668 resultados para diagnostic approach route


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Developing economies accommodate more than three quarters of the world's population. This means understanding their growth and well-being is of critical importance. Information technology (IT) is one resource that has had a profound effect in shaping the global economy. IT is also an important resource for driving growth and development in developing economies. Investments in developing economies, however, have focused on the exploitation of labor and natural resources. Unlike in developed economies, focus on IT investment to improve efficiency and effectiveness of business process in developing economies has been sparse, and mechanisms for deriving better IT-related business value is not well understood. This study develops a complementarities-based business value model for developing economies, and tests the relationship between IT investments, IT-related complementarities, and business process performance. It also considers the relationship between business processes performance and firm-level performance. The results suggest that a coordinated investment in IT and IT-related complementarities related favorably to business process performance. Improvements in process-level performance lead to improvements in firm-level performance. The results also suggest that the IT-related complementarities are not only a source of business value on their own, but also enhance the IT resources' ability to contribute to business process performance. This study demonstrates that a coordinated investment approach is required in developing economies. With this approach, their IT resources and IT-related complementaries would help them significantly in improving their business processes, and eventually their firm-level performances.

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There has been much written about the Internet’s potential to enhance international market growth opportunities for SME’s. However, the literature is vague as to how Internet usage and the application of Internet marketing also known as Internet marketing intensity has an impact on firm international market growth. This paper examines the level and role of the Internet in the international operations of a sample of 218 Australian SMEs with international customers. This study shows evidence of a statistical relationship between Internet usage and Internet marketing intensity, which in turn leads to international market growth, in terms of increased sales from new customers in new countries, new customers in existing countries and from existing customers.

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Chronic venous leg ulcers are a detrimental health issue plaguing our society, resulting in long term pain, immobility and decreased quality of life for a large proportion of sufferers. The frequency of these chronic wounds has led current research to focus on the wound environment to provide important information regarding the prolonged, fluctuated or static healing patterns of these wounds. Disruption to the normal wound healing process results in release of multiple factors in the wound environment that could correlate to wound chronicity. These biochemical factors can often be detected through non-invasively sampling chronic wound fluid (CWF) from the site of injury. Of note, whilst there are numerous studies comparing acute and chronic wound fluids, there have not been any reports in the literature employing a longitudinal study in order to track biochemical changes in wound fluid as patients transition from a non-healing to healed state. Initially the objective of this study was to identify biochemical changes in CWF associated with wound healing using a proteomic approach. The proteomic approach incorporated a multi-dimensional liquid chromatography fractionation technique coupled with mass spectrometry (MS) to enable identification of proteins present in lower concentrations in CWF. Not surprisingly, many of the proteins identified in wound fluid were acute phase proteins normally expressed during the inflammatory phase of healing. However, the number of proteins positively identified by MS was quite low. This was attributed to the diverse range in concentration of protein species in CWF making it challenging to detect the diagnostically relevant low molecular weight proteins. In view of this, SELDI-TOF MS was also explored as a means to target low molecular weight proteins in sequential patient CWF samples during the course of healing. Unfortunately, the results generated did not yield any peaks of interest that were altered as wounds transitioned to a healed state. During the course of proteomic assessment of CWF, it became evident that a fraction of non-proteinaceous compounds strongly absorbed at 280 nm. Subsequent analyses confirmed that most of these compounds were in fact part of the purine catabolic pathway, possessing distinctive aromatic rings and which results in high absorbance at 254 nm. The accumulation of these purinogenic compounds in CWF suggests that the wound bed is poorly oxygenated resulting in a switch to anaerobic metabolism and consequently ATP breakdown. In addition, the presence of the terminal purine catabolite, uric acid (UA), indicates that the enzyme xanthine oxidoreductase (XOR) catalyses the reaction of hypoxanthine to xanthine and finally to UA. More importantly, the studies provide evidence for the first time of the exogenous presence of XOR in CWF. XOR is the only enzyme in humans capable of catalysing the production of UA in conjunction with a burst of the highly reactive superoxide radical and other oxidants like H2O2. Excessive release of these free radicals in the wound environment can cause cellular damage disrupting the normal wound healing process. In view of this, a sensitive and specific assay was established for monitoring low concentrations of these catabolites in CWF. This procedure involved combining high performance liquid chromatography (HPLC) with tandem mass spectrometry and multiple reaction monitoring (MRM). This application was selective, using specific MRM transitions and HPLC separations for each analyte, making it ideal for the detection and quantitation of purine catabolites in CWF. The results demonstrated that elevated levels of UA were detected in wound fluid obtained from patients with clinically worse ulcers. This suggests that XOR is active in the wound site generating significant amounts of reactive oxygen species (ROS). In addition, analysis of the amount of purine precursors in wound fluid revealed elevated levels of purine precursors in wound fluid from patients with less severe ulcers. Taken together, the results generated in this thesis suggest that monitoring changes of purine catabolites in CWF is likely to provide valuable information regarding the healing patterns of chronic venous leg ulcers. XOR catalysis of purine precursors not only provides a method for monitoring the onset, prognosis and progress of chronic venous leg ulcers, but also provides a potential therapeutic target by inhibiting XOR, thus blocking UA and ROS production. Targeting a combination of these purinogenic compounds and XOR could lead to the development of novel point of care diagnostic tests. Therefore, further investigation of these processes during wound healing will be worthwhile and may assist in elucidating the pathogenesis of this disease state, which in turn may lead to the development of new diagnostics and therapies that target these processes.

