Identification of patients at risk of poor outcomes following hip or knee arthroplasty

Les arthroplasties totales de la hanche (ATH) et du genou (ATG) sont souvent offertes aux patients atteints de dégénérescence articulaire sévère. Bien qu’efficace chez la majorité des patients, ces interventions mènent à des résultats sous-optimaux dans de nombreux cas. Il demeure difficile d’identifier les patients à risque de résultats sous-optimaux à l’heure actuelle. L’identification de ces patients avant la chirurgie pourrait permettre d’optimiser la gamme de soins et de services offerts et de possiblement améliorer les résultats de leur chirurgie. Ce mémoire a comme objectifs : 1) de réaliser une revue systématique des déterminants associés à la douleur et aux incapacités fonctionnelles rapportées par les patients à moyen-terme suivant ces deux types d’arthroplastie et 2) de développer des modèles de prédiction clinique permettant l’identification des patients à risque de mauvais résultats en terme de douleur et d’incapacités fonctionnelles suivant l’ATH et l’ATG. Une revue systématique de la littérature identifiant les déterminants de la douleur et de la fonction suivant l’ATH et l’ATG a été réalisée dans quatre bases de données jusqu’en avril 2015 et octobre 2014, respectivement. Afin de développer un algorithme de prédiction pouvant identifier les patients à risque de résultats sous-optimaux, nous avons aussi utilisé des données rétrospectives provenant de 265 patients ayant subi une ATH à l’Hôpital Maisonneuve-Rosemont (HMR) de 2004 à 2010. Finalement, des données prospectives sur 141 patients recrutés au moment de leur inclusion sur une liste d’attente pour une ATG dans trois hôpitaux universitaires à Québec, Canada et suivis jusqu’à six mois après la chirurgie ont permis l’élaboration d’une règle de prédiction clinique permettant l’identification des patients à risque de mauvais résultats en terme de douleur et d’incapacités fonctionnelles. Vingt-deux (22) études d’une qualité méthodologique moyenne à excellente ont été incluses dans la revue. Les principaux déterminants de douleur et d’incapacités fonctionnelles après l’ATH incluaient: le niveau préopératoire de douleur et de fonction, un indice de la masse corporelle plus élevé, des comorbidités médicales plus importantes, un état de santé générale diminué, une scolarité plus faible, une arthrose radiographique moins sévère et la présence d’arthrose à la hanche controlatérale. Trente-quatre (34) études évaluant les déterminants de douleur et d’incapacités fonctionnelles après l’ATG avec une qualité méthodologique moyenne à excellente ont été évaluées et les déterminants suivant ont été identifiés: le niveau préopératoire de douleur et de fonction, des comorbidités médicales plus importantes, un état de santé générale diminué, un plus grands niveau d’anxiété et/ou de symptômes dépressifs, la présence de douleur au dos, plus de pensées catastrophiques ou un faible niveau socioéconomique. Pour la création d’une règle de prédiction clinique, un algorithme préliminaire composé de l’âge, du sexe, de l’indice de masse corporelle ainsi que de trois questions du WOMAC préopératoire a permis l’identification des patients à risque de résultats chirurgicaux sous-optimaux (pire quartile du WOMAC postopératoire et percevant leur hanche opérée comme artificielle avec des limitations fonctionnelles mineures ou majeures) à une durée moyenne ±écart type de 446±171 jours après une ATH avec une sensibilité de 75.0% (95% IC: 59.8 – 85.8), une spécificité de 77.8% (95% IC: 71.9 – 82.7) et un rapport de vraisemblance positif de 3.38 (98% IC: 2.49 – 4.57). Une règle de prédiction clinique formée de cinq items du questionnaire WOMAC préopratoire a permis l’identification des patients en attente d’une ATG à risque de mauvais résultats (pire quintile du WOMAC postopératoire) six mois après l’ATG avec une sensibilité de 82.1 % (95% IC: 66.7 – 95.8), une spécificité de 71.7% (95% IC: 62.8 – 79.8) et un rapport de vraisemblance positif de 2.9 (95% IC: 1.8 – 4.7). Les résultats de ce mémoire ont permis d’identifier, à partir de la littérature, une liste de déterminants de douleur et d’incapacités fonctionnelles après l’ATH et l’ATG avec le plus haut niveau d’évidence à ce jour. De plus, deux modèles de prédiction avec de très bonnes capacités prédictives ont été développés afin d’identifier les patients à risque de mauvais résultats chirurgicaux après l’ATH et l’ATG. L’identification de ces patients avant la chirurgie pourrait permettre d’optimiser leur prise en charge et de possiblement améliorer les résultats de leur chirurgie.

