Perceptions of French and Creole Among First-Generation Adult Haitian English Language Learners

Context: Due to a unique combination of factors, outdoor athletes in the Southeastern United States are at high risk of lightning deaths and injuries. Lightning detection methods are available to minimize lightning strike victims. Objective: Becoming aware of the risk factors that predispose athletes to lightning strikes and determining the most reliable detection method against hazardous weather will enable Certified Athletic Trainers to develop protocols that protect athletes from injury. Data Sources: A comprehensive literature review of Medline and Pubmed using key words: lightning, lightning risk factors, lightning safety, lightning detection, and athletic trainers and lightning was completed. Data Synthesis: Factors predisposing athletes to lighting death or injury include: time of year, time of day, the athlete’s age, geographical location, physical location, sex, perspiration level, and lack of education and preparedness by athletes and staff. Although handheld lightning detectors have become widely accessible to detect lightning strikes, their performance has not been independently or objectively confirmed. There is evidence that these detectors inaccurately detect strike locations by recording false strikes and not recording actual strikes. Conclusions: Lightning education and preparation are two factors that can be controlled. Measures need to be taken by Certified Athletic Trainers to ensure the safety of athletes during outdoor athletics. It is critical for athletic trainers and supervising staff members to become fully aware of the risks of lightning strikes in order to most effectively protect everyone under their supervision. Even though lightning detectors have been manufactured in an attempt to minimize death and injuries due to lightning strikes, none of the detectors have been proven to be 100% effective. Educating coaches, athletes, and parents on the risks of lightning and the detection methods available, while implementing an emergency action plan for lightning safety, is crucial to ensure the well being of the student-athlete population.

Explaining the increase in coronary heart disease mortality in Syria between 1996 and 2006

Background Despite advances made in treating coronary heart disease (CHD), mortality due to CHD in Syria has been increasing for the past two decades. This study aims to assess CHD mortality trends in Syria between 1996 and 2006 and to investigate the main factors associated with them. Methods The IMPACT model was used to analyze CHD mortality trends in Syria based on numbers of CHD patients, utilization of specific treatments, trends in major cardiovascular risk factors in apparently healthy persons and CHD patients. Data sources for the IMPACT model included official statistics, published and unpublished surveys, data from neighboring countries, expert opinions, and randomized trials and meta-analyses. Results Between 1996 and 2006, CHD mortality rate in Syria increased by 64%, which translates into 6370 excess CHD deaths in 2006 as compared to the number expected had the 1996 baseline rate held constant. Using the IMPACT model, it was estimated that increases in cardiovascular risk factors could explain approximately 5140 (81%) of the CHD deaths, while some 2145 deaths were prevented or postponed by medical and surgical treatments for CHD. Conclusion Most of the recent increase in CHD mortality in Syria is attributable to increases in major cardiovascular risk factors. Treatments for CHD were able to prevent about a quarter of excess CHD deaths, despite suboptimal implementation. These findings stress the importance of population-based primary prevention strategies targeting major risk factors for CHD, as well as policies aimed at improving access and adherence to modern treatments of CHD.

Enhanced skip -list search algorithm in 3-layer mediator framework

The Three-Layer distributed mediation architecture, designed by Secure System Architecture laboratory, employed a layered framework of presence, integration, and homogenization mediators. The architecture does not have any central component that may affect the system reliability. A distributed search technique was adapted in the system to increase its reliability. An Enhanced Chord-like algorithm (E-Chord) was designed and deployed in the integration layer. The E-Chord is a skip-list algorithm based on Distributed Hash Table (DHT) which is a distributed but structured architecture. DHT is distributed in the sense that no central unit is required to maintain indexes, and it is structured in the sense that indexes are distributed over the nodes in a systematic manner. Each node maintains three kind of routing information: a frequency list, a successor/predecessor list, and a finger table. None of the nodes in the system maintains all indexes, and each node knows about some other nodes in the system. These nodes, also called composer mediators, were connected in a P2P fashion. ^ A special composer mediator called a global mediator initiates the keyword-based matching decomposition of the request using the E-Chord. It generates an Integrated Data Structure Graph (IDSG) on the fly, creates association and dependency relations between nodes in the IDSG, and then generates a Global IDSG (GIDSG). The GIDSG graph is a plan which guides the global mediator how to integrate data. It is also used to stream data from the mediators in the homogenization layer which connected to the data sources. The connectors start sending the data to the global mediator just after the global mediator creates the GIDSG and just before the global mediator sends the answer to the presence mediator. Using the E-Chord and GIDSG made the mediation system more scalable than using a central global schema repository since all the composers in the integration layer are capable of handling and routing requests. Also, when a composer fails, it would only minimally affect the entire mediation system. ^

