The good, the bad and the ugly of bone-anchored prostheses: Guideline to assess true clinical outcomes

The aim of this study is to share the key elements of an evaluation framework to determine the true clinical outcomes of bone-anchored prostheses. Scientists, clinicians and policy makers are encouraged to implement their own evaluations relying on the proposed framework using a single database to facilitate reflective practice and, eventually, robust prospective studies.

How can a Bourdieusian perspective aid the analysis of MBA education?

There is a lack of integrative conceptual models that would help to better understand the underlying reasons for the alleged problems of MBA education. To address this challenge, we draw on the work of Pierre Bourdieu to examine MBA education as an activity with its own ‘economy of exchange’ and ‘rules of the game.’ We argue that application of Bourdieu’s theoretical ideas elucidates three key issues in debate around MBA education: the outcomes of MBA programs, the inculcation of potentially problematic values and practices through the programs, and the potential of self-regulation such as accreditation and ranking for impeding development of MBA education. First, Bourdieu’s notions of capital – intellectual, social and symbolic – shed light on the ‘economy of exchange’ in MBA education. Critics of MBA programs have pointed out that the value of MBA degrees lies not only in ‘learning.’ Bourdieu’s framework allows further analysis of this issue by distinguishing between intellectual (learning), social (social networks), and symbolic capital (credentials and prestige). Second, the concept of ‘habitus’ suggests how values and practices are inculcated through MBA education. This process is often a ‘voluntary’ one where problematic or ethically questionable ideas may be regarded as natural. Third, Bourdieu’s reflections on the ‘doxa’ and its reproduction and legitimation illuminate the role of accreditation and ranking in MBA education. An analysis of such self-regulation explains in part how the system may turn out impeding change.

Examining effectiveness of an immigrant labor market integration intervention. The role of acculturation, discrimination, self-efficacy, outcome expectances, action and coping planning.

The designing of effective intervention tools to improve immigrants’ labor market integration remains an important topic in contemporary Western societies. This study examines whether and how a new intervention tool, Working Life Certificate (WLC), helps unemployed immigrants to find employment and strengthen their belief of their vocational skills. The study is based on quantitative longitudinal survey data from 174 unemployed immigrants of various origins who participated in the pilot phase of WLC examinations in 2009. Surveys were administered in three waves: before the test, right after it, and three months later. Although it is often argued that the unemployment among immigrants is due either to their lack of skills and cultural differences or to discrimination in recruitment, scholars within social psychology of behavior change argue that the best way of helping people to achieve their goals (e.g. finding employment) is to build up their sense of self-efficacy, alter their outcome expectances in a more positive direction or to help them to construct more detailed action and coping plans. This study aims to shed light on the role of these concepts in immigrants’ labor market integration. The results support the theories of behavior change moderately. Having positive expectances regarding the outcomes of various job search behaviors was found to predict employment in the future. Together with action and coping planning it also predicted increase in job search behavior. The intervention, WLC, was able to affect participants’ self-efficacy, but contrary to expectations, self-efficacy was found not to be related to either job search behavior or future labor market status. Also, perceived discrimination did not explain problems in finding employment, but hints of subtle or structural discrimination were found. Adoption of Finnish work culture together with strong family culture was found to predict future employment. Hence, in this thesis I argue that awarding people diplomas should be preferred in immigrant integration training as it strengthens people’s sense of self-efficacy. Instead of teaching new information, more attention should be directed at changing people’s outcome expectances in a more positive direction and helping them to construct detailed plans on how to achieve their goals.

A macroeconomic analysis of adaptation to climate change impacts on forests in India

We examine the potential for adaptation to climate change in Indian forests, and derive the macroeconomic implications of forest impacts and adaptation in India. The study is conducted by integrating results from the dynamic global vegetation model IBIS and the computable general equilibrium model GRACE-IN, which estimates macroeconomic implications for six zones of India. By comparing a reference scenario without climate change with a climate impact scenario based on the IPCC A2-scenario, we find major variations in the pattern of change across zones. Biomass stock increases in all zones but the Central zone. The increase in biomass growth is smaller, and declines in one more zone, South zone, despite higher stock. In the four zones with increases in biomass growth, harvest increases by only approximately 1/3 of the change in biomass growth. This is due to two market effects of increased biomass growth. One is that an increase in biomass growth encourages more harvest given other things being equal. The other is that more harvest leads to higher supply of timber, which lowers market prices. As a result, also the rent on forested land decreases. The lower prices and rent discourage more harvest even though they may induce higher demand, which increases the pressure on harvest. In a less perfect world than the model describes these two effects may contribute to an increase in the risk of deforestation because of higher biomass growth. Furthermore, higher harvest demands more labor and capital input in the forestry sector. Given total supply of labor and capital, this increases the cost of production in all the other sectors, although very little indeed. Forestry dependent communities with declining biomass growth may, however, experience local unemployment as a result.

