940 resultados para Panel Study


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Gerbrand van den Eeckhout; 1 ft. 1/64 in.x 1 ft. 8 5/64 in.; tempera and gouache on panel

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Aims To determine the cost savings of pharmacist initiated changes to hospitalized patients' drug therapy or management in eight major acute care government funded teaching hospitals in Australia. Methods This was a prospective study performed in eight hospitals examining resource implications of pharmacists' interventions assessed by an independent clinical panel. Pharmacists providing clinical services to inpatients recorded details of interventions, defined as any action that directly resulted in a change to patient management or therapy. An independent clinical review panel, convened at each participating centre, confirmed or rejected the clinical pharmacist's assessment of the impact on length of stay (LOS), readmission probability, medical procedures and laboratory monitoring and quantified the resultant changes, which were then costed. Results A total of 1399 interventions were documented. Eight hundred and thirty-five interventions impacted on drug costs alone. Five hundred and eleven interventions were evaluated by the independent panels with three quarters of these confirmed as having an impact on one or more of: length of stay, readmission probability, medical procedures or laboratory monitoring. There were 96 interventions deemed by the independent panels to have reduced LOS and 156 reduced the potential for readmission. The calculated savings was $263 221 for the eight hospitals during the period of the study. This included $150 307 for length of stay reduction, $111 848 for readmission reduction. Conclusions The annualized cost savings relating to length of stay, readmission, drugs, medical procedures and laboratory monitoring as a result of clinical pharmacist initiated changes to hospitalized patient management or therapy was $4 444 794 for eight major acute care government funded teaching hospitals in Australia.

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To investigate the technical feasibility of a novel cooling system for commercial greenhouses, knowledge of the state of the art in greenhouse cooling is required. An extensive literature review was carried out that highlighted the physical processes of greenhouse cooling and showed the limitations of the conventional technology. The proposed cooling system utilises liquid desiccant technology; hence knowledge of liquid desiccant cooling is also a prerequisite before designing such a system. Extensive literature reviews on solar liquid desiccant regenerators and desiccators, which are essential parts of liquid desiccant cooling systems, were carried out to identify their advantages and disadvantages. In response to the findings, a regenerator and a desiccator were designed and constructed in lab. An important factor of liquid desiccant cooling is the choice of liquid desiccant itself. The hygroscopicity of the liquid desiccant affects the performance of the system. Bitterns, which are magnesium-rich brines derived from seawater, are proposed as an alternative liquid desiccant for cooling greenhouses. A thorough experimental and theoretical study was carried out in order to determine the properties of concentrated bitterns. It was concluded that their properties resemble pure magnesium chloride solutions. Therefore, magnesium chloride solution was used in laboratory experiments to assess the performance of the regenerator and the desiccator. To predict the whole system performance, the physical processes of heat and mass transfer were modelled using gPROMS® advanced process modelling software. The model was validated against the experimental results. Consequently it was used to model a commercials-scale greenhouse in several hot coastal areas in the tropics and sub-tropics. These case studies show that the system, when compared to evaporative cooling, achieves 3oC-5.6oC temperature drop inside the greenhouse in hot and humid places (RH>70%) and 2oC-4oC temperature drop in hot and dry places (50%

