s overarching theme of how to leverage innovation to increase the sustainability of the construction process and product. Participants sought to generate discussion on the topics of innovation and sustainability within the construction field, to share international examples of innovation from the research community and from industry, and to establish a point of reference for ongoing enquiry. In particular, our contributors have noted the value of learning through practice in order to orient research based on real-world industry experience. Chapters two and three present complementary models of sustainable research programs through the three parts collaboration of government, industry, and academia. Chapters four and five explore new tools and forms of technological innovation as they are deployed to improve construction project management and set the direction for advances in research. Chapters six, seven, and eight closely study practical examples of innovation in large-scale construction projects, showing with concrete results the impact of applying creative methods and best practices to the field. Innovation and sustainability in construction are truly global efforts; these papers illustrate how we can draw on international examples and cooperative organizations to address these important issues for long-term benefit of the industry.

Hospital outpatient responses to potential driving impairment due to prescribed medications

Driving and using prescription medicines that have the potential to impair driving is an emerging research area. To date it is characterised by a limited (although growing) number of studies and methodological complexities that make generalisations about impairment due to medications difficult. Consistent evidence has been found for the impairing effects of hypnotics, sedative antidepressants and antihistamines, and narcotic analgesics, although it has been estimated that as many as nine medication classes have the potential to impair driving (Alvarez & del Rio, 2000; Walsh, de Gier, Christopherson, & Verstraete, 2004). There is also evidence for increased negative effects related to concomitant use of other medications and alcohol (Movig et al., 2004; Pringle, Ahern, Heller, Gold, & Brown, 2005). Statistics on the high levels of Australian prescription medication use suggest that consumer awareness of driving impairment due to medicines should be examined. One web-based study has found a low level of awareness, knowledge and risk perceptions among Australian drivers about the impairing effects of various medications on driving (Mallick, Johnston, Goren, & Kennedy, 2007). The lack of awareness and knowledge brings into question the effectiveness of the existing countermeasures. In Australia these consist of the use of ancillary warning labels administered under mandatory regulation and professional guidelines, advice to patients, and the use of Consumer Medicines Information (CMI) with medications that are known to cause impairment. The responsibility for the use of the warnings and related counsel to patients primarily lies with the pharmacist when dispensing relevant medication. A review by the Therapeutic Goods Administration (TGA) noted that in practice, advice to patients may not occur and that CMI is not always available (TGA, 2002). Researchers have also found that patients' recall of verbal counsel is very low (Houts, Bachrach, Witmer, Tringali, Bucher, & Localio, 1998). With healthcare observed as increasingly being provided in outpatient conditions (Davis et al., 2006; Vingilis & MacDonald, 2000), establishing the effectiveness of the warning labels as a countermeasure is especially important. There have been recent international developments in medication categorisation systems and associated medication warning labels. In 2005, France implemented a four-tier medication categorisation and warning system to improve patients' and health professionals' awareness and knowledge of related road safety issues (AFSSAPS, 2005). This warning system uses a pictogram and indicates the level of potential impairment in relation to driving performance through the use of colour and advice on the recommended behaviour to adopt towards driving. The comparable Australian system does not indicate the severity level of potential effects, and does not provide specific guidelines on the attitude or actions that the individual should adopt towards driving. It is reliant upon the patient to be vigilant in self-monitoring effects, to understand the potential ways in which they may be affected and how serious these effects may be, and to adopt the appropriate protective actions. This thesis investigates the responses of a sample of Australian hospital outpatients who receive appropriate labelling and counselling advice about potential driving impairment due to prescribed medicines. It aims to provide baseline data on the understanding and use of relevant medications by a Queensland public hospital outpatient sample recruited through the hospital pharmacy. It includes an exploration and comparison of the effect of the Australian and French medication warning systems on medication user knowledge, attitudes, beliefs and behaviour, and explores whether there are areas in which the Australian system may be improved by including any beneficial elements of the French system. A total of 358 outpatients were surveyed, and a follow-up telephone survey was conducted with a subgroup of consenting participants who were taking at least one medication that required an ancillary warning label about driving impairment. A complementary study of 75 French hospital outpatients was also conducted to further investigate the performance of the warnings. Not surprisingly, medication use among the Australian outpatient sample was high. The ancillary warning labels required to appear on medications that can impair driving were prevalent. A subgroup of participants was identified as being potentially at-risk of driving impaired, based on their reported recent use of medications requiring an ancillary warning label and level of driving activity. The sample reported previous behaviour and held future intentions that were consistent with warning label advice and health protective action. Participants did not express a particular need for being advised by a health professional regarding fitness to drive in relation to their medication. However, it was also apparent from the analysis that the participants would be significantly more likely to follow advice from a doctor than a pharmacist. High levels of knowledge in terms of general principles about effects of alcohol, illicit drugs and combinations of substances, and related health and crash risks were revealed. This may reflect a sample specific effect. Emphasis is placed in the professional guidelines for hospital pharmacists that make it essential that advisory labels are applied to medicines where applicable and that warning advice is given to all patients on medication which may affect driving (SHPA, 2006, p. 221). The research program applied selected theoretical constructs from Schwarzer's (1992) Health Action Process Approach, which has extended constructs from existing health theories such as the Theory of Planned Behavior (Ajzen, 1991) to better account for the intention-behaviour gap often observed when predicting behaviour. This was undertaken to explore the utility of the constructs in understanding and predicting compliance intentions and behaviour with the mandatory medication warning about driving impairment. This investigation revealed that the theoretical constructs related to intention and planning to avoid driving if an effect from the medication was noticed were useful. Not all the theoretical model constructs that had been demonstrated to be significant predictors in previous research on different health behaviours were significant in the present analyses. Positive outcome expectancies from avoiding driving were found to be important influences on forming the intention to avoid driving if an effect due to medication was noticed. In turn, intention was found to be a significant predictor of planning. Other selected theoretical constructs failed to predict compliance with the Australian warning label advice. It is possible that the limited predictive power of a number of constructs including risk perceptions is due to the small sample size obtained at follow up on which the evaluation is based. Alternately, it is possible that the theoretical constructs failed to sufficiently account for issues of particular relevance to the driving situation. The responses of the Australian hospital outpatient sample towards the Australian and French medication warning labels, which differed according to visual characteristics and warning message, were examined. In addition, a complementary study with a sample of French hospital outpatients was undertaken in order to allow general comparisons concerning the performance of the warnings. While a large amount of research exists concerning warning effectiveness, there is little research that has specifically investigated medication warnings relating to driving impairment. General established principles concerning factors that have been demonstrated to enhance warning noticeability and behavioural compliance have been extrapolated and investigated in the present study. The extent to which there is a need for education and improved health messages on this issue was a core issue of investigation in this thesis. Among the Australian sample, the size of the warning label and text, and red colour were the most visually important characteristics. The pictogram used in the French labels was also rated highly, and was salient for a large proportion of the sample. According to the study of French hospital outpatients, the pictogram was perceived to be the most important visual characteristic. Overall, the findings suggest that the Australian approach of using a combination of visual characteristics was important for the majority of the sample but that the use of a pictogram could enhance effects. A high rate of warning recall was found overall and a further important finding was that higher warning label recall was associated with increased number of medication classes taken. These results suggest that increased vigilance and care are associated with the number of medications taken and the associated repetition of the warning message. Significantly higher levels of risk perception were found for the French Level 3 (highest severity) label compared with the comparable mandatory Australian ancillary Label 1 warning. Participants' intentions related to the warning labels indicated that they would be more cautious while taking potentially impairing medication displaying the French Level 3 label compared with the Australian Label 1. These are potentially important findings for the Australian context regarding the current driving impairment warnings about displayed on medication. The findings raise other important implications for the Australian labelling context. An underlying factor may be the differences in the wording of the warning messages that appear on the Australian and French labels. The French label explicitly states "do not drive" while the Australian label states "if affected, do not drive", and the difference in responses may reflect that less severity is perceived where the situation involves the consumer's self-assessment of their impairment. The differences in the assignment of responsibility by the Australian (the consumer assesses and decides) and French (the doctor assesses and decides) approaches for the decision to drive while taking medication raises the core question of who is most able to assess driving impairment due to medication: the consumer, or the health professional? There are pros and cons related to knowledge, expertise and practicalities with either option. However, if the safety of the consumer is the primary aim, then the trend towards stronger risk perceptions and more consistent and cautious behavioural intentions in relation to the French label suggests that this approach may be more beneficial for consumer safety. The observations from the follow-up survey, although based on a small sample size and descriptive in nature, revealed that just over half of the sample recalled seeing a warning label about driving impairment on at least one of their medications. The majority of these respondents reported compliance with the warning advice. However, the results indicated variation in responses concerning alcohol intake and modifying the dose of medication or driving habits so that they could continue to drive, which suggests that the warning advice may not be having the desired impact. The findings of this research have implications for current countermeasures in this area. These have included enhancing the role that prescribing doctors have in providing warnings and advice to patients about the impact that their medication can have on driving, increasing consumer perceptions of the authority of pharmacists on this issue, and the reinforcement of the warning message. More broadly, it is suggested that there would be benefit in a wider dissemination of research-based information on increased crash risk and systematic monitoring and publicity about the representation of medications in crashes resulting in injuries and fatalities. Suggestions for future research concern the continued investigation of the effects of medications and interactions with existing medical conditions and other substances on driving skills, effects of variations in warning label design, individual behaviours and characteristics (particularly among those groups who are dependent upon prescription medication) and validation of consumer self-assessment of impairment.

