989 resultados para Risco versus incerteza


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Background Centers for Disease Control Guidelines recommend replacement of peripheral intravenous (IV) catheters every 72 to 96 hours. Routine replacement is thought to reduce the risk of phlebitis and bacteraemia. Catheter insertion is an unpleasant experience for patients and replacement may be unnecessary if the catheter remains functional and there are no signs of inflammation. Costs associated with routine replacement may be considerable. Objectives To assess the effects of removing peripheral IV catheters when clinically indicated compared with removing and re-siting the catheter routinely.

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This study explores full-time workers' understanding of and assumptions about part-time work against six job quality components identified in recent literature. Forty interviews were conducted with employees in a public sector agency in Australia, a study context where part-time work is ostensibly 'good quality' and is typically long term, voluntary, involving secure contracts (i.e. permanent rather than casual) and having predictable hours distributed evenly over the week and year. Despite strong collective bargaining arrangements as well as substantial legal and industrial obligations, the findings revealed some serious concerns for part-time job quality. These concerns included reduced responsibilities and lesser access to high status roles and projects, a lack of access to promotion opportunities, increased work intensity and poor workplace support. The highly gendered, part-time labour market also means that it is women who disproportionately experience this disadvantage. To foster equity, greater attention needs to focus on monitoring and enhancing job quality, regardless of hours worked.

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Background The problem of silent multiple comparisons is one of the most difficult statistical problems faced by scientists. It is a particular problem for investigating a one-off cancer cluster reported to a health department because any one of hundreds, or possibly thousands, of neighbourhoods, schools, or workplaces could have reported a cluster, which could have been for any one of several types of cancer or any one of several time periods. Methods This paper contrasts the frequentist approach with a Bayesian approach for dealing with silent multiple comparisons in the context of a one-off cluster reported to a health department. Two published cluster investigations were re-analysed using the Dunn-Sidak method to adjust frequentist p-values and confidence intervals for silent multiple comparisons. Bayesian methods were based on the Gamma distribution. Results Bayesian analysis with non-informative priors produced results similar to the frequentist analysis, and suggested that both clusters represented a statistical excess. In the frequentist framework, the statistical significance of both clusters was extremely sensitive to the number of silent multiple comparisons, which can only ever be a subjective "guesstimate". The Bayesian approach is also subjective: whether there is an apparent statistical excess depends on the specified prior. Conclusion In cluster investigations, the frequentist approach is just as subjective as the Bayesian approach, but the Bayesian approach is less ambitious in that it treats the analysis as a synthesis of data and personal judgements (possibly poor ones), rather than objective reality. Bayesian analysis is (arguably) a useful tool to support complicated decision-making, because it makes the uncertainty associated with silent multiple comparisons explicit.

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The overall rate of omission of items for 28,331 17 year old Australian students on a high stakes test of achievement in the common elements or cognitive skills of the senior school curriculum is reported for a subtest in multiple choice format and a subtest in short response format. For the former, the omit rates were minuscule and there was no significant difference by gender or by type of school attended. For the latter, where an item can be 'worth' up to five times that of a single multiple choice item, the omit rates were between 10 and 20 times that for multiple choice and the difference between male and female omit rate was significant as was the difference between students from government and non-government schools. For both formats, females from single sex schools omitted significantly fewer items than did females from co-educational schools. Some possible explanations of omit behaviour are alluded to.

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The structures of two 1:1 proton-transfer red-black dye compounds formed by reaction of aniline yellow [4-(phenyldiazenyl)aniline] with 5-sulfosalicylic acid and benzenesulfonic acid, and a 1:2 nontransfer adduct compound with 3,5-dinitrobenzoic acid have been determined at either 130 or 200 K. The compounds are 2-(4-aminophenyl)-1-phenylhydrazin-1-ium 3-carboxy-4-hydroxybenzenesulfonate methanol solvate, C12H12N3+.C7H5O6S-.CH3OH (I), 2-(4-aminophenyl)-1-hydrazin-1-ium 4-(phenydiazinyl)anilinium bis(benzenesulfonate), 2C12H12N3+.2C6H5O3S-, (II) and 4-(phenyldiazenyl)aniline-3,5-dinitrobenzoic acid (1/2) C12H11N3.2C~7~H~4~N~2~O~6~, (III). In compound (I) the diaxenyl rather than the aniline group of aniline yellow is protonated and this group subsequently akes part in a primary hydrogen-bonding interaction with a sulfonate O-atom acceptor, producing overall a three-dimensional framework structure. A feature of the hydrogen bonding in (I) is a peripheral edge-on cation-anion association involving aromatic C--H...O hydrogen bonds, giving a conjoint R1/2(6)R1/2(7)R2/1(4)motif. In the dichroic crystals of (II), one of the two aniline yellow species in the asymmetric unit is diazenyl-group protonated while in the other the aniline group is protonated. Both of these groups form hydrogen bonds with sulfonate O-atom acceptors and thee, together with other associations give a one-dimensional chain structure. In compound (III), rather than proton-transfer, there is a preferential formation of a classic R2/2(8) cyclic head-to-head hydrogen-bonded carboxylic acid homodimer between the two 3,5-dinitrobenzoic acid molecules, which in association with the aniline yellow molecule that is disordered across a crystallographic inversion centre, result in an overall two-dimensional ribbon structure. This work has shown the correlation between structure and observed colour in crystalline aniline yellow compounds, illustrated graphically in the dichroic benzenesulfonate compound.

