379 resultados para Mutual Gains


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Reviews outcome studies on the course of schizophrenia as predicted by expressed emotion (EE) and considers methodological issues. The nature of EE and the mechanism for the predictive results are explored. EE probably determines relapse through its effect on emotions and symptom control. A stress-vulnerability model of relapse is advanced that incorporates biological factors and cycles of mutual influence between symptomatic behavior, life events, and EE. A social interaction model of schizophrenia may help to alleviate concerns that EE represents an attempt to blame families for schizophrenic relapse. Aversive types of behavior in patients and their relatives are seen as understandable reactions to stress that are moderated by social perceptions and coping skills. Families have made positive achievements, including the provision of noninvasive support.

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Describes case studies of 2 males (aged 28 and 30 yrs) in which in vivo practice was applied to needle phobia and associated vasovagal fainting. In vivo practice combines skill acquisition with an opportunity to disconfirm negative expectations. Substantial improvements in self-efficacy, anxiety, and performance were obtained. Treatment gains generalized to other settings and were maintained at 3–6 mo follow-up. In vivo practice is recommended for further research into needle phobias.

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Professionals working in disability services often encounter clients who have chromosome disorders such as Williams, Angelman or Down syndromes. As chromosome testing becomes increasingly sophisticated, however, more people are being diagnosed with very rare chromosome disorders that are identified not by a syndrome name, but rather by a description of the number, size and shape of their chromosomes (called the karyotype) or by a report of chromosome losses and gains detected through an advanced process known as microarray-based comparative genomic hybridisation (array CGH). For practitioners who work with individuals with rare chromosome disorders and their families, a basic level of knowledge about the evolving field of genetics, as well as specific knowledge about chromosome abnormalities, is essential since they must be able to demonstrate their knowledge and skills to clients (Simic & Turk, 2004). In addition, knowledge about the developmental consequences of various rare chromosome disorders is important for guiding prognoses, expectations, decisions and interventions. The current article provides information that aims to help practitioners work more effectively with this population. It begins by presenting essential information about chromosomes and their numerical and structural abnormalities and then considers the developmental consequences of rare chromosome disorders through a critical review of relevant literature.

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The problem of impostor dataset selection for GMM-based speaker verification is addressed through the recently proposed data-driven background dataset refinement technique. The SVM-based refinement technique selects from a candidate impostor dataset those examples that are most frequently selected as support vectors when training a set of SVMs on a development corpus. This study demonstrates the versatility of dataset refinement in the task of selecting suitable impostor datasets for use in GMM-based speaker verification. The use of refined Z- and T-norm datasets provided performance gains of 15% in EER in the NIST 2006 SRE over the use of heuristically selected datasets. The refined datasets were shown to generalise well to the unseen data of the NIST 2008 SRE.

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A data-driven background dataset refinement technique was recently proposed for SVM based speaker verification. This method selects a refined SVM background dataset from a set of candidate impostor examples after individually ranking examples by their relevance. This paper extends this technique to the refinement of the T-norm dataset for SVM-based speaker verification. The independent refinement of the background and T-norm datasets provides a means of investigating the sensitivity of SVM-based speaker verification performance to the selection of each of these datasets. Using refined datasets provided improvements of 13% in min. DCF and 9% in EER over the full set of impostor examples on the 2006 SRE corpus with the majority of these gains due to refinement of the T-norm dataset. Similar trends were observed for the unseen data of the NIST 2008 SRE.

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Since the industrial revolution, our world has experienced rapid and unplanned industrialization and urbanization. As a result, we have had to cope with serious environmental challenges. In this context, an explanation of how smart urban ecosystems can emerge, gains a crucial importance. Capacity building and community involvement have always been key issues in achieving sustainable development and enhancing urban ecosystems. By considering these, this paper looks at new approaches to increase public awareness of environmental decision making. This paper will discuss the role of Information and Communication Technologies (ICT), particularly Webbased Geographic Information Systems (Web-based GIS) as spatial decision support systems to aid public participatory environmental decision making. The paper also explores the potential and constraints of these webbased tools for collaborative decision making.