Re-examining the evidence in radiation dermatitis management literature : an overview and a critical appraisal of systematic reviews

Purpose: To provide an overview and a critical appraisal of systematic reviews (SRs) of published interventions for the prevention/management of radiation dermatitis. Methods and Materials: We searched Medline, CINAHL, Embase, and the Cochrane Library. We also manually searched through individual reference lists of potentially eligible articles and a number of key journals in the topic area. Two authors screened all potential articles and included eligible SRs. Two authors critically appraised and extracted key findings from the included reviews using AMSTAR (the measurement tool for “assessment of multiple systematic reviews”). Results: Of 1837 potential titles, 6 SRs were included. A number of interventions have been reported to be potentially beneficial for managing radiation dermatitis. Interventions evaluated in these reviews included skin care advice, steroidal/nonsteroidal topical agents, systemic therapies, modes of radiation delivery, and dressings. However, all the included SRs reported that there is insufficient evidence supporting any single effective intervention. The methodological quality of the included studies varied, and methodological shortfalls in these reviews might create biases to the overall results or recommendations for clinical practice. Conclusions: An up-to-date high-quality SR in the prevention/management of radiation dermatitis is needed to guide practice and direction for future research. We recommend that clinicians or guideline developers critically evaluate the information of SRs in their decision making.