820 resultados para American Medical Association


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Here we present a sequential Monte Carlo (SMC) algorithm that can be used for any one-at-a-time Bayesian sequential design problem in the presence of model uncertainty where discrete data are encountered. Our focus is on adaptive design for model discrimination but the methodology is applicable if one has a different design objective such as parameter estimation or prediction. An SMC algorithm is run in parallel for each model and the algorithm relies on a convenient estimator of the evidence of each model which is essentially a function of importance sampling weights. Other methods for this task such as quadrature, often used in design, suffer from the curse of dimensionality. Approximating posterior model probabilities in this way allows us to use model discrimination utility functions derived from information theory that were previously difficult to compute except for conjugate models. A major benefit of the algorithm is that it requires very little problem specific tuning. We demonstrate the methodology on three applications, including discriminating between models for decline in motor neuron numbers in patients suffering from neurological diseases such as Motor Neuron disease.

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Purpose This chapter investigates an episode where a supervising teacher on playground duty asks two boys to each give an account of their actions over an incident that had just occurred on some climbing equipment in the playground. Methodology This paper employs an ethnomethodological approach using conversation analysis. The data are taken from a corpus of video recorded interactions of children, aged 7-9 years, and the teacher, in school playgrounds during the lunch recess. Findings The findings show the ways that children work up accounts of their playground practices when asked by the teacher. The teacher initially provided interactional space for each child to give their version of the events. Ultimately, the teacher’s version of how to act in the playground became the sanctioned one. The children and the teacher formulated particular social orders of behavior in the playground through multi-modal devices, direct reported speech and scripts. Such public displays of talk work as socialization practices that frame teacher-sanctioned morally appropriate actions in the playground. Value of paper This chapter shows the pervasiveness of the teacher’s social order, as she presented an institutional social order of how to interact in the playground, showing clearly the disjunction of adult-child orders between the teacher and children.

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Volume 15 of Sociological Studies of Children and Youth (SSYC) presents a rich description of children’s and young people’s disputes. Children and young people live and experience their youth in a variety of contexts, settings and situations in contemporary society, and the studies discussed in this volume draw on empirical data to investigate the interactional procedures used by children and young people as disputes arise in varying contexts of their everyday life. The aim of this volume is to extend current understandings of on children’s disputes by examining how, in the varying arenas and social worlds of children and young people, matters of ownership, alignment and social and moral order are always at play. Applying a sociological perspective, the research papers in this special volume show that disputes can offer analytic opportunities to examine, and make visible typically unseen social and moral orders. This consideration provides rich accounts of dispute practices within social and institutional contexts.

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Learning Outcome: Gain knowledge in the area of dietetic training in Australia and the benefits of collaborative partnerships between government and universities to achieve improvements in dietetic service delivery, evidenced based practice, and student placements. Prisoners have high rates of chronic disease, however dietetic services and research in this sector is limited. Securing high quality professional practice placements for dietetic training in Australia is competitive, and prisons provide exciting opportunities. Queensland University of Technology (QUT) has a unique twenty year partnership with Queensland Corrective Services (QCS) with a service learning model placing final year dietetic students within prisons. Building on this partnership, in 2007 a new joint position was funded to establish dietetic services to over 5500 prisoners and support viable best practice dietetic education. Evaluation of the past three years of this partnership has shown an expansion of QUT student placements in Queensland prisons, with a third of final year students each undertaking 120 hours of foodservice management practicum. Student evaluations of placement over this period are much higher than the University average. Through the joint position student projects have been targeted on strategic areas to support nutrition and dietetic policy and practice. Projects have been broadened from menu reviews to more comprehensive quality improvement and dietetic research activities, with all student learning activities transferrable to other foodservice settings. Student practice in the prisons has been extended beyond foodservice management to include group education and dietetic counseling. For QCS, student placements have equated to close to a full-time dietitian position, with nutrition policy now being implemented as an outcome of this support. This innovative partnership has achieved a sustainable student placement model, supported research, whilst delivering dietetic services to a difficult to access group. Funding Disclosure: None

