900 resultados para Study of multiple cases


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This study is a consumer-survey conducted with former Marriage Guidance Council clients. The objectives were to identify and examine why they chose the agency, what their expectations and experiences were of marital counselling and whether anything was achieved. The material was derived from tape recorded interviews with 51 former M.G. clients (17 men and 34 women) from 42 marriages and with 21 counsellors; data from written material and a card-sort completed by the research sample; and the case record sheets of the research population (174 cases). The results from the written data of clients showed that 49% were satisfied with counselling, 25.5% were satisfied in some ways but not in others, and 25.5% were dissatisfied. Forty-six percent rated they had benefited from counselling, either a great deal or to some degree, 4% were neutral and 50% recorded they had not benefited. However the counsellors' assessments were more optimistic. It was also ascertained that 50% of the research sample eventually separated or divorced subsequent to counselling. A cross-check revealed that the majority who rated they were satisfied with counselling were those who remained married, whilst dissatisfied clients were the ones who unwillingly separated or divorced. The study then describes, discusses and assesses the experiences of clients in the light of these findings on a number of dimensions. From this it was possible to construct a summary profile of a "successful" client describing the features which would contribute to "success". Two key themes emerged from the data. (1) the discrepancy between clients expectations and the counselling offered, which included mis­ match over the aims and methods of counselling, and problem definition; and (2) the importance of the client/counsellor relationship. The various implications for the agency are then discussed which include recommendations on policy, the training of counsellors and further research.

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This thesis is organised into four parts. In Part 1 relevant literature is reviewed and presented in three chapters. Chapter 1 examines legal and cultural factors in identifying the. boundaries of rape. Chapter 2 discusses idiographic features· and causal characteristics of rape suspects and victims. Chapter 3 reviews the evidence relating to attitudes toward rape,. attribution of responsibility to victims and the routine management of rape cases by the police. Part II comprises an experimental investigation of observer perception of the victims of violent crime. The experiment, examined the processes by which impressions were attributed to victims of personal crime. The results suggested that discrepancies from observers' stereotypes were an important factor in their polarisation of victim ratings. The relevance of. examining . both the structure and process of' impression, formation was highlighted. Part III describes an extensive field study in which the West. Midlands police files on rape for an eight year period (1071-1978) were analysed. The study revealed a large number of interesting findings related to a wide range of relevant features of the crime. Further, the impact .of common misconceptions and "myths" of rape were investigated across the legal and judicial processing of rape cases. The evidence suggests that these "myths" lead·to differential biasing effects at different stages in the process. In the final part of this thesis,. salient issues raised by the experiment and field study .are discussed·within the framework outlined in Part 1. Potential implications for future developments and research: are presented.

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Factors affecting the current role of the community pharmacist in responding to symptoms are investigated. Communication and collaboration with general medical practitioners (GPs), and the competency of pharmacists and counter assistants to perform the role of responding to symptoms, are examined. A national survey of GPs, conducted by postal questionnaire, explores attitudes towards the role of the community pharmacist in the treatment of patients' symptoms, and towards future extension of such a role. A majority (over 90%) of respondents thought that the counter prescribing activities of the pharmacist should be maintained or increased. Doctors supported treatment of most minor illnesses by pharmacists, but there was relatively little support for the deregulation of selected Prescription Only Medicines. Three quarters of respondents were in favour of joint educational meetings for pharmacists and doctors. Most GPs (85%) expressed support for a formal referral route from pharmacists to doctors, using a "notification card". A pilot study of the use of a notification card was conducted . Two thirds of the patients who were advised to see their doctor by the pharmacist subsequently did so. In most cases , the GP rated the patients' symptoms " significant" and the card "helpful". Pharmacists' and counter assistants' competency in responding to symptoms was assessed by a programme of pharmacy visits, where previously-defined symptoms were presented. Some pharmacists' questioning skills were found to be inadequate, and their knowledge not sufficiently current. Counter assistants asked fewer and less appropriate questions than did pharmacists, and assistants ' knowledge base was shown to be inadequate. Recommendations are made in relation to the education and training of pharmacists and counter assistants in responding to symptoms .

