Standardized Performance Analysis (SPA) Summary for 1999-2000 Veterinary Medicine Students

Nine Iowa State University veterinary medical students completed SPA records on herds from Iowa, North Dakota and South Dakota. The Iowa herds were included in the SPA summary for Iowa, but the six North and South Dakota herds were summarized separately. These six herds had an average herd size of 371 cows and had a financial return to capital, labor and management of $175 per cow. Total financial cost per cow averaged $286 for these herds with a range of $211 to $388. Feed utilized averaged 4,442 pounds of dry matter per cow and the average pounds of calf produced per exposed female was 506 pounds.

Explanations for unsuccessful weight loss among bariatric surgery candidates.

BACKGROUND: Our objective was to analyze subjective explanations for unsuccessful weight loss among bariatric surgery candidates. METHODS: This was a retrospective analysis of 909 bariatric surgery candidates (78.2% female, average body mass index [BMI] 47.3) at a university center from 2001 to April 2007 who answered an open-ended question about why they were unable to lose weight. We generated a coding scheme for answers to the question and established inter-rater reliability of the coding process. Associations with demographic parameters and initial BMI were tested. RESULTS: The most common categories of answers were nonspecific explanations related to diet (25.3%), physical activity (21.0%), or motivation (19.7%), followed by diet-related motivation (12.7%) and medical conditions or medications affecting physical activity (12.7%). Categories related to time, financial cost, social support, physical environment, and knowledge occurred in less than 4% each. Men were more likely than women to cite a medical condition or medication affecting physical activity (19.2% vs 10.8%, P = 0.002, odds ratio [OR] = 1.96, 95% confidence interval [CI] = 1.28-2.99) but less likely to cite diet-related motivation (7.1% vs 14.2%, P = 0.008, OR = 0.46, 95% CI = 0.26-0.82). CONCLUSIONS: Our findings suggest that addressing diet, physical activity, and motivation in a comprehensive approach would meet the stated needs of obese patients. Raising patient awareness of under-recognized barriers to weight loss, such as the physical environment and lack of social support, should also be considered. Lastly, anticipating gender-specific attributions may facilitate tailoring of interventions.

Commentary on "Child Welfare Waivers: The Stakes for Families"

The purpose of this piece is to provide commentary of an article, Child Welfare Waivers: The Stakes for Your State, that discusses the recent reauthorization of the Title IV-E Child Welfare Waivers. The article provides an overview of funds available to the states for child welfare programs and their intended purpose and restrictions placed on use. As structured, the present system rewards states monetarily for maintaining foster care. Research from waiver programs shows promising results for improved outcomes at the same or lower financial cost by utilizing safe, proven alternatives to the current foster care system. Waiver funds also protect the financial commitment to child welfare because state legislative budget slashing in this area will result in the loss of Federal funding. The independent analysis required with the grant of a waiver must be maintained to provide ongoing analysis and oversight of the increase spending flexibility. Stakeholders must be aware of the program and its results and use these funds as an opportunity to assess new concepts and apply programs best suited to the needs of children in their state. Allowing those “on the ground” to determine appropriate programming and careful result assessment may be the best means for protecting children, preserving families and doing both in a manner that makes the most efficient use of available resources.

Economic analysis of soil conservation: Case studies from the highlands of Amhara Region, Ethiopia

Soil degradation is widespread in the Ethiopian Highlands. Its negative impacts on soil productivity contribute to the extreme poverty of the rural population. Soil conservation is propagated as a means of reducing soil erosion, however, it is a costly investment for small-scale farming households. The present study is an attempt to show whether or not selected mechanical Soil and Water Conservation (SWC) technologies are profitable from a farmer’s point of view. A financial Cost-Benefit Analysis (CBA) is carried out to assess whether or not the considered SWC technologies are profitable from a farmer’s point of view. The CBA is supplemented by an evaluation of aspects from the economic and institutional environment. Whether or not soil conservation is profitable from a farmer’s point of view depends on a broad range of factors from the ecological, economic, political, institutional and socio-cultural sphere and also depends on the technology and the prevailing farming system. Because these factors are closely interlinked, it is often not sufficient to change or influence one to make SWC profitable. Several recommendations are formulated with regard to improving the profitability of SWC investments from a farmer’s point of view. Because the reasons for unsustainable resource use are manifold and highly interlinked, only a multi-stakeholder, multi-level and multi-objective approach is likely to offer solutions that address the underlying problems adequately.