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Organizations today invest in collaborative IT to engage in collaborative alliances to sustain or improve their competitive positions. Effective use of this collaborative IT in an alliance requires a deeper understanding of their governance structures. This effort is to ensure the sustainability of these alliances. Through the relational view of the firm, we suggest relational lateral IT-steering committees, relational IT operational committees, and relational IT performance management systems as IT governance structures for collaborative alliances. We then incorporate these structures, develop a model for approaches to governing collaborative IT, and evaluate the effectiveness for such governance structures in the IT-dependent alliances. We suggest that IT governance efforts of an alliance should contribute to their collaborative rent. We also suggest that the collaborative rent of an alliance would relate to the business value of its alliance partners. Field survey data containing 192 responses indicates a positive influence of the suggested IT governance efforts of the alliance on the collaborative rent of the alliance. The results also suggest a positive impact of the collaborative rent of the alliance on the business value of the alliance partners.

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Problem, research strategy, and findings: The privatization of airports in Australia included airport property development rights, regulated only by federal, not local, land use control. Airports then developed commercial and retail centers outside local community plans, resulting in a history of poor coordination of planning and reflecting strong differences between public and private values in the role of the airport. Private owners embraced the concept of an Airport City, envisioning the airport as a portal of global infrastructure, whereas public planning agencies are struggling with infrastructure coordination and the development of real estate outside of the local planning regulations. Stakeholder workshops were conducted in each of the cases where key stakeholders from airports, regulating agencies, state and local governments participated in identifying key issues impacting the planning in and around airports. This research demonstrates that if modes of infrastructure provision change significantly (such as through privatization of public services), that transformation would best be accompanied by comprehensive changes in planning regimes to accommodate metropolitan and airport interdependencies. Privatization has exacerbated the poor coordination of planning in the past, and a focus on coordination between public and private infrastructure planning is needed to overcome differences in values and interests. Takeaway for practice: Governance styles differ considerably between public agencies and private corporations. Planners should understand the drivers and value differences to better coordinate infrastructure delivery and effective planning. Research support: The Airport Metropolis Research Project under the Australian Research Council's Linkage Projects funding scheme (LP0775225).

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The publication of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994) introduced the notion that a life-threatening illness can be a stressor and catalyst for Posttraumatic Stress Disorder (PTSD). Since then a solid body of research has been established investigating the post-diagnosis experience of cancer. These studies have identified a number of short and long-term life changes resulting from a diagnosis of cancer and associated treatments. In this chapter, we discuss the psychosocial response to the cancer experience and the potential for cancer-related distress. Cancer can represent a life-threatening diagnosis that may be associated with aggressive treatments and result in physical and psychological changes. The potential for future trauma through the lasting effects of the disease and treatment, and the possibility of recurrence, can be a source of continued psychological distress. In addition to the documented adverse repercussions of cancer, we also outline the recent shift that has occurred in the psycho-oncology literature regarding positive life change or posttraumatic growth that is commonly reported after a diagnosis of cancer. Adopting a salutogenic framework acknowledges that the cancer experience is a dynamic psychosocial process with both negative and positive repercussions. Next, we describe the situational and individual factors that are associated with posttraumatic growth and the types of positive life change that are prevalent in this context. Finally, we discuss the implications of this research in a therapeutic context and the directions of future posttraumatic growth research with cancer survivors. This chapter will present both quantitative and qualitative research that indicates the potential for personal growth from adversity rather than just mere survival and return to pre-diagnosis functioning. It is important to emphasise however, that the presence of growth and prevalence of resilience does not negate the extremely distressing nature of a cancer diagnosis for the patient and their families and the suffering that can accompany treatment regimes. Indeed, it will be explained that for growth to occur, the experience must be one that quite literally shatters previously held schemas in order to act as a catalyst for change.

