965 resultados para dementia case-finding
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Electropalatography (EPG) was used as a biofeedback tool in a case study of a 30-year-old male with disordered articulation following traumatic brain injury (TBI). Based on qualitative measures of the participant's intelligibility, improved articulation of the fricatives /s/ and /integral/ were selected as treatment targets. Therapy was administered three times a week for 5 weeks. Results showed that word and sentence intelligibility increased approximately 10%, and error patterns for lingual articulation indicated that fricative -> stop and other fricative errors decreased considerably. EPG measures for /s/ exhibited a significantly more anterior main focus of articulatory contact post therapy. Consonant durations were significantly longer during weeks 3 and 4, and this finding was associated with the emergence of an articulatory contact pattern with a groove rather than complete closure. This articulatory pattern appeared inconsistently and was found to vary across articulations of /s/ but also within a single consonant production. For /integral/, the amount of contact was significantly reduced post therapy and an increase in duration was noted during week 4, similar to that occurring in the production of /s/. Spatial and timing measures were more variable than in normal speakers of English and indicated a general increase in variability across weeks for both /s/ and /integral/. It was concluded that, although the correct fricative patterns appeared only intermittently during production of the consonants, there seemed to be sufficient information for the listener to be able to classify the sound as a fricative. As a part of an intervention program, visual EPG biofeedback therapy would appear to have a definite role in assisting dysarthric speakers exhibiting difficulties with lingual articulation in understanding their errors, learning how to exploit kinesthetic, and acoustic sources of feedback, and how to make appropriate adjustments in tongue articulation to increase the level of speech intelligibility.
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Since the late 1980s, it has been increasingly recognized that the experiences of people with dementia have been omitted from research in the area of dementia and memory loss. More recently, it has been accepted that people with dementia have insight into their condition and, therefore, the ability to contribute to research. A qualitative research project was undertaken with nine participants to explore the experiences and coping strategies of people with dementia. Interviews were undertaken and the data analysed using thematic analysis. Three major themes emerged: coming to terms with memory loss, maintaining control and independence, and the impact of illness on relationships. Understanding the reality for people is essential given that representations of the catastrophic impact of dementia generate high levels of anxiety and depression. Implications for nurses' practice include the need for skilled, well-paced, sensitive and ongoing information about the condition, along with the need to recognize and support the active coping strategies of people with memory loss.
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Email is an important form of asynchronous communication. Visualizing analyses of email communication patterns during a collaborative activity help us better understand the nature of collaboration, and identify the key players. By analysing the contents of email communication and adding reflective comments on its perceived importance from the participants of a collaboration new information can be gleaned not immediately obvious in its original flat form. This paper outlines a proof-of-concept prototype collaborative email visualisation schema. Data from a collaboration case study is analysed and subsequently employed to construct a display of the relative impact of both key players and the types of email used.
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This study highlights the variables associated with the implementation of renewable energy (RE) projects for sustainable development in India, by using an interpretive structural modeling (ISM) - based approach to model variables' interactions, which impact RE adoption. These variables have been categorized under enablers that help to enhance implementation of RE projects for sustainable development. A major finding is that public awareness regarding RE for sustainable development is a very significant enabler. For successful implementation of RE projects, it has been observed that top management should focus on improving highdriving power enablers (leadership, strategic planning, public awareness, management commitment, availability of finance, government support, and support from interest groups).