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Many cities around the globe are now considering tourism facilities and their remarkable revenues in order to become competitive in the global economy. In many of these cities a great emphasis is given to the cultural tourism as it plays an important role in the establishment of creative and knowledge-base of cities. The literature points out the importance of local community support in cultural tourism. In such context, the use of new approach and technologies in tourism planning in order to increase the community participation and competitiveness of cities’ cultural assets gains a great significance. This paper advocates a new planning approach for tourism planning, particularly for cultural tourism, to increase the competitiveness of cities. As part of this new approach, the paper introduces the joined up planning approach integrated with a collaborative decision support system: ‘the community-oriented decision support system’. This collaborative planning support system is an effective and efficient tool for cultural tourism planning, which provides a platform for local communities’ participation in the development decision process.

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Despite the facts that vehicle incidents continue to be the most common mechanism for Australian compensated fatalities and that employers have statutory obligations to provide safe workplaces, very few organisations are proactively and comprehensively managing their work-related road risks. Unfortunately, limited guidance is provided in the existing literature to assist practitioners in managing work-related road risks. The current research addresses this gap in the literature. To explore how work-related road safety can be enhanced, three studies were conducted. Study one explored the effectiveness of a range of risk management initiatives and whether comprehensive risk management practices were associated with safety outcomes. Study two explored barriers to, and facilitators for, accepting risk management initiatives. Study three explored the influence of organisational factors on road safety outcomes to identify optimal work environments for managing road risks. To maximise the research sample and increase generalisability, the studies were designed to allow data collection to be conducted simultaneously drawing upon the same sample obtained from four Australian organisations. Data was collected via four methods. A structured document review of published articles was conducted to identify what outcomes have been observed in previously investigated work-related road safety initiatives. The documents reviewed collectively assessed the effectiveness of 19 work-related road safety initiatives. Audits of organisational practices and process operating within the four researched organisations were conducted to identify whether organisations with comprehensive work-related road risk management practices and processes have better safety outcomes than organisations with limited risk management practices and processes. Interviews were conducted with a sample of 24 participants, comprising 16 employees and eight managers. The interviews were conducted to identify what barriers and facilitators within organisations are involved in implementing work-related road safety initiatives and whether differences in fleet safety climate, stage of change and safety ownership relate to work-related road safety outcomes. Finally, questionnaires were administered to a sample of 679 participants. The questionnaires were conducted to identify which initiatives are perceived by employees to be effective in managing work-related road risks and whether differences in fleet safety climate, stage of change and safety ownership relate to work-related road safety outcomes. Seven research questions were addressed in the current research project. The key findings with respect to each of the research questions are presented below. Research question one: What outcomes have been observed in previously investigated work-related road safety initiatives? The structured document review indicated that initiatives found to be positively associated with occupational road safety both during and after the intervention period included: a pay rise; driver training; group discussions; enlisting employees as community road safety change agents; safety reminders; and group and individual rewards. Research question two: Which initiatives are perceived by employees to be effective in managing work-related road risks? Questionnaire findings revealed that employees believed occupational road risks could best be managed through making vehicle safety features standard, providing practical driver skills training and through investigating serious vehicle incidents. In comparison, employees believed initiatives including signing a promise card commitment to drive safely, advertising the organisation’s phone number on vehicles and consideration of driving competency in staff selection process would have limited effectiveness in managing occupational road safety. Research question three: Do organisations with comprehensive work-related road risk management practices and processes have better safety outcomes than organisations with limited risk management practices and processes? The audit identified a difference among the organisations in their management of work-related road risks. Comprehensive risk management practices were associated with employees engaging in overall safer driving behaviours, committing less driving errors, and experiencing less fatigue and distraction issues when driving. Given that only four organisations participated in this research, these findings should only be considered as preliminary. Further research should be conducted to explore the relationship between comprehensiveness of risk management practices and road safety outcomes with a larger sample of organisations. Research question four: What barriers and facilitators within organisations are involved in implementing work-related road safety initiatives? The interviews identified that employees perceived six organisational characteristics as potential barriers to implementing work-related road safety initiatives. These included: prioritisation of production over safety; complacency towards work-related road risks; insufficient resources; diversity; limited employee input in safety decisions; and a perception that road safety initiatives were an unnecessary burden. In comparison, employees perceived three organisational characteristics as potential facilitators to implementing work-related road safety initiatives. These included: management commitment; the presence of existing systems that could support the implementation of initiatives; and supportive relationships. Research question five: Do differences in fleet safety climate relate to work-related road safety outcomes? The interviews and questionnaires identified that organisational climates with high management commitment, support for managing work demands, appropriate safety rules and safety communication were associated with employees who engaged in safer driving behaviours. Regression analyses indicated that as participants’ perceptions of safety climate increased, the corresponding likelihood of them engaging in safer driving behaviours increased. Fleet safety climate was perceived to influence road safety outcomes through several avenues. Some of these included: the allocation of sufficient resources to manage occupational road risks; fostering a supportive environment of mutual responsibility; resolving safety issues openly and fairly; clearly communicating to employees that safety is the top priority; and developing appropriate work-related road safety policies and procedures. Research question six: Do differences in stage of change relate to work-related road safety outcomes? The interviews and questionnaires identified that participants’ perceptions of initiative effectiveness were found to vary with respect to their individual stage of readiness, with stage-matched initiatives being perceived most effective. In regards to safety outcomes, regression analyses identified that as participants’ progress through the stages of change, the corresponding likelihood of them being involved in vehicle crashes decreases. Research question seven: Do differences in safety ownership relate to work-related road safety outcomes? The interviews and questionnaires revealed that management of road risks is often given less attention than other areas of health and safety management in organisations. In regards to safety outcomes, regression analyses identified that perceived authority and perceived shared ownership both emerged as significant independent predictors of self-reported driving behaviours pertaining to fatigue and distractions. The regression models indicated that as participants’ perceptions of the authority of the person managing road risks increases, and perceptions of shared ownership of safety tasks increases, the corresponding likelihood of them engaging in driving while fatigued or multitasking while driving decreases. Based on the findings from the current research, the author makes several recommendations to assist practitioners in developing proactive and comprehensive approaches to managing occupational road risks. The author also suggests several avenues for future research in the area of work-related road safety.

