859 resultados para case outcomes


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There is sparse systematic examination of the potential for growth as well as distress that may occur for some adult survivors of childhood sexual abuse. The presented study explored posttraumatic growth and its relationship with negative posttrauma outcomes within the specific population of survivors of childhood sexual abuse (N = 40). Results showed that 95% of the participants experienced clinically significant post-traumatic stress disorder symptomatology related to their childhood sexual abuse. In conjunction with these high levels of negative symptoms, the population evidenced posttraumatic growth levels that were comparable to other trauma samples. This research has clinical relevance in terms of adding to the knowledge base on sexual abuse and the usefulness of this knowledge in therapeutic interventions and relationships.

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Predicted the outcomes of 40 men and 20 women who attended a controlled drinking program in a general hospital. Measures included a behavioral interview, the Alcohol Dependence Scale (ADS), the Severity of Alcohol Dependence Questionnaire (SADQ) described by T. Stockwell et al (1979), and a problem drinking self-efficacy scale (PDSES). Substantial reductions in drinking appeared after the program and appeared to be sustained over a 6-mo follow-up. Intake dropped from 11.3 drinks per day to 2.2 drinks during follow-up. Drinking history and alcohol dependence (as measured by the SADQ, but not the ADS) were significant predictors of alcohol consumption during follow-up. Predictive utility of the PDSES was confirmed. PDSES administered at the end of the program significantly predicted alcohol consumption over the next 6 mo.

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Worldwide, education systems have undergone unprecedented change due to a variety of economic, social, and political forces (Limerick, Cunnington & Crowther, 2002). The People’s Republic of China (PRC) is no exception. Continuous educational reform at primary and secondary levels in Mainland China has created new challenges and accountabilities for school principals. The important role of principals in primary and secondary schools has been acknowledged in both policy documents and the broader literature (Central Committee of the Chinese Communist Party, 1985; F. Chen, 2005; Chu, 2003; W. Huang, 2005; T. Wang, 2003). Yet, most of the literature on primary and secondary school principals in Mainland China is prescriptive in nature, identifying from the perspectives of researchers and academics what principals should do and how they should enact leadership. Lacking in this research is an awareness of the daily practices and lived experiences of principals. Furthermore, within the small body of writing on primary and secondary school principals in Mainland China, gender is seldom given any attention. To date, only a small number of empirical studies have focused on female principals as a specific category of research (Zen, 2004; Zhong, 2004). This study aimed to explore the professional lives of two female exemplary school principals in urban primary schools in Mainland China. A qualitative exploratory case study was used. Semi-structured interviews with each individual female principal, with six teachers in each of the school sites and with the superintendent of each principal were conducted. Field observations and document analysis were also undertaken to obtain multiple insights about their leadership practices. The conceptual framework was based largely on the theory of Gronn (1999) and incorporated five core leadership practices (vision building, ethical considerations, teaching and learning, power utilisation, and dealing with risks and challenges) taken from the wider literature. The key findings of this study were twofold. Firstly, while the five leadership practices were evident in the leadership of the two principals, this study identified some subtle differences in the way they approached each of them. Secondly, contextual factors such as Chinese traditional culture, the contemporary societal context, and the school organisational context, in addition to the biographical experiences of each principal were significant factors in shaping the way in which they exercised their leadership practices in the schools.

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Improving urban ecosystems and the quality of life of citizens have become a central issue in the global effort of creating sustainable built environments. As human beings our lives completely depend on the sustainability of the nature and we need to protect and manage natural resources in a more sustainable way in order to sustain our existence. As a result of population growth and rapid urbanisation, increasing demand of productivity depletes and degrades natural resources. However, the increasing activities and rapid development require more resources, and therefore, ecological planning becomes an essential vehicle in preserving scarce natural resources. This paper aims to indentify the interation between urban ecosystems and human activities in the context of urban sustainability and explores the degrading environmental impacts of this interaction and the necessity and benefits of using sustainability indicators as a tool in sustainable urban evnironmental management. Additionally, the paper also introduces an environmental sustainability indexing model (ASSURE) as an innovative approach to evaluate the environmental conditions of built environment.