Sistema de simulación de escenarios de ciclos avanzados de combustible nuclear en transición = Simulation system for advanced fuel cycle transition scenarios

El estudio de los ciclos del combustible nuclear requieren de herramientas computacionales o "códigos" versátiles para dar respuestas al problema multicriterio de evaluar los actuales ciclos o las capacidades de las diferentes estrategias y escenarios con potencial de desarrollo en a nivel nacional, regional o mundial. Por otra parte, la introducción de nuevas tecnologías para reactores y procesos industriales hace que los códigos existentes requieran nuevas capacidades para evaluar la transición del estado actual del ciclo del combustible hacia otros más avanzados y sostenibles. Brevemente, esta tesis se centra en dar respuesta a las principales preguntas, en términos económicos y de recursos, al análisis de escenarios de ciclos de combustible, en particular, para el análisis de los diferentes escenarios del ciclo del combustible de relativa importancia para España y Europa. Para alcanzar este objetivo ha sido necesaria la actualización y el desarrollo de nuevas capacidades del código TR_EVOL (Transition Evolution code). Este trabajo ha sido desarrollado en el Programa de Innovación Nuclear del CIEMAT desde el año 2010. Esta tesis se divide en 6 capítulos. El primer capítulo ofrece una visión general del ciclo de combustible nuclear, sus principales etapas y los diferentes tipos utilizados en la actualidad o en desarrollo para el futuro. Además, se describen las fuentes de material nuclear que podrían ser utilizadas como combustible (uranio y otros). También se puntualizan brevemente una serie de herramientas desarrolladas para el estudio de estos ciclos de combustible nuclear. El capítulo 2 está dirigido a dar una idea básica acerca de los costes involucrados en la generación de electricidad mediante energía nuclear. Aquí se presentan una clasificación de estos costos y sus estimaciones, obtenidas en la bibliografía, y que han sido evaluadas y utilizadas en esta tesis. Se ha incluido también una breve descripción del principal indicador económico utilizado en esta tesis, el “coste nivelado de la electricidad”. El capítulo 3 se centra en la descripción del código de simulación desarrollado para el estudio del ciclo del combustible nuclear, TR_EVOL, que ha sido diseñado para evaluar diferentes opciones de ciclos de combustibles. En particular, pueden ser evaluados las diversos reactores con, posiblemente, diferentes tipos de combustibles y sus instalaciones del ciclo asociadas. El módulo de evaluaciones económica de TR_EVOL ofrece el coste nivelado de la electricidad haciendo uso de las cuatro fuentes principales de información económica y de la salida del balance de masas obtenido de la simulación del ciclo en TR_EVOL. Por otra parte, la estimación de las incertidumbres en los costes también puede ser efectuada por el código. Se ha efectuado un proceso de comprobación cruzada de las funcionalidades del código y se descrine en el Capítulo 4. El proceso se ha aplicado en cuatro etapas de acuerdo con las características más importantes de TR_EVOL, balance de masas, composición isotópica y análisis económico. Así, la primera etapa ha consistido en el balance masas del ciclo de combustible nuclear actual de España. La segunda etapa se ha centrado en la comprobación de la composición isotópica del flujo de masas mediante el la simulación del ciclo del combustible definido en el proyecto CP-ESFR UE. Las dos últimas etapas han tenido como objetivo validar el módulo económico. De este modo, en la tercera etapa han sido evaluados los tres principales costes (financieros, operación y mantenimiento y de combustible) y comparados con los obtenidos por el proyecto ARCAS, omitiendo los costes del fin del ciclo o Back-end, los que han sido evaluado solo en la cuarta etapa, haciendo uso de costes unitarios y parámetros obtenidos a partir de la bibliografía. En el capítulo 5 se analizan dos grupos de opciones del ciclo del combustible nuclear de relevante importancia, en términos económicos y de recursos, para España y Europa. Para el caso español, se han simulado dos grupos de escenarios del ciclo del combustible, incluyendo estrategias de reproceso y extensión de vida de los reactores. Este análisis se ha centrado en explorar las ventajas y desventajas de reprocesado de combustible irradiado en un país con una “relativa” pequeña cantidad de reactores nucleares. Para el grupo de Europa se han tratado cuatro escenarios, incluyendo opciones de transmutación. Los escenarios incluyen los reactores actuales utilizando la tecnología reactor de agua ligera y ciclo abierto, un reemplazo total de los reactores