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Work-integrated learning in the form of internships is increasingly important for universities as they seek to compete for students, and seek links with industries. Yet, there is surprisingly little empirical research on the details of internships: (1) What they should accomplish? How they should be structure? (3) How students performance should be assess? There is also surprisingly little conceptual analysis of these key issues, either for business internships in general. or for marketing internships in particular. Furthermore, the "answers" on these issues may differ depending upon the perspective if the three stakeholders: students, business managers and university academics. There is not study in the marketing literature which surveys all three groups on these important aspects of internships. To fill these gaps, this paper discusses and analyses internships goals, internship structure, and internship assessment or undergraduate marketing internships, and then reports on a survey of the views of all three stakeholder groups on these issues. There are a considerable variety of approaches for internships, but generally there is consensus among the stake holder groups, with some notable differences. Managerial implication include recognition of the importance of having and academic aspects in internships; mutual understanding concerning needs and constraints; and the requirement that companies, students, and academics take a long-term view of internship programs to achieve mutually beneficial outcomes.

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This paper investigates the robust H∞ control for Takagi-Sugeno (T-S) fuzzy systems with interval time-varying delay. By employing a new and tighter integral inequality and constructing an appropriate type of Lyapunov functional, delay-dependent stability criteria are derived for the control problem. Because neither any model transformation nor free weighting matrices are employed in our theoretical derivation, the developed stability criteria significantly improve and simplify the existing stability conditions. Also, the maximum allowable upper delay bound and controller feedback gains can be obtained simultaneously from the developed approach by solving a constrained convex optimization problem. Numerical examples are given to demonstrate the effectiveness of the proposed methods.