Effect of Pavement-Vehicle Interaction on Highway Fuel Consumption and Emission

Vehicle fuel consumption and emission are two important effectiveness measurements of sustainable transportation development. Pavement plays an essential role in goals of fuel economy improvement and greenhouse gas (GHG) emission reduction. The main objective of this dissertation study is to experimentally investigate the effect of pavement-vehicle interaction (PVI) on vehicle fuel consumption under highway driving conditions. The goal is to provide a better understanding on the role of pavement in the green transportation initiates. Four study phases are carried out. The first phase involves a preliminary field investigation to detect the fuel consumption differences between paired flexible-rigid pavement sections with repeat measurements. The second phase continues the field investigation by a more detailed and comprehensive experimental design and independently investigates the effect of pavement type on vehicle fuel consumption. The third study phase calibrates the HDM-IV fuel consumption model with data collected in the second field phase. The purpose is to understand how pavement deflection affects vehicle fuel consumption from a mechanistic approach. The last phase applies the calibrated HDM-IV model to Florida’s interstate network and estimates the total annual fuel consumption and CO2 emissions on different scenarios. The potential annual fuel savings and emission reductions are derived based on the estimation results. Statistical results from the two field studies both show fuel savings on rigid pavement compared to flexible pavement with the test conditions specified. The savings derived from the first phase are 2.50% for the passenger car at 112km/h, and 4.04% for 18-wheel tractor-trailer at 93km/h. The savings resulted from the second phase are 2.25% and 2.22% for passenger car at 93km/h and 112km/h, and 3.57% and 3.15% for the 6-wheel medium-duty truck at 89km/h and 105km/h. All savings are statistically significant at 95% Confidence Level (C.L.). From the calibrated HDM-IV model, one unit of pavement deflection (1mm) on flexible pavement can cause an excess fuel consumption by 0.234-0.311 L/100km for the passenger car and by 1.123-1.277 L/100km for the truck. The effect is more evident at lower highway speed than at higher highway speed. From the network level estimation, approximately 40 million gallons of fuel (combined gasoline and diesel) and 0.39 million tons of CO2 emission can be saved/reduced annually if all Florida’s interstate flexible pavement are converted to rigid pavement with the same roughness levels. Moreover, each 1-mile of flexible-rigid conversion can result in a reduction of 29 thousand gallons of fuel and 258 tons of CO2 emission yearly.

Identification of patients at risk of poor outcomes following hip or knee arthroplasty