Localisation of discrete change in a transformer winding: a network-function-loci approach

An entirely different approach for localisation of winding deformation based on terminal measurements is presented. Within the context of this study, winding deformation means, a discrete and specific change externally imposed at a particular position on the winding. The proposed method is based on pre-computing and plotting the complex network-function loci e.g. driving-point impedance (DPI)] at a selected frequency, for a meaningful range of values for each element (increasing and decreasing) of the ladder network which represents the winding. This loci diagram is called the nomogram. After introducing a discrete change, amplitude and phase of DPI are measured. By plotting this single measurement on the nomogram, it is possible to estimate the location and identify the extent of change. In contrast to the existing approach, the proposed method is fast, non-iterative and yields reasonably good localisation. Experimental results for actual transformer windings (interleaved and continuous disc) are presented.

Return levels of hydrologic droughts under climate change

Developments in the statistical extreme value theory, which allow non-stationary modeling of changes in the frequency and severity of extremes, are explored to analyze changes in return levels of droughts for the Colorado River. The transient future return levels (conditional quantiles) derived from regional drought projections using appropriate extreme value models, are compared with those from observed naturalized streamflows. The time of detection is computed as the time at which significant differences exist between the observed and future extreme drought levels, accounting for the uncertainties in their estimates. Projections from multiple climate model-scenario combinations are considered; no uniform pattern of changes in drought quantiles is observed across all the projections. While some projections indicate shifting to another stationary regime, for many projections which are found to be non-stationary, detection of change in tail quantiles of droughts occurs within the 21st century with no unanimity in the time of detection. Earlier detection is observed in droughts levels of higher probability of exceedance. (C) 2014 Elsevier Ltd. All rights reserved.

Caribbean connectivity: implications for Marine Protected Area Management. Proceedings of a Special Symposium, 9-11 November 2006, 59th Annual Meeting of the Gulf and Caribbean Fisheries Institute, Belize City, Belize

Executive Summary: Tropical marine ecosystems in the Caribbean region are inextricably linked through the movement of pollutants, nutrients, diseases, and other stressors, which threaten to further degrade coral reef communities. The magnitude of change that is occurring within the region is considerable, and solutions will require investigating pros and cons of networks of marine protected areas (MPAs), cooperation of neighboring countries, improved understanding of how external stressors degrade local marine resources, and ameliorating those stressors. Connectivity can be broadly defined as the exchange of materials (e.g., nutrients and pollutants), organisms, and genes and can be divided into: 1) genetic or evolutionary connectivity that concerns the exchange of organisms and genes, 2) demographic connectivity, which is the exchange of individuals among local groups, and 3) oceanographic connectivity, which includes flow of materials and circulation patterns and variability that underpin much of all these exchanges. Presently, we understand little about connectivity at specific locations beyond model outputs, and yet we must manage MPAs with connectivity in mind. A key to successful MPA management is how to most effectively work with scientists to acquire the information managers need. Oceanography connectivity is poorly understood, and even less is known about the shape of the dispersal curve for most species. Dispersal kernels differ for various systems, species, and life histories and are likely highly variable in space and time. Furthermore, the implications of different dispersal kernels on population dynamics and management of species is unknown. However, small dispersal kernels are the norm - not the exception. Linking patterns of dispersal to management options is difficult given the present state of knowledge. The behavioral component of larval dispersal has a major impact on where larvae settle. Individual larval behavior and life history details are required to produce meaningful simulations of population connectivity. Biological inputs are critical determinants of dispersal outcomes beyond what can be gleaned from models of passive dispersal. There is considerable temporal and spatial variation to connectivity patterns. New models are increasingly being developed, but these must be validated to understand upstream-downstream neighborhoods, dispersal corridors, stepping stones, and source/sink dynamics. At present, models are mainly useful for providing generalities and generating hypotheses. Low-technology approaches such as drifter vials and oceanographic drogues are useful, affordable options for understanding local connectivity. The “silver bullet” approach to MPA design may not be possible for several reasons. Genetic connectivity studies reveal divergent population genetic structures despite similar larval life histories. Historical stochasticity in reproduction and/or recruitment likely has important, longlasting consequences on present day genetic structure. (PDF has 200 pages.)