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Research on analogies in science education has focussed on student interpretation of teacher and textbook analogies, psychological aspects of learning with analogies and structured approaches for teaching with analogies. Few studies have investigated how analogies might be pivotal in students’ growing participation in chemical discourse. To study analogies in this way requires a sociocultural perspective on learning that focuses on ways in which language, signs, symbols and practices mediate participation in chemical discourse. This study reports research findings from a teacher-research study of two analogy-writing activities in a chemistry class. The study began with a theoretical model, Third Space, which informed analyses and interpretation of data. Third Space was operationalized into two sub-constructs called Dialogical Interactions and Hybrid Discourses. The aims of this study were to investigate sociocultural aspects of learning chemistry with analogies in order to identify classroom activities where students generate Dialogical Interactions and Hybrid Discourses, and to refine the operationalization of Third Space. These aims were addressed through three research questions. The research questions were studied through an instrumental case study design. The study was conducted in my Year 11 chemistry class at City State High School for the duration of one Semester. Data were generated through a range of data collection methods and analysed through discourse analysis using the Dialogical Interactions and Hybrid Discourse sub-constructs as coding categories. Results indicated that student interactions differed between analogical activities and mathematical problem-solving activities. Specifically, students drew on discourses other than school chemical discourse to construct analogies and their growing participation in chemical discourse was tracked using the Third Space model as an interpretive lens. Results of this study led to modification of the theoretical model adopted at the beginning of the study to a new model called Merged Discourse. Merged Discourse represents the mutual relationship that formed during analogical activities between the Analog Discourse and the Target Discourse. This model can be used for interpreting and analysing classroom discourse centred on analogical activities from sociocultural perspectives. That is, it can be used to code classroom discourse to reveal students’ growing participation with chemical (or scientific) discourse consistent with sociocultural perspectives on learning.

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Small element spacing in compact arrays results in strong mutual coupling between the array elements. A decoupling network consisting of reactive cross-coupling elements can alleviate problems associated with the coupling. Closed-form design equations for the decoupling networks of symmetrical arrays with two or three elements are presented.

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An alternative approach to port decoupling and matching of arrays with tightly coupled elements is proposed. The method is based on the inherent decoupling effect obtained by feeding the orthogonal eigenmodes of the array. For this purpose, a modal feed network is connected to the array. The decoupled external ports of the feed network may then be matched independently by using conventional matching circuits. Such a system may be used in digital beam forming applications with good signal-to-noise performance. The theory is applicable to arrays with an arbitrary number of elements, but implementation is only practical for smaller arrays. The principle is illustrated by means of two examples.

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An element spacing of less than half a wavelength introduces strong mutual coupling between the ports of compact antenna arrays. The strong coupling causes significant system performance degradation. A decoupling network may compensate for the mutual coupling. Alternatively, port decoupling can be achieved using a modal feed network. In response to an input signal at one of the input ports, this feed network excites the antenna elements in accordance with one of the eigenvectors of the array scattering parameter matrix. In this paper, a novel 4-element monopole array is described. The feed network of the array is implemented as a planar ring-type circuit in stripline with four coupled line sections. The new configuration offers a significant reduction in size, resulting in a very compact array.