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It is widely accepted that the Thatcher years and their immediate aftermath were associated with substantive social and organizational change. The privatisation programme, 'the rolling back of the State', prosecuted by the successive Conservative Governments from 1979-1997 was a central pillar of Governmental policy. This thesis seeks to engage with privatization through the of CoastElectric, a newly privatised Regional Electricity Company. This thesis contributes to the extant understanding of the dynamics of organizational change in four major ways. Firstly, the study into CoastElectric addresses the senior management decision making within the organization: in particular, it will attempt to make sense of 'why' particular decisions were made. The theoretical backdrop to this concern will draw on the concepts of normalization, cultural capital and corporate fashion. The argument presented in this thesis is that the decision-making broadly corresponded with that which could be considered to be at the vanguard of mangerialist thought. However, a detailed analysis suggested that at different junctures in CoastElectric's history there were differences in the approach to decision making that warranted further analysis. The most notable finding was that the relative levels of new managerialist cultural capital possessed by the decision-making elite had an important bearing upon whether the decision was formulated either endogenously or exogenously, with the assistance of cultural intermediaries such as management consultants. The thesis demonstrates the importance of the broader discourse of new managerialism in terms of shaping what is considered to be a 'commonsensical, rational' strategy. The second concern of this thesis is that of the process of organizational change. The study of CoastElectric attempts to provide a rich account of the dynamics of organizational change. This is realized through, first, examining the pre-existing context of the organization; second, through analyzing the power politics of change interventions. The master concepts utilised in this endeavour are that of: dividing practices, the establishment of violent hierarchies between competing discourses; symbolic violence; critical turning points; recursiveness; creative destruction; legitimation strategies and the reconstitution of subjects in the workplace.
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The role of the production system as a key determinant of competitive performance of business operations- has long been the subject of industrial organization research, even predating the .explicit conceptua1isation of manufacturing, strategy in the literature. Particular emergent production issues such as the globalisation of production, global supply chain management, management of integrated manufacturing and a growing e~busjness environment are expected to critically influence the overall competitive performance and therefore the strategic success of the organization. More than ever, there is a critical need to configure and improve production system and operations competence in a strategic way so as to contribute to the long-term competitiveness of the organization. In order to operate competitively and profitably, manufacturing companies, no matter how well managed, all need a long-term 'strategic direction' for the development of operations competence in order to consistently produce more market value with less cost towards a leadership position. As to the long-term competitiveness, it is more important to establish a dynamic 'strategic perspective' for continuous operational improvements in pursuit of this direction, as well as ongoing reviews of the direction in relation to the overall operating context. However, it also clear that the 'existing paradigm of manufacturing strategy development' is incapable of adequately responding to the increasing complexities and variations of contemporary business operations. This has been factually reflected as many manufacturing companies are finding that methodologies advocated in the existing paradigm for developing manufacturing strategy have very limited scale and scope for contextual contingency in empirical application. More importantly, there has also emerged a deficiency in the multidimensional and integrative profile from a theoretical perspective when operationalising the underlying concept of strategic manufacturing management established in the literature. The point of departure for this study was a recognition of such contextual and unitary limitations in the existing paradigm of manufacturing strategy development when applied to contemporary industrial organizations in general, and Chinese State Owned Enterprises (SOEs) in particular. As China gradually becomes integrated into the world economy, the relevance of Western management theory and its paradigm becomes a practical matter as much as a theoretical issue. Since China markedly differs from Western countries in terms of culture, society, and political and economic systems, it presents promising grounds to test and refine existing management theories and paradigms with greater contextual contingency and wider theoretical perspective. Under China's ongoing programmes of SOE reform, there has been an increased recognition that strategy development is the very essence of the management task for managers of manufacturing companies in the same way as it is for their counterparts in Western economies. However, the Western paradigm often displays a rather naive and unitary perspective of the nature of strategic management decision-making, one which largely overlooks context-embedded factors and social/political influences on the development of manufacturing strategy. This thesis studies the successful experiences of developing manufacturing strategy from five high-performing large-scale SOEs within China’s petrochemical industry. China’s petrochemical industry constitutes a basic heavy industrial sector, which has always been a strategic focus for reform and development by the Chinese government. Using a confirmation approach, the study has focused on exploring and conceptualising the empirical paradigm of manufacturing strategy development practiced by management. That is examining the ‘empirical specifics’ and surfacing the ‘managerial perceptions’ of content configuration, context of consideration, and process organization for developing a manufacturing strategy during the