Inflammation, hepatic enzymes and resistance training in individuals with metabolic risk factors

AIMS: Increases in inflammatory markers, hepatic enzymes and physical inactivity are associated with the development of the metabolic syndrome (MetS). We examined whether inflammatory markers and hepatic enzymes are correlated with traditional risk factors for MetS and studied the effects of resistance training (RT) on these emerging risk factors in individuals with a high number of metabolic risk factors (HiMF, 2.9 +/- 0.8) and those with a low number of metabolic risk factors (LoMF, 0.5 +/- 0.5). METHODS: Twenty-eight men and 27 women aged 50.8 +/- 6.5 years (mean +/- sd) participated in the study. Participants were randomized to four groups, HiMF training (HiMFT), HiMF control (HiMFC), LoMF training (LoMFT) and LoMF control (LoMFC). Before and after 10 weeks of RT [3 days/week, seven exercises, three sets with intensity gradually increased from 40-50% of one repetition maximum (1RM) to 75-85% of 1RM], blood samples were obtained for the measurement of pro-inflammatory cytokines, C-reactive protein (CRP), gamma-glutamyltransferase (GGT) and alanine aminotransferase (ALT). RESULTS: At baseline, HiMF had higher interleukin-6 (33.9%), CRP (57.1%), GGT (45.2%) and ALT (40.6%) levels, compared with LoMF (all P < 0.05). CRP, GGT and ALT correlated with the number of risk factors (r = 0.48, 0.51 and 0.57, respectively, all P < 0.01) and with other anthropometric and clinical measures (r range from 0.26 to 0.60, P < 0.05). RT did not significantly alter inflammatory markers or hepatic enzymes (all P > 0.05). CONCLUSIONS: HiMF was associated with increased inflammatory markers and hepatic enzyme concentrations. RT did not reduce inflammatory markers and hepatic enzymes in individuals with HiMF.

Factors affecting the stability analysis of earth dam slopes subjected to reservoir drawdown

The drawdown of reservoirs can significantly affect the stability of upstream slopes of earth dams. This is due to the removal of the balancing hydraulic forces acting on the dams and the undrained condition within the upstream slope soils. In such scenarios, the stability of the slopes can be influenced by a range of factors including drawdown rates, slope inclination and soil properties. This paper investigates the effects of drawdown rate, saturated hydraulic conductivity and unsaturated shear strength of dam materials on the stability of the upstream slope of an earth dam. In this study, the analysis of pore-water pressure changes within the upstream slope during reservoir drawdown was coupled with the slope stability analysis using the general limit equilibrium method. The results of the analysis suggested that a decrease in the reservoir water level caused the stability of the upstream slope to decrease. The dam embankment constructed with highly permeable soil was found to be more stable during drawdown scenarios, compared to others. Further, lower drawdown rates resulted in a higher safety factor for the upstream slope. Also, the safety factor of the slope calculated using saturated shear strength properties of the dam materials was slightly higher than that calculated using unsaturated shear strength properties. In general, for all the scenarios analysed, the lowest safety factor was found to be at the reservoir water level of about 2/3 of drawdown regime.

Ranked critical factors in PPP briefings

Public-private partnerships (PPPs) are increasingly used to procure Australian infrastructure projects. As with all construction projects, the early briefing stages are often the most crucial in determining a successful outcome. There is, however, a lack of systematic research on the type and nature of the critical factors affecting the effectiveness and efficiency of PPP during this period. A literature review is presented of PPP usage in Australia, in which four main categories of factors (procurement, stakeholder, risk, and finance) are identified, each with several subfactors. A questionnaire survey involving state government stakeholders is also described, and a mathematical model that ranks the factors involved is developed. This is followed by an examination of the potential of the factors to help improve the PPP briefing stage for both public and private sectors.