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We report on a theoretical study of an interferometric system in which half of a collimated beam from a broadband optical source is intercepted by a glass slide, the whole beam subsequently being incident on a diffraction grating and the resulting spectrum being viewed using a linear CCD array. Using Fourier theory, we derive the expression of the intensity distribution across the CCD array. This expression is then examined for non-cavity and cavity sources for different cases determined by the direction from which the slide is inserted into the beam and the source bandwidth. The theoretical model shows that the narrower the source linewidth, the higher the deviation of the Talbot bands' visibility (as it is dependent on the path imbalance) from the previously known triangular shape. When the source is a laser diode below threshold, the structure of the CCD signal spectrum is very complex. The number of components present simultaneously increases with the number of grating lines and decreases with the laser cavity length. The model also predicts the appearance of bands in situations not usually associated with Talbot bands.

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This thesis is a qualitative case study drawing on discourse analysis and ethnographic traditions. The aim of the study is to provide a description of the discourse consciously constructed by a group of six TESOL professionals in the interests of their own development. Once a week, the group met for one hour and took turns to act as 'Speaker'. The other five individuals acted as Understanders. The extra space given to the Speaker allowed a fuller articulation of a problem or focus than would normally be possible in other professional talk. The Understanders contributed moves to support this articulation. The description covers a two-year period (1998-2000) of this constructed discourse. Data, collected during this period, are drawn from several different sources: recordings, interviews, diaries and critical incident journals. The main recordings are of the actual Group Development Meetings (GDMs). Discussion of six transcribed GDMs demonstrates which discourse choices and decisions were important. In particular, the study looks at the key role played by 'Reflection' in this process. It is argued that Reflection is the key element in supporting the Speaker. The analysis of Reflection, which is considered from four perspectives (values, purpose, form and outcomes) draws on data from the featured cases. Issues relating to the transfer to other groups of this discourse-based approach to professional development are considered.

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East-West trade has grown rapidly since the sixties, stimulating a parallel expansion in the literature on the subject. An extensive review of this literature shows how: (i) most of the issues involved have at their source the distinctions between East and West in political ideology and/or economic management, and (ii) there has been a tendency to keep theoretical and practical perspectives on the subject too separate. This thesis demonstrates the importance of understanding the fundamental principles implied in the first point, and represents an attempt to bridge the gap identified in the second. A detailed study of the market for fire fighting equipment in Eastern Europe is undertaken in collaboration with a medium-sized company, Angus Fire Armour Limited. Desk research methods are combined with visits to the market to assess the potential for the company's products, and recommendations for future strategy are made. The case demonstrates the scope and limitations of various research methods for the East European market, and a model for market research relevant to all companies is developed. Tne case study highlights three areas largely neglected in the literature: (i) the problems of internal company adaptation to East European conditions; (ii) the division of responsibility between foreign trade organisations; and (iii) bribery and corruption in East-West trade. Further research into the second topic - through a survey of 36 UK exporters - and the third - through analysis of publicised corruption cases - confirms the representativeness of the Angus experience, and reflects on the complexity of the Bast European import process, which does not always function as is commonly supposed. The very complexity of the problems confronting companies reaffirms the need to appreciate the principles underlying the subject, while the detailed analysis into questions of, originally, a marketing nature, reveals wider implications for East-West trade and East-West relations.

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Investment in transport infrastructure can be highly sensitive to uncertainty. The scale and lead time of strategic transport programmes are such that they require continuing policy support and accurate forecasting. Delay, cost escalation and abandonment of projects often result if these conditions are not present. In Part One the physical characteristics of infrastructure are identified as a major constraint on planning processes. The extent to which strategies and techniques acknowledge these constraints is examined. A simple simulation model is developed to evaluate the effects on system development of variations in the scale and lead time of investments. In Part Two, two case studies of strategic infrastructure investment are analysed. The absence of a policy consensus for airport location was an important factor in the delayed resolution of the Third London Airport issue. In London itself, the traffic and environmental effects of major highway investment ultimately resulted in the abandonment of plans to construct urban motorways. In both cases, the infrastructure implications of alternative strategies are reviewed with reference to the problems of uncertainty. In conclusion, the scale of infrastructure investment is considered the most important of the constraints on the processes of transport planning. Adequate appraisal of such constraints may best be achieved by evaluation more closely aligned to policy objectives.