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This thesis explores the processes of team innovation. It utilises two studies, an organisationally based pilot and an experimental study, to examine and identify aspects of teams' behaviours that are important for successful innovative outcome. The pilot study, based in two automotive manufacturers, involved the collection of team members' experiences through semi-structured interviews, and identified a number of factors that affected teams' innovative performance. These included: the application of ideative & dissemination processes; the importance of good team relationships, especially those of a more informal nature, in facilitating information and ideative processes; the role of external linkages in enhancing quality and radicality of innovations; and the potential attenuation of innovative ideas by time deadlines. This study revealed a number key team behaviours that may be important in successful innovation outcomes. These included; goal setting, idea generation and development, external contact, task and personal information exchange, leadership, positive feedback and resource deployment. These behaviours formed the basis of a coding system used in the second part of the research. Building on the results from the field based research, an experimental study was undertaken to examine the behavioural differences between three groups of sixteen teams undertaking innovative an task to produce an anti-drugs poster. They were randomly assigned to one of three innovation category conditions suggested by King and Anderson (1990), emergent, imported and imposed. These conditions determined the teams level of access to additional information on previously successful campaigns and the degree of freedom they had with regarding to the design of the poster. In addition, a further experimental condition was imposed on half of the teams per category which involved a formal time deadline for task completion. The teams were video taped for the duration of their innovation and their behaviours analysed and coded in five main aspects including; ideation, external focus, goal setting, interpersonal, directive and resource related activities. A panel of experts, utilising five scales developed from West and Anderson's (1996) innovation outcome measures, assessed the teams' outputs. ANOVAs and repeated measure ANOVAs were deployed to identify whether there were significant differences between the different conditions. The results indicated that there were some behavioural differences between the categories and that over the duration of the task behavioural changes were identified. The results, however, revealed a complex picture and suggested limited support for three distinctive innovation categories. There were many differences in behaviours, but rarely between more than two of the categories. A main finding was the impact that different levels of constraint had in changing teams' focus of attention. For example, emergent teams were found to use both their own team and external resources, whilst those who could import information about other successful campaigns were likely to concentrate outside the team and pay limited attention to the internal resources available within the team. In contrast, those operating under task constraints with aspects of the task imposed onto them were more likely to attend to internal team resources and pay limited attention to the external world. As indicated by the earlier field study, time deadlines did significantly change teams' behaviour, reducing ideative and information exchange behaviours. The model shows an important behavioural progression related to innovate teams. This progression involved the teams' openness initially to external sources, and then to the intra-team environment. Premature closure on the final idea before their mid-point was found to have a detrimental impact on team's innovation. Ideative behaviour per se was not significant for innovation outcome, instead the development of intra-team support and trust emerged as crucial. Analysis of variance revealed some limited differentiation between the behaviours of teams operating under the aforementioned three innovation categories. There were also distinct detrimental differences in the behaviour of those operating under a time deadline. Overall, the study identified the complex interrelationships of team behaviours and outcomes, and between teams and their context.

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The HT-29 human colon adenocarcinoma cell line, like many epithelial cells, displays an undifferentiated phenotype when cultured on plastic substrata. Biochemical markers of differentiation, such as brush border associated enzymes and carcinoembryonic antigen were expressed at very low levels. The differentiation-inducing effects of the culture of HT-29 cells on collagen type I gels were evaluated, and were assessed by morphological appearance, brush border associated enzyme activities and the secretion of CEA. The effect that this more physiological environment had on their chemosensitivity to a panel of chemotherapeutic agents was determined, so as to indicate whether this system could be used to improve the selectivity of screening for novel anticancer agents. Initial studies were performed on HT-29 cells derived from cells seeded directly from plastic substrata onto the collagen gels (designated Non-PPC gels). Their time of exposure to the collagen was limited to the time course of a single experiment and the results suggested that a longer, more permanent exposure might produce a more pronounced differentiation. HT-29 cells were then passaged continuously on collagen gels for a minimum of 10 passages prior to experimentation (designated PPC gels). The same parameters were measured, and compared to those for the cells grown on plastic and on the non-passaged collagen gels (Non-PPC) from the original studies. Permanently passaged cells displayed a similar degree of morphological differentiation as the non-passaged cells, with both culture conditions resulting in a more pronounced differentiation than that achieved by culture on plastic. It was noted that the morphological differentiation observed was very heterogeneous, a situation also seen in xenografted tumours in vivo. The activity of alkaline phosphatase and the production of CEA was higher in the cells passaged on collagen (PPC) than the cells cultured on non-passaged collagen gel (Non-PPC) and plastic. The biochemical determination of aminopeptidase activity showed that collagen gel culture enhanced the activity in both non-passaged and passaged HT-29 cells above that of the cells cultured on plastic. However, immunocytochemical localization of aminopeptidase and sucrase-isomaltase of samples of cells grown on the various substrata for 7, 14, 21 and 28 days showed a reduction in both enzymes in the cells grown on collagen gels when compared to cells grown on plastic. The reason for the discrepancy between the two assays for aminopeptidase is at this stage unexplained. Although, there was evidence to suggest that the culture of HT-29 cells on collagen gels was capable of inducing morphological and biochemical markers of enterocytic differentiation, there were no differences in the chemosensitivity of the different cell groups to a panel of anticancer agents. Preliminary studies suggested that the ability of the cells to polarize by their culture on porous filter chambers without any exogenous ECM was sufficient to enhance HT-29 differentiation and the onset of differentiation was probably correlated with the production of ECM by the cells themselves.

