Breast cancer teams:the impact of constitution, new cancer workload and methods of operation on their effectiveness

National guidance and clinical guidelines recommended multidisciplinary teams (MDTs) for cancer services in order to bring specialists in relevant disciplines together, ensure clinical decisions are fully informed, and to coordinate care effectively. However, the effectiveness of cancer teams was not previously evaluated systematically. A random sample of 72 breast cancer teams in England was studied (548 members in six core disciplines), stratified by region and caseload. Information about team constitution, processes, effectiveness, clinical performance, and members' mental well-being was gathered using appropriate instruments. Two input variables, team workload (P=0.009) and the proportion of breast care nurses (P=0.003), positively predicted overall clinical performance in multivariate analysis using a two-stage regression model. There were significant correlations between individual team inputs, team composition variables, and clinical performance. Some disciplines consistently perceived their team's effectiveness differently from the mean. Teams with shared leadership of their clinical decision-making were most effective. The mental well-being of team members appeared significantly better than in previous studies of cancer clinicians, the NHS, and the general population. This study established that team composition, working methods, and workloads are related to measures of effectiveness, including the quality of clinical care. © 2003 Cancer Research UK.

Informal caregiving and mental ill health – differential relationships by workload, gender, age and area-remoteness in a UK region

Informal caregiving can be a demanding role which has been shown to impact on physical, psychological and social wellbeing. Methodological weaknesses including small sample sizes and subjective measures of mental health have led to inconclusive evidence about the relationship between informal caregiving and mental health. This paper reports on a study carried out in a UK region which investigated the relationship between informal caregiving and mental ill health. The analysis was conducted by linking three datasets, the Northern Ireland Longitudinal Study, the Northern Ireland Enhanced Prescribing Database and the Proximity to Service Index from the Northern Ireland Statistics and Research Agency. Our analysis used both a subjective measure of mental ill health, i.e. a question asked in the 2011 Census, and an objective measure, whether the respondents had been prescribed antidepressants by a General Practitioner between 2010 and 2012. We applied binary logistic multilevel modelling to these two responses to test whether, and for what sub-groups of the population, informal caregiving was related to mental ill health. The results showed that informal caregiving per se was not related to mental ill health although there was a strong relationship between the intensity of the caregiving role and mental ill health. Females under 50, who provided over 19 hours of care, were not employed or worked part-time and who provided care in both 2001 and 2011 were at a statistically significantly elevated risk of mental ill health. Caregivers in remote areas with limited access to shops and services were also at a significantly increased risk as evidenced by prescription rates for antidepressants. With community care policies aimed at supporting people to remain at home, the paper highlights the need for further research in order to target resources appropriately.

Dynamic Workload Parallelization and System Calibration on Single-Chip Cloud Computer

Many-core systems are emerging from the need of more computational power and power efficiency. However there are many issues which still revolve around the many-core systems. These systems need specialized software before they can be fully utilized and the hardware itself may differ from the conventional computational systems. To gain efficiency from many-core system, programs need to be parallelized. In many-core systems the cores are small and less powerful than cores used in traditional computing, so running a conventional program is not an efficient option. Also in Network-on-Chip based processors the network might get congested and the cores might work at different speeds. In this thesis is, a dynamic load balancing method is proposed and tested on Intel 48-core Single-Chip Cloud Computer by parallelizing a fault simulator. The maximum speedup is difficult to obtain due to severe bottlenecks in the system. In order to exploit all the available parallelism of the Single-Chip Cloud Computer, a runtime approach capable of dynamically balancing the load during the fault simulation process is used. The proposed dynamic fault simulation approach on the Single-Chip Cloud Computer shows up to 45X speedup compared to a serial fault simulation approach. Many-core systems can draw enormous amounts of power, and if this power is not controlled properly, the system might get damaged. One way to manage power is to set power budget for the system. But if this power is drawn by just few cores of the many, these few cores get extremely hot and might get damaged. Due to increase in power density multiple thermal sensors are deployed on the chip area to provide realtime temperature feedback for thermal management techniques. Thermal sensor accuracy is extremely prone to intra-die process variation and aging phenomena. These factors lead to a situation where thermal sensor values drift from the nominal values. This necessitates efficient calibration techniques to be applied before the sensor values are used. In addition, in modern many-core systems cores have support for dynamic voltage and frequency scaling. Thermal sensors located on cores are sensitive to the core's current voltage level, meaning that dedicated calibration is needed for each voltage level. In this thesis a general-purpose software-based auto-calibration approach is also proposed for thermal sensors to calibrate thermal sensors on different range of voltages.