Les arthroplasties totales de la hanche (ATH) et du genou (ATG) sont souvent offertes aux patients atteints de dégénérescence articulaire sévère. Bien qu’efficace chez la majorité des patients, ces interventions mènent à des résultats sous-optimaux dans de nombreux cas. Il demeure difficile d’identifier les patients à risque de résultats sous-optimaux à l’heure actuelle. L’identification de ces patients avant la chirurgie pourrait permettre d’optimiser la gamme de soins et de services offerts et de possiblement améliorer les résultats de leur chirurgie. Ce mémoire a comme objectifs : 1) de réaliser une revue systématique des déterminants associés à la douleur et aux incapacités fonctionnelles rapportées par les patients à moyen-terme suivant ces deux types d’arthroplastie et 2) de développer des modèles de prédiction clinique permettant l’identification des patients à risque de mauvais résultats en terme de douleur et d’incapacités fonctionnelles suivant l’ATH et l’ATG. Une revue systématique de la littérature identifiant les déterminants de la douleur et de la fonction suivant l’ATH et l’ATG a été réalisée dans quatre bases de données jusqu’en avril 2015 et octobre 2014, respectivement. Afin de développer un algorithme de prédiction pouvant identifier les patients à risque de résultats sous-optimaux, nous avons aussi utilisé des données rétrospectives provenant de 265 patients ayant subi une ATH à l’Hôpital Maisonneuve-Rosemont (HMR) de 2004 à 2010. Finalement, des données prospectives sur 141 patients recrutés au moment de leur inclusion sur une liste d’attente pour une ATG dans trois hôpitaux universitaires à Québec, Canada et suivis jusqu’à six mois après la chirurgie ont permis l’élaboration d’une règle de prédiction clinique permettant l’identification des patients à risque de mauvais résultats en terme de douleur et d’incapacités fonctionnelles. Vingt-deux (22) études d’une qualité méthodologique moyenne à excellente ont été incluses dans la revue. Les principaux déterminants de douleur et d’incapacités fonctionnelles après l’ATH incluaient: le niveau préopératoire de douleur et de fonction, un indice de la masse corporelle plus élevé, des comorbidités médicales plus importantes, un état de santé générale diminué, une scolarité plus faible, une arthrose radiographique moins sévère et la présence d’arthrose à la hanche controlatérale. Trente-quatre (34) études évaluant les déterminants de douleur et d’incapacités fonctionnelles après l’ATG avec une qualité méthodologique moyenne à excellente ont été évaluées et les déterminants suivant ont été identifiés: le niveau préopératoire de douleur et de fonction, des comorbidités médicales plus importantes, un état de santé générale diminué, un plus grands niveau d’anxiété et/ou de symptômes dépressifs, la présence de douleur au dos, plus de pensées catastrophiques ou un faible niveau socioéconomique. Pour la création d’une règle de prédiction clinique, un algorithme préliminaire composé de l’âge, du sexe, de l’indice de masse corporelle ainsi que de trois questions du WOMAC préopératoire a permis l’identification des patients à risque de résultats chirurgicaux sous-optimaux (pire quartile du WOMAC postopératoire et percevant leur hanche opérée comme artificielle avec des limitations fonctionnelles mineures ou majeures) à une durée moyenne ±écart type de 446±171 jours après une ATH avec une sensibilité de 75.0% (95% IC: 59.8 – 85.8), une spécificité de 77.8% (95% IC: 71.9 – 82.7) et un rapport de vraisemblance positif de 3.38 (98% IC: 2.49 – 4.57). Une règle de prédiction clinique formée de cinq items du questionnaire WOMAC préopratoire a permis l’identification des patients en attente d’une ATG à risque de mauvais résultats (pire quintile du WOMAC postopératoire) six mois après l’ATG avec une sensibilité de 82.1 % (95% IC: 66.7 – 95.8), une spécificité de 71.7% (95% IC: 62.8 – 79.8) et un rapport de vraisemblance positif de 2.9 (95% IC: 1.8 – 4.7). Les résultats de ce mémoire ont permis d’identifier, à partir de la littérature, une liste de déterminants de douleur et d’incapacités fonctionnelles après l’ATH et l’ATG avec le plus haut niveau d’évidence à ce jour. De plus, deux modèles de prédiction avec de très bonnes capacités prédictives ont été développés afin d’identifier les patients à risque de mauvais résultats chirurgicaux après l’ATH et l’ATG. L’identification de ces patients avant la chirurgie pourrait permettre d’optimiser leur prise en charge et de possiblement améliorer les résultats de leur chirurgie.