actuales con reactores rápidos que queman combustible U-Pu MOX y dos escenarios del ciclo del combustible con transmutación de actínidos minoritarios en una parte de los reactores rápidos o en sistemas impulsados por aceleradores dedicados a transmutación. Finalmente, el capítulo 6 da las principales conclusiones obtenidas de esta tesis y los trabajos futuros previstos en el campo del análisis de ciclos de combustible nuclear. ABSTRACT The study of the nuclear fuel cycle requires versatile computational tools or “codes” to provide answers to the multicriteria problem of assessing current nuclear fuel cycles or the capabilities of different strategies and scenarios with potential development in a country, region or at world level. Moreover, the introduction of new technologies for reactors and industrial processes makes the existing codes to require new capabilities to assess the transition from current status of the fuel cycle to the more advanced and sustainable ones. Briefly, this thesis is focused in providing answers to the main questions about resources and economics in fuel cycle scenario analyses, in particular for the analysis of different fuel cycle scenarios with relative importance for Spain and Europe. The upgrade and development of new capabilities of the TR_EVOL code (Transition Evolution code) has been necessary to achieve this goal. This work has been developed in the Nuclear Innovation Program at CIEMAT since year 2010. This thesis is divided in 6 chapters. The first one gives an overview of the nuclear fuel cycle, its main stages and types currently used or in development for the future. Besides the sources of nuclear material that could be used as fuel (uranium and others) are also viewed here. A number of tools developed for the study of these nuclear fuel cycles are also briefly described in this chapter. Chapter 2 is aimed to give a basic idea about the cost involved in the electricity generation by means of the nuclear energy. The main classification of these costs and their estimations given by bibliography, which have been evaluated in this thesis, are presented. A brief description of the Levelized Cost of Electricity, the principal economic indicator used in this thesis, has been also included. Chapter 3 is focused on the description of the simulation tool TR_EVOL developed for the study of the nuclear fuel cycle. TR_EVOL has been designed to evaluate different options for the fuel cycle scenario. In particular, diverse nuclear power plants, having possibly different types of fuels and the associated fuel cycle facilities can be assessed. The TR_EVOL module for economic assessments provides the Levelized Cost of Electricity making use of the TR_EVOL mass balance output and four main sources of economic information. Furthermore, uncertainties assessment can be also carried out by the code. A cross checking process of the performance of the code has been accomplished and it is shown in Chapter 4. The process has been applied in four stages according to the most important features of TR_EVOL. Thus, the first stage has involved the mass balance of the current Spanish nuclear fuel cycle. The second stage has been focused in the isotopic composition of the mass flow using the fuel cycle defined in the EU project CP-ESFR. The last two stages have been aimed to validate the economic module. In the third stage, the main three generation costs (financial cost, O&M and fuel cost) have been assessed and compared to those obtained by ARCAS project, omitting the back-end costs. This last cost has been evaluated alone in the fourth stage, making use of some unit cost and parameters obtained from the bibliography. In Chapter 5 two groups of nuclear fuel cycle options with relevant importance for Spain and Europe are analyzed in economic and resources terms. For the Spanish case, two groups of fuel cycle scenarios have been simulated including reprocessing strategies and life extension of the current reactor fleet. This analysis has been focused on exploring the advantages and disadvantages of spent fuel reprocessing in a country with relatively small amount of nuclear power plants. For the European group, four fuel cycle scenarios involving transmutation options have been addressed. Scenarios include the current fleet using Light Water Reactor technology and open fuel cycle, a full replacement of the initial fleet with Fast Reactors burning U-Pu MOX fuel and two fuel cycle scenarios with Minor Actinide transmutation in a fraction of the FR fleet or in dedicated Accelerator Driven Systems. Finally, Chapter 6 gives the main conclusions obtained from this thesis and the future work foreseen in the field of nuclear fuel cycle analysis.