Examination of factors affecting caring efficacy, job satisfaction in Australian registered nurses

Research Question: What relationships exist between general self efficacy, locus of control and the nursing practice environment and caring efficacy and job satisfaction? Background: Important characteristics of current nursing practice include nurses having the ability to develop and continue therapeutic relationships with patients, nurses having autonomy and control over the practice environment and nurses having more involvement in decision making. In addition, employee satisfaction is enhanced when organisations offer access to authority. Despite this, nurses continue to complain of feeling powerless in their ability to make decisions. Sample: The study population and criteria for selection included Registered Nurses in Australia who were at the time members of an Australian professional and industrial organisation. Methods: A cross-sectional survey was undertaken. Data analysis was conducted using descriptive and bivariate statistics, and structural equation modelling. Results: The model fit the data well (χ² = 2.3594, χ²/df = 2.3594 and CFI = 0.9987). Twenty four percent of variation in caring efficacy (CE) can be accounted for by general self-efficacy (GSE); work locus of control (WLC) and practice environment (PE) and 62% of the variation in job satisfaction (JS) can be accounted for by GSE, WLC and PE. All pathways were found to be significant except PE to CE. GSE positively explained CE (β = 0.38). WLC was negatively related to CE i.e., as CE scores increased WLC scores decreased (β = -0.23). Further testing of the model found CE was positively related to GSE (βZ = 0.38, p < 0.001) and negatively related to WLC (βZ = - 0.23, p = 0.001). PE was not significantly associated with CE (βZ = - 0.01, p = 0.85). JS was explained by PE, which was positively related (βZ = 0.69, p = < 0.001); GSE which was negatively related (βZ - 0 .09, p < 0.001) and WLC, which was also negatively related (βZ = - 0.20, p < 0.001). Implications for Practice Nursing and organisational leaders should ensure the development of strategies for professional development and orientation programmes which may enhance nurses’ ability to develop caring relationships and express caring behaviours to their patients and as a result improve organisational and patient outcomes. Nursing shortages and turnover rates are associated with job satisfaction and the nursing practice environment. Improving the nursing environment can produce benefits to the health system such as better job satisfaction, improved workforce retention and better patient outcomes.

Classification of railway bridges based on criticality and vulnerability factors

Bridges are currently rated individually for maintenance and repair action according to the structural conditions of their elements. Dealing with thousands of bridges and the many factors that cause deterioration, makes this rating process extremely complicated. The current simplified but practical methods are not accurate enough. On the other hand, the sophisticated, more accurate methods are only used for a single or particular bridge type. It is therefore necessary to develop a practical and accurate rating system for a network of bridges. The first most important step in achieving this aim is to classify bridges based on the differences in nature and the unique characteristics of the critical factors and the relationship between them, for a network of bridges. Critical factors and vulnerable elements will be identified and placed in different categories. This classification method will be used to develop a new practical rating method for a network of railway bridges based on criticality and vulnerability analysis. This rating system will be more accurate and economical as well as improve the safety and serviceability of railway bridges.

Impact of organisational cultural factors on knowledge management in construction

Knowledge Management (KM) is a process that focuses on knowledge-related activities to facilitate knowledge creation, capture, transformation and use, with the ultimate aim of leveraging organisations’ intellectual capital to achieve organisational objectives. Organisational culture and climate have been identified as major catalysts to knowledge creation and sharing, and hence are considered important dimensions of KM research. The fragmented and hierarchical nature of the construction industry illustrates its difficulties to operate in a co-ordinated and homogeneous way when dealing with knowledge-related issues such as research and development, training and innovation. The culture and climate of organisations operating within the construction industry are profoundly shaped by the long-established characteristics of the industry, whilst also being influenced by the changes within the sector. Meanwhile, the special project-based structure of construction organisations constitutes additional challenges in facing knowledge production. The study this paper reports on addresses the impact of organisational culture and climate on the intensity of KM activities within construction organisations, with specific focus on the managerial activities that help to manage these challenges and to facilitate KM. A series of semi-structured interviews were undertaken to investigate the KM activities of the contractors operating in Hong Kong. The analysis on the qualitative data revealed that leadership on KM, innovation management, communication management and IT development were key factors that impact positively on the KM activities within the organisations under investigation.

