776 resultados para Automobile Industry, Quality Change, Innovation, and Hedonic Prices.
Resumo:
NPM has been generally regarded as an administrative reform for which resilience and consequences have been mainly investigated at a country level. Although accounting played a central role in NPM reforms over the last decades, how accounting change actually took place, and through what organizational dynamics, has been under-investigated. This paper adopts a new perspective, archetype theory, and looks into how intra-organizational dynamics (values, interests, power, capabilities) combine with reform processes to influence the outcome of accounting change. Evidence from Italian (disruptive process) and Canadian (sedimented process) municipalities shows that radical change is associated with specific configurations of intra-organizational dynamics.
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The aim of our study was to discover the health status and healthcare utilisation associated with pulmonary exacerbations in cystic fibrosis (CF) and chronic Pseudomonas aeruginosa infection.
Patients with CF from five UK CF centres attended two visits, 8–12 weeks apart. They were classified at visit 1 as being in one of the three health states: no current pulmonary exacerbation; “mild” (no hospitalisation) pulmonary exacerbation; and “severe” (hospitalisation) pulmonary exacerbation. All patients completed the Cystic Fibrosis Questionnaire-Revised (CFQ-R) and EuroQol (EQ-5D) and a clinical form, and forced expiratory volume in 1 s (FEV1) was measured at visits 1 and 2. Annual healthcare utilisation data were collected.
94 patients of mean±sd age 28.5±8.2 yrs and FEV1 58.7±26.8% were recruited. 60 patients had no pulmonary exacerbation, 15 had a mild and 19 had a severe pulmonary exacerbation at visit 1. EQ-5D and CFQ-R data showed that the worse the exacerbation, the poorer the health-related quality of life (HRQoL). There were strong relationships between the CFQ-R and EQ-5D domain scores. The mean rate of pulmonary exacerbations per patient per year was 3.6 (1.5 in hospital and 2.2 at home). The mean length of stay per hospital pulmonary exacerbation was 9 days.
As exacerbation status worsens, patients experience worse HRQoL. There is a significant healthcare burden associated with treatment of pulmonary exacerbation and long-term prophylaxis.
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The reasons why animal populations decline in response to anthropogenic noise are still poorly understood. To understand how populations are affected by noise, we must understand how individuals are affected by noise. By modifying the acoustic environment experimentally, we studied the potential relationship between noise levels and both spatial and singing behaviour in the European robin (Erithacus rubecula). We found that with increasing noise levels, males were more likely to move away from the noise source and changed their singing behaviour. Our results provide the first experimental evidence in a free ranging species, that not merely the presence of noise causes changes in behaviour and distribution, but that the level of noise pollution plays a crucial role as well. Our results have important implications for estimating the impact of infrastructure which differs in the level of noise produced. Thus, governmental planning bodies should not only consider the physical effect on the landscape when assessing the impact of new infrastructure, but also the noise levels emitted, which may reduce the loss of suitable habitats available for animals. © 2012 The Author(s) Published by the Royal Society. All rights reserved.
Resumo:
PURPOSE: To investigate the quality of life and priorities of patients with glaucoma.
METHODS: Patients diagnosed with glaucoma and no other ocular comorbidity were consecutively recruited. Clinical information was collected. Participants were asked to complete three questionnaires: EuroQuol (EQ-5D), time tradeoff (TTO), and choice-based conjoint analysis. The latter used five-attribute outcomes: (1) reading and seeing detail, (2) peripheral vision, (3) darkness and glare, (4) household chores, and (5) outdoor mobility. Visual field loss was estimated by using binocular integrated visual fields (IVFs).
RESULTS: Of 84 patients invited to participate, 72 were enrolled in the study. The conjoint utilities showed that the two main priorities were "reading and seeing detail" and "outdoor mobility." This rank order was stable across all segmentations of the data by demographic or visual state. However, the relative emphasis of these priorities changed with increasing visual field loss, with concerns for central vision increasing, whereas those for outdoor mobility decreased. Two subgroups of patients with differing priorities on the two main attributes were identified. Only 17% of patients (those with poorer visual acuity) were prepared to consider TTO. A principal component analysis revealed relatively independent components (i.e., low correlations) between the three different methodologies for assessing quality of life.
CONCLUSIONS: Assessments of quality of life using different methodologies have been shown to produce different outcomes with low intercorrelations between them. Only a minority of patients were prepared to trade time for a return to normal vision. Conjoint analysis showed two subgroups with different priorities. Severity of glaucoma influenced the relative importance of priorities.