practice. The research investigation adopts a qualitative exploratory case study methodology with a semi-structural front-end research design. Data collection follows a longitudinal and multiple-case design and triangulates case evidence from sources including qualitative interviews, direct observation, and a search of documentations and archival records. Data analysis follows an investigative progression from a within-case preliminary interpretation of facts to a cross-case search for patterns through theoretical comparison and analytical generalization. The underlying conceptions in both the literature of manufacturing strategy and related studies in business strategy were used to develop theoretical framework and analytical templates applied during data collection and analysis. The thesis makes both empirical and theoretical contributions to our understanding of 'contemporary management paradigm of manufacturing strategy development'. First, it provides a valuable contextual contingency of the 'subject' using the business setting of China's SOEs in petrochemical industry. This has been unpacked into empirical configurations developed for its context of consideration, its content and process respectively. Of special note, a lean paradigm of business operations and production management discovered at case companies has significant implications as an emerging alternative for high-volume capital intensive state manufacturing in China. Second, it provides a multidimensional and integrative theoretical profile of the 'subject' based upon managerial perspectives conceptualised at case companies when operationalising manufacturing strategy. This has been unpacked into conceptual frameworks developed for its context of consideration, its content constructs, and its process patterns respectively. Notably, a synergies perspective towards the operating context, competitive priorities and competence development of business operations and production management has significant implications for implementing a lean manufacturing paradigm. As a whole, in so doing, the thesis established a theoretical platform for future refinement and development of context-specific methodologies for developing manufacturing strategy.
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A prominent theme emerging in Occupational Health and Safety (OSH) is the development of management systems. A range of interventions, according to a prescribed route detailed by one of the management systems, can be introduced into an organisation with some expectation of improved OSH performance. This thesis attempts to identify the key influencing factors that may impact upon the process of introducing interventions, (according to B88800: 1996, Guide to Implementing Occupational Health and Safety Management Systems) into an organisation. To help identify these influencing factors a review of possible models from the sphere of Total Quality Management (TQM) was undertaken and the most suitable TQM model selected for development and use in aSH. By anchoring the aSH model's development in the reviewed literature a range ofeare, medium and low level influencing factors were identified. This model was developed in conjunction with the research data generated within the case study organisation (rubber manufacturer) and applied to the organisation. The key finding was that the implementation of an OSH intervention was dependant upon three broad vectors of influence. These are the Incentive to introduce change within an organisation which refers to the drivers or motivators for OSH. Secondly the Ability within the management team to actually implement the changes refers to aspects, amongst others, such as leadership, commitment and perceptions of OSH. Ability is in turn itself influenced by the environment within which change is being introduced. TItis aspect of Receptivity refers to the history of the plant and characteristics of the workforce. Aspects within Receptivity include workforce profile and organisational policies amongst others. It was found that the TQM model selected and developed for an OSH management system intervention did explain the core influencing factors and their impact upon OSH performance. It was found that within the organisation the results that may have been expected from implementation of BS8800:1996 were not realised. The OSH model highlighted that given the organisation's starting point, a poor appreciation of the human factors of OSH, gave little reward for implementation of an OSH management system. In addition it was found that general organisational culture can effectively suffocate any attempts to generate a proactive safety culture.
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Despite the increasing popularity of research on intercultural preparation and its effectiveness, research on training for inpatriates has not been developed with the same level of rigour as research on training for expatriates. Furthermore, research on intercultural training hardly ever includes the aspect of preparing for the corporate culture of a company. For expatriates coming from headquarters’ national culture and equipped with a good knowledge of headquarters’ corporate culture, it might be sufficient to address only the national culture of the location abroad. But can the same be said for inpatriates coming from a foreign subsidiary? Therefore the qualitative research of my thesis was aimed at finding out if intercultural training programmes that address only the national culture of the host country are sufficient to prepare inpatriates for working at headquarters. A case study using a German multinational company has been conducted in order to find out what kind of problems and irritations inpatriates at the company’s headquarters perceive at work. In order to determine whether the findings are related to the national or the corporate culture, Hall’s and Hofstede’s approaches to culture were used. The interview analysis produced the following conclusion: Although the researched company promotes standardised worldwide corporate guidelines, there are many differences between headquarters and subsidiaries regarding the interpretation and realisation of these guidelines. These differences cause irritation, confusion and problems for the inpatriates. Therefore an effective intercultural preparation for inpatriates should be tailor-made and take into account the aspect of corporate culture, as well as the specific roles and functions of inpatriates.