Aging and semantic integration in sentence processing: Testing the cognitive workload of wrap-up

The current study investigated the cognitive workload of sentence and clause wrap-up in younger and older readers. A large number of studies have demonstrated the presence of wrap-up effects, peaks in processing time at clause and sentence boundaries that some argue reflect attention to organizational and integrative semantic processes. However, the exact nature of these wrap-up effects is still not entirely clear, with some arguing that wrap-up is not related to processing difficulty, but rather is triggered by a low-level oculomotor response or the implicit monitoring of intonational contour. The notion that wrap-up effects are resource-demanding was directly tested by examining the degree to which sentence and clause wrap-up affects the parafoveal preview benefit. Older and younger adults read passages in which a target word N occurred in a sentence-internal, clause-final, or sentence-final position. A gaze-contingent boundary change paradigm was used in which, on some trials, a non-word preview of word N+1 was replaced by a target word once the eyes crossed an invisible boundary located between words N and N+1. All measures of reading time on word N were longer at clause and sentence boundaries than in the sentence-internal position. In the earliest measures of reading time, sentence and clause wrap-up showed evidence of reducing the magnitude of the preview benefit similarly for younger and older adults. However, this effect was moderated by age in gaze duration, such that older adults showed a complete reduction in the preview benefit in the sentence-final condition. Additionally, sentence and clause wrap-up were negatively associated with the preview benefit. Collectively, the findings from the current study suggest that wrap-up is cognitively demanding and may be less efficient with age, thus, resulting in a reduction of the parafoveal preview during normal reading.

Too Busy to Be Fair? The Effect of Managers’ Perceived Workload on Their Core Technical Performance and Justice Rule Adherence

Despite the organizational benefits of treating employees fairly, both anecdotal and empirical evidence suggest that managers do not behave fairly towards their employees in a consistent manner. As treating employees fairly takes up personal resources such as time, effort, and attention, I argue that when managers face high workloads (i.e., high amounts of work and time pressure), they are unable to devote such personal resources to effectively meet both core technical task requirements and treat employees fairly. I propose that in general, managers tend to view their core technical task performance as more important than being fair in their dealings with employees; as a result, when faced with high workloads, they tend to prioritize the former at the expense of the latter. I also propose that managerial fairness will suffer more as a result of heightened workloads than will core technical task performance, unless managers perceive their organization to explicitly reward fair treatment of employees. I find support for my hypotheses across three studies: two experimental studies (with online participants and students respectively) and one field study of managers from a variety of organizations. I discuss the implications of studying fairness in the wider context of managers’ complex role in organizations to the fairness and managerial work demands literatures.

How to Efficiently Control the Title and Registration Mail-in Workload Backlog Processing

The Titles and Registration Mail-In Unit of the Department of Motor Vehicles only processes title and registration work that has been mailed in. During the time periods of May through June and November through January, the mail workload backlog becomes overbearing. This research will attempt to find out the cause of this increase backlog during those periods, determine what procedures or steps are currently in place and unnecessarily creating needless work that has a direct correlation with the backlog and deploy a recommendation that will totally eliminate peak time backlog work loads.

Cariology In Curriculum Of Brazilian Dental Schools.