La escalera de caracol con ojo a finales del S.XV y comienzos del S.XVI: el caso de la ciudad y tierra de Segovia

Este trabajo de investigación se ha centrado en la escalera de caracol con ojo también denominado caracol de mallorca, en sus primeras apariciones a finales del s.XV y comienzos del s.XVI durante el llamado periodo tardogótico. Este elemento aparentemente sencillo presenta, sin embargo, una gran diversidad de esquemas geométricos. Todavía a día de hoy, no hay explicación del por qué de la mayor difusión de unos con respecto a otros. El objetivo de este trabajo ha sido valorar el papel que el confort/seguridad de uso así como la economía en el trabajo –sencillez de ejecución y coste económico– tuvieron en el contexto de la difusión de este elemento arquitectónico. Este estudio ha analizado en base a estos criterios objetivos, la geometría de cada uno de los esquemas tipo que resuelven la formación del hueco central característico este tipo de escaleras, con la intención de determinar las causas objetivas que pudieron motivar la desigual expansión de los mismos. Una vez determinado el marco teórico, se han establecido dos líneas para abordar el problema. Por un lado se ha planteado el análisis de los modelos teóricos recogidos en los distintos textos de cantería escritos por autores españoles desde finales del s.XVI. Si bien en la época en que se escribieron, la arquitectura gótica como sistema había desaparecido, alguno de sus elementos más característicos, como la escalera de caracol, continuaban empleándose. Las trazas del caracol con ojo recogidas en estos textos, describen habitualmente las soluciones geométricas más frecuentes e incluso los ejemplos construidos más conocidos, los cuales fueron levantados en su mayoría en el período en el cual se desarrolla esta investigación. Por otro lado, este estudio se plantea el análisis de modelos construidos existentes en la Ciudad y Tierra de Segovia. La razón que justifica dichos límites geográficos, la encontramos en que la mayor parte del patrimonio gótico existente en este área fue construido entre finales del s.XV y comienzos del s. XVI. Ambos grupos, modelos teóricos y modelos construidos, recogen la herencia gótica heredada en la construcción de este elemento arquitectónico. Cada una de estas dos líneas establecidas han seguido una metodología específica adaptada al objeto de análisis, si bien ambas se basan en un primer análisis individual y posterior análisis comparativo de los modelos seleccionados. Estos análisis han permitido identificar los distintos esquemas empleados para resolver el hueco central, lo que ha posibilitado establecer una clasificación general de los mismos en tres grupos: caracol con ojo de solución radial, el caracol con ojo de solución no radial y el caracol con ojo de solución tangencial. A partir de los datos y resultados obtenidos del análisis comparativo de los parámetros geométricos que afectan al confort/seguridad de uso y economía en el trabajo de dichos esquemas, podemos concluir que a pesar que los tres esquemas identificados resuelven el caracol con ojo de forma muy similar, el predominio de la solución radial y la caída en el olvido de las soluciones tangencial y no radial estuvieron justificados. ABSTRACT This work focused on the helical staircase, also known as mallorca staircase, in the late 15th and the early 16th centuries. This seemingly simple element, presents however a wide variety of geometrical designs. Still to date, there is no explanation of why some of them were limited use, while others had a wide impact. The aim of this study was to assess the influence which comfort, safety and work economy –ease of construction and financial cost– had on their widespread. This study analysed, following these objective criteria, the geometry of the different designs, which solve the characteristic inner aperture of this type of staircase. And thus, find the reasons, which motivated their uneven spread. Once the theoretical framework was developed, two research lines were set up to address the problem. On one hand, this study analysed the theoretical helical staircases described in the early Spanish texts, which were written since the end of the 16th century. Although these texts were written after the Gothic Architecture system had already disappeared, some of its more representative elements like the helical staircase were still in use. The traces of the helical stair, which are included in these texts, describe the most frequently-used designs and even the most famous real examples which were usually constructed in the Late Gothic period. On the other hand, this study analysed some real helical staircases, which were constructed in the Ciudad y Tierra de Segovia. The reason for choosing these geographical limits is that most of the Gothic buildings of this area were constructed between the end of the 15th and the early 16th centuries, during the Late Gothic period. Both groups, theoretical and constructed samples, collect the Gothic construction tradition of the helical stair. Each of these research lines followed a specific methodology, which was adapted to the research object. Nevertheless, both are based on a first individual analysis of each selected example and a later on comparative one. These analysis allowed the identification of the different layouts which solve the inner aperture of the helical staircase, what made possible to set up a broad classification in three groups, according to the geometrical design strategy that solves the central aperture: the helical staircase by radial solution, the helical staircase by non-radial solution and the helical staircase by tangent solution. The research findings of the comparative analysis of their geometrical parameters, which have an impact in the comfort, safety and work economy, have shown that although all of them solve the helical staircase in a really similar way, the fade into oblivion of the non-radial and tangent approaches was objectively motivated.