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This research investigates the contribution that Geographic Information Systems (GIS) can make to the land suitability process used to determine the effects of a climate change scenario. The research is intended to redress the severe under representation of Developing countries within the literature examining the impacts of climatic change upon crop productivity. The methodology adopts some of the Intergovernmental Panel on Climate Change (IPCC) estimates for regional climate variations, based upon General Circulation Model predictions (GCMs) and applies them to a baseline climate for Bangladesh. Utilising the United Nations Food & Agricultural Organisation's Agro-ecological Zones land suitability methodology and crop yield model, the effects of the scenario upon agricultural productivity on 14 crops are determined. A Geographic Information System (IDRISI) is adopted in order to facilitate the methodology, in conjunction with a specially designed spreadsheet, used to determine the yield and suitability rating for each crop. A simple optimisation routine using the GIS is incorporated to provide an indication of the 'maximum theoretical' yield available to the country, should the most calorifically significant crops be cultivated on each land unit both before and after the climate change scenario. This routine will provide an estimate of the theoretical population supporting capacity of the country, both now and in the future, to assist with planning strategies and research. The research evaluates the utility of this alternative GIS based methodology for the land evaluation process and determines the relative changes in crop yields that may result from changes in temperature, photosynthesis and flooding hazard frequency. In summary, the combination of a GIS and a spreadsheet was successful, the yield prediction model indicates that the application of the climate change scenario will have a deleterious effect upon the yields of the study crops. Any yield reductions will have severe implications for agricultural practices. The optimisation routine suggests that the 'theoretical maximum' population supporting capacity is well in excess of current and future population figures. If this agricultural potential could be realised however, it may provide some amelioration from the effects of climate change.

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This exploratory study is concerned with the integrated appraisal of multi-storey dwelling blocks which incorporate large concrete panel systems (LPS). The first step was to look at U.K. multi-storey dwelling stock in general, and under the management of Birmingham City Council in particular. The information has been taken from the databases of three departments in the City of Birmingham, and rearranged in a new database using a suite of PC software called `PROXIMA' for clarity and analysis. One hundred of their stock were built large concrete panel system. Thirteen LPS blocks were chosen for the purpose of this study as case-studies depending mainly on the height and age factors of the block. A new integrated appraisal technique has been created for the LPS dwelling blocks, which takes into account the most physical and social factors affecting the condition and acceptability of these blocks. This appraisal technique is built up in a hierarchical form moving from the general approach to particular elements (a tree model). It comprises two main approaches; physical and social. In the physical approach, the building is viewed as a series of manageable elements and sub-elements to cover every single physical or environmental factor of the block, in which the condition of the block is analysed. A quality score system has been developed which depends mainly on the qualitative and quantitative conditions of each category in the appraisal tree model, and leads to physical ranking order of the study blocks. In the social appraisal approach, the residents' satisfaction and attitude toward their multi-storey dwelling block was analysed in relation to: a. biographical and housing related characteristics; and b. social, physical and environmental factors associated with this sort of dwelling, block and estate in general.The random sample consisted of 268 residents living in the 13 case study blocks. Data collected was analysed using frequency counts, percentages, means, standard deviations, Kendall's tue, r-correlation coefficients, t-test, analysis of variance (ANOVA) and multiple regression analysis. The analysis showed a marginally positive satisfaction and attitude towards living in the block. The five most significant factors associated with the residents' satisfaction and attitude in descending order were: the estate, in general; the service categories in the block, including heating system and lift services; vandalism; the neighbours; and the security system of the block. An important attribute of this method, is that it is relatively inexpensive to implement, especially when compared to alternatives adopted by some local authorities and the BRE. It is designed to save time, money and effort, to aid decision making, and to provide ranked priority to the multi-storey dwelling stock, in addition to many other advantages. A series of solution options to the problems of the block was sought for selection and testing before implementation. The traditional solutions have usually resulted in either demolition or costly physical maintenance and social improvement of the blocks. However, a new solution has now emerged, which is particularly suited to structurally sound units. The solution of `re-cycling' might incorporate the reuse of an entire block or part of it, by removing panels, slabs and so forth from the upper floors in order to reconstruct them as low-rise accommodations.