The role of human factors when evaluating information accountability for eHealth systems

The availability of health information is rapidly increasing; its expansion and proliferation is inevitable. At the same time, breeding of health information silos is an unstoppable and relentless exercise. Information security and privacy concerns are therefore major barriers in the eHealth socio-eco system. We proposed Information Accountability as a measurable human factor that should eliminate and mitigate security concerns. Information accountability measures would be practicable and feasible if legislative requirements are also embedded. In this context, information accountability constitutes a key component for the development of effective information technology requirements for health information system. Our conceptual approach to measuring human factors related to information accountability in eHealth is presented in this paper with some limitations.

Pressure ulcers in the adult intensive care unit : a literature review of patient risk factors and risk assessment scales

Background: Critically ill patients are at high risk for pressure ulcer (PrU) development due to their high acuity and the invasive nature of the multiple interventions and therapies they receive. With reported incidence rates of PrU development in the adult critical care population as high as 56%, the identification of patients at high risk of PrU development is essential. This paper will explore the association between PrU development and risk factors. It will also explore PrU development and the use of risk assessment scales for critically ill patients in adult intensive care units. Method: A literature search from 2000 to 2012 using the CINHAL, Cochrane Library, EBSCOHost, Medline (via EBSCOHost), PubMed, ProQuest and Google Scholar databases was conducted. Key words used were: pressure ulcer/s; pressure sore/s; decubitus ulcer/s; bed sore/s; critical care; intensive care; critical illness; prevalence; incidence; prevention; management; risk factor; risk assessment scale. Results: Nineteen articles were included in this review; eight studies addressing PrU risk factors, eight studies addressing risk assessment scales and three studies overlapping both. Results from the studies reviewed identified 28 intrinsic and extrinsic risk factors which may lead to PrU development. Development of a risk factor prediction model in this patient population, although beneficial, appears problematic due to many issues such as diverse diagnoses and subsequent patient needs. Additionally, several risk assessment instruments have been developed for early screening of patients at higher risk of developing PrU in the ICU. No existing risk assessment scales are valid for identification high risk critically ill patient,with the majority of scales potentially over-predicting patients at risk for PrU development. Conclusion: Research studies to inform the risk factors for potential pressure ulcer development are inconsistent. Additionally, there is no consistent or clear evidence which demonstrates any scale to better or more effective than another when used to identify the patients at risk for PrU development. Furthermore robust research is needed to identify the risk factors and develop valid scales for measuring the risk of PrU development in ICU.

Rebuilding housing after a disaster : factors for failure

Unlike most normal construction projects, post-disaster housing projects are diverse in nature, have unique socio-cultural and economical requirements, and are extremely dynamic and thus necessitate a meaningful and dynamic response. Post-disaster reconstruction practices that lack a strategy compatible with the severity of disaster, community culture, socio-economic requirements, environmental condition, government legislations, and technical and technological situations, often fail to operate and respond effectively to the needs of the wider affected population. Factors that frequently pose real threats to the eventual success of reconstruction projects are rarely given appropriate consideration when designing such projects. Research into past reconstruction practices has shown that ignoring these factors altogether or failing to give them meaningful consideration can affect housing reconstruction projects. In other words, they either miss their targets altogether or undergo serious modifications after their occupancy, subsequently resulting in an overall loss of project resources. This article touches upon the common factors that negatively impact the outcome of such projects.