Impacts of climate change of seaports: A survey of knowledge, perceptions, and planning efforts among port administrators

Port authorities from around the world were surveyed to ascertain how administrators feel climate change might impact their operations, what level of change would be problematic, and how they plan to adapt to new conditions. The survey was distributed to 350 major ports through two leading international port organizations, the International Association of Ports and Harbors and the American Association of Port Authorities. (PDF contains 4 pages)

Aquatic insects as target organisms for the study of effects of projected climate change in the British Isles

The chief objectives of this brief review are to collate and synthesise quantitative information on the temperature requirements of aquatic insects, and to identify species, and groups of species, that could be useful indicators of climate change and predictors of the ecological effects of change. It arose from the first phase of the Terrestrial Initiative in Global Environmental Research (TIGER), a five-year, NERC Community Programme on the role of the terrestrial biosphere in the science of global change. This phase involved the identification of criteria for selecting species suitable for the study of effects of projected climate change in the British Isles. Field and laboratory studies are reviewed, and criteria for selection of species for future research are suggested. The literature survey shows that no species of aquatic insect can be found to meet all three criteria, but information on the British stoneflies and their eggs already satisfies two of them.

The potential of RIVPACS for predicting the effects of environmental change

RIVPACS has been used successfully for biological assessment of river water quality but its potential in forecasting the effects of environmental change has not been investigated. This study has shown that it is possible to simulate faunal changes in response to environmental disturbance, provided that the disturbance directly involves the environmental variables used in RIVPACS predictions. These variables relate to channel shape, discharge and substratum. Many impacts, particularly those associated with pollution, will not affect these variables and therefore RIVPACS cannot simulate the effects of pollution. RIVPACS was sensitive only to major changes in substratum. It was concluded that, because of the static nature of RIVPACS, it cannot respond to the dynamic effects and processes associated with environmental disturbance. Thus RIVPACS, while showing direction of change and indicating sensitive taxa, cannot be used to predict or forecast the effects of environmental impacts.

Subtypes of Patients Experiencing Exacerbations of COPD and Associations with Outcomes

Chronic obstructive pulmonary disease (COPD) is a complex and heterogeneous condition characterized by occasional exacerbations. Identifying clinical subtypes among patients experiencing COPD exacerbations (ECOPD) could help better understand the pathophysiologic mechanisms involved in exacerbations, establish different strategies of treatment, and improve the process of care and patient prognosis. The objective of this study was to identify subtypes of ECOPD patients attending emergency departments using clinical variables and to validate the results using several outcomes. We evaluated data collected as part of the IRYSS-COPD prospective cohort study conducted in 16 hospitals in Spain. Variables collected from ECOPD patients attending one of the emergency departments included arterial blood gases, presence of comorbidities, previous COPD treatment, baseline severity of COPD, and previous hospitalizations for ECOPD. Patient subtypes were identified by combining results from multiple correspondence analysis and cluster analysis. Results were validated using key outcomes of ECOPD evolution. Four ECOPD subtypes were identified based on the severity of the current exacerbation and general health status (largely a function of comorbidities): subtype A (n = 934), neither high comorbidity nor severe exacerbation; subtype B (n = 682), moderate comorbidities; subtype C (n = 562), severe comorbidities related to mortality; and subtype D (n = 309), very severe process of exacerbation, significantly related to mortality and admission to an intensive care unit. Subtype D experienced the highest rate of mortality, admission to an intensive care unit and need for noninvasive mechanical ventilation, followed by subtype C. Subtypes A and B were primarily related to other serious complications. Hospitalization rate was more than 50% for all the subtypes, although significantly higher for subtypes C and D than for subtypes A and B. These results could help identify characteristics to categorize ECOPD patients for more appropriate care, and help test interventions and treatments in subgroups with poor evolution and outcomes.

