36 resultados para Extension of the arbitration clause
Resumo:
This study analyses the metaphor of spirituality in the non-profit art gallery, a metaphor overlooked in previous marketing research. Using content analysis and interviews in a single depth case study, this article illustrates how spirituality has been a staple in the non-profit art gallery over time. It was found that even though the non-profit art gallery acknowledges its use of spirituality, it has a paradoxical attitude to it. Therefore this article (a) traces the historical influences that led to the extension of metaphor in the art gallery and its relationship to marketing theory, and (b) draws on Hunt and Menon (1995) to identify deliberate and emergent strategies using metaphor in the non-profit cultural organisation.
Resumo:
The Orthopaedic Unit of the Repatriation General Hospital (RGH) in Adelaide, South Australia has implemented a quality care management system for patients with arthritis of the hip and knee. The system not only optimises conservative management but ensures that joint replacement surgery is undertaken in an appropriate and timely manner. This new service model addresses identified barriers to service access and provides a comprehensive, coordinated strategy for patient management. Over 4 years the model has reduced waiting times for initial outpatient assessment from 8 to 3 months and surgery from 18 to 8 months, while decreasing length of stay from 6.3 to 5.3 days for hips and 5.8 to 5.3 days for knees. The service reforms have been accompanied by positive feedback from patients and referring general practitioners in relation to the improved coordination of care and enhanced efficiency in service delivery.
What is known about the topic? Several important initiatives both overseas and within Australia have contributed significantly to the development of this model of care. These include the UK National Health Service ‘18 weeks’ Project, the Western Canada Waiting List Project, the New Zealand priority criteria project, the Queensland Health Orthopaedic Physiotherapy Screening Clinic, and most importantly the Melbourne Health–University of Melbourne Orthopaedic Waiting List Project where a wide range of models were explored across Victorian hospitals from 2005 and the Multi-Attribute Prioritisation Tool (MAPT) was developed, validated and tested. This project became the Osteoarthritis Hip and Knee Service (OAHKS) and was operationalised in the Victorian healthcare system from 2012. These initiatives examined and addressed various aspects of management systems for patients with arthritis of the hip and knee in their particular setting.
What does this paper add? The development of this system is an extension of what is already known and is the first to encompass a comprehensive and coordinated strategy across all stages of the care management pathway for this patient group. Their management extends from the initial referral to development and implementation of a management plan, including surgery if assessed as necessary and organisation of long-term post operative follow up as required. By detailing the elements, key processes and measurable outcomes of the service redesign this paper provides a model for other institutions to implement a similar initiative.
What are the implications for practitioners? An important aspect of the design process was practitioner acceptance and engagement and the ability to improve their capacity to deliver services within an efficient and effective model. Intrinsic to the model’s development was assessment of practitioner satisfaction. Data obtained including practitioner surveys indicated an increased level of both satisfaction with the redesigned management service, and confidence in it to deliver its intended improvements.
Resumo:
In this paper, the Young’s modulus and the yield strength of the strip are considered in order to modify the deformation length analysis proposed by Bhattacharyya et al. New analytical equations are developed assuming an elastic-perfectly plastic material behaviour and the deformation length analysed for the simple case of roll forming a U-channel; the analytical results are verified by comparison with experimental data found in the literature. The proposed elastic-plastic deformation length is shorter than Bhattacharyya’s which is rigid-perfectly plastic. It is observed that the influence of elastic properties on the deformation length is not as significant as the plastic properties; however, the authors believe that the elastic effects become more important under conditions where a major area of the strip is under elastic deformation such as when the flange length is long.
Resumo:
Excessive axial elongation of the eye is the principal structural cause of myopia. The increase in eye size results from active remodelling of the sclera, producing a weakened scleral matrix. The present study will detail the biomechanics of the sclera and highlight the matrix and cellular factors important in the control of eye size. Scleral elasticity (load vs. tissue extension) and creep rate (tissue extension vs. time) have been measured postmortem in human eyes. Animal models of myopia have allowed the direct relevance of scleral biomechanics to be investigated during myopia development. Recently, data on tissue matrices incorporating scleral fibroblasts have highlighted the role of cellular contraction in scleral biomechanics. Scleral elasticity is increased in eyes developing myopia, with a reduction in the failure load of the tissue. Scleral creep rate is increased in the sclera from eyes developing myopia, and reduced in eyes recovering from myopia. These changes in biomechanical properties of the sclera occur early in the development of myopia (within 24 h). Alterations in scleral biomechanics during myopia development have been attributed to changes in matrix constituents, principally reduced collagen content. Although the biochemical structure of the sclera plays a critical role in defining the mechanical properties, recent studies investigating the cellular mechanics of the sclera, implicate myofibroblasts in scleral biomechanics. Scleral myofibroblasts have the capacity to contract the matrix and are regulated by tissue stress and growth factors such as transforming growth factor-ß. Changes in these regulatory factors have been observed during myopia development, implicating cellular factors in the resultant weakened sclera. Changes in the biomechanical properties of the sclera are important in facilitating the increase in axial length that results in myopia. Understanding the matrix and cellular factors contributing to the weakened sclera may aid in the development of a clinically appropriate treatment for myopia.
Resumo:
The performance of a repetitive index finger flexion–extension task at maximal voluntary rate (MVR) begins to decline just a few seconds into the task and we have previously postulated that this breakdown has a central origin. To test this hypothesis, we have combined two objectives; to determine whether motor practice can lessen the performance deterioration in an MVR task, and whether further gains can be achieved with a transcranial magnetic stimulation (TMS) protocol that increases corticomotor excitability (CME). Eleven right-handed subjects participated in a randomized crossover study design that consisted of a 15-min interventional TMS at I-wave periodicity (ITMS) and single-pulsed Sham intervention prior to six 10-s practice sets of a repetitive finger flexion–extension task at MVR. Motor-evoked potentials (MEPs) were recorded from the first dorsal interosseous muscle. The starting movement rate, and the percentage decline in rate by the end of the MVR were quantitated. Training of the MVR task improved the sustainability of the task by reducing the decline in movement rate. CME increased steadily after each training bout, and this increase was maintained up to 20 min after the last bout. ITMS further increased CME, and was associated with an increase in both the starting rate of the MVR task and its sustainability, when compared to Sham. The results implicate central motor processes in the performance and sustainability of the MVR task, and indicate that MVR kinematics can improve with short-term training and with non-invasive neuro-modulation.
Resumo:
© 2015 Elsevier Inc. In 2009, the US Securities and Exchange Commission (SEC) made it mandatory for firms to file interactive data using XBRL along with their 10-K and 10-Q reports on EDGAR. There was an initial three-year phase-in period, with the first (last) phase covering the largest (smallest) firms in the US capital markets. We examine the implications of the SEC's XBRL mandate for financial statement comparability. Our results indicate that financial statement comparability declined in the initial years after the mandate. We also find that firms that use more company-specific extension taxonomies (companies are allowed to use their own taxonomies when the standard taxonomy provided by the Financial Accounting Standards Board (FASB) is inadequate) have lower financial statement comparability in the post-mandate years. Finally, we document that the level of discretion involved in measuring particular financial statement line items is related to the post-mandate change in comparability - we find that selling, general and administrative expense (SG&A) comparability declined after the mandate, while depreciation comparability did not change.