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Recent research suggests cell-to-cell transfer of pathogenic proteins such as tau and α-synuclein may play a role in neurodegeneration. Pathogenic spread along neural pathways may give rise to specific spatial patterns of the neuronal cytoplasmic inclusions (NCI) characteristic of these disorders. Hence, the spatial patterns of NCI were compared in four tauopathies, viz., Alzheimer's disease, Pick's disease, corticobasal degeneration, and progressive supranuclear palsy, two synucleinopathies, viz., dementia with Lewy bodies and multiple system atrophy, the 'fused in sarcoma' (FUS)-immunoreactive inclusions in neuronal intermediate filament inclusion disease, and the transactive response DNA-binding protein (TDP-43)-immunoreactive inclusions in frontotemporal lobar degeneration, a TDP-43 proteinopathy (FTLD-TDP). Regardless of molecular group or morphology, NCI were most frequently aggregated into clusters, the clusters being regularly distributed parallel to the pia mater. In a significant proportion of regions, the regularly distributed clusters were in the size range 400-800 μm, approximating to the dimension of cell columns associated with the cortico-cortical pathways. The data suggest that cortical NCI in different disorders exhibit a similar spatial pattern in the cortex consistent with pathogenic spread along anatomical pathways. Hence, treatments designed to protect the cortex from neurodegeneration may be applicable across several different disorders. © 2012 Springer-Verlag.

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Electronic commerce (e-commerce) has become an increasingly important initiative among organisations. The factors affecting adoption decisions have been well-documented, but there is a paucity of empirical studies that examine the adoption of e-commerce in developing economies in the Arab world. The aim of this study is to provide insights into the salient e-commerce adoption issues by focusing on Saudi Arabian businesses. Based on the Technology-Organisational-Environmental framework, an integrated research model was developed that explains the relative influence of 19 known determinants. A measurement scale was developed from prior empirical studies and revised based on feedback from the pilot study. Non-interactive adoption, interactive adoption and stabilisation of e-commerce adoption were empirically investigated using survey data collected from Saudi manufacturing and service companies. Multiple discriminant function analysis (MDFA) was used to analyse the data and research hypotheses. The analysis demonstrates that (1) regarding the non-interactive adoption of e-commerce, IT readiness, management team support, learning orientation, strategic orientation, pressure from business partner, regulatory and legal environment, technology consultants‘ participation and economic downturn are the most important factors, (2) when e-commerce interactive adoption is investigated, IT readiness, management team support, regulatory environment and technology consultants‘ participation emerge as the strongest drivers, (3) pressure from customers may not have much effect on the non-interactive adoption of e-commerce by companies, but does significantly influence the stabilisation of e-commerce use by firms, and (4) Saudi Arabia has a strong ICT infrastructure for supporting e-commerce practices. Taken together, these findings on the multi-dimensionality of e-commerce adoption show that non-interactive adoption, interactive adoption and stabilisation of e-commerce are not only different measures of e-commerce adoption, but also have different determinants. Findings from this study may be valuable for both policy and practice as it can offer a substantial understanding of the factors that enhance the widespread use of B2B e-commerce. Also, the integrated model provides a more comprehensive explanation of e-commerce adoption in organisations and could serve as a foundation for future research on information systems.

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Abnormally enlarged neurons (AEN) occur in many neurodegenerative diseases. To define AEN more objectively, the frequency distribution of the ratio of greatest cell diameter(CD) to greatest nuclear diameter (ND) was studied in populations of cortical neurons in tissue sections of seven cognitively normal brains. The frequency distribution of CD/ND deviated from a normal distribution in 15 out of 18 populations of neurons studied and hence, the 95th percentile (95P) was used to define a limit of the CD/ND ratio excluding the5% most extreme observations. The 95P of the CD/ ND ratio varied from 2.0 to 3.0 in different cases and regions and a value of 95P = 3.0 was chosen to define the limit for normalneurons under non-pathological conditions. Based on the 95P = 3.0 criterion, the proportion of AEN with a CD/ND ≥ 3 varied from 2.6% in Alzheimer's disease (AD) to 20.3% in Pick's disease (PiD). The data suggest: (1) that a CL/ND ≥ 3.0 may be a useful morphological criterion for defining AEN, and (2) AEN were most numerous in PiD and corticobasal degeneration (CBD) and least abundant in AD and in dementia with Lewy bodies (DLB). © 2013 Dustri-Verlag Dr. K. Feistle.