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In order to generate sales promotion response predictions, marketing analysts estimate demand models using either disaggregated (consumer-level) or aggregated (store-level) scanner data. Comparison of predictions from these demand models is complicated by the fact that models may accommodate different forms of consumer heterogeneity depending on the level of data aggregation. This study shows via simulation that demand models with various heterogeneity specifications do not produce more accurate sales response predictions than a homogeneous demand model applied to store-level data, with one major exception: a random coefficients model designed to capture within-store heterogeneity using store-level data produced significantly more accurate sales response predictions (as well as better fit) compared to other model specifications. An empirical application to the paper towel product category adds additional insights. This article has supplementary material online.

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To investigate investment behaviour the present study applies panel data techniques, in particular the Arellano-Bond (1991) GMM estimator, based on data on Estonian manufacturing firms from the period 1995-1999. We employ the model of optimal capital accumulation in the presence of convex adjustment costs. The main research findings are that domestic companies seem to be financially more constrained than those where foreign investors are present, and also, smaller firms are more constrained than their larger counterparts.

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Purpose: The paper aims to further extend our understanding by assessing the extent to which two prominent cultural values in East Asia i.e. face saving and group orientation drive consumers' perceptions of luxury goods across four East Asian markets. Design/methodology/approach: A multi-methods research approach was adopted consisting of: an expert panel of close to 70 participants, group discussions with five extended East Asian families, personal interviews with eight East Asian scholars, a pilot test with over 50 East Asian graduate students and a multi-market survey of 443 consumer respondents in Beijing, Tokyo, Singapore and Hanoi. Findings: The authors extend previous conceptual studies by empirically investigating the impact of these two cultural values on the perception of luxury among East Asian societies. Specifically the study reveals that across all four markets face saving has the strongest influence on the conspicuous and hedonistic dimensions of luxury, group orientation meanwhile is the strongest predictor of the quality, extended self and exclusivity dimensions of luxury. Collectively these two cultural values significantly influence East Asian perceptions of luxury. Overall, the findings reiterate the importance of understanding different cultural values and their influence across different East Asian societies. Practical implications: The findings have important implications for managers of western luxury branded goods that are seeking to penetrate East Asian markets or seek to serve East Asian consumers. Specifically, to assist with developing suitable brand positioning, products, services, communications and pricing strategies. Originality/value: This study contributes to our understanding of the subject by exploring the impact of face saving and group orientation on the perception of luxury goods across four East Asian countries. Several directions for future research are suggested. © Emerald Group Publishing Limited.

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Background: In December 2007, the National Institute for Health and Clinical Excellence and the National Patient Safety Agency in the UK (NICE-NPSA) published guidance that recommends all adults admitted to hospital receive medication reconciliation, usually by pharmacy staff. A costing and report tool was provided indicating a resource requirement of d12.9 million for England per year. Pediatric patients are excluded from this guidance. Objective: To determine the clinical significance of medication reconciliation in children on admission to hospital. Methods: A prospective observational study included pediatric patients admitted to a neurosurgical ward at Birmingham Childrens Hospital, Birmingham, England, between September 2006 and March 2007. Medication reconciliation was conducted by a pharmacist after the admission of each of 100 consecutive eligible patients aged 4 months to 16 years. The clinical significance of prescribing disparities between pre-admission medications and initial admission medication orders was determined by an expert multidisciplinary panel and quantified using an analog scale. The main outcome measure was the clinical signficance of unintentional variations between hospital admission medication orders and physician-prescribed pre-admission medication for repeat (continuing) medications. Results: Initial admission medication orders for children differed from prescribed pre-admission medication in 39%of cases. Half of all resulting prescribing variations in this setting had the potential to cause moderate or severe discomfort or clinical deterioration. These results mirror findings for adults. Conclusions: The introduction of medication reconciliation in children on admission to hospital has the potential to reduce discomfort or clinical deterioration by reducing unintentional changes to repeat prescribed medication. Consequently, there is no justification for the omission of children from the NICENPSA guidance concerning medication reconciliation in hospitals, and costing tools should include pediatric patients. © 2010 Adis Data Information BV. All rights reserved.