The use of visualization, onset-and-rime, story read-alouds, and discussion to improve diverse first graders' vocabulary and comprehension

It has long been known that vocabulary is essential in the development of reading. Because vocabulary leading to increased comprehension is important, it necessary to determine strategies for ensuring that the best methods of teaching vocabulary are used to help students make gains in vocabulary leading to reading comprehension. According to the National Reading Panel, multiple strategies that involve active engagement on the part of the student are more effective than the use of just one strategy. The purpose of this study was to determine if students' use of visualization, student-generated pictures of onset-and-rime-patterned vocabulary, and story read-alouds with discussion, would enable diverse first-grade students to increase their vocabulary and comprehension. In addition, this study examined the effect of the multimodal framework of strategies on English learners (ELs). This quasi-experimental study (N=69) was conducted in four first-grade classrooms in a low socio-economic school. Two treatment classes used a multimodal framework of strategies to learn weekly vocabulary words and comprehension. Two comparison classrooms used the traditional method of teaching weekly vocabulary and comprehension. Data sources included Florida Assessments for Instruction in Reading (FAIR), comprehension and vocabulary scores, and weekly MacMillan/McGraw Hill Treasures basal comprehension questions and onset-and-rime vocabulary questions. This research determined that the treatment had an effect in adjusted FAIR comprehension means by group, with the treatment group (adj M = 5.14) significantly higher than the comparison group ( adj M = -8.26) on post scores. However, the treatment means did not increase from pre to post, but the comparison means significantly decreased from pre to post as the materials became more challenging. For the FAIR vocabulary, there was a significant difference by group with the comparison adjusted post mean higher than the treatment's, although both groups significantly increased from pre to post. However, the FAIR vocabulary posttest was not part of the Treasures vocabulary, which was taught using the multimodal framework of strategies. The Treasures vocabulary scores were not significantly different by group on the assessment across the weeks, although the treatment means were higher than those of the comparison group. Continued research is needed in the area of vocabulary and comprehension instructional methods in order to determine strategies to increase diverse, urban students' performance.

Estimation and Prediction of Average Vehicle Occupancies using Traffic Accident Records

As congestion management strategies begin to put more emphasis on person trips than vehicle trips, the need for vehicle occupancy data has become more critical. The traditional methods of collecting these data include the roadside windshield method and the carousel method. These methods are labor-intensive and expensive. An alternative to these traditional methods is to make use of the vehicle occupancy information in traffic accident records. This method is cost effective and may provide better spatial and temporal coverage than the traditional methods. However, this method is subject to potential biases resulting from under- and over-involvement of certain population sectors and certain types of accidents in traffic accident records. In this dissertation, three such potential biases, i.e., accident severity, driver¡¯s age, and driver¡¯s gender, were investigated and the corresponding bias factors were developed as needed. The results show that although multi-occupant vehicles are involved in higher percentages of severe accidents than are single-occupant vehicles, multi-occupant vehicles in the whole accident vehicle population were not overrepresented in the accident database. On the other hand, a significant difference was found between the distributions of the ages and genders of drivers involved in accidents and those of the general driving population. An information system that incorporates adjustments for the potential biases was developed to estimate the average vehicle occupancies (AVOs) for different types of roadways on the Florida state roadway system. A reasonableness check of the results from the system shows AVO estimates that are highly consistent with expectations. In addition, comparisons of AVOs from accident data with the field estimates show that the two data sources produce relatively consistent results. While accident records can be used to obtain the historical AVO trends and field data can be used to estimate the current AVOs, no known methods have been developed to project future AVOs. Four regression models for the purpose of predicting weekday AVOs on different levels of geographic areas and roadway types were developed as part of this dissertation. The models show that such socioeconomic factors as income, vehicle ownership, and employment have a significant impact on AVOs.

