874 resultados para Physician-patient relationship
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GAEC1 (gene amplified in oesophageal cancer 1) is located at 7q22.1, first identified in oesophageal cancer.1 Initial work indicated that GAEC1 can act as an oncogene.2 Our pilot study found ∼80% of colorectal cancers showing amplification of GAEC1.3 In this research, we will study GAEC1 copy number in colon cancer cell lines and colorectal tissues, and its prognostic significance. Two human colon cancer cell lines (SW480 and SW48) and one normal colonic epithelial cell line (FHC) were obtained from American Type Culture Collection. Culturing conditions for these cell lines were as published previously.4 Tissues were collected from 283 patients (213 Australian; 70 Japanese) diagnosed with colorectal cancers. Ninety surgically removed non-cancer colorectal tissues (diverticular diseases, hyperplastic polyps and volvulus) were used as controls. H&E stained sections from each cancer were checked to select a block with sufficient cancer tissue and representative morphological features for each patient for DNA extraction...
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Variations that exist in the treatment of patients (with similar symptoms) across different hospitals do substantially impact the quality and costs of healthcare. Consequently, it is important to understand the similarities and differences between the practices across different hospitals. This paper presents a case study on the application of process mining techniques to measure and quantify the differences in the treatment of patients presenting with chest pain symptoms across four South Australian hospitals. Our case study focuses on cross-organisational benchmarking of processes and their performance. Techniques such as clustering, process discovery, performance analysis, and scientific workflows were applied to facilitate such comparative analyses. Lessons learned in overcoming unique challenges in cross-organisational process mining, such as ensuring population comparability, data granularity comparability, and experimental repeatability are also presented.
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This paper recognises that customer loyalty is important for many competitive organisations, and that retail firms make investments to build and maintain loyal relationships with their existing and potential customers (e.g. loyalty programs). However, there has been little focus on the mechanisms by which these relationship investments operate to achieve customer loyalty. This paper examines one mechanism, namely customer gratitude, which works to make a firm’s relationship marketing investment a success or a failure. Using data from 1600 undergraduate students, this study empirically confirms the mediating role of customer gratitude between the customers’ perceptions a firm’s relationship marketing investments and customers’ perceptions of the value of the relationship with the firm. Further, a significant moderating effect of perceived benevolence on the relationship between customers’ perceptions a firm’s relationship marketing investments and customer gratitude was identified. For theorists, this customer gratitude model offers a better psychological explanation of how relationship marketing investments operate to improve the value that customers place on their relationships with retailers. Our research suggests that managers should invest resources to stimulate customer gratitude in order to build strong customer–seller relationships.
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Research that applies agency theory to boards of directors suffers from being quite narrow as it does not recognize the true legal relationships between directors, managers and shareholders. Instead, the board of directors is best conceptualized as the principal, management as agents and stockholders’ relationships as a mix of legal and implicit contracts. We propose a recast agency relationship and develop a contingency approach that proposes (1) how a corporation’s goals vary with a board’s implicit contracting and (2) a reconceptualization of the agency problem facing boards.
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Microbial respiratory reduction of nitrous oxide (N2O) to dinitrogen (N2) via denitrification plays a key role within the global N-cycle since it is the most important process for converting reactive nitrogen back into inert molecular N2. However, due to methodological constraints, we still lack a comprehensive, quantitative understanding of denitrification rates and controlling factors across various ecosystems. We investigated N2, N2O and NO emissions from irrigated cotton fields within the Aral Sera Basin using the He/O2 atmosphere gas flow soil core technique and an incubation assay. NH4NO3 fertilizer, equivalent to 75 kg ha−1 and irrigation water, adjusting the water holding capacity to 70, 100 and 130% were applied to the incubation vessels to assess its influence on gaseous N emissions. Under soil conditions as they are naturally found after concomitant irrigation and fertilization, denitrification was the dominant process and N2 the main end product of denitrification. The mean ratios of N2/N2O emissions increased with increasing soil moisture content. N2 emissions exceeded N2O emissions by a factor of 5 ± 2 at 70% soil water holding capacity (WHC) and a factor of 55 ± 27 at 130% WHC. The mean ratios of N2O/NO emissions varied between 1.5 ± 0.4 (70% WHC) and 644 ± 108 (130% WHC). The magnitude of N2 emissions for irrigated cotton was estimated to be in the range of 24 ± 9 to 175 ± 65 kg-N ha−1season−1, while emissions of NO were only of minor importance (between 0.1 to 0.7 kg-N ha−1 season−1). The findings demonstrate that for irrigated dryland soils in the Aral Sera Basin, denitrification is a major pathway of N-loss and that substantial amounts of N-fertilizer are lost as N2 to the atmosphere for irrigated dryland soils.