Factors influencing funding decisions by elected politicians at the state/provincial level : a case study of public libraries in Canada

The purpose of this study was to determine factors (internal and external) that influenced Canadian provincial (state) politicians when making funding decisions about public libraries. Using the case study methodology, Canadian provincial/state level funding for public libraries in the 2009-10 fiscal year was examined. After reviewing funding levels across the country, three jurisdictions were chosen for the case: British Columbia's budget revealed dramatically decreased funding, Alberta's budget showed dramatically increased funding, and Ontario's budget was unchanged from the previous year. The primary source of data for the case was a series of semi-structured interviews with elected officials and senior bureaucrats from the three jurisdictions. An examination of primary and secondary documents was also undertaken to help set the political and economic context as well as to provide triangulation for the case interviews. The data were analysed to determine whether Cialdini's theory of influence (2001) and specifically any of the six tactics of influence (i.e, commitment and consistency, authority, liking, social proof, scarcity and reciprocity) were instrumental in these budget processes. Findings show the principles of "authority", "consistency and commitment" and "liking" were relevant, and that "liking" were especially important to these decisions. When these decision makers were considering funding for public libraries, they most often used three distinct lenses: the consistency lens (what are my values? what would my party do?), the authority lens (is someone with hierarchical power telling me to do this? are the requests legitimate?), and most importantly, the liking lens (how much do I like and know about the requester?). These findings are consistent with Cialdini's theory, which suggests the quality of some relationships is one of six factors that can most influence a decision maker. The small number of prior research studies exploring the reasons for increases or decreases in public library funding allocation decisions have given little insight into the factors that motivate those politicians involved in the process and the variables that contribute to these decisions. No prior studies have examined the construct of influence in decision making about funding for Canadian public libraries at any level of government. Additionally, no prior studies have examined the construct of influence in decision making within the context of Canadian provincial politics. While many public libraries are facing difficult decisions in the face of uncertain funding futures, the ability of the sector to obtain favourable responses to requests for increases may require a less simplistic approach than previously thought. The ability to create meaningful connections with individuals in many communities and across all levels of government should be emphasised as a key factor in influencing funding decisions.

From consumer to community : factors of influence in the purchasing decision making process

The impacts of online collaboration and networking among consumers on social media (SM) websites which are featuring user generated content in a form of product reviews, ratings and recommendations (PRRR) as an emerging information source is the focus of this research. The proliferation of websites where consumers are able to post the PRRR and share them with other consumers has altered the marketing environment in which companies, marketers and advertisers operate. This cross-sectional study explored consumers’ attitudes and behaviour toward various information sources (IS), used in the information search phase of the purchasing decision-making process. The study was conducted among 300 international consumers. The results were showing that personal and public IS were far more reliable than commercial. The findings indicate that traditional marketing tools are no longer viable in the SM milieu.

Factors affecting the accuracy of engineers' estimates

Emerging sciences, such as conceptual cost estimating, seem to have to go through two phases. The first phase involves reducing the field of study down to its basic ingredients - from systems development to technological development (techniques) to theoretical development. The second phase operates in the direction in building up techniques from theories, and systems from techniques. Cost estimating is clearly and distinctly still in the first phase. A great deal of effort has been put into the development of both manual and computer based cost estimating systems during this first phase and, to a lesser extent, the development of a range of techniques that can be used (see, for instance, Ashworth & Skitmore, 1986). Theoretical developments have not, as yet, been forthcoming. All theories need the support of some observational data and cost estimating is not likely to be an exception. These data do not need to be complete in order to build theories. As it is possible to construct an image of a prehistoric animal such as the brontosaurus from only a few key bones and relics, so a theory of cost estimating may possibly be found on a few factual details. The eternal argument of empiricists and deductionists is that, as theories need factual support, so do we need theories in order to know what facts to collect. In cost estimating, the basic facts of interest concern accuracy, the cost of achieving this accuracy, and the trade off between the two. When cost estimating theories do begin to emerge, it is highly likely that these relationships will be central features. This paper presents some of the facts we have been able to acquire regarding one part of this relationship - accuracy, and its influencing factors. Although some of these factors, such as the amount of information used in preparing the estimate, will have cost consequences, we have not yet reached the stage of quantifying these costs. Indeed, as will be seen, many of the factors do not involve any substantial cost considerations. The absence of any theory is reflected in the arbitrary manner in which the factors are presented. Rather, the emphasis here is on the consideration of purely empirical data concerning estimating accuracy. The essence of good empirical research is to .minimize the role of the researcher in interpreting the results of the study. Whilst space does not allow a full treatment of the material in this manner, the principle has been adopted as closely as possible to present results in an uncleaned and unbiased way. In most cases the evidence speaks for itself. The first part of the paper reviews most of the empirical evidence that we have located to date. Knowledge of any work done, but omitted here would be most welcome. The second part of the paper presents an analysis of some recently acquired data pertaining to this growing subject.