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During the last decade many cities have sought to promote creativity as a driver for economic growth. They have done this by encouraging specific sectors of creative industries. This paper focuses on the film industry as one of these sectors which also has a high level of interaction with place. Film industry, has had an important role in incubating the creativity potential. It can be a powerful magnet for creative people, fostering indigenous creativity and attracting outside talent, and might thus contribute to the formation of creative cities. This recent research suggests that the film industry has positively effect on tourism by increasing place recognition through the locations used in films and for cities that host film festivals. Film festivals provide events, workshops and experiences that allow visitors to express themselves through interaction with the place and its living culture. This paper examines the importance of creative industries for both urban development and sustainable tourism. To explore the relation between creative tourism, culture and the film industry and its effect on successful tourism planning this paper presents the preliminary findings of case studies of the film industry in Beyo

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This paper examines a sequence of asynchronous interaction on the photosharing website, Flickr. In responding to a call for a focus on the performative aspects of online annotation (Wolff & Neuwirth, 2001), we outline and apply an interaction order approach to identify temporal and cultural aspects of the setting that provide for commonality and sharing. In particular, we study the interaction as a feature of a synthetic situation (Knorr Cetina, 2009) focusing on the requirements of maintaining a sense of an ongoing discussion online. Our analysis suggests that the rhetorical system of the Flickr environment, its appropriation by participants as a context for bounded activities, and displays of commonality, affiliation, and shared access provide for a common sense of participation in a time envelope. This, in turn, is argued to be central to new processes of consociation (Schutz, 1967; Zhao, 2004) occurring in the life world of Web 2.0 environments.

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A collection of 60 case studies of the use of Creative Commons licensing in different sectors, including: music, social activism, film, visual arts, collecting, government, publishing and education.

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Background Patella resurfacing in total knee arthroplasty is a contentious issue. The literature suggests that resurfacing of the patella is based on surgeon preference, and little is known about the role and timing of resurfacing and how this affects outcomes. Methods We analyzed 134,799 total knee arthroplasties using data from the Australian Orthopaedic Association National Joint Replacement Registry. Hazards ratios (HRs) were used to compare rates of early revision between patella resurfacing at the primary procedure (the resurfacing group, R) and primary arthroplasty without resurfacing (no-resurfacing group, NR). We also analyzed the outcomes of NR that were revised for isolated patella addition. Results At 5 years, the R group showed a lower revision rate than the NR group: cumulative per cent revision (CPR) 3.1% and 4.0%, respectively (HR = 0.75, p < 0.001). Revisions for patellofemoral pain were more common in the NR group (17%) than in the R group (1%), and “patella only” revisions were more common in the NR group (29%) than in the R group (6%). Non-resurfaced knees revised for isolated patella addition had a higher revision rate than patella resurfacing at the primary procedure, with a 4-year CPR of 15% and 2.8%, respectively (HR = 4.1, p < 0.001). Interpretation Rates of early revision of primary total knees were higher when the patella was not resurfaced, and suggest that surgeons may be inclined to resurface later if there is patellofemoral pain. However, 15% of non-resurfaced knees revised for patella addition are re-revised by 4 years. Our results suggest an early beneficial outcome for patella resurfacing at primary arthroplasty based on revision rates up to 5 years.

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Place branding has become a major focus of operations for destination marketing organizations (DMOs) striving for differentiation in cluttered markets. The topic of destination branding has only received attention in the tourism literature since the late 1990s, and there has been relatively little research reported in relations to analyzing destination brand effectiveness over time. This article reports an attempt to oprationalize the concept of consumer-based brand equity (CBBE) for an emerging destination over two points in time. The purpose of the project was to track the effectiveness of the brand in 2007 against benchmarks that were established in a 2003 student at the commencement of a new destination brand campaign. The key finding was there was no change in perceived performance for the destination across the brand's performance indicators and CBBE dimensions. Because of the common challenges faced by DMOs worldwide, it is suggested the CBBE hierarchy provides destination marketers with a practical tool for evaluation brand performance over time.