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The improvement and optimization of business processes is one of the top priorities in an organization. Although process analysis methods are mature today, business analysts and stakeholders are still hampered by communication issues. That is, analysts cannot effectively obtain accurate business requirements from stakeholders, and stakeholders are often confused about analytic results offered by analysts. We argue that using a virtual world to model a business process can benefit communication activities. We believe that virtual worlds can be used as an efficient model-view approach, increasing the cognition of business requirements and analytic results, as well as the possibility of business plan validation. A healthcare case study is provided as an approach instance, illustrating how intuitive such an approach can be. As an exploration paper, we believe that this promising research can encourage people to investigate more research topics in the interdisciplinary area of information system, visualization and multi-user virtual worlds.

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Context-based chemistry education aims to improve student interest and motivation in chemistry by connecting canonical chemistry concepts with real-world contexts. Implementation of context-based chemistry programmes began 20 years ago in an attempt to make the learning of chemistry meaningful for students. This paper reviews such programmes through empirical studies on six international courses, ChemCom (USA), Salters (UK), Industrial Science (Israel), Chemie im Kontext (Germany), Chemistry in Practice (The Netherlands) and PLON (The Netherlands). These studies are categorised through emergent characteristics of: relevance, interest/attitudes motivation and deeper understanding. These characteristics can be found to an extent in a number of other curricular initiatives, such as science-technology-society approaches and problem-based learning or project based science, the latter of which often incorporates an inquiry-based approach to science education. These initiatives in science education are also considered with a focus on the characteristics of these approaches that are emphasised in context-based education. While such curricular studies provide a starting point for discussing context-based approaches in chemistry, to advance our understanding of how students connect canonical science concepts with the real-world context, a new theoretical framework is required. A dialectical sociocultural framework originating in the work of Vygotsky is used as a referent for analysing the complex human interactions that occur in context-based classrooms, providing teachers with recent information about the pedagogical structures and resources that afford students the agency to learn.

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This paper provides a critique of the Water Sensitive Urban Design (WSUD) paradigm by discussing its congruence with an established sustainable design principle called 'whole system design'. It was found that WSUD is congruent with the whole system design approach as a philosophy, but not in practice. Future improvement of WSUD practice may depend on the adoption of a front-loaded, teamwork-based design and planning process that is embedded in the principle of whole system design.