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Objective To explore whether improvements in physical activity following the MobileMums intervention were mediated by changes in Social Cognitive Theory (SCT) constructs targeted in the intervention (barrier self efficacy, goal setting skills, outcome expectancy, social support, and perceived environmental opportunity for exercise). This paper also examined if the mediating constructs differed between initial (baseline to 6 weeks) and overall (baseline to 13 weeks) changes in physical activity. Methods Secondary analysis of data from a randomized controlled trial involving 88 postnatal women (<12 months postpartum). Participants were randomized to receive either the 12-week MobileMums intervention or a minimal-contact control condition. Physical activity and proposed mediators were assessed by self-report at baseline, 6 weeks, and 13 weeks. Walking for Exercise frequency was assessed using the Australian Women's Activity Survey and frequency of moderate-to-vigorous physical activity (MVPA) was assessed using a single-item question. Results Initial improvements in goal-setting skills mediated the relationship between experimental condition and initial changes in MVPA, αβ (95% CI) = 0.23(0.01, 0.59), and Walking for Exercise, αβ (95% CI) = 0.34(0.06, 0.73). Initial improvements in barrier self efficacy mediated the relationship between experimental condition and initial change in MVPA, αβ (95% CI) = 0.36(0.12, 0.65), but not Walking for Exercise. None of the SCT outcomes significantly mediated the relationship between experimental condition and overall (baseline to 13 weeks) change in frequency of MVPA or Walking for Exercise. Conclusion Future interventions with postnatal women using SCT should target barrier self-efficacy and goal setting skills in order to increase physical activity. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

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This study tested the hypothesis that negative symptoms and quality of life for patients with functional psychoses are associated with family environment. Fifty-seven first-admission patients with functional psychoses were assessed at hospital admission for severity of psychopathology and premorbid adjustment. Relatives residing with patients rated the family environment at admission and one month after discharge on the Family Environment Scale. Patients made the same ratings after discharge. Six months later, patients were reassessed on severity of psychopathology, negative symptoms, and quality of life. Multiple regression analyses showed that higher levels of positive emotional expressiveness in the family predicted milder and fewer negative symptoms and better quality of life at follow-up. The prediction was statistically independent of the initial severity of psychopathology or premorbid adjustment

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The publication of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994) introduced the notion that a life-threatening illness can be a stressor and catalyst for Posttraumatic Stress Disorder (PTSD). Since then a solid body of research has been established investigating the post-diagnosis experience of cancer. These studies have identified a number of short and long-term life changes resulting from a diagnosis of cancer and associated treatments. In this chapter, we discuss the psychosocial response to the cancer experience and the potential for cancer-related distress. Cancer can represent a life-threatening diagnosis that may be associated with aggressive treatments and result in physical and psychological changes. The potential for future trauma through the lasting effects of the disease and treatment, and the possibility of recurrence, can be a source of continued psychological distress. In addition to the documented adverse repercussions of cancer, we also outline the recent shift that has occurred in the psycho-oncology literature regarding positive life change or posttraumatic growth that is commonly reported after a diagnosis of cancer. Adopting a salutogenic framework acknowledges that the cancer experience is a dynamic psychosocial process with both negative and positive repercussions. Next, we describe the situational and individual factors that are associated with posttraumatic growth and the types of positive life change that are prevalent in this context. Finally, we discuss the implications of this research in a therapeutic context and the directions of future posttraumatic growth research with cancer survivors. This chapter will present both quantitative and qualitative research that indicates the potential for personal growth from adversity rather than just mere survival and return to pre-diagnosis functioning. It is important to emphasise however, that the presence of growth and prevalence of resilience does not negate the extremely distressing nature of a cancer diagnosis for the patient and their families and the suffering that can accompany treatment regimes. Indeed, it will be explained that for growth to occur, the experience must be one that quite literally shatters previously held schemas in order to act as a catalyst for change.