Reasons for the iniquities of caries, globally recognized, may be related to how Cariology has been taught in dental schools. In Brazil, the most important universities, when considering healthcare teaching, are the public ones. The objective of this study was to identify the insertion of the contents of Cariology in the course flowcharts of public dental schools in the country. The survey was conducted in 2013 seeking to identify the realities of different geographical regions, aimed to the census of public dental schools. It was performed a documentary analysis of the menus of disciplines, identifying the following issues: number of dental schools that include content related to Cariology in their curricula; average total workload undergraduate courses and disciplines that contemplate the theme; distribution of disciplines in professional training cycles (basic, clinical and public health); existence of discipline and/or a specific department; verification of bibliographic indication directly related to Cariology. The response rate was 93.6%. All dental schools recommended specific books, and none of them had a Department of Cariology. All dental schools in the country contemplated content related to Cariology in their disciplines, distributed in specific disciplines (except for the Northern region) and disciplines in the three cycles of learning (basic, clinical and public health), with larger workload in the clinical cycle. Although public dental schools in Brazil demonstrated commitment to contemplating the content related to Cariology in their disciplines, the emphasis on the clinical cycle may not be promoting the integrated formation of students, which could be contributing to reflect the inequalities of the disease in the country.

Application Of A Semi-empirical Model For The Evaluation Of Transmission Properties Of Barite Mortar.

The aim of this study was to estimate barite mortar attenuation curves using X-ray spectra weighted by a workload distribution. A semi-empirical model was used for the evaluation of transmission properties of this material. Since ambient dose equivalent, H(⁎)(10), is the radiation quantity adopted by IAEA for dose assessment, the variation of the H(⁎)(10) as a function of barite mortar thickness was calculated using primary experimental spectra. A CdTe detector was used for the measurement of these spectra. The resulting spectra were adopted for estimating the optimized thickness of protective barrier needed for shielding an area in an X-ray imaging facility.

Creatina quinase e dor muscular tardia na musculação : estudo experimental em adultos e jovens com o "circuit weight training" e o "multiple set system"

Universidade Estadual de Campinas . Faculdade de Educação Física

Controle autonomico da frequencia cardiaca de adolescentes em treinamento

Universidade Estadual de Campinas . Faculdade de Educação Física

Projeto multicentrico em fisiologia do exercicio : etapa de calibração de cicloergometros

Universidade Estadual de Campinas . Faculdade de Educação Física

Variabilidade da frequencia cardiaca : estudo das influencias autonomicas sobre suas caracteristicas temporal e espectral em halterofilistas e sedentarios

Universidade Estadual de Campinas. Faculdade de Educação Física

Respostas cardiorrespiratorias ao exercicio fisico dinamico e função autonomica em primigestas

Universidade Estadual de Campinas . Faculdade de Educação Física

Estudo dos ajustes cardiorrespiratorios ao exercicio fisico dinamico em adolescentes

Universidade Estadual de Campinas . Faculdade de Educação Física

Fatores associados à capacidade para o trabalho de trabalhadores do Setor Elétrico

O Setor Elétrico passou por recente processo de reestruturação produtiva com reflexos nas condições e organização do trabalho, podendo comprometer a capacidade para o trabalho. Este estudo objetivou avaliar fatores associados à capacidade para o trabalho junto a 475 trabalhadores de uma empresa do Setor Elétrico no Estado de São Paulo, Brasil. Neste estudo transversal foi realizada análise descritiva e análise de regressão linear múltipla. A média do Índice de Capacidade para o Trabalho (ICT) foi de 41,8 pontos (escala de 7,0 a 49,0 pontos). A análise múltipla mostrou que os fatores que melhor explicaram a variabilidade do ICT foram estresse no trabalho (p < 0,001) e saúde física (p < 0,001 em todas as dimensões). Em outra análise, excluídas as dimensões da saúde, as variáveis associadas ao ICT foram estresse no trabalho (p < 0,001), local de trabalho (p = 0,022), prática de atividade física (p = 0,001), consumo de álcool (p = 0,012) e índice de massa corporal (p < 0,001). Os resultados identificaram aspectos a serem considerados no desenvolvimento de medidas visando a preservação da capacidade para o trabalho, com ênfase no controle do estresse no trabalho e na promoção da saúde.