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Background: Integrating 3D virtual world technologies into educational subjects continues to draw the attention of educators and researchers alike. The focus of this study is the use of a virtual world, Second Life, in higher education teaching. In particular, it explores the potential of using a virtual world experience as a learning component situated within a curriculum delivered predominantly through face-to-face teaching methods. Purpose: This paper reports on a research study into the development of a virtual world learning experience designed for marketing students taking a Digital Promotions course. The experience was a field trip into Second Life to allow students to investigate how business branding practices were used for product promotion in this virtual world environment. The paper discusses the issues involved in developing and refining the virtual course component over four semesters. Methods: The study used a pedagogical action research approach, with iterative cycles of development, intervention and evaluation over four semesters. The data analysed were quantitative and qualitative student feedback collected after each field trip as well as lecturer reflections on each cycle. Sample: Small-scale convenience samples of second- and third-year students studying in a Bachelor of Business degree, majoring in marketing, taking the Digital Promotions subject at a metropolitan university in Queensland, Australia participated in the study. The samples included students who had and had not experienced the field trip. The numbers of students taking part in the field trip ranged from 22 to 48 across the four semesters. Findings and Implications: The findings from the four iterations of the action research plan helped identify key considerations for incorporating technologies into learning environments. Feedback and reflections from the students and lecturer suggested that an innovative learning opportunity had been developed. However, pedagogical potential was limited, in part, by technological difficulties and by student perceptions of relevance.

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Society faces an unprecedented global education challenge to equip professionals with the knowledge and skills to address emerging 21st Century challenges, spanning climate change mitigation through to adaptation measures to deal with issues such as temperature and sea level rise, and diminishing fresh water and fossil fuel reserves. This paper discusses the potential for systemic and synergistic integration of curriculum with campus operations to accelerate curriculum renewal towards ESD, drawing on the authors' experiences within engineering education. The paper begins by a providing a brief overview of the need for timely curriculum renewal towards ESD in tertiary education. The paper then highlights some examples of academic barriers that need to be overcome for integration efforts to be successful, and opportunities for promoting the benefits of such integration. The paper concludes by discussing the rational for planning green campus initiatives within a larger system of curriculum renewal considerations, including awareness raising and developing a common understanding, identifying and mapping graduate attributes, curriculum auditing, content development and strategic renewal, and bridging and outreach.

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The current regulatory approach to coal seam gas projects in Queensland is based on the philosophy of adaptive environmental management. This method of “learning by doing” is implemented in Queensland primarily through the imposition of layered monitoring and reporting duties on the coal seam gas operator alongside obligations to compensate and “make good” harm caused. The purpose of this article is to provide a critical review of the Queensland regulatory approach to the approval and minimisation of adverse impacts from coal seam gas activities. Following an overview of the hallmarks of an effective adaptive management approach, this article begins by addressing the mosaic of approval processes and impact assessment regimes that may apply to coal seam gas projects. This includes recent Strategic Cropping Land reforms. This article then turns to consider the preconditions for land access in Queensland and the emerging issues for landholders relating to the negotiation of access and compensation agreements. This article then undertakes a critical review of the environmental duties imposed on coal seam gas operators relating to hydraulic fracturing, well head leaks, groundwater management and the disposal and beneficial use of produced water. Finally, conclusions are drawn regarding the overall effectiveness of the Queensland framework and the lessons that may be drawn from Queensland’s adaptive environmental management approach.