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This thesis proposes that contemporary printmaking, at its most significant, marks the present through reconstructing pasts and anticipating futures. It argues this through examples in the field, occurring in contexts beyond the Euramerican (Europe and North America). The arguments revolve around how the practice of a number of significant artists in Japan, Australia and Thailand has generated conceptual and formal innovations in printmaking that transcend local histories and conventions, whilst paradoxically, also building upon them and creating new meanings. The arguments do not portray the relations between contemporary and traditional art as necessarily antagonistic but rather, as productively dialectical. Furthermore, the case studies demonstrate that, in the 1980s and 1990s particularly, the studio practice of these printmakers was informed by other visual arts disciplines and reflected postmodern concerns. Departures from convention witnessed in these countries within the Asia-Pacific region shifted the field of the print into a heterogeneous and hybrid realm. The practitioners concerned (especially in Thailand) produced work that was more readily equated with performance and installation art than with printmaking per se. In Japan, the incursion of photography interrupted the decorative cast of printmaking and delivered it from a straightforward, craft-based aesthetic. In Australia, fixed notions of national identity were challenged by print practitioners through deliberate cultural rapprochements and technical contradictions (speaking across old and new languages).However time-honoured print methods were not jettisoned by any case study artists. Their re-alignment of the fundamental attributes of printmaking, in line with materialist formalism, is a core consideration of my arguments. The artists selected for in-depth analysis from these three countries are all innovators whose geographical circumstances and creative praxis drew on local traditions whilst absorbing international trends. In their radical revisionism, they acknowledged the specificity of history and place, conditions of contingency and forces of globalisation. The transformational nature of their work during the late twentieth century connects it to the postmodern ethos and to a broader artistic and cultural nexus than has hitherto been recognised in literature on the print. Emerging from former guild-based practices, they ambitiously conceived their work to be part of a continually evolving visual arts vocabulary. I argue in this thesis that artists from the Asia-Pacific region have historically broken with the hermetic and Euramerican focus that has generally characterised the field. Inadequate documentation and access to print activity outside the dominant centres of critical discourse imply that readings of postmodernism have been too limited in their scope of inquiry. Other locations offer complexities of artistic practice where re-alignments of customary boundaries are often the norm. By addressing innovative activity in Japan, Australia and Thailand, this thesis exposes the need for a more inclusive theoretical framework and wider global reach than currently exists for ‘printmaking’.

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Abstract: Purpose – Several major infrastructure projects in the Hong Kong Special Administrative Region (HKSAR) have been delivered by the build-operate-transfer (BOT) model since the 1960s. Although the benefits of using BOT have been reported abundantly in the contemporary literature, some BOT projects were less successful than the others. This paper aims to find out why this is so and to explore whether BOT is the best financing model to procure major infrastructure projects. Design/methodology/approach – The benefits of BOT will first be reviewed. Some completed BOT projects in Hong Kong will be examined to ascertain how far the perceived benefits of BOT have been materialized in these projects. A highly profiled project, the Hong Kong-Zhuhai-Macau Bridge, which has long been promoted by the governments of the People's Republic of China, Macau Special Administrative Region and the HKSAR that BOT is the preferred financing model, but suddenly reverted back to the traditional financing model to be funded primarily by the three governments with public money instead, will be studied to explore the true value of the BOT financial model. Findings – Six main reasons for this radical change are derived from the analysis: shorter take-off time for the project; difference in legal systems causing difficulties in drafting BOT agreements; more government control on tolls; private sector uninterested due to unattractive economic package; avoid allegation of collusion between business and the governments; and a comfortable financial reserve possessed by the host governments. Originality/value – The findings from this paper are believed to provide a better understanding to the real benefits of BOT and the governments' main decision criteria in delivering major infrastructure projects.