Critical Factors for Sustainable Post Natural Disaster Reconstruction : Chinese Data

While scientists continue to explore the level of climate change impact to new weather patterns and our environment in general, there have been some devastating natural disasters worldwide in the last two decades. Indeed natural disasters are becoming a major concern in our society. Yet in many previous examples, our reconstruction efforts only focused on providing short-term necessities. How to develop resilience in the long run is now a highlight for research and industry practice. This paper introduces a research project aimed at exploring the relationship between resilience building and sustainability in order to identify key factors during reconstruction efforts. From extensive literature study, the authors considered the inherent linkage between the two issues as evidenced from past research. They found that sustainability considerations can improve the level of resilience but are not currently given due attention. Reconstruction efforts need to focus on resilience factors but as part of urban development, they must also respond to the sustainability challenge. Sustainability issues in reconstruction projects need to be amplified, identified, processed, and managed properly. On-going research through empirical study aims to establish critical factors (CFs) for stakeholders in disaster prone areas to plan for and develop new building infrastructure through holistic considerations and balanced approaches to sustainability. A questionnaire survey examined a range of potential factors and the subsequent data analysis revealed six critical factors for sustainable Post Natural Disaster Reconstruction that include: considerable building materials and construction methods, good governance, multilateral coordination, appropriate land-use planning and policies, consideration of different social needs, and balanced combination of long-term and short-term needs. Findings from this study should have an influence on policy development towards Post Natural Disaster Reconstruction and help with the achievement of sustainable objectives.

Factors associated with suboptimal adherence to antiretroviral therapy in Viet Nam: A cross-sectional study using audio computer-assisted self-interview (ACASI)

Background: Optimal adherence to antiretroviral therapy (ART) is necessary for people living with HIV/AIDS (PLHIV). There have been relatively few systematic analyses of factors that promote or inhibit adherence to antiretroviral therapy among PLHIV in Asia. This study assessed ART adherence and examined factors associated with suboptimal adherence in northern Viet Nam. Methods: Data from 615 PLHIV on ART in two urban and three rural outpatient clinics were collected by medical record extraction and from patient interviews using audio computer-assisted self-interview (ACASI). Results: The prevalence of suboptimal adherence was estimated to be 24.9% via a visual analogue scale (VAS) of past-month dose-missing and 29.1% using a modified Adult AIDS Clinical Trial Group scale for on-time dose-taking in the past 4 days. Factors significantly associated with the more conservative VAS score were: depression (p < 0.001), side-effect experiences (p < 0.001), heavy alcohol use (p = 0.001), chance health locus of control (p = 0.003), low perceived quality of information from care providers (p = 0.04) and low social connectedness (p = 0.03). Illicit drug use alone was not significantly associated with suboptimal adherence, but interacted with heavy alcohol use to reduce adherence (p < 0.001). Conclusions: This is the largest survey of ART adherence yet reported from Asia and the first in a developing country to use the ACASI method in this context. The evidence strongly indicates that ART services in Viet Nam should include screening and treatment for depression, linkage with alcohol and/or drug dependence treatment, and counselling to address the belief that chance or luck determines health outcomes.