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Accurate and detailed road models play an important role in a number of geospatial applications, such as infrastructure planning, traffic monitoring, and driver assistance systems. In this thesis, an integrated approach for the automatic extraction of precise road features from high resolution aerial images and LiDAR point clouds is presented. A framework of road information modeling has been proposed, for rural and urban scenarios respectively, and an integrated system has been developed to deal with road feature extraction using image and LiDAR analysis. For road extraction in rural regions, a hierarchical image analysis is first performed to maximize the exploitation of road characteristics in different resolutions. The rough locations and directions of roads are provided by the road centerlines detected in low resolution images, both of which can be further employed to facilitate the road information generation in high resolution images. The histogram thresholding method is then chosen to classify road details in high resolution images, where color space transformation is used for data preparation. After the road surface detection, anisotropic Gaussian and Gabor filters are employed to enhance road pavement markings while constraining other ground objects, such as vegetation and houses. Afterwards, pavement markings are obtained from the filtered image using the Otsu's clustering method. The final road model is generated by superimposing the lane markings on the road surfaces, where the digital terrain model (DTM) produced by LiDAR data can also be combined to obtain the 3D road model. As the extraction of roads in urban areas is greatly affected by buildings, shadows, vehicles, and parking lots, we combine high resolution aerial images and dense LiDAR data to fully exploit the precise spectral and horizontal spatial resolution of aerial images and the accurate vertical information provided by airborne LiDAR. Objectoriented image analysis methods are employed to process the feature classiffcation and road detection in aerial images. In this process, we first utilize an adaptive mean shift (MS) segmentation algorithm to segment the original images into meaningful object-oriented clusters. Then the support vector machine (SVM) algorithm is further applied on the MS segmented image to extract road objects. Road surface detected in LiDAR intensity images is taken as a mask to remove the effects of shadows and trees. In addition, normalized DSM (nDSM) obtained from LiDAR is employed to filter out other above-ground objects, such as buildings and vehicles. The proposed road extraction approaches are tested using rural and urban datasets respectively. The rural road extraction method is performed using pan-sharpened aerial images of the Bruce Highway, Gympie, Queensland. The road extraction algorithm for urban regions is tested using the datasets of Bundaberg, which combine aerial imagery and LiDAR data. Quantitative evaluation of the extracted road information for both datasets has been carried out. The experiments and the evaluation results using Gympie datasets show that more than 96% of the road surfaces and over 90% of the lane markings are accurately reconstructed, and the false alarm rates for road surfaces and lane markings are below 3% and 2% respectively. For the urban test sites of Bundaberg, more than 93% of the road surface is correctly reconstructed, and the mis-detection rate is below 10%.

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The paper introduces the underlying principles and the general features of a meta-method (MAP method) developed as part of and used in various research, education and professional development programmes at ESC Lille. This method aims at providing effective and efficient structure and process for acting and learning in various complex, uncertain and ambiguous managerial situations (projects, programmes, portfolios). The paper is developed around three main parts. First, I suggest revisiting the dominant vision of the project management knowledge field, based on the assumptions they are not addressing adequately current business and management contexts and situations, and that competencies in management of entrepreneurial activities are the sources of creation of value for organisations. Then, grounded on the former developments, I introduce the underlying concepts supporting MAP method seen as a ‘convention generator’ and how this meta method inextricably links learning and practice in addressing managerial situations. Finally, I briefly describe an example of application, illustrating with a case study how the method integrates Project Management Governance, and give few examples of use in Management Education and Professional Development.