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Of the early modern writers on the division of labour, Bernard Mandeville alone extended it to all aspects of human activity and emphasised its role in a cumulative process of evolution in which each generation modified and built on what had been achieved by earlier generations. This required exploration of the mechanisms through which new knowledge was developed as well as the means by which knowledge was transmitted between the generations. The present article examines Mandeville’s treatment of these mechanisms and explores their theoretical origins. It examines Mandeville’s understanding of the role of the division of labour in facilitating discovery and learning and the role of education and imitation in transmitting social knowledge. It shows that, for Mandeville, innovators were people of ordinary capacity who were alert to the opportunities and challenges of their environment. As a result of specialisation, they possessed tacit knowledge which was actualised in what they did rather than in theoretical propositions. Mandeville’s evolutionary thought influenced subsequent writers on political economy and evolutionary social thinkers. It may also have had some influence on Charles Darwin, though it is not, in itself, Darwinian. © The Author 2013. Published by Oxford University Press on behalf of the Cambridge Political Economy Society. All rights reserved.
Resumo:
Existing climate change mitigation policies are particularly concerned with the reconciliation of two seemingly conflicting aims: environmental protection and economic efficiency. The normative principles underlying these policies meanwhile focus on two central ideas: fair burden-sharing and agents' responsibility. However, both existing policy instruments and their supporting philosophical principles are highly problematic in terms of intergenerational justice and truly effective climate change mitigation. Three competing conceptions for allocating and distributing the burdens of climate change mitigation (cap-and-trade schemes, carbon emission taxes, and personal ecological space quotas) and their compatibility with principles of intra- and intergenerational justice are analysed and evaluated. None of the proposed instruments is able to satisfy the demands of effective mitigation and egalitarian justice on its own, which suggests that existing proposals for the distribution of emission rights and climate change-related costs need to be supported by a thicker account of intergenerational justice.
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This paper considers the evolution of Homo sapiens in eastern Africa in relation to refugia and bottlenecks around ~200 ka BP, at a macro scale. Middle Stone Age (MSA) lithics, site distributions and locations are analysed in relation to palaeovegetation maps of the last glacial/interglacial cycle, which are used as a proxy for earlier climate cycles. A ‘‘push and pull’’ model is then postulated for the spread of Homo sapiens out of refugia in eastern Africa, involving both volcanism (push) and habitat availability (pull). A date within OIS 5 is suggested for this expansion to other parts of the continent, and potentially further a?eld, contrary to a frequently proposed expansion within OIS 3. ©2008 Elsevier Ltd. All rights reserved.
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It has been acknowledged that poor quality of sleep significantly correlates with poor quality of life; evidence suggests that counselling has a positive impact not only on the cancer patient's quality of life, but also on family members and friends. The aim of this service evaluation was to determine if there was an improvement in clients’ quality of life and sleep patterns following counselling as offered by a local cancer charity. A total of 60 matched pre- and post-counselling questionnaires were completed and subjected to statistical analysis. When considering quality of life, in the domains of Role Emotional, Mental Health and Mental Component Summary Score, it can be concluded that counselling has a positive effect on emotional health and mental wellbeing. The mean total number of hours sleep per night significantly increased from 6 hours sleep per night at baseline to 6.8 hours sleep per night at the completion of counselling (p=0.005) showing clients gained an extra 48 minutes sleep per night. The improved emotional and mental wellbeing alongside the extra 48 minutes sleep per night provides evidence that there is a positive outcome for those patients and families who use counselling services. Nurses and other members of the multidisciplinary team should be encouraged to discuss supportive therapies with patients and those affected by cancer at all stages of the cancer trajectory, regardless of social status, gender or cancer type.
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Non-invasive population genetics has become a valuable tool in ecology and conservation biology, allowing genetic studies of wild populations without the need to catch, handle or even observe the study subjects directly. We address some of the concerns regarding the limitations of using non-invasive samples by comparing the quality of population genetic information gained through DNA extracted from faecal samples and biopsy samples of two elusive bat species, Myotis mystacinus and Myotis nattereri. We demonstrate that DNA extracted from faeces and tissue samples gives comparable results for frequency based population genetic analyses, despite the occurrence of genotyping errors when using faecal DNA. We conclude that non-invasive genetic sampling for population genetic analysis in bats is viable, and although more labour-intensive and expensive, it is an alternative to tissue sampling, which is particularly pertinent when specimens are rare, endangered or difficult to capture. © 2012 Museum and Institute of Zoology PAS.