Incidence of debris discs around FGK stars in the solar neighbourhood

Context. Debris discs are a consequence of the planet formation process and constitute the fingerprints of planetesimal systems. Their counterparts in the solar system are the asteroid and Edgeworth-Kuiper belts. Aims. The aim of this paper is to provide robust numbers for the incidence of debris discs around FGK stars in the solar neighbourhood. Methods. The full sample of 177 FGK stars with d ≤ 20 pc proposed for the DUst around NEarby Stars (DUNES) survey is presented. Herschel/PACS observations at 100 and 160 μm were obtained, and were complemented in some cases with data at 70 μm and at 250, 350, and 500 μm SPIRE photometry. The 123 objects observed by the DUNES collaboration were presented in a previous paper. The remaining 54 stars, shared with the Disc Emission via a Bias-free Reconnaissance in IR and Sub-mm (DEBRIS) consortium and observed by them, and the combined full sample are studied in this paper. The incidence of debris discs per spectral type is analysed and put into context together with other parameters of the sample, like metallicity, rotation and activity, and age. Results. The subsample of 105 stars with d ≤ 15 pc containing 23 F, 33 G, and 49 K stars is complete for F stars, almost complete for G stars, and contains a substantial number of K stars from which we draw solid conclusions on objects of this spectral type. The incidence rates of debris discs per spectral type are 0.26^+0.21_-0.14 (6 objects with excesses out of 23 F stars), 0.21^+0.17_-0.11 (7 out of 33 G stars), and 0.20^+0.14_-0.09 (10 out of 49 K stars); the fraction for all three spectral types together is 0.22^+0.08_-0.07 (23 out of 105 stars). The uncertainties correspond to a 95% confidence level. The medians of the upper limits of L_dust/L_∗ for each spectral type are 7.8 × 10^-7 (F), 1.4 × 10^-6 (G), and 2.2 × 10^-6 (K); the lowest values are around 4.0 × 10^-7. The incidence of debris discs is similar for active (young) and inactive (old) stars. The fractional luminosity tends to drop with increasing age, as expected from collisional erosion of the debris belts.

The influence of nursing student characteristics on performance in the Quebec licensing exam.

This study examines whether certain academic, demographic or psychosocial characteristics of students can be indicators of future success on the Provincial Nursing Licensing exam. A cohort of 42 third year Nursing students was the study sample. Data were collected using a self-reporting questionnaire, academic marks, and graduate interviews. Academic variables that were studied included: first year nursing marks, college biology marks, final year nursing marks, and literacy level. Demographic variables that were studied included : age, gender, socioeconomic status and level of life responsabilities, academic motivation (hours spent studying) and hours worked at unrelated employment. Lastly, psychosocial variables that were studied included: test taking anxiety, stress and overall confidence level in terms of success on the upcoming exam. A comparison was then undertaken between the two groups-students that passed and students that failed the Licensing exam on their first sitting-with respect to specific student characteristics. The conceptual framework for this study is based on Leinbach and Jenkin's model of the correlation of milestones to momentum points in the educational experience. Results of this study suggest that exam anxiety and content review in the months that follow graduation seem to affect exam performance. Also, certain demographic characteristics such as age and financial strain seemed to be good indicators of future success.||Résumé : Cette étude tente d'établir si certaines caractéristiques liées aux études ainsi que des caractéristiques démographiques ou psychosociales des étudiantes et des étudiants peuvent être indicatives du succès futur à l'examen professionnel provincial d'admission à la profession infirmière. Une cohorte de 42 étudiantes et étudiants de troisième année en sciences infirmières formait l'échantillon de l'étude. Les données ont été recueillies au moyen d'un questionnaire d'autoévaluation, des résultats scolaires et d'entrevues avec les infirmières et infirmiers gradués. Les variables liées aux études examinées ont été les résultats de la première année d'études en sciences infirmières, les résultats en biologie au collégial, les résultats de la dernière année d'études en sciences infirmières et le niveau de littératie. Les variables démographiques étudiées ont été l'âge, le sexe, le statut socioéconomique, le niveau de responsabilités sociales, la motivation dans les études (les heures passées à étudier) et les heures consacrées à un travail non lié aux études. Enfin, les variables psychosociales examinées ont été l'anxiété devant l'examen, le stress et le niveau général de confiance quant à la réussite de l'examen à venir. Une comparaison des deux groupes d'étudiantes et d'étudiants, soit ceux qui ont réussi l'examen et ceux qui l'ont échoué à leur première tentative, a ensuite été faite en tenant compte des caractéristiques particulières à chacun. Le cadre conceptuel de cette étude repose sur le modèle de la corrélation entre les jalons (milestones) et les accomplissements (momentum points) dans l'expérience des études de Leinbach and Jenkin. Les résultats de cette étude laissent entendre que l'anxiété devant l'examen et la révision de la matière dans les mois suivant l'obtention du diplôme semblent avoir un effet sur le rendement à l'examen. Aussi, certaines caractéristiques démographiques comme l'âge et les difficultés financières semblaient être indicatifs du succès futur.