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Introduction The suitability of video conferencing (VC) technology for clinical purposes relevant to geriatric medicine is still being established. This project aimed to determine the validity of the diagnosis of dementia via VC. Methods This was a multisite, noninferiority, prospective cohort study. Patients, aged 50 years and older, referred by their primary care physician for cognitive assessment, were assessed at 4 memory disorder clinics. All patients were assessed independently by 2 specialist physicians. They were allocated one face-to-face (FTF) assessment (Reference standard – usual clinical practice) and an additional assessment (either usual FTF assessment or a VC assessment) on the same day. Each specialist physician had access to the patient chart and the results of a battery of standardized cognitive assessments administered FTF by the clinic nurse. Percentage agreement (P0) and the weighted kappa statistic with linear weight (Kw) were used to assess inter-rater reliability across the 2 study groups on the diagnosis of dementia (cognition normal, impaired, or demented). Results The 205 patients were allocated to group: Videoconference (n = 100) or Standard practice (n = 105); 106 were men. The average age was 76 (SD 9, 51–95) and the average Standardized Mini-Mental State Examination Score was 23.9 (SD 4.7, 9–30). Agreement for the Videoconference group (P0= 0.71; Kw = 0.52; P < .0001) and agreement for the Standard Practice group (P0= 0.70; Kw = 0.50; P < .0001) were both statistically significant (P < .05). The summary kappa statistic of 0.51 (P = .84) indicated that VC was not inferior to FTF assessment. Conclusions Previous studies have shown that preliminary standardized assessment tools can be reliably administered and scored via VC. This study focused on the geriatric assessment component of the interview (interpretation of standardized assessments, taking a history and formulating a diagnosis by medical specialist) and identified high levels of agreement for diagnosing dementia. A model of service incorporating either local or remote administered standardized assessments, and remote specialist assessment, is a reliable process for enabling the diagnosis of dementia for isolated older adults.

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The purpose of this paper is to show how project management governance is addressed through the use of a specific meta-method. Governance is defined here on two criteria: accountability and performance. Accountability is promoted through transparency and performance is promoted by responsive and responsible decision-making. According to a systemic perspective, transparency and decision-making involve having information, tacit or explicit knowledge, as well as understanding of the context, the different parameters and variables, their interaction and conditions of change. Although this method of methods was built according a heuristic process involving 25 years of various researches and consulting activities, it seems appropriate to draw its foundations. I clarify first my epistemological position and the notion of project and project management, as Art and Science. This lead me to define a "Be" / "Have" posture to this regards. Then, the main theoretical roots of MAP Method are exposed: Boisot' s Social Learning Cycle, Praxeology and Theory of Convention. Then we introduced the main characteristics of the method and the 17 methods and tools constituting MAP "tool box", thus with regard to the project management governance perspective. Finally, I discuss the integration of two managerial modes (operational and project modes) and the consequence in term of governance in a specific socio-techno-economic project/context ecosystem.

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Foreword: In this paper I call upon a praxiological approach. Praxeology (early alteration of praxiology) is the study of human action and conduct. The name praxeology/praxiologyakes is root in praxis, Medieval Latin, from Greek, doing, action, from prassein to do, practice (Merriam-Webster Dictionary). Having been involved in project management education, research and practice for the last twenty years, I have constantly tried to improve and to provide a better understanding/knowledge of the field and related practice, and as a consequence widen and deepen the competencies of the people I was working with (and my own competencies as well!), assuming that better project management lead to more efficient and effective use of resources, development of people and at the end to a better world. For some time I have perceived a need to clarify the foundations of the discipline of project management, or at least elucidate what these foundations could be. An immodest task, one might say! But not a neutral one! I am constantly surprised by the way the world (i.e., organizations, universities, students and professional bodies) sees project management: as a set of methods, techniques, tools, interacting with others fields – general management, engineering, construction, information systems, etc. – bringing some effective ways of dealing with various sets of problems – from launching a new satellite to product development through to organizational change.

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Project management is increasingly regarded as a strategic competency because projects play an active part in defining an organization’s relationship to its environment. It is now widely accepted that projects and programmes are at the centre of strategy implementation. However, the conditions and underlying assumptions of this dynamic relationship are still unclear. This paper aims to clarify the dynamics of the strategy process, by defining traditional approaches (corporate/business) and introducing three strategy core logics (archetypes). Building on this 'archetypology' the authors demonstrate how project management, through enactment and sense-making of strategy, enables organizations to face the challenge of complexity and uncertainty. While recognizing that the "traditional" methods of analysis and management remain valid under certain conditions, this paper offers new avenues of reflection concerning the necessary contextualization of the project management approaches in order to ensure coherence between archetypes, enactment, learning and decision-making.