Bases teóricas dos processos de medicalização: um olhar sobre as forças motrizes

Introdução: O tema medicalização emerge como objeto de estudo no campo da sociologia da saúde, a partir da década de 70, nas vozes de Irving Zola, Ivan Illich, Peter Conrad e Michel Foucalt; as quais indicaram a crescente influência da medicina em campos que até então não lhe pertenciam. E, no decorrer dos anos, o termo vem sendo apropriado por vários campos: na saúde, na educação, na psicologia, entre outros. Esta configuração levou alguns estudiosos da primeira década do século XXI, a se preocupar com o uso impreciso e vago do conceito de medicalização na produção científica. Neste sentido, este estudo busca olhar para os processos de medicalização, tomando-o em sua pluralidade a fim de discernir as principais forças motrizes e coteja-las com as mudanças na contemporaneidade. Objetivo: Recuperar as forças motrizes contidas nas principais contribuições dos autores primários sobre os processos de medicalização. Método: Realizou-se um exercício hermenêutico composto pelos seguintes passos: leitura profunda do texto, fichamento dos aspectos centrais que caracterizam as diversas concepções sobre medicalização. Interpretação do conteúdo por meio da abstração dos núcleos de sentido e dos referenciais teóricos que lhe dão suporte. Resultados: A partir deste movimento reflexivo e crítico conseguiu-se desvelar quatro conceitos nucleares que representam as principais forças motrizes: a indústria, as instituições, o Estado e a sociedade. Zola oferece indícios que o Estado e a indústria teriam levado a sociedade à dependência da medicina. Para Illich, a medicina, por si só, detém o poder comparada as outras instituições. Para Michel Foucault, a medicina deixou de ser uma ciência pura e transformou-se numa instituição subordinada a um sistema econômico e de poder, enfim a uma lógica subjacente aos princípios e regras de governo. Em contrapartida, para Conrad a medicalização não constitui um empreendimento exclusivo da medicina, prevalecendo os interesses de outras instituições e organizações sociais. O sentido com que cada um desses conceitos é usado difere entre os autores e a distinção desses aspectos é chave para compreender a contribuição efetiva de cada um. Da mesma forma, ocorre quando os autores discutem as consequências e os efeitos causados pelos processos de medicalização. Alguns autores direcionam seus efeitos para os indivíduos, num processo de exacerbação da individualização; enquanto que outros focam os efeitos da medicalização nas políticas de saúde e na questão econômica associada ao oneroso custo financeiro para a sociedade e o país. Considerações finais: A recuperação e a compreensão dos significados subjacentes às principais forças motrizes presentes nas contribuições de cada autor apresentadas nesta investigação constituem-se em passo importante para subsidiar a reflexão sobre processos concretos de medicalização no início do século XXI, um período marcado por aceleradas transformações, no qual, entre outros aspectos, a medicina e várias instituições têm sido crescentemente, capturadas para satisfazer, de um lado o consumismo, e de outro, a avidez pelo lucro do mercado capitalista; ao mesmo tempo em que forças desagregadoras atravessam os sujeitos impactando sua autonomia e identidade política, social e econômica.