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Background: Reducing rates of healthcare acquired infection has been identified by the Australian Commission on Safety and Quality in Health Care as a national priority. One of the goals is the prevention of central venous catheter-related bloodstream infection (CR-BSI). At least 3,500 cases of CR-BSI occur annually in Australian hospitals, resulting in unnecessary deaths and costs to the healthcare system between $25.7 and $95.3 million. Two approaches to preventing these infections have been proposed: use of antimicrobial catheters (A-CVCs); or a catheter care and management ‘bundle’. Given finite healthcare budgets, decisions about the optimal infection control policy require consideration of the effectiveness and value for money of each approach. Objectives: The aim of this research is to use a rational economic framework to inform efficient infection control policy relating to the prevention of CR-BSI in the intensive care unit. It addresses three questions relating to decision-making in this area: 1. Is additional investment in activities aimed at preventing CR-BSI an efficient use of healthcare resources? 2. What is the optimal infection control strategy from amongst the two major approaches that have been proposed to prevent CR-BSI? 3. What uncertainty is there in this decision and can a research agenda to improve decision-making in this area be identified? Methods: A decision analytic model-based economic evaluation was undertaken to identify an efficient approach to preventing CR-BSI in Queensland Health intensive care units. A Markov model was developed in conjunction with a panel of clinical experts which described the epidemiology and prognosis of CR-BSI. The model was parameterised using data systematically identified from the published literature and extracted from routine databases. The quality of data used in the model and its validity to clinical experts and sensitivity to modelling assumptions was assessed. Two separate economic evaluations were conducted. The first evaluation compared all commercially available A-CVCs alongside uncoated catheters to identify which was cost-effective for routine use. The uncertainty in this decision was estimated along with the value of collecting further information to inform the decision. The second evaluation compared the use of A-CVCs to a catheter care bundle. We were unable to estimate the cost of the bundle because it is unclear what the full resource requirements are for its implementation, and what the value of these would be in an Australian context. As such we undertook a threshold analysis to identify the cost and effectiveness thresholds at which a hypothetical bundle would dominate the use of A-CVCs under various clinical scenarios. Results: In the first evaluation of A-CVCs, the findings from the baseline analysis, in which uncertainty is not considered, show that the use of any of the four A-CVCs will result in health gains accompanied by cost-savings. The MR catheters dominate the baseline analysis generating 1.64 QALYs and cost-savings of $130,289 per 1.000 catheters. With uncertainty, and based on current information, the MR catheters remain the optimal decision and return the highest average net monetary benefits ($948 per catheter) relative to all other catheter types. This conclusion was robust to all scenarios tested, however, the probability of error in this conclusion is high, 62% in the baseline scenario. Using a value of $40,000 per QALY, the expected value of perfect information associated with this decision is $7.3 million. An analysis of the expected value of perfect information for individual parameters suggests that it may be worthwhile for future research to focus on providing better estimates of the mortality attributable to CR-BSI and the effectiveness of both SPC and CH/SSD (int/ext) catheters. In the second evaluation of the catheter care bundle relative to A-CVCs, the results which do not consider uncertainty indicate that a bundle must achieve a relative risk of CR-BSI of at least 0.45 to be cost-effective relative to MR catheters. If the bundle can reduce rates of infection from 2.5% to effectively zero, it is cost-effective relative to MR catheters if national implementation costs are less than $2.6 million ($56,610 per ICU). If the bundle can achieve a relative risk of 0.34 (comparable to that reported in the literature) it is cost-effective, relative to MR catheters, if costs over an 18 month period are below $613,795 nationally ($13,343 per ICU). Once uncertainty in the decision is considered, the cost threshold for the bundle increases to $2.2 million. Therefore, if each of the 46 Level III ICUs could implement an 18 month catheter care bundle for less than $47,826 each, this approach would be cost effective relative to A-CVCs. However, the uncertainty is substantial and the probability of error in concluding that the bundle is the cost-effective approach at a cost of $2.2 million is 89%. Conclusions: This work highlights that infection control to prevent CR-BSI is an efficient use of healthcare resources in the Australian context. If there is no further investment in infection control, an opportunity cost is incurred, which is the potential for a more efficient healthcare system. Minocycline/rifampicin catheters are the optimal choice of antimicrobial catheter for routine use in Australian Level III ICUs, however, if a catheter care bundle implemented in Australia was as effective as those used in the large studies in the United States it would be preferred over the catheters if it was able to be implemented for less than $47,826 per Level III ICU. Uncertainty is very high in this decision and arises from multiple sources. There are likely greater costs to this uncertainty for A-CVCs, which may carry hidden costs, than there are for a catheter care bundle, which is more likely to provide indirect benefits to clinical practice and patient safety. Research into the mortality attributable to CR-BSI, the effectiveness of SPC and CH/SSD (int/ext) catheters and the cost and effectiveness of a catheter care bundle in Australia should be prioritised to reduce uncertainty in this decision. This thesis provides the economic evidence to inform one area of infection control, but there are many other infection control decisions for which information about the cost-effectiveness of competing interventions does not exist. This work highlights some of the challenges and benefits to generating and using economic evidence for infection control decision-making and provides support for commissioning more research into the cost-effectiveness of infection control.