Research on the influence of behavioral forces that motivate trader behavior and sentiment- a prospect theory exegesis

This study focuses on empirical investigations and seeks implications by utilizing three different methodologies to test various aspects of trader behavior. The first methodology utilizes Prospect Theory to determine trader behavior during periods of extreme wealth contracting periods. Secondly, a threshold model to examine the sentiment variable is formulated and thirdly a study is made of the contagion effect and trader behavior. The connection between consumers' sense of financial well-being or sentiment and stock market performance has been studied at length. However, without data on actual versus experimental performance, implications based on this relationship are meaningless. The empirical agenda included examining a proprietary file of daily trader activities over a five-year period. Overall, during periods of extreme wealth altering conditions, traders "satisfice" rather than choose the "best" alternative. A trader's degree of loss aversion depends on his/her prior investment performance. A model that explains the behavior of traders during periods of turmoil is developed. Prospect Theory and the data file influenced the design of the model. Additional research included testing a model that permitted the data to signal the crisis through a threshold model. The third empirical study sought to investigate the existence of contagion caused by declining global wealth effects using evidence from the mining industry in Canada. Contagion, where a financial crisis begins locally and subsequently spreads elsewhere, has been studied in terms of correlations among similar regions. The results provide support for Prospect Theory in two out of the three empirical studies. The dissertation emphasizes the need for specifying precise, testable models of investors' expectations by providing tools to identify paradoxical behavior patterns. True enhancements in this field must include empirical research utilizing reliable data sources to mitigate data mining problems and allow researchers to distinguish between expectations-based and risk-based explanations of behavior. Through this type of research, it may be possible to systematically exploit "irrational" market behavior.

The effect of a reform on a school organizational culture after receiving a failing Florida Comprehensive Assessment Test rating

The purpose of this research was to explore the effects of a reform that took place in an elementary school during 2000/2001 as a result of a failure rating on the Florida Comprehensive Assessment Test on the structure and the personnel of the organization. The exploration took place over a period of 10 months starting in August 2000 until June 2001. It focused on the effect of the failure rating on the: (a) structure and operation of the school; (b) morale, beliefs, behaviors, and daily lives of teachers and the principal; and (c) the effect of the reform effort on the leadership style of the principal, whether she became a transactional or a transformative leader. The researcher assumed the role of a participant observer. Data sources were her personal recollections of major events that took place during the year of the reform, interviews, observations, and school documents. The sample included 15 teachers present during the time of the reform. Ten taught second through fifth grade. The remaining five participants were the music teacher, the counselor, and the writing, reading and technology specialists. Together they represented the instructional team or represented special education areas. The findings indicated that the reform effort had an effect on the structure and the operation of the school. The changes included reorganization of the physical set up, changes in curriculum and instruction, changes in the means of communication among the staff, and the addition of new staff members including an official agent of change. The reform had a greater effect on the daily lives of teachers and their morale than on their beliefs and behaviors. Teachers reported that during the effort their daily lives were stressful and their morale very low due to the enormous expectations that they had to meet. On the other hand, the reform effort had a positive effect on the daily life, morale, beliefs, and behaviors of the principal. It energized her. She spoke positively about the change. She functioned as an effective, positive, resilient transactional leader who did what was necessary in order to enable the teachers to cope with the complex situation.

School desegregation in Broward County, Florida 1970-1998 : a historical study of power

This is a historical case study on school desegregation and power in Broward County, Florida from 1970 to 1998. The purpose of this study is to describe, explain and analyze types of power used by the School Board of Broward County, Florida and community activists, in their efforts to influence desegregation decisions from 1970 to 1998. In addition, this study explains who benefited and who won from the School Board's desegregation decisions and who governed those decisions? A historical case study approach was used as the method for conducting this study. Data sources included 11 interviews of individuals who were involved in school desegregation issues as either School Board officials or community activists and 10 archival data sources. The theoretical models of Russell, Galbraith, Wartenberg and Domhoff were used to determine the different types of power techniques used by School Board officials and community activists and to answer the questions: who benefited and who won from the School Board's desegregation decisions and who governed those policies and practices? The primary beneficiaries of school desegregation policies and practices in Broward County were: white, affluent communities and the builders, developers, realtors and other businesses in the western suburban communities. All of the data sources indicated that the black community did not benefit from the School Board's desegregation policies. The primary power techniques used by School Board officials to influence desegregation policies and practices was "power over opinions" and compensation. These power techniques were manifested by the School Board publicly disputing the allegations raised by community activists and by compensating those who supported and promoted the School Board's desegregation policies and practices. The power techniques primarily used by community activists were coercive force and "power over opinions." They effectively used these power techniques to change the School Board's policies and practices they felt were detrimental to black children and the black community. Based on the analysis of the qualitative data, it can be concluded that black children did not benefit from school desegregation in Broward County, Florida and the community continues to suffer residual effects from past desegregation policies and practices.