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This study compares interpreter-mediated face-to-face Magistrates Court hearings with those conducted through prison video link in which interpreters are located in court and non- English-speaking defendants in prison. It seeks to examine the impact that the presence of video link has on court actors in terms of interaction and behaviour. The data comprises 11 audio-recordings of face-to-face hearings, 10 recordings of prison video link hearings, semistructured interviews with 27 court actors, and ethnographic observation of hearings as viewed by defendants in Wormwood Scrubs prison in London. The over-arching theme is the pervasive influence of the ecology of the courtroom upon all court actors in interpretermediated hearings and thus on the communication process. Close analysis of the court transcripts shows that their relative proximity to one another can be a determinant of status, interpreting role, mode and volume. The very few legal protocols which apply to interpretermediated cases (acknowledging and ratifying the interpreter, for example), are often forgotten or dispensed with. Court interpreters lack proper training in the specific challenges of court interpreting, whether they are co-present with the defendant or not. Other court actors often misunderstand the interpreter’s role. This has probably come about because courts have adjusted their perceptions of what they think interpreters are supposed to do based on their own experiences of working with them, and have gradually come to accept poor practice (the inability to perform simultaneous interpreting, for example) as the norm. In video link courts, mismatches of sound and image due to court clerks’ failure to adequately track current speakers, poor image and sound quality and the fact that non-English-speaking defendants in pre-and post-court consultations can see and hear interpreters but not their defence advocates are just some of the additional layers of disadvantage and confusion already suffered by non- English-speaking defendants. These factors make it less likely that justice will be done.

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The objective of this study was to determine the degree of white matter pathology in the cerebral cortex in cases of variant Creutzfeldt-Jakob disease (vCJD) and to study the relationships between the white matter and grey matter pathologies. Hence, the pathological changes in cortical white matter were studied in individual gyri of the frontal, parietal, occipital, and temporal cortex in eleven cases of vCJD. Vacuolation (‘spongiform change’), deposition of the disease form of prion protein (PrPsc) in the form of discrete PrP deposits, and gliosis were observed in the white matter of virtually all cortical regions studied. Mean density of the vacuoles in the white matter was greater in the parietal lobe compared with the frontal, occipital, and temporal lobes but there were fewer glial cells in the occipital lobe compared with the other cortical regions. In the white matter of the frontal cortex, vacuole density was negatively correlated with the density of both glial cell nuclei and the PrP deposits. In addition, the densities of glial cells and PrP deposits were positively correlated in the frontal and parietal cortex. In the white matter of the frontal cortex and inferior temporal gyrus, there was a negative correlation between the densities of the vacuoles and the number of surviving neurons in laminae V/VI of the adjacent grey matter. In addition, in the frontal cortex, vacuole density in the white matter was negatively correlated with the density of the diffuse PrP deposits in laminae II/III and V/VI of the adjacent grey matter. The densities of PrP deposits in the white matter of the frontal cortex were positively correlated with the density of the diffuse PrP deposits in laminae II/III and V/V1 and with the number of surviving neurons in laminae V/V1. The data suggest that in the white matter in vCJD, gliosis is associated with the development of PrP deposits while the appearance of the vacuolation is a later development. In addition, neuronal loss and PrP deposition in the lower cortical laminae of the grey matter may be a consequence of axonal degeneration within the white matter.