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The purpose of this study was to identify the needed competencies of a Recreational Foodservice manager. A three round Delphi method of iteration was used. Delphi is a research method that utilizes iterating rounds to elicit the opinion of a panel of experts regarding a specific subject.^ A nominating committee of 22 industry leaders was consulted to establish a panel of 40 management experts, of which 35 (87.5%) completed all three rounds of the Delphi study.^ Round One of the study identified 17 specific job functions of a Recreational Foodservice manager. The researcher prepared an instrument detailing 60 competencies derived from an analysis of Round One results and distributed it as a Round Two instrument requesting the panel opinion regarding the relative importance of each listed competency on a five point Likert scale.^ The results of Round Two were tabulated and analyzed to ascertain areas of consensus. A Round Three instrument was prepared advising panelists of all areas of consensus, their dissenting opinions, if any, and a request for a revised opinion.^ A final report was prepared listing the 60 competencies and the panel opinion that eight were of highest priority, 29 of above average priority, and 23 of average priority. No item received two other available ratings, below average priority and lowest priority.^ The implications of these findings suggest necessary areas of curriculum development and industry management development to implement professionalism for Recreational Foodservice managers. ^

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This research will investigate what it will take to develop principals who will embrace the recommendations of reform as proposed by National Association of Secondary School Principals (NASSP, 1996) in the Breaking Ranks document. Breaking Ranks is based on the belief that it is within the dynamics of the school culture that principals must gain insight into strategies for improving the schools for which they are held responsible. Given this context, it is important to examine perspectives that are held by principals who lead schools that embrace the concepts of reform as proposed by NASSP, thereby, could be deemed “Breaking Ranks” schools. It is within these schools that the new role of the principal develops. NASSP has identified seven key recommendations for leadership development; “attributes that need nourishing” (p. 12) for the success of school reform. The seven recommendations are included in Breaking Ranks. ^ The purpose of this study is to identify and describe how principals put the seven recommendations into practice as they function in their schools. In addition, this study will gather information on the characteristics, support, skills, and training these principals identify as critical aspects and components of their success. This is a study of principal leadership at four high school sites where “Breaking Ranks” principals have been identified. ^ This research plan will be designed to utilize an inquiry-based process with a panel of experts and four “Breaking Ranks” principals. This study will describe: (1) how a panel of experts identify what they believe needs to be done in order to put the recommendations of the Breaking Ranks document into practice and their identification of principals who are breaking ranks; (2) how identified principals say they have been able to put the recommendations of the Breaking Ranks document into practice; (3) How both groups identify and describe: (a) the characteristics and behaviors of a “Breaking Ranks” principal; (b) the new leadership skills as described by the seven recommendations identified in the Breaking Ranks document; (c) the support necessary in order to meet the recommendations in the Breaking Ranks document; and (d) The training needed in order to become “Breaking Ranks” principals; and (4) how the process of creating “Breaking Ranks” principals can be described by experts who have studied it theoretically and principals who have demonstrated it in their schools. ^

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The purpose of this study was to examine a Higher Education Institution’s (HEI) process of internationalization. The theoretical model developed by Van Dijk and Miejer (1997) was used to review Florida International University (FIU)’s policy, support, and implementation dimensions and determine its position on the Internationalization Cube, and assess how FIU’s international activities fit into its different organizational processes. In addition, the study sought to shed light on student and faculty attitudes toward internationalization. Qualitative and quantitative data were collected from examining organizational documents, interviews, descriptive data on FIU’s international activities using the International Dimension Index, and the Student and Faculty Survey on Internationalization. FIU’s international activities results were analyzed in relation to a panel of experts’ item relevancy index. The Likert-type survey scales’ frequencies and percentages were calculated as well as Spearman Rho correlations between the survey’s three scales and demographic and experiences variables. The study found that FIU is located on position six of a possible eight positions on the Van Dijk and Meijer Internationalization Cube with the following characteristics: Priority Policy, One-Sided Support, and Structured Implementation toward internationalization. The analysis of FIU’s results on international activities showed that FIU exhibits all the activities considered to be strong indicators of internationalization but for position seven placement special attention is needed in the areas of foreign language study, international students, study abroad, faculty movement and involvement in international projects. The survey indicated students and faculty rated the Benefits of Internationalization highly but didn’t perceive strong institutional Support for Internationalization. Faculty age and offshore programs participation; student gender, race/ethnicity and class status; and for both, study abroad and knowledge of students travel grant had significant positive correlations with student and faculty attitudes. The study concluded that an association exists between FIU’s position on the Internationalization Cube and its international activities. Recommendations for policy, implementation, and future studies were made. It was concluded that advancing FIU’s position on the Cube will require adjustments in FIU’s policy, support and implementation dimensions. Differences in student and faculty views toward internationalization should be taken into account when planning internationalization efforts.