The science of citizen science

Biodiversity citizen science projects are growing in number, size, and scope, and are gaining recognition as valuable data sources that build public engagement. Yet publication rates indicate that citizen science is still infrequently used as a primary tool for conservation research and the causes of this apparent disconnect have not been quantitatively evaluated. To uncover the barriers to the use of citizen science as a research tool, we surveyed professional biodiversity scientists (n = 423) and citizen science project managers (n = 125). We conducted three analyses using non-parametric recursive modeling (random forest), using questions that addressed: scientists' perceptions and preferences regarding citizen science, scientists' requirements for their own data, and the actual practices of citizen science projects. For all three analyses we identified the most important factors that influence the probability of publication using citizen science data. Four general barriers emerged: a narrow awareness among scientists of citizen science projects that match their needs; the fact that not all biodiversity science is well-suited for citizen science; inconsistency in data quality across citizen science projects; and bias among scientists for certain data sources (institutions and ages/education levels of data collectors). Notably, we find limited evidence to suggest a relationship between citizen science projects that satisfy scientists' biases and data quality or probability of publication. These results illuminate the need for greater visibility of citizen science practices with respect to the requirements of biodiversity science and show that addressing bias among scientists could improve application of citizen science in conservation.

Mesure de la performance dans les organisations de réadaptation en déficience physique

La présente thèse vise à évaluer le degré d’implantation et d’utilisation de systèmes de mesure de la performance (SMP) par les décideurs des organisations de réadaptation et à comprendre les facteurs contextuels ayant influencé leur implantation. Pour ce faire, une étude de cas multiples a été réalisée comprenant deux sources de données: des entrevues individuelles avec des cadres supérieurs des organisations de réadaptation du Québec et des documents organisationnels. Le cadre conceptuel Consolidated Framework for Implementation Research a été utilisé pour guider la collecte et l’analyse des données. Une analyse intra-cas ainsi qu’une analyse inter-cas ont été réalisées. Nos résultats montrent que le niveau de préparation organisationnelle à l’implantation d’un SMP était élevé et que les SMP ont été implantés avec succès et utilisés de plusieurs façons. Les organisations les ont utilisés de façon passive (comme outil d’information), de façon ciblée (pour tenter d’améliorer des domaines sous-performants) et de façon politique (comme outil de négociation auprès des autorités gouvernementales). Cette utilisation diversifiée des SMP est suscitée par l’interaction complexe de facteurs provenant du contexte interne propre à chaque organisation, des caractéristiques du SMP, du processus d’implantation appliqué et du contexte externe dans lequel évoluent ces organisations. Au niveau du contexte interne, l’engagement continu et le leadership de la haute direction ont été décisifs dans l’implantation du SMP de par leur influence sur l’identification du besoin d’un SMP, l’engagement des utilisateurs visés dans le projet, la priorité organisationnelle accordée au SMP ainsi que les ressources octroyées à son implantation, la qualité des communications et le climat d’apprentissage organisationnel. Toutefois, même si certains de ces facteurs, comme les ressources octroyées à l’implantation, la priorité organisationnelle du SMP et le climat d’apprentissage se sont révélés être des barrières à l’implantation, ultimement, ces barrières n’étaient pas suffisamment importantes pour entraver l’utilisation du SMP. Cette étude a également confirmé l’importance des caractéristiques du SMP, particulièrement la perception de qualité et d’utilité de l’information. Cependant, à elles seules, ces caractéristiques sont insuffisantes pour assurer le succès d’implantation. Cette analyse d’implantation a également révélé que, même si le processus d’implantation ne suit pas des étapes formelles, un plan de développement du SMP, la participation et l’engagement des décideurs ainsi que la désignation d’un responsable de projet ont tous facilité son implantation. Cependant, l’absence d’évaluation et de réflexion collective sur le processus d’implantation a limité le potentiel d’apprentissage organisationnel, un prérequis à l’amélioration de la performance. Quant au contexte externe, le soutien d’un organisme externe s’est avéré un facilitateur indispensable pour favoriser l’implantation de SMP par les organisations de réadaptation malgré l’absence de politiques et incitatifs gouvernementaux à cet effet. Cette étude contribue à accroître les connaissances sur les facteurs contextuels ainsi que sur leurs interactions dans l’utilisation d’innovations tels les SMP et confirme l’importance d’aborder l’analyse de l’implantation avec une perspective systémique.