Impacts of climate change and variability on fish value chains in Uganda

This study examines the vulnerability of fish pr oduction in Uganda, particularly as it r elates to the predicted impacts from climate change, using the concept of the value chain. The value chain approach has been recommended as a useful tool to study specific challenges facing a sector resulting from various drivers of change, including climate. Critically, such analyses can reveal context-specific response strategies to enhance a sector (Jacinto and Pomer oy 2010). The specific purpose of the study was to identify curr ent and potential impacts of climate change and corresponding adaptation strategies in fish value chains. The study builds upon information fr om earlier value chain analyses on fisheries and aquaculture production in Uganda to provide a more in-depth understanding of issues facing the fish industry, in particular, those to be incorporated in the CGIAR Resear ch Program Livestock and Fish.

Which of the three action-oriented corporate social responsibility (CSR) types is the most effective in improving the public attitude toward tobacco companies?

Dissertação apresentada à Universidade Fernando Pessoa como parte dos requisitos para a obtenção do grau de Mestre em Ciências da Comunicação, ramo de Marketing e Publicidade

An exploratory study on the impact of an early years' preschool intervention programme in the Republic of Ireland

Early years’ education has increasingly been identified as a mechanism to alleviate educational disadvantage in areas of social exclusion. Early years’ intervention programmes are now a common government social policy for addressing social problems (Reynolds, Mann, Miedel, and Smokowski, 1997). In particular, state provided early years’ programmes such as Head Start in the United States and Early Start in Ireland have been established to combat educational disadvantage for children experiencing poverty and socio-economic inequality. The focus of this research is on the long-term outcomes of an early years’ intervention programme in Ireland. It aims to assess whether participation in the programme enhances the life course of children at-risk of educational disadvantage. It involves an in-depth analysis of one Early Start project which was included in the original eight projects established by the Department of Education and Science in 1994. The study utilises a multi-group design to provide a detailed analysis of both the academic and social progress of programme participants. It examines programme outcomes from a number of perspectives by collecting the views of the three main stakeholders involved in the education process; students who participated in Early Start in 1994/5, their parents and their teachers. To contribute to understanding the impact of the programme from a community perspective interviews were also conducted with local community educators and other local early years’ services. In general, Early Start was perceived by all participants in this study as making a positive contribution to parent involvement in education and to strengthening educational capital in the local area. The study found that parents and primary school teachers identified aspects of school readiness as the main benefit of participation in Early Start and parents and teachers were very positive about the role of Early Start in preparing children for the transition to formal school. In addition to this, participation in Early Start appears to have made a positive contribution to academic attainment in Maths and Science at Junior Certificate level. Students who had participated in Early Start were also rated more highly by their second level teachers in terms of goal-setting and future orientation which are important factors in educational attainment. Early Start then can be viewed as providing a positive contribution to the long-term social and academic outcomes for its participants.

Examining the post-adoptive infusion of mobile technology in a healthcare domain: determinants and outcomes

The healthcare industry is beginning to appreciate the benefits which can be obtained from using Mobile Health Systems (MHS) at the point-of-care. As a result, healthcare organisations are investing heavily in mobile health initiatives with the expectation that users will employ the system to enhance performance. Despite widespread endorsement and support for the implementation of MHS, empirical evidence surrounding the benefits of MHS remains to be fully established. For MHS to be truly valuable, it is argued that the technological tool be infused within healthcare practitioners work practices and used to its full potential in post-adoptive scenarios. Yet, there is a paucity of research focusing on the infusion of MHS by healthcare practitioners. In order to address this gap in the literature, the objective of this study is to explore the determinants and outcomes of MHS infusion by healthcare practitioners. This research study adopts a post-positivist theory building approach to MHS infusion. Existing literature is utilised to develop a conceptual model by which the research objective is explored. Employing a mixed-method approach, this conceptual model is first advanced through a case study in the UK whereby propositions established from the literature are refined into testable hypotheses. The final phase of this research study involves the collection of empirical data from a Canadian hospital which supports the refined model and its associated hypotheses. The results from both phases of data collection are employed to develop a model of MHS infusion. The study contributes to IS theory and practice by: (1) developing a model with six determinants (Availability, MHS Self-Efficacy, Time-Criticality, Habit, Technology Trust, and Task Behaviour) and individual performance-related outcomes of MHS infusion (Effectiveness, Efficiency, and Learning), (2) examining undocumented determinants and relationships, (3) identifying prerequisite conditions that both healthcare practitioners and organisations can employ to assist with MHS infusion, (4) developing a taxonomy that provides conceptual refinement of IT infusion, and (5) informing healthcare organisations and vendors as to the performance of MHS in post-adoptive scenarios.