Informações de suporte ao escalonamento de workflows científicos para a execução em plataformas de computação em nuvem

A ciência tem feito uso frequente de recursos computacionais para execução de experimentos e processos científicos, que podem ser modelados como workflows que manipulam grandes volumes de dados e executam ações como seleção, análise e visualização desses dados segundo um procedimento determinado. Workflows científicos têm sido usados por cientistas de várias áreas, como astronomia e bioinformática, e tendem a ser computacionalmente intensivos e fortemente voltados à manipulação de grandes volumes de dados, o que requer o uso de plataformas de execução de alto desempenho como grades ou nuvens de computadores. Para execução dos workflows nesse tipo de plataforma é necessário o mapeamento dos recursos computacionais disponíveis para as atividades do workflow, processo conhecido como escalonamento. Plataformas de computação em nuvem têm se mostrado um alternativa viável para a execução de workflows científicos, mas o escalonamento nesse tipo de plataforma geralmente deve considerar restrições específicas como orçamento limitado ou o tipo de recurso computacional a ser utilizado na execução. Nesse contexto, informações como a duração estimada da execução ou limites de tempo e de custo (chamadas aqui de informações de suporte ao escalonamento) são importantes para garantir que o escalonamento seja eficiente e a execução ocorra de forma a atingir os resultados esperados. Este trabalho identifica as informações de suporte que podem ser adicionadas aos modelos de workflows científicos para amparar o escalonamento e a execução eficiente em plataformas de computação em nuvem. É proposta uma classificação dessas informações, e seu uso nos principais Sistemas Gerenciadores de Workflows Científicos (SGWC) é analisado. Para avaliar o impacto do uso das informações no escalonamento foram realizados experimentos utilizando modelos de workflows científicos com diferentes informações de suporte, escalonados com algoritmos que foram adaptados para considerar as informações inseridas. Nos experimentos realizados, observou-se uma redução no custo financeiro de execução do workflow em nuvem de até 59% e redução no makespan chegando a 8,6% se comparados à execução dos mesmos workflows sendo escalonados sem nenhuma informação de suporte disponível.

Finding Onesimus: Recovering the Story of a First-Century Fugitive Slave

Author: Ryan Lokkesmoe Title: Finding Onesimus: Recovering the Story of a First-Century Fugitive Slave Advisor: Pamela Eisenbaum Degree Date: August 2015 ABSTRACT This dissertation is an investigation into the experience of a first-century fugitive slave named Onesimus, who is known to us primarily through Paul’s letter to Philemon (Phlm) in the New Testament. Within this broader purpose, this project challenges a popular historical theory for Onesimus’ flight, the so-called Amicus Domini theory. This is the theory that Onesimus fled his master Philemon with the premeditated intention of seeking out the Apostle Paul as a peacemaker in a conflict Onesimus was having with Philemon. The Amicus Domini theory is accepted by many scholars, though rarely discussed in detail or examined critically. The goal of this project is to offer a more probable historical reconstruction of Onesimus’ flight – one that takes better stock of the available evidence (historical, textual, archaeological, legal, and rhetorical). This project is rooted in the sub-discipline of the Historical Critical method, though rhetorical analysis is applied as well. This study offers a translation and commentary of Phlm, as well as an examination of Paul’s rhetoric in the letter. Other sources that specifically mention Onesimus are also investigated, e.g. Colossians, ancient Christian commentators, and the subscriptions in the manuscripts. The project also examines slavery in the Ancient Mediterranean world with a view toward understanding what most slaves experienced, and especially fugitive slaves. Roman law of slavery is also discussed, as well as the estimated travel times and cost of Onesimus’ journey (whether from Colossae to Rome, Caesarea Maritima, or Ephesus). There are many factors that are problematic for the Amicus Domini theory, e.g. the duration of Onesimus’ journey, the financial cost to Philemon, and the fact that the documents typically used to support the Amicus Domini theory (Pliny’s letters to Sabinianus and the writings of Roman jurists) do not comport with the data in Phlm. This dissertation offers a modified theory for Onesimus’ predicament: Amicus Domini Ex Post Facto. Onesimus did not leave Philemon intending to seek out Paul and reconcile with Philemon, but he eventually decided to seek help long after the fact. This historical reconstruction makes better sense of the evidence, and provides a clearer view of what Onesimus faced during his flight.