Social representations about the Portuguese adolescent alcohol consumption

Alcohol is currently the most widely consumed psychoactive substance in the world and Portugal is the second country where such consumption is greater, registering a large increase in consumption by young people. Currently continue still, beliefs, myths and prejudices that because they are well rooted culturally serve as good reasons for drinking. This study sought therefore to identify the myths associated by adolescents to alcohol consumption. A questionnaire was developed for this purpose (74 items, α = 0.947) and applied to a sample of 1176 adolescents schooled between 14 and 18 years old, with a return rate of 42.6% (margin of error of 5% for a confidence level of 95%) in the district of Beja, Portugal, in 2012. The collected data were statistically analyzed using measures of association, factor analysis and linear regression. The results show that many myths are unknown among adolescents, verifying the presence of many questions, among which stands out: alcohol "warm", "thirst quenching", "gives strength", "facilitates digestion" "whet the appetite", "is a medicine", "is aphrodisiac", "facilitates social relations", among others. Age and sex are variables significantly affected the myths and objectives of alcohol consumption. These results clearly point to the need to be disassembled beliefs and wrong conceptions about the effects of alcohol consumption, particularly in the school environment, reducing the risk of the consequences and promoting adolescent health, preventing any future dependence on this psychoactive substance.

How is a fruit tree like you? Using artistic metaphors to explore and develop emotional competence in children

Counselling children often requires the use of supplementary strategies in order to interest and engage the child in the therapeutic process. One such strategy is the Metaphorical Fruit Tree (MFT); an art metaphor suited to exploring and developing self-concept. Quantitative and qualitative data was used to explore the relationships between children’s ability to use metaphor, age, gender, and level of emotional competence (N = 58). Quantitative and qualitative analyses revealed a significant negative relationship between self-reported emotional competence and ability to use the MFT. It is proposed that children rely on different processes to understand self and as children’s ability to cognitively report on their emotional capabilities via the Emotional Competence Questionnaire (ECQ) increases, their ability to report creatively on those capabilities via the MFT is undermined. It is suggested that the MFT may be used, via creative processes and as an alternative to cognitive processes, to increase understanding and awareness of intrapersonal and interpersonal concepts of self in the child during counselling.