Do selective cyclo-oxygenase-2 inhibitors and traditional non-steroidal anti-inflammatory drugs increase the risk of atherothrombosis? Meta-analysis of randomised trials

Objective: To assess the effects of selective cyclo-oxygenase-2 (COX 2) inhibitors and traditional non-steroidal anti-inflammatory drugs (NSAIDs) on the risk of vascular events. Design: Meta-analysis of published and unpublished tabular data from randomised trials, with indirect estimation of the effects of traditional NSAIDs. Data sources: Medline and Embase (January 1966 to April 2005); Food and Drug Administration records; and data on file from Novartis, Pfizer, and Merck. Review methods: Eligible studies were randomised trials that included a comparison of a selective COX 2 inhibitor versus placebo or a selective COX 2 inhibitor versus a traditional NSAID, of at least four weeks' duration, with information on serious vascular events (defined as myocardial infarction, stroke, or vascular death). Individual investigators and manufacturers provided information on the number of patients randomised, numbers of vascular events, and the person time of follow-up for each randomised group. Results: In placebo comparisons, allocation to a selective COX 2 inhibitor was associated with a 42% relative increase in the incidence of serious vascular events (1.2%/year v 0.9%/year; rate ratio 1.42, 95% confidence interval 1.13 to 1.78; P = 0.003), with no significant heterogeneity among the different selective COX 2 inhibitors. This was chiefly attributable to an increased risk of myocardial infarction (0.6%/year v 0.3%/year; 1.86, 1.33 to 2.59; P = 0.0003), with little apparent difference in other vascular outcomes. Among trials of at least one year's duration (mean 2.7 years), the rate ratio for vascular events was 1.45 (1.12 to 1.89; P = 0.005). Overall, the incidence of serious vascular events was similar between a selective COX 2 inhibitor and any traditional NSAID (1.0%/year v 0.9/%year; 1.16, 0.97 to 1.38; P = 0.1). However, statistical heterogeneity (P = 0.001) was found between trials of a selective COX 2 inhibitor versus naproxen (1.57, 1.21 to 2.03) and of a selective COX 2 inhibitor versus non-naproxen NSAIDs (0.88, 0.69 to 1.12). The summary rate ratio for vascular events, compared with placebo, was 0.92 (0.67 to 1.26) for naproxen, 1.51 (0.96 to 2.37) for ibuprofen, and 1.63 (1.12 to 2.37) for diclofenac. Conclusions: Selective COX 2 inhibitors are associated with a moderate increase in the risk of vascular events, as are high dose regimens of ibuprofen and diclofenac, but high dose naproxen is not associated with such an excess.

Can a Broader Education Narrow the Gap? Evidence on Non-Academic Features of Schooling

Empirical studies of education programs and systems, by nature, rely upon use of student outcomes that are measurable. Often, these come in the form of test scores. However, in light of growing evidence about the long-run importance of other student skills and behaviors, the time has come for a broader approach to evaluating education. This dissertation undertakes experimental, quasi-experimental, and descriptive analyses to examine social, behavioral, and health-related mechanisms of the educational process. My overarching research question is simply, which inside- and outside-the-classroom features of schools and educational interventions are most beneficial to students in the long term? Furthermore, how can we apply this evidence toward informing policy that could effectively reduce stark social, educational, and economic inequalities?

