Utility of signs and symptoms of chronic cough in predicting specific cause in children

Background: Paediatricians rely on cough descriptors to direct them to the level of investigations needed for a child presenting with chronic cough, yet there is a lack of published data to support this approach. A study was undertaken to evaluate ( 1) whether historical cough pointers can predict which children have a specific cause for their cough and ( 2) the usefulness of chest radiography and spirometry as standard investigations in children with chronic cough. Methods: This was a prospective cohort study of children referred to a tertiary hospital with a cough lasting 3 weeks between June 2002 and July 2004. All included children completed a detailed history and examination using a standardised data collection sheet and followed a pathway of investigation until a diagnosis was made. Results: In 100 consecutively recruited children of median age 2.8 years, the best predictor of specific cough observed was a moist cough at the time of consultation with an odds ratio ( OR) of 9.34 (95% CI 3.49 to 25.03). Chest examination or chest radiographic abnormalities were also predictive with OR 3.60 ( 95% CI 1.31 to 9.90) and 3.16 (95% CI 1.32 to 7.62), respectively. The most significant historical pointer for predicting a specific cause of the cough was a parental history of moist cough ( sensitivity 96%, specificity 26%, positive predictive value 74%). Conclusions: The most useful clinical marker in predicting specific cough is the presence of a daily moist cough. Both chest examination and chest radiographic abnormalities are also useful in predicting whether children have a specific cause of their cough.

The Strategic Utility of ‘Chineseness’ in the Political Cultures of Diasporic Chinese Communities: Some Preliminary Thoughts

It is not especially controversial to suggest that the academic literature on Chineseness has for some time been focused upon the ‘porousness’ and ‘strategic’ possibilities of identity categories. This is most clearly observable in the legacy of cultural theory upon identity politics. In particular, terms such as hybridity have not only expanded the political potential for fragmenting conventional identifications, but also symbolised the sorts of ‘complicated entanglements’ within which individuals and communities are perpetually caught. The discursive mileage of hybridity has meant, over time, that it has also attracted criticism. Some of this criticism comes from academics engaged in more materialist forms of research. These sorts of contrary perspectives have often sought to ground hybrid identifications within the cultural and historical milieu from which they are enacted, whenever they are enacted.

The utility of aminoterminal pro-B-type natriuretic peptide for the detection of preclinical systolic and diastolic dysfunction in the community

Background: There is scant data regarding methods to identify subjects in the community with preclinical left ventricular (LV) systolic and diastolic dysfunction. Methods: A population-based sample of 1229 older adults underwent examination with transthoracic echocardiography and measurement of circulating aminoterminal pro-Btype natriuretic peptide (N-BNP) levels. Heart failure status was ascertained according to past history and clinical examination. The ability of N-BNP to detect preclinical LV ejection fraction (EF)