Forecasting time-varying value-at-risk

In this thesis we are interested in financial risk and the instrument we want to use is Value-at-Risk (VaR). VaR is the maximum loss over a given period of time at a given confidence level. Many definitions of VaR exist and some will be introduced throughout this thesis. There two main ways to measure risk and VaR: through volatility and through percentiles. Large volatility in financial returns implies greater probability of large losses, but also larger probability of large profits. Percentiles describe tail behaviour. The estimation of VaR is a complex task. It is important to know the main characteristics of financial data to choose the best model. The existing literature is very wide, maybe controversial, but helpful in drawing a picture of the problem. It is commonly recognised that financial data are characterised by heavy tails, time-varying volatility, asymmetric response to bad and good news, and skewness. Ignoring any of these features can lead to underestimating VaR with a possible ultimate consequence being the default of the protagonist (firm, bank or investor). In recent years, skewness has attracted special attention. An open problem is the detection and modelling of time-varying skewness. Is skewness constant or there is some significant variability which in turn can affect the estimation of VaR? This thesis aims to answer this question and to open the way to a new approach to model simultaneously time-varying volatility (conditional variance) and skewness. The new tools are modifications of the Generalised Lambda Distributions (GLDs). They are four-parameter distributions, which allow the first four moments to be modelled nearly independently: in particular we are interested in what we will call para-moments, i.e., mean, variance, skewness and kurtosis. The GLDs will be used in two different ways. Firstly, semi-parametrically, we consider a moving window to estimate the parameters and calculate the percentiles of the GLDs. Secondly, parametrically, we attempt to extend the GLDs to include time-varying dependence in the parameters. We used the local linear regression to estimate semi-parametrically conditional mean and conditional variance. The method is not efficient enough to capture all the dependence structure in the three indices —ASX 200, S&P 500 and FT 30—, however it provides an idea of the DGP underlying the process and helps choosing a good technique to model the data. We find that GLDs suggest that moments up to the fourth order do not always exist, there existence appears to vary over time. This is a very important finding, considering that past papers (see for example Bali et al., 2008; Hashmi and Tay, 2007; Lanne and Pentti, 2007) modelled time-varying skewness, implicitly assuming the existence of the third moment. However, the GLDs suggest that mean, variance, skewness and in general the conditional distribution vary over time, as already suggested by the existing literature. The GLDs give good results in estimating VaR on three real indices, ASX 200, S&P 500 and FT 30, with results very similar to the results provided by historical simulation.

An identification of factors influencing police workplace motivation

Police work tasks are diverse and require the ability to take command, demonstrate leadership, make serious decisions and be self directed (Beck, 1999; Brunetto & Farr-Wharton, 2002; Howard, Donofrio & Boles, 2002). This work is usually performed in pairs or sometimes by an officer working alone. Operational police work is seldom performed under the watchful eyes of a supervisor and a great amount of reliance is placed on the high levels of motivation and professionalism of individual officers. Research has shown that highly motivated workers produce better outcomes (Whisenand & Rush, 1998; Herzberg, 2003). It is therefore important that Queensland police officers are highly motivated to provide a quality service to the Queensland community. This research aims to identify factors which motivate Queensland police to perform quality work. Researchers acknowledge that there is a lack of research and knowledge in regard to the factors which motivate police (Beck, 1999; Bragg, 1998; Howard, Donofrio & Boles, 2002; McHugh & Verner, 1998). The motivational factors were identified in regard to the demographic variables of; age, sex, rank, tenure and education. The model for this research is Herzberg’s two-factor theory of workplace motivation (1959). Herzberg found that there are two broad types of workplace motivational factors; those driven by a need to prevent loss or harm and those driven by a need to gain personal satisfaction or achievement. His study identified 16 basic sub-factors that operate in the workplace. The research utilised a questionnaire instrument based on the sub-factors identified by Herzberg (1959). The questionnaire format consists of an initial section which sought demographic information about the participant and is followed by 51 Likert scale questions. The instrument is an expanded version of an instrument previously used in doctoral studies to identify sources of police motivation (Holden, 1980; Chiou, 2004). The questionnaire was forwarded to approximately 960 police in the Brisbane, Metropolitan North Region. The data were analysed using Factor Analysis, MANOVAs, ANOVAs and multiple regression analysis to identify the key sources of police motivation and to determine the relationships between demographic variables such as: age, rank, educational level, tenure, generation cohort and motivational factors. A total of 484 officers responded to the questionnaire from the sample population of 960. Factor analysis revealed five broad Prime Motivational Factors that motivate police in their work. The Prime Motivational Factors are: Feeling Valued, Achievement, Workplace Relationships, the Work Itself and Pay and Conditions. The factor Feeling Valued highlighted the importance of positive supportive leaders in motivating officers. Many officers commented that supervisors who only provided negative feedback diminished their sense of feeling valued and were a key source of de-motivation. Officers also frequently commented that they were motivated by operational police work itself whilst demonstrating a strong sense of identity with their team and colleagues. The study showed a general need for acceptance by peers and an idealistic motivation to assist members of the community in need and protect victims of crime. Generational cohorts were not found to exert a significant influence on police motivation. The demographic variable with the single greatest influence on police motivation was tenure. Motivation levels were found to drop dramatically during the first two years of an officer’s service and generally not improve significantly until near retirement age. The findings of this research provide the foundation of a number of recommendations in regard to police retirement, training and work allocation that are aimed to improve police motivation levels. The five Prime Motivational Factor model developed in this study is recommended for use as a planning tool by police leaders to improve motivational and job-satisfaction components of police Service policies. The findings of this study also provide a better understanding of the current sources of police motivation. They are expected to have valuable application for Queensland police human resource management when considering policies and procedures in the areas of motivation, stress reduction and attracting suitable staff to specific areas of responsibility.