The first study of three assesses mechanisms by which the Fast Track project, a randomized intervention in the early 1990s for high-risk children in four communities (Durham, NC; Nashville, TN; rural PA; and Seattle, WA), reduced delinquency, arrests, and health and mental health service utilization in adolescence through young adulthood (ages 12-20). A decomposition of treatment effects indicates that about a third of Fast Track’s impact on later crime outcomes can be accounted for by improvements in social and self-regulation skills during childhood (ages 6-11), such as prosocial behavior, emotion regulation and problem solving. These skills proved less valuable for the prevention of mental and physical health problems.

The second study contributes new evidence on how non-instructional investments – such as increased spending on school social workers, guidance counselors, and health services – affect multiple aspects of student performance and well-being. Merging several administrative data sources spanning the 1996-2013 school years in North Carolina, I use an instrumental variables approach to estimate the extent to which local expenditure shifts affect students’ academic and behavioral outcomes. My findings indicate that exogenous increases in spending on non-instructional services not only reduce student absenteeism and disciplinary problems (important predictors of long-term outcomes) but also significantly raise student achievement, in similar magnitude to corresponding increases in instructional spending. Furthermore, subgroup analyses suggest that investments in student support personnel such as social workers, health services, and guidance counselors, in schools with concentrated low-income student populations could go a long way toward closing socioeconomic achievement gaps.

The third study examines individual pathways that lead to high school graduation or dropout. It employs a variety of machine learning techniques, including decision trees, random forests with bagging and boosting, and support vector machines, to predict student dropout using longitudinal administrative data from North Carolina. I consider a large set of predictor measures from grades three through eight including academic achievement, behavioral indicators, and background characteristics. My findings indicate that the most important predictors include eighth grade absences, math scores, and age-for-grade as well as early reading scores. Support vector classification (with a high cost parameter and low gamma parameter) predicts high school dropout with the highest overall validity in the testing dataset at 90.1 percent followed by decision trees with boosting and interaction terms at 89.5 percent.

Inequality, the Welfare State, and Demographic Change

This dissertation is a three-part analysis examining how the welfare state in advanced Western democracies has responded to recent demographic changes. Specifically, this dissertation investigates two primary relationships, beginning with the influence of government spending on poverty. I analyze two at-risk populations in particular: immigrants and children of single mothers. Next, attention is turned to the influence of individual and environmental traits on preferences for social spending. I focus specifically on religiosity, religious beliefs and religious identity. I pool data from a number of international macro- and micro-data sources including the Luxembourg Income Study (LIS), International Social Survey Program (ISSP), the World Bank Databank, and the OECD Databank. Analyses highlight the power of the welfare state to reduce poverty, but also the effectiveness of specific areas of spending focused on addressing new social risks. While previous research has touted the strength of the welfare state, my analyses highlight the need to consider new social risks and encourage closer attention to how social position affects preferences for the welfare state.

The effects of agglomeration economies on the productivity of manufacturing local units in Ireland