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For over a decade, IT expenditure in China and Malaysia has shown a significant increase, as organisations in these countries are increasingly dependent on information systems (IS) for achieving strategic advantages and business benefits. However, there have been numerous reports of dissatisfaction with IS, and in some cases the effectiveness of the information systems have yet to be reviewed. Two exploratory case studies reported in this paper are the first phase of an overall research in validating the IS-Impact model introduced by Gable, Sedera and Chan in two countries: China and Malaysia. This validation research aims to produce a standard measuring model across different contexts. The purpose of this paper is to present preliminary findings from two exploratory case studies, attempt to test the feasibility of the research design and to investigate applicability of the IS-Impact model in Chinese and Malaysian organisations. Twenty-nine respondents from a Chinese private company and seventeen respondents from a state government in Malaysia were involved in these studies. Findings indicated that most of existing IS-Impact measures are applicable in the study contexts, however, there are some new measures informed by the respondents. Feedback from the case studies also suggested necessary modifications to the Mandarin instrument.

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In this paper, the train scheduling problem is modelled as a blocking parallel-machine job shop scheduling (BPMJSS) problem. In the model, trains, single-track sections and multiple-track sections, respectively, are synonymous with jobs, single machines and parallel machines, and an operation is regarded as the movement/traversal of a train across a section. Due to the lack of buffer space, the real-life case should consider blocking or hold-while-wait constraints, which means that a track section cannot release and must hold the train until next section on the routing becomes available. Based on literature review and our analysis, it is very hard to find a feasible complete schedule directly for BPMJSS problems. Firstly, a parallel-machine job-shop-scheduling (PMJSS) problem is solved by an improved shifting bottleneck procedure (SBP) algorithm without considering blocking conditions. Inspired by the proposed SBP algorithm, feasibility satisfaction procedure (FSP) algorithm is developed to solve and analyse the BPMJSS problem, by an alternative graph model that is an extension of the classical disjunctive graph models. The proposed algorithms have been implemented and validated using real-world data from Queensland Rail. Sensitivity analysis has been applied by considering train length, upgrading track sections, increasing train speed and changing bottleneck sections. The outcomes show that the proposed methodology would be a very useful tool for the real-life train scheduling problems

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Background In many clinical areas, integrated care pathways are utilised as structured multidisciplinary care plans which detail essential steps in caring for patients with specific clinical problems. Particularly, care pathways for the dying have been developed as a model to improve the end-of-life care of all patients. They aim to ensure that the most appropriate management occurs at the most appropriate time and that it is provided by the most appropriate health professional. Clinical pathways for end-of-life care management are used widely around the world and have been regarded as the gold standard. Therefore, there is a significant need for clinicians to be informed about the utilisation of end-of-life care pathways with a systematic review. Objectives To assess the effects of end-of-life care pathways, compared with usual care (no pathway) or with care guided by another end-of-life care pathway across all healthcare settings (e.g. hospitals, residential aged care facilities, community). Search strategy The Cochrane Register of controlled Trials (CENTRAL), the Pain, Palliative and Supportive Care Review group specialised register,MEDLINE, EMBASE, review articles and reference lists of relevant articles were searched. The search was carried out in September 2009. Selection criteria All randomised controlled trials (RCTs), quasi-randomised trial or high quality controlled before and after studies comparing use versus non-use of an end-of-life care pathway in caring for the dying. Data collection and analysis Results of searches were reviewed against the pre-determined criteria for inclusion by two review authors. Main results The search identified 920 potentially relevant titles, but no studies met criteria for inclusion in the review. Authors’ conclusions Without further available evidence, recommendations for the use of end-of-life pathways in caring for the dying cannot be made. RCTs or other well designed controlled studies are needed for evaluating the use of end-of-life care pathways in caring for dying people.

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Maternal obesity is an important aspect of reproductive care. It is the commonest risk factor for maternal mortality in developed countries and is also associated with a wide spectrum of adverse pregnancy outcomes. Maternal obesity may have longer-term implications for the health of the mother and infant, which in turn will have economic implications. Efforts to prevent, manage and treat obesity in pregnancy will be costly, but may pay dividends from reduced future economic costs, and subsequent improvements to maternal and infant health. Decision-makers working in this area of health services should understand whether the problem can be reduced, at what cost; and then, what cost savings and health benefits will accrue in the future from a reduction of the problem.