Upper-body morbidity following breast cancer treatment is common, may persist longer-term and adversely influences quality of life

Background: Impairments in upper-body function (UBF) are common following breast cancer. However, the relationship between arm morbidity and quality of life (QoL) remains unclear. This investigation uses longitudinal data to describe UBF in a population-based sample of women with breast cancer and examines its relationship with QoL. ---------- Methods: Australian women (n = 287) with unilateral breast cancer were assessed at three-monthly intervals, from six- to 18-months post-surgery (PS). Strength, endurance and flexibility were used to assess objective UBF, while the Disability of the Arm, Shoulder and Hand questionnaire and the Functional Assessment of Cancer Therapy- Breast questionnaire were used to assess self-reported UBF and QoL, respectively. ---------- Results: Although mean UBF improved over time, up to 41% of women revealed declines in UBF between sixand 18-months PS. Older age, lower socioeconomic position, treatment on the dominant side, mastectomy, more extensive lymph node removal and having lymphoedema each increased odds of declines in UBF by at least twofold (p < 0.05). Lower baseline and declines in perceived UBF between six- and 18-months PS were each associated with poorer QoL at 18-months PS (p < 0.05). ---------- Conclusions: Significant upper-body morbidity is experienced by many following breast cancer treatment, persisting longer term, and adversely influencing the QoL of breast cancer survivors.

Women's labor force participation and marriage : the case of Korea

In this paper, we examine the relationship between marital status and female labor force participation in Korea, and argue that marriage remains a major obstacle to young Korean women's employment. We find that an average married woman is much less likely (by 40–60%) to participate in the labor force than a single woman in urban Korea. Further investigation into the participation patterns among married women reveals that labor force participation rate (LFPR) varies with husband's occupation and her own age. Lower LFPR among the young married women is explained by demand-side factors, while relatively higher LFPR among the middle-aged married women is mostly explained by the supply-side factors.

The impact of taxes on optimal portfolio choice : an Australian study

Taxes are an important component of investing that is commonly overlooked in both the literature and in practice. For example, many understand that taxes will reduce an investment’s return, but less understood is the risk-sharing nature of taxes that also reduces the investment’s risk. This thesis examines how taxes affect the optimal asset allocation and asset location decision in an Australian environment. It advances the model of Horan & Al Zaman (2008), improving the method by which the present value of tax liabilities are calculated, by using an after-tax risk-free discount rate, and incorporating any new or reduced tax liabilities generated into its expected risk and return estimates. The asset allocation problem is examined for a range of different scenarios using Australian parameters, including different risk aversion levels, personal marginal tax rates, investment horizons, borrowing premiums, high or low inflation environments, and different starting cost bases. The findings support the Horan & Al Zaman (2008) conclusion that equities should be held in the taxable account. In fact, these findings are strengthened with most of the efficient frontier maximising equity holdings in the taxable account instead of only half. Furthermore, these findings transfer to the Australian case, where it is found that taxed Australian investors should always invest into equities first through the taxable account before investing in super. However, untaxed Australian investors should invest their equity first through superannuation. With borrowings allowed in the taxable account (no borrowing premium), Australian taxed investors should hold 100% of the superannuation account in the risk-free asset, while undertaking leverage in the taxable account to achieve the desired risk-return. Introducing a borrowing premium decreases the likelihood of holding 100% of super in the risk-free asset for taxable investors. The findings also suggest that the higher the marginal tax rate, the higher the borrowing premium in order to overcome this effect. Finally, as the investor’s marginal tax rate increases, the overall allocation to equities should increase due to the increased risk and return sharing caused by taxation, and in order to achieve the same risk/return level as the lower taxation level, the investor must take on more equity exposure. The investment horizon has a minimal impact on the optimal allocation decision in the absence of factors such as mean reversion and human capital.