The purpose of this study is to examine the effects of agglomeration economies on the productivity of manufacturing local units in Ireland. Four types of agglomeration economies are considered in this study. These are internal economies of scale, localization economies, related variety and urbanization economies. This study makes a number of contributions to the literature. Firstly, this is the first study to conduct an investigation of the effects of agglomeration economies on the productivity of manufacturing local units operating in Ireland. Secondly, this study distinguishes between indigenous and foreign-owned local units which is important given the dual nature of the Irish economy (Krugman, 1997). Thirdly, in addition to considering the effects of agglomeration economies, this study examines the impact of spurious agglomeration on the productivity of foreign-owned local units. Using data from the Census of Industrial Local Units and a series of IV GMM estimators to control for endogeneity, the results of the analysis conducted in Chapter 6 reveal that there are differences in the effects of agglomeration economies on the productivity of indigenous and foreign-owned local units. In Chapter 7 the Census of Industrial Local Units is supplemented by additional data sources and more in-depth measures are generated to capture the features of each of the external agglomeration economies considered in this analysis. There is some evidence to suggest that the availability of local inputs has a negative and significant impact on productivity. The NACE based measures of related variety reveal that the availability of local inputs and knowledge spillovers for related sectors have a negative and significant impact on productivity. There is clear evidence to suggest that urbanization economies are important for increasing the productivity of indigenous local units. The findings reveal that a 1% increase in population density in the NUTS 3 region leads to an increase in the productivity of indigenous local units of approximately 0.07% to 0.08%. The results also reveal that there is a significant difference in the effects of agglomeration economies on the productivity of low-tech and medium/high-tech indigenous local units. The more in-depth measures of agglomeration economies used in Chapter 7 are also used in Chapter 8. A series of IV GMM regressions are estimated in order to identify the impact of agglomeration economies and spurious agglomeration on the productivity of foreign-owned local units operating in Ireland. There is some evidence found to suggest that the availability of a pool of skilled labour has a positive and significant on productivity of foreign-owned local units. There is also evidence to suggest that localization knowledge spillovers have a negative impact on the productivity of foreign-owned local units. There is strong evidence to suggest that the availability of local inputs has a negative impact on the productivity. The negative impact is not confined to the NACE 4-digit sector but also extends into related sectors as determined by Porter’s (2003) cluster classification. The cluster based skills measure of related variety has a positive and significant impact on the productivity of foreign-owned local units. Similar to Chapter 7, there is clear evidence to suggest that urbanization economies are important for increasing the productivity of foreign-owned local units. Both the summary measure and each of the more in-depth measures of agglomeration economies have a positive and significant impact on productivity. Spurious agglomeration has a positive and significant impact on the productivity of foreign-owned local units. The results indicate that the more foreign-owned local units of the same nationality in the country the greater the levels of productivity for the local unit. From a policy perspective, urbanization economies are clearly important for increasing the productivity of both indigenous and foreign-owned local units. Furthermore, the availability of a pool of skilled labour appears to be important for increasing the productivity of foreign-owned local units. Another policy implication that arises from these results relates to the differences observed between indigenous local units and foreign-owned local units and also between low-tech and medium/high-tech indigenous local units. These findings indicate that ‘one-size-fits-all’ type policies are not appropriate for increasing the productivity of local units operating in Ireland. Policies should be tailored to the needs of either indigenous or foreign-owned local units and also to specific sectors. This positive finding for own country spurious agglomeration is important from a policy perspective and is one that IDA Ireland should take on board.

The knowledge, attitudes and beliefs of patients and their healthcare professionals around oral dosage form modification: a systematic review of the qualitative literature

Objectives: The objective of this systematic review was to synthesize the available qualitative evidence on the knowledge, attitudes and beliefs of adult patients, healthcare professionals and carers about oral dosage form modification. Design: A systematic review and synthesis of qualitative studies was undertaken, utilising the thematic synthesis approach. Data sources: The following databases were searched from inception to September 2015: PubMed, Medline (EBSCO), EMBASE, CINAHL, PsycINFO, Web of Science, ProQuest Databases, Scopus, Turning Research Into Practice (TRIP), Cochrane Central Register of Controlled Trials (CENTRAL) and the Cochrane Database of Systematic Reviews (CDSR). Citation tracking and searching the references lists of included studies was also undertaken. Grey literature was searched using the OpenGrey database, internet searching and personal knowledge. An updated search was undertaken in June 2016. Review methods: Studies meeting the following criteria were eligible for inclusion; (i) used qualitative data collection and analysis methods; (ii) full-text was available in English; (iii) included adult patients who require oral dosage forms to be modified to meet their needs or; (iv) carers or healthcare professionals of patients who require oral dosage forms to be modified. Two reviewers independently appraised the quality of the included studies using the Critical Appraisal Skills Programme Checklist. A thematic synthesis was conducted and analytical themes were generated. Results: Of 5455 records screened, seven studies were eligible for inclusion; three involved healthcare professionals and the remaining four studies involved patients. Four analytical themes emerged from the thematic synthesis: (i) patient-centred individuality and variability; (ii) communication; (iii) knowledge and uncertainty and; (iv) complexity. The variability of individual patient’s requirements, poor communication practices and lack of knowledge about oral dosage form modification, when combined with the complex and multi-faceted healthcare environment complicate decision making regarding oral dosage form modification and administration. Conclusions: This systematic review has highlighted the key factors influencing the knowledge, attitudes and beliefs of patients and healthcare professionals about oral dosage form modifications. The findings suggest that in order to optimise oral medicine modification practices the needs of individual patients should be routinely and systematically assessed and decision-making should be supported by evidence based recommendations with multidisciplinary input. Further research is needed to optimise oral dosage form modification practices and the factors identified in this review should be considered in the development of future interventions.