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Strategic sourcing has increased in importance in recent years, and now plays an important role in companies’ planning. The current volatility in supply markets means companies face multiple challenges involving lock-in situations, supplier bankruptcies or supply security issues. In addition, their exposure can increase due to natural disasters, as witnessed recently in the form of bird flu, volcanic ash and tsunamis. Therefore, the primary focus of this study is risk management in the context of strategic sourcing. The study presents a literature review on sourcing based on the 15 years from 1998–2012, and considers 131 academic articles. The literature describes strategic sourcing as a strategic, holistic process in managing supplier relationships, with a long-term focus on adding value to the company and realising competitive advantage. Few studies discovered the real risk impact and status of risk management in strategic sourcing, and evaluation across countries and industries was limited, with the construction sector particularly under-researched. This methodology is founded on a qualitative study of twenty cases across Ger-many and the United Kingdom from the construction sector and electronics manufacturing industries. While considering risk management in the context of strategic sourcing, the thesis takes into account six dimensions that cover trends in strategic sourcing, theoretical and practical sourcing models, risk management, supply and demand management, critical success factors and the strategic supplier evaluation. The study contributes in several ways. First, recent trends are traced and future needs identified across the research dimensions of countries, industries and companies. Second, it evaluates critical success factors in contemporary strategic sourcing. Third, it explores the application of theoretical and practical sourcing models in terms of effectiveness and sustainability. Fourth, based on the case study findings, a risk-oriented strategic sourcing framework and a model for strategic sourcing are developed. These are based on the validation of contemporary requirements and a critical evaluation of the existing situation. It contemplates the empirical findings and leads to a structured process to manage risk in strategic sourcing. The risk-oriented framework considers areas such as trends, corporate and sourcing strategy, critical success factors, strategic supplier selection criteria, risk assessment, reporting, strategy alignment and reporting. The proposed model highlights the essential dimensions in strategic sourcing and guides us to a new definition of strategic sourcing supported by this empirical study.

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We report on a theoretical study of an interferometric system in which half of a collimated beam from a broadband optical source is intercepted by a glass slide, the whole beam subsequently being incident on a diffraction grating and the resulting spectrum being viewed using a linear CCD array. Using Fourier theory, we derive the expression of the intensity distribution across the CCD array. This expression is then examined for non-cavity and cavity sources for different cases determined by the direction from which the slide is inserted into the beam and the source bandwidth. The theoretical model shows that the narrower the source linewidth, the higher the deviation of the Talbot bands' visibility (as it is dependent on the path imbalance) from the previously known triangular shape. When the source is a laser diode below threshold, the structure of the CCD signal spectrum is very complex. The number of components present simultaneously increases with the number of grating lines and decreases with the laser cavity length. The model also predicts the appearance of bands in situations not usually associated with Talbot bands.

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Objective - We tested the hypothesis that patients with difficult asthma have an increased frequency of certain genotypes that predispose them to asthma exacerbations and poor asthma control. Methods - A total of 180 Caucasian children with confirmed asthma diagnosis were selected from two phenotypic groups; difficult (n = 112) versus mild/moderate asthma (n = 68) groups. All patients were screened for 19 polymorphisms in 9 candidate genes to evaluate their association with difficult asthma. Key Results - The results indicated that LTA4H A-9188>G, TNFα G-308>A and IL-4Rα A1727>G polymorphisms were significantly associated with the development of difficult asthma in paediatric patients (p<0.001, p = 0.019 and p = 0.037, respectively). Haplotype analysis also revealed two haplotypes (ATA haplotype of IL-4Rα A1199>C, IL-4Rα T1570>C and IL-4Rα A1727>G and CA haplotype of TNFα C-863>A and TNFα G-308>A polymorphisms) which were significantly associated with difficult asthma in children (p = 0.04 and p = 0.018, respectively). Conclusions and Clinical Relevance - The study revealed multiple SNPs and haplotypes in LTA4H, TNFα and IL4-Rα genes which constitute risk factors for the development of difficult asthma in children. Of particular interest is the LTA4H A-9188>G polymorphism which has been reported, for the first time, to have strong association with severe asthma in children. Our results suggest that screening for patients with this genetic marker could help characterise the heterogeneity of responses to leukotriene-modifying medications and, hence, facilitate targeting these therapies to the subset of patients who are most likely to gain benefit.