An investigation of building physical properties selection to combat global warming

Global warming can have a significant impact on building energy performance and indoor thermal environment, as well as the health and productivity of people living and working inside them. Through the building simulation technique, this paper investigates the adaptation potential of different selections of building physical properties to increased outdoor temperature in Australia. It is found that overall, an office building with lower insulation level, smaller window to wall ratio and/or a glass type with lower shading coefficient, and lower internal load density will have the effect of lowering building cooling load and total energy use, and therefore have a better potential to adapt to the warming external climate. Compared with clear glass, it is shown that the use of reflective glass for the sample building with WWR being 0.5 reduces the building cooling load by more than 12%. A lower internal load can also have a significant impact on the reduction of building cooling load, as well as the building energy use. Through the comparison of results between current and future weather scenarios, it is found that the patterns found in the current weather scenario also exist in the future weather scenarios, but to a smaller extent.

Vulnerable road user groups : a review of younger drivers, motorcyclists and older drivers

Scientific efforts to understand and reduce the occurrence of road crashes continue to expand, particularly in the areas of vulnerable road user groups. Three groups that are receiving increasing attention within the literature are younger drivers, motorcyclists and older drivers. These three groups are at an elevated risk of being in a crash or seriously injured, and research continues to focus on the origins of this risk as well as the development of appropriate countermeasures to improve driving outcomes for these cohorts. However, it currently remains unclear what factors produce the largest contribution to crash risk or what countermeasures are likely to produce the greatest long term positive effects on road safety. This paper reviews research that has focused on the personal and environmental factors that increase crash risk for these groups as well as considers direction for future research in the respective areas. A major theme to emerge from this review is that while there is a plethora of individual and situational factors that influence the likelihood of crashes, these factors often combine in an additive manner to exacerbate the risk of both injury and fatality. Additionally, there are a number of risk factors that are pertinent for all three road user groups, particularly age and the level of driving experience. As a result, targeted interventions that address these factors are likely to maximise the flow-on benefits to a wider range of road users. Finally, there is a need for further research that aims to bridge the research-to-practice gap, in order to develop appropriate pathways to ensure that evidenced-based research is directly transferred to effective policies that improve safety outcomes.

Corporate governance and misappropriation

This study examines the occurrence of misappropriation-type fraud within Australian listed firms and the relation between the incidence of this type of fraud and a firm's governance strength. We measure governance strength using factors relating to traditional corporate governance, such as board composition, CEO duality, and audit committee composition, as well as factors relating to information technology governance. In our study, we use actual dollar amount of fraud reported by listed companies responding to the 2004 KPMG Fraud Survey as one of three different misappropriation measures and publicly available firm-specific data to measure the other variables in the model. Our study found that where the chief executive officer (CEO) also holds the position of chairperson of the board of directors, the likelihood of fraud increases. We also find that the greater the number of independent directors on the audit committee, the lower the level of fraud. Taken together, these results are particularly encouraging as they provide support for regulatory bodies such as the Australian Stock Exchange (ASX) and the Australian Securities and Investment Commission (ASIC), which place considerable emphasis on the importance of establishing good corporate governance practices. The study provides empirical evidence that employing good corporate governance reduces the risk of the misappropriation of assets.