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Research shows that consumers are readily embracing the Internet to buy products. This paper proposes that, in the case of grocery shopping, this may lead to sub-optimal decisions at the household level. Decisions online on what, where and from who to buy are normally taken by one individual. In the case of grocery shopping, decisions, however, need to be ‘vetted’ by ‘other’ individuals within the household. The ‘household wide related’ decisions influence how information technologies and systems for commerce should be designed and managed for optimum decision making. This paper argues, unlike previous research, that e-grocery retailing is failing to grow to its full potential not solely because of the ‘classical’ hazards and perceived risks associated with doing grocery shopping online but because e-grocery retailing strategy has failed to acknowledge the micro-household level specificities that affect decision making. Our exploratory research is based on empirical evidence which were collected through telephone interviews. We offer an insight into how e-grocery ‘fits’ and is ‘disrupted’ by the reality of day to day consumption decision making at the household level. Our main finding is to advocate a more role-neutral, multi-user and multi-technology approach to e-grocery shopping which re-defines the concept of the main shopper/decision maker thereby reconceptualising the ‘shopping logic’ for grocery products.
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Background - The loss of cholinergic, dopaminergic and noradrenergic innervations seen in Parkinson's Disease Dementia (PDD) suggest a potential role for cholinesterase inhibitors. Concerns have been expressed about a theoretical worsening of Parkinson's disease related symptoms, particularly movement symptoms. Objectives - To assess the efficacy, safety, tolerability and health economic data relating to the use of cholinesterase inhibitors in PDD. Search methods - The trials were identified from the Specialized Register of the Cochrane Dementia and Cognitive Improvement Group on 19 April 2005 using the search term parkinson*. This register contains records from major health care databases and many ongoing trial databases and is updated regularly. Comprehensive searches of abstracts from major scientific meetings were performed. Pharmaceutical companies were approached for information regarding additional and ongoing studies. Selection criteria - Randomized, double-blind, placebo-controlled studies assessing the effectiveness of cholinesterase inhibitors in PDD. Inclusion and exclusion criteria were stated to limit bias. Data collection and analysis - Two reviewers (IM, CF) independently reviewed the quality of the studies utilizing criteria from the Cochrane Collaboration Handbook. Medications were examined separately and as a group. The outcome measures assessed were in the following domains: neuropsychiatric features, cognition, global impression, daily living activities, quality of life, burden on caregiver, Parkinsonian related symptoms, treatment acceptability as determined by withdrawal from trials, safety as determined by the frequency of adverse events, institutionalisation, death and health economic factors. Main results - A detailed and systematic search of relevant databases identified one published randomized, double-blind, placebo-controlled study (Emre 2004) involving 541 patients that compared rivastigmine with placebo. Rivastigmine produced statistically significant improvements in several outcome measures. On the primary cognitive measure, the ADAS-Cog, rivastigmine was associated with a 2.80 point ADAS-Cog improvement [WMD -2.80, 95% Cl -4.26 to -1.34, P = 0.0002] and a 2.50 point ADCS-ADL improvement [95% Cl 0.43 to 4.57, P = 0.02] relative to placebo. Clinically meaningful (moderate or marked) improvement occurred in 5.3% more patients on rivastigmine, and meaningful worsening occurred in 10.1% more patients on placebo. Tolerability appeared to be a significant issue. Significantly more patients on rivastigmine dropped out of the study due to adverse events [62/362 versus 14/179, OR 2.44, 95% Cl 1.32 to 4.48, P = 0.004]. Nausea [20/179 versus 105/362, OR 3.25, 95% Cl 1.94 to 5.45, P < 0.00001], tremor [7/179 versus 37/362, OR 2.80, 95% Cl 1.22 to 6.41, P = 0.01] and in particular vomiting [3/179 versus 60/362, OR 11.66, 95% Cl 3.60 to 37.72, P < 0.0001] were significantly more common with rivastigmine. However, significantly fewer patients died on rivastigmine than placebo [4/362 versus 7/179, OR 0.27, 95% CI 0.08 to 0.95, P = 0.04] Authors' conclusions - Rivastigmine appears to improve cognition and activities of daily living in patients with PDD. This results in clinically meaningful benefit in about 15% of cases. There is a need for more studies utilising pragmatic measures such as time to residential care facility and both patient and carer quality of life assessments. Future trials should involve other cholinesterase inhibitors, utilise tools to analyse the data that limit any bias and measure health economic factors. It is unlikely that relying solely on the last observation carried forward (LOCF) is sufficient. Publication of the observed case data in the largest trial would assist (Emre 2004). Adverse events were associated with the cholinergic activity of rivastigmine, but may limit patient acceptability as evidenced by the high drop out rate in the active arm.