General practitioner, specialist providers case conferences in palliative care: Lessons learned from 56 case conferences

OBJECTIVE: To describe the utility and acceptability to general practitioners and palliative care staff of case conferences in palliative care. METHOD: Research focussed on case conferences conducted between GPs and staff of three specialist palliative care units (in an inner urban, outer metropolitan and regional setting), at the time of referral of patients to the service. Telephone interviews were conducted with all GPs who participated in a case conference, and focus groups were conducted with palliative care staff. RESULTS: For most GPs, case conferences by teleconference were a time effective and immediate means of information transfer. The best instances for a conference were at time of patient referral, time of discharge to the community, or where the case was complex. General practitioners appreciated access to multiple professionals simultaneously. Workload pressures were a drawback of participation for both GPs and specialists. Palliative care team members thought case conferences gave GPs an appreciation of a team approach, and reduced professional isolation. The usefulness of the case conferences depended on the willingness of the GP to participate. General practitioners would participate again provided they did not have to organise the case conference. Specialist staff were concerned by the financial cost of organising case conferences. DISCUSSION: Case conferences provide useful information exchange between GPs and specialist staff, and are acceptable to both parties. Much depends on the individual GPs attitude toward participation, as well as the timing of the conferences in the course of the patient's illness. Organisation needs to be a task of the specialist units, who would need administrative support to organise them. (author abstract)

Going green: prospects for SME's to attain ISO 14001 and the challenges they face in the process

This research aimed to identify any common factors that have enabled and/or motivated SMEs to successfully implement ISO 14001 whilst the majority have not. It also identified what challenges and barriers SMEs face in doing so and how some have overcome these. The existing literature suggests that the majority of SMEs perceive their environmental impacts to be proportional to their size; have a poor understanding of environmental issues; have a poor awareness of environmental regulations; do that have the necessary expertise or leadership to address environmental issues and that SMEs with an environmental management system such as ISO 14001 are very much the minority. The main factors that influenced whether an SME had implemented ISO 14001 were: competitive advantage, regulatory compliance, supply chain pressures, leadership, expertise, resources and external support. This research used qualitative analysis of interviews with managers and directors from 8 SMEs with ISO 14001 and 4 without. All of the SMEs were based in the West Midlands or Staffordshire. Interviews were also conducted with 3 organisations offering support to businesses on environmental issues and with 1 large business who was engaging their suppliers (which included SMEs within this sample) on environmental issues. The research found that there were four main factors that enabled or motivated the SMEs to implement ISO 14001, these were: leadership, supply chain pressures, external support and SMEs' history and experience of accredited management systems. The main challenges that these business had to overcome and that prevented the other SMEs from achieving ISO 14001 were: achieving regulatory compliance, perceived financial cost, lack of perceived competitive advantage, access to relevant and affordable support and for those SMEs without ISO 14001 there was very little perceived external pressure or need for them to do so.

Experiences of patients with age-related macular degeneration receiving anti-vascular endothelial growth factor therapy:a qualitative study

The societal cost for the average health authority in the United Kingdom for the care of wet age-related macular degeneration (AMD) has been suggested to be around £7.4 million. It is vital that the best possible care based on the best available evidence is provided to reduce the impact of AMD on patients' lives and the financial cost to the health-care system. This study explored the experiences of AMD patients treated with intravitreal ranibizumab injections. Three semistructured interviews were conducted with seven participants over the course of 18 months. Transcripts were analysed using interpretative phenomenological analysis. Analysis identified four themes: preparing for treatment, the treatment process, patient-provider communication, and results of treatment. Patient experiences highlighted the need to move away from the reliance on letters for information provision, and the need for clearer guidelines about when to cease AMD treatment. Interviews highlighted the need for the inclusion of rigorous qualitative evidence with experiential data in future good clinical practice guideline development for AMD. © The Author(s) 2013.