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In many organizations, e-mail is an effective and dominant workplace application tool; however, research identifying its role as a potential workplace stressor remains limited. Utilizing the Transactional Model of Stress (Lazarus & Folkman, 1984), 215 full-time administrative and academic staff at a university were surveyed about workplace e-mail. The aim was to study the effects of potential e-mail stressors on emotional exhaustion as mediated and moderated by person and situation variables. Results indicated that 2 distinct e-mail stressors—high quantity and poor quality (in terms of high emotionality and ambiguity) of workplace e-mail—were associated both with stress appraisals (e-mail overload and e-mail uncertainty) and with emotional exhaustion. Furthermore, the effects of the 2 e-mail stressors on emotional exhaustion were mediated by appraised e-mail overload. Perceived normative response pressure—a relevant aspect of the specific work environment—added to the explanation of emotional exhaustion and accentuated the positive effect of e-mail ambiguity on emotional exhaustion, although effects involving normative response pressure were not explained by the stress appraisals.
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The close relationship between rain and lightning is well known. However, there are numerous documented observations of heavy rain accompanied by little or no lightning activity (Williams et al, 1992; Jayaratne, 1993). Kuleshov et al (2002) studied thunderstorm distribution and frequency in Australia and concluded that thunderstorm frequency (as expressed by number of thunder-days) in Australia does not, in general, appear to vary in any consistent way with rainfall. However, thunder-days describe occurrence of thunderstorms as heard by an observer, and therefore could be only proxy data to evaluate actual lightning activity (i.e. number of total or cloud-to-ground flashes). Field experiments have demonstrated a strong increase in lightning activity with convective available potential energy (CAPE). It has also been shown that CAPE increases linearly with potential wet bulb temperature, Tw (Williams et al, 1992). In this study, we examine the relationship between lightning ground flash incidence and the two parameters – surface rainfall and surface wet bulb maximum temperature for selected localities around Australia...
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Considerable discussion has taken place during the last decade regarding the role of economic growth in determining environmental quality. Using data from 30 OECD countries for the period 1960-2003 and the nonparametric method of generalized additive models, which enables us to use flexible functional forms, this paper examines the environmental Kuznets curve hypothesis for carbon dioxide (CO2). We find that the reduction of coal share in energy use has a significant effect on CO2. Our results imply that economic growth is not sufficient to decrease CO2 emissions.
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The relationship between small firm growth and HRM practices Rowena Barrett, Susan Mayson and Niel Warriner Introduction In this chapter we explore the relationship between small firms’ growth orientation, their business planning efforts and the role the owner plays and whether or not formal HRM practices are used. Formal HRM practices are assessed in terms of whether they are written down, regularly applied or assured to take place. We take on board Heneman et al.’s (2000) suggestion that ‘surveys of employer practices across SMEs [would] be [a] valuable addition to the strategic human resource management literature’ (p. 23) and report the results of an online and paper survey of a sample of 1753 small firms (defined as those employing less than 20 people) in the state of Victoria (SE Australia). Our particular interest in this chapter, which is based on an analysis of 410 responses to the survey, is whether growthoriented small firms adopt formal HRM practices. This research contributes to understanding whether more formal organizational systems and routines are more likely to be used (or not) to nurture human capital in growth-oriented small firms. Moreover by focusing on firm growth, this chapter, consistent with recent calls in the literature (see Baron, 2003; Barrett and Mayson, 2006; Katz et al., 2000; Tansky and Heneman, 2003), contributes to a better understanding of issues at the intersection of entrepreneurship and HRM research.
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Road asset managers are seeking analysis of the whole road network to supplement statistical analyses of small subsets of homogeneous roadway. This study outlines the use of data mining capable of analyzing the wide range of situations found on the network, with a focus on the role of skid resistance in the cause of crashes. Results from the analyses show that on non-crash-prone roads with low crash rates, skid resistance contributes only in a minor way, whereas on high-crash roadways, skid resistance often contributes significantly in the calculation of the crash rate. The results provide evidence supporting a causal relationship between skid resistance and crashes and highlight the importance of the role of skid resistance in decision making in road asset management.
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Objective Exercise has the potential to offer a range of health benefits in addition to improving healing outcomes for people with venous leg ulcers. However despite evidence based recommendations, most of these individuals do not engage in regular exercise. The aim of this study was to gain an understanding of the perspectives of adults with venous leg ulcers, in relation to exercise. Method This was a qualitative design using semi-structured interviews and discussions. Ten participants with venous leg ulceration volunteered to participate. Recruitment was through a specialist wound clinic. Verbatim data were collected by an experienced moderator using a semi-structured guide. Data saturation was reached after three group discussions and two interviews. A random selection of transcripts was sent back to the participants for verification. Thematic content analysis was used to determine major themes and categories. Two transcripts were independently analysed, categories and themes independently developed, cross checked and found comparable. Remaining transcripts were analysed using developed categories and codes. Results Regardless of their current exercise routine, participants reported exercising prior to venous leg ulceration and expressed an interest in either becoming active or maintaining an active lifestyle. Overall four themes emerged from the findings: i) participant understanding of the relationship between chronic venous insufficiency and exercise patterns, ii) fear of harm impacts upon positive beliefs and attitudes to exercise, iii) perceived factors limit exercise and iv) structured management facilitates exercise. Conclusion The value of exercise in improving outcomes in venous leg ulcers lies in its capacity to promote venous return and reduce the risk of secondary conditions in this population. Despite motivation and interest in being exercise active, people with venous leg ulcers report many obstacles. Further exploration of mechanisms that assist this patient population and promote understanding about management of barriers, coupled with promotion of enabling factors is vital for improving their exercise participation.