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This study examines the information content of alternative implied volatility measures for the 30 components of the Dow Jones Industrial Average Index from 1996 until 2007. Along with the popular Black-Scholes and \model-free" implied volatility expectations, the recently proposed corridor implied volatil- ity (CIV) measures are explored. For all pair-wise comparisons, it is found that a CIV measure that is closely related to the model-free implied volatility, nearly always delivers the most accurate forecasts for the majority of the firms. This finding remains consistent for different forecast horizons, volatility definitions, loss functions and forecast evaluation settings.
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In this article we discuss a possibility to use genetic algorithms in cryptanalysis. We developed and described the genetic algorithm for finding the secret key of a block permutation cipher. In this case key is a permutation of some first natural numbers. Our algorithm finds the exact key’s length and the key with controlled accuracy. Evaluation of conducted experiment’s results shows that the almost automatic cryptanalysis is possible.
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2000 Mathematics Subject Classification: 62P10, 92D10, 92D30, 94A17, 62L10.
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In 1917 Pell (1) and Gordon used sylvester2, Sylvester’s little known and hardly ever used matrix of 1853, to compute(2) the coefficients of a Sturmian remainder — obtained in applying in Q[x], Sturm’s algorithm on two polynomials f, g ∈ Z[x] of degree n — in terms of the determinants (3) of the corresponding submatrices of sylvester2. Thus, they solved a problem that had eluded both J. J. Sylvester, in 1853, and E. B. Van Vleck, in 1900. (4) In this paper we extend the work by Pell and Gordon and show how to compute (2) the coefficients of an Euclidean remainder — obtained in finding in Q[x], the greatest common divisor of f, g ∈ Z[x] of degree n — in terms of the determinants (5) of the corresponding submatrices of sylvester1, Sylvester’s widely known and used matrix of 1840. (1) See the link http://en.wikipedia.org/wiki/Anna_Johnson_Pell_Wheeler for her biography (2) Both for complete and incomplete sequences, as defined in the sequel. (3) Also known as modified subresultants. (4) Using determinants Sylvester and Van Vleck were able to compute the coefficients of Sturmian remainders only for the case of complete sequences. (5) Also known as (proper) subresultants.
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Case-based Reasoning's (CBR) origins were stimulated by a desire to understand how people remember information and are in turn reminded of information, and that subsequently it was recognized that people commonly solve problems by remembering how they solved similar problems in the past. Thus CBR became an appropriate way to find out the most suitable solution method for a new problem based on the old methods for the same or even similar problems. The research highlights how to use CBR to aid biologists in finding the best method to cryo preserve algae. The study found CBR could be used successfully to find the similarity percentage between the new algae and old cases in the case base. The prediction result showed approximately 93.75% accuracy, which proves the CBR system can offer appropriate recommendations for most situations. © 2011 IEEE.