AVALIAÇÃO DA ACEITAÇÃO DO PORTAL INOVAÇÃO: UM ESTUDO DE CASO

Esta pesquisa apresenta estudo de caso cujo objetivo foi analisar a aceitação do Portal Inovação, identificando os fatores preditivos da intenção comportamental de uso e do comportamento de uso direcionadores da adoção da tecnologia por seus usuários via extensão do Modelo Unificado de Aceitação de Tecnologia, denominado pela sigla UTAUT (Unified Theory of Acceptance and Use of Technololgy) de Venkatesh et al. (2003). O objeto da pesquisa o Portal Inovação foi desenvolvido pelo Ministério da Ciência, Tecnologia e Inovação (MCTI) em parceria com o Centro de Gestão e Estudos Estratégicos (CGEE), Associação Brasileira de Desenvolvimento Industrial (ABDI) e Instituto Stela, visando atender às demandas do Sistema Nacional de Ciência, Tecnologia e Inovação (SNCTI) do País. Para atingir os objetivos propostos, recorreu-se às abordagens qualitativa, que foi subsidiada pelo método estudo de caso (YIN, 2005) e quantitativa, apoiada pela metodologia UTAUT, aplicada a usuários do portal e que contemplou o resultado de 264 respondentes validados. Quanto ao material de análise, utilizou-se da pesquisa bibliográfica sobre governo eletrônico (e-Gov), Internet, Sistema Nacional de Inovação, modelos de aceitação de tecnologia, dados oficiais públicos e legislações atinentes ao setor de inovação tecnológica. A técnica de análise empregada quantitativamente consistiu no uso de modelagem por equações estruturais, com base no algoritmo PLS (Partial Least Square) com bootstrap de 1.000 reamostragens. Os principais resultados obtidos demonstraram alta magnitude e significância preditiva sobre a Intenção Comportamental de Uso do Portal pelos fatores: Expectativa de Desempenho e Influência Social. Além de evidenciarem que as condições facilitadoras impactam significativamente sobre o Comportamento de Uso dos usuários. A conclusão principal do presente estudo é a de que ao considerarmos a aceitação de um portal governamental em que a adoção é voluntária, o fator social é altamente influente na intenção de uso da tecnologia, bem como os aspectos relacionados à produtividade consequente do usuário e o senso de utilidade; além da facilidade de interação e domínio da ferramenta. Tais constatações ensejam em novas perspectivas de pesquisa e estudos no âmbito das ações de e-Gov, bem como no direcionamento adequado do planejamento, monitoramento e avaliação de projetos governamentais.

A aplicação do Gerenciamento de Riscos nas PMEs na cidade de São Bernardo do Campo

Este estudo analisa a utilização do gerenciamento de riscos em algumas Empresas de Pequeno e Médio Porte (PMEs) na cidade de São Bernardo do Campo. A análise do risco empresarial possui uma crescente importância e ela pode contribuir fortemente para a continuidade dos negócios. A capacidade para gerenciar os riscos do negócio em relação ás inevitáveis incertezas e com uma valorização futura dos resultados é um fator substancial de vantagem competitiva. Este processo de geração de valor providencia a disciplina e ferramentas de administração dos riscos empresariais permitindo a criação de valor para sua organização. As Metodologias de Análise de Risco, em sua maioria, são aplicadas para grandes corporações. Uma das motivações desse trabalho é verificar o grau de utilidade dessas metodologias para as empresas PMEs escolhidas para a pesquisa em São Bernardo do Campo. O estudo é desenvolvido por meio de pesquisas bibliográficas e pesquisa exploratória nas empresas escolhidas. Após as pesquisas, foi feita uma análise qualitativa utilizando o método de estudo de casos. Finalmente, conclui-se que as empresas pesquisadas de São Bernardo do Campo, podem obter vantagens significativas ao implantar metodologias de gerenciamento de risco. Todas as empresas pesquisadas possuem mais de dez anos e consideram importante controlar a continuidade de seus negócios.

Methods and trends of performance benchmarking in UK utility regulation

Regulation is subject to information asymmetries that can lead to allocative and productive inefficiencies. One solution, suggested by Shleifer in 1985 and now adopted by many regulatory bodies round the world, is 'benchmarking', which is sometimes called 'yardstick competition'. In this paper we consider Shleifer's original approach to benchmarking and contrast this with the actual use of benchmarking by UK regulatory bodies in telecommunications, water and the energy sector since the privatizations of the 1980s and early 1990s. We find that benchmarking plays only one part and sometimes a small part in the setting of regulatory price caps in the UK. We also find that in practice benchmarking has been subject to a number of difficulties, which mean that it is never likely to be more than one tool in the regulator's armoury. The UK's experience provides lessons for regulation internationally. © 2006 Elsevier Ltd. All rights reserved.

Control, accounting and value-for-money implications of utility regulation:a literature review

This paper reviews and evaluates the literature concerning the privatisation and regulation of the utility industries in the UK. The economic theories behind and political reasons for the programme are considered to give the reader an appreciation of the environment from which these organisations were born and the implications for their continued existence. Once this has been established the paper then considers the role that accounting has played and will continue to play in these industries. This includes consideration of the technical questions which these new organisations are asking and also the role that accounting has in the organisational structure and culture. It draws as a conclusion that these recently privatised industries provide a unique and rich source for further accounting research.