Use of farmer-prioritized vertisol management options for enhanced green gram and tomato production in central Kenya

Green grams (Phaseolus aures L.) and tomato (Solanum lycopersicum L) are widely grown in the vertisols of the Mwea Irrigation Scheme alongside the rice fields. Green grams can fix nitrogen (biological nitrogen fixation) and are grown for its highly nutritious and curative seeds while tomatoes are grown for its fruit rich in fibres, minerals and vitamins. The two can be prepared separately or together in a variety of ways including raw salads and/or cooked/fried. They together form significant delicacies consumed with rice which is the major cash crop grown in the black cotton soils. The crops can grow well in warm conditions but tomato is fairly adaptable except under excessive humidity and temperatures that reduce yields. Socio-economic prioritization by the farming community and on-farm demonstrations of soil management options were instituted to demonstrate enhanced green gram and tomato production in vertisol soils of lower parts of Kirinyaga County (Mwea East and Mwea West districts). Drainage management was recognized by the farming community as the best option although a reduced number of farmers used drainage and furrows/ridges, manure, fertilizer and shifting options with reducing order of importance. Unavailability of labour and/or financial cost for instituting these management options were indicated as major hindrances to adopt the yield enhancing options. Labour force was contributed to mainly by the family alongside hiring (64.2%) although 28% and 5.2% respectively used hired or family labour alone. The female role in farming activities dominated while the male role was minimal especially at weeding. The youth role remained excessively insignificant and altogether absent at marketing. Despite the need for labour at earlier activities (especially when management options needed to be instituted) it was at the marketing stage that this force was directed. Soils were considered infertile by 60% but 40% indicated that their farms had adequate fertility. Analysis showed that ridging and application of farm yard manure and fertilizer improved fertility, crop growth and income considerably. Phosphate and zinc enhancement reduced alkalinity and sodicity. Green gram and tomato yields increased under ridges and farm yard manure application by 17-25% which significantly enhanced household income.

Passivity Framework for Modeling, Composing and Mitigating Cyber Attacks

Thesis (Ph.D.)--University of Washington, 2016-08

Higher Education - Border or Boundary? Can Theatre in Education Help Promote a University Education?

With the expansion and increased availability of Higher Education the progression to study for an undergraduate degree has been viewed as a simple stepping stone with examination success a straight - forward border pass. Changes in the funding of degree courses has established a series of more challenging boundaries to entry which demand a rigorous assessment of the benefits of Higher Education. The Widening Participation Unit at The University of Worcester has sought to ease this border crossing for pupils whose parents have not been to university. Their experience from previous projects was that school pupils more easily relate to undergraduate students whose experience of Higher Education is recent and relevant. With this in mind they commissioned the Drama and Performance Department to create a Theatre in Education programme that introduced an awareness of post sixteen options and future choices to challenge Higher Education stereotypes. As a result of this collaboration Why Bother? was created, directed by myself and devised and researched with four students who were studying drama. Their own experiences were used to inform the character development and dealt with worrying as a mature student about integration into full – time education, loss of income after working, the pressures of emotional commitments to partners and being away from home. The programme toured to two thousand year 9 – 11 pupils in Worcestershire and Herefordshire schools in January and May 2011. Devising and touring Why Bother provided students with an opportunity to work as a professional paid TIE team that it is not possible for them to do as part of their undergraduate degree course. My initial research looks at the effectiveness and limitations of this project based on pupil questionnaires and the experiences of the team which are explored within the broader context of TIE and its potential for affecting attitudinal change. This has given rise to a number of questions that need consideration in the development of a new TIE programme aimed at raising the awareness of sixth form students who are about to make the decision whether to apply to university or not. Collaboration with university students in exploring the value of an education that they have subscribed to raises issues of bias and whether their powers of persuasion actually prevent pupils from making their own individual decision. The ethics of promoting a “free” university education seem much less complex than the decision required now which involves balancing the real value against the high financial cost suggested in the working title of Is it Worth it? This paper will present my first attempts to develop research methods and methodologies that will enable me to evaluate the success of this and future TIE.