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The range of political information sources available to modern Australians is greater and more varied today than at any point in the nation’s history, incorporating print, broadcast, Internet, mainstream and non-mainstream media. In such a competitive media environment, the factors which influence the selection of some information sources above others are of interest to political agents, media institutions and communications researchers alike. A key factor in information source selection is credibility. At the same time that the range of political information sources is increasing rapidly, due to the development of new information and communication technologies, audience research suggests that trust in mainstream media organisations in many countries is declining. So if people distrust the mainstream media, but have a vast array of alternative political information sources available to them, what do their personal media consumption patterns look like? How can we analyse such media consumption patterns in a meaningful way? In this paper I will briefly map the development of media credibility research in the US and Australia, leading to a discussion of one of the most recent media credibility constructs to be shown to influence political information consumption, media scepticism. Looking at the consequences of media scepticism, I will then consider the associated media consumption construct, media diet, and evaluate its usefulness in an Australian, as opposed to US, context. Finally, I will suggest alternative conceptualisations of media diets which may be more suited to Australian political communications research.

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Background: Blood for transfusion may become contaminated at any point between collection and transfusion and may result in bacteraemia (the presence of bacteria in the blood),severe illness or even death for the blood recipient. Donor arm skin is one potential source of blood contamination, so it is usual to cleanse the skin with an antiseptic before blood donation. One-step and two-step alcohol based antiseptic regimens are both commonly advocated but there is uncertainty as to which is most effective.----- Objectives: To assess the effects of cleansing the skin of blood donors with alcohol in a one-step compared with alcohol in a two-step procedure to prevent contamination of collected blood or bacteraemia in the recipient.----- Search strategy: We searched the Cochrane Wounds Group Specialised Register (March 10 2009); The Cochrane Central Register of Controlled Trials(CENTRAL) The Cochrane Library 2009, Issue 1; Ovid MEDLINE - (1950 to February Week 4 2009); Ovid EMBASE - (1980 to 2009 Week 9); and EBSCO CINAHL - (1982 to February Week 4 2009). We also searched the reference lists of key papers.----- Selection criteria: All randomised trials (RCTs) comparing alcohol based donor skin cleansing in a one-step versus a two-step process that includes alcohol and any other antiseptic for pre-venepuncture skin cleansing were considered. Quasi randomised trials were to have been considered in the absence of RCTs.----- Data collection and analysis: Two review authors independently assessed studies for inclusion.----- Main results: No studies (RCTs or quasi RCTs) met the inclusion criteria. Authors’ conclusions We did not identify any eligible studies for inclusion in this review. It is therefore unclear whether a two-step, alcohol followed by antiseptic skin cleansing process prior to blood donation confers any reduction in the risk of blood contamination or bacteraemia in blood recipients, or conversely whether a one-step process increases risk above that associated with a two-step process.

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The purpose of this paper is to conduct a qualitative review of randomised controlled trials in relation to the treatment of adults with co-occurring mental health and substance use disorder (MH/SUD). In particular, integrated approaches are compared with non-integrated approaches to treatment. Ten articles were identified for inclusion in the review. The findings are equivocal with regard to the superior efficacy of integrated approaches to treatment, although the many limitations of the studies need to be considered in our understanding of this finding. Clearly, this is an extremely challenging client group to engage and maintain in intervention research, and the complexity and variability of the problems render control particularly difficult. The lack of available evidence to support the superiority of integration is discussed in relation to these challenges. Much remains to be investigated with regard to integrated management and care for people with co-occurring and MH/SUD, particularly for specific combinations of dual diagnosis and giving consideration to the level of inter-relatedness between the disorders.

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A commonly held belief in the IS discipline is that rigour and relevance are contrary to each other and that addressing both is virtually impossible. It is also believed widely that the editorial practices of our premier conferences and journals over-emphasise rigour on the cost of relevance. However, while these two topics have been filled with numerous subjective discussions, more solid evidence into the true relationship between rigour and relevance and the impact of conference editors on this relationship is still outstanding. This paper contributes to this debate by deriving empirical evidence from a comprehensive and detailed analysis of the characteristics of the submissions and the reviewing practices of three recent IS conferences. It provides first insights into the actual relationship between rigour and relevance and into the role conference chairs play in balancing rigour and relevance. Besides the outcomes that the current set of evaluation criteria does not provide a straight forward proxy for relevance to practitioners, the paper offers two main contributions. First, empirical insights are provided that rigour and relevance do in fact not have to be mutually exclusive. Second, the editorial practices at conferences are skewed towards rigorous papers rather than relevant papers.

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While there is substantial research on attitudinal and behavioral loyalty, the deconstruction of attitudinal loyalty into its two key components – emotional and cognitive loyalty – has been largely ignored. Despite the existence of managerial strategies aimed at increasing each of these two components, there is little academic research to support these managerial efforts. This paper seeks to advance the understanding of emotional and cognitive brand loyalty by examining the psychological function that these dimensions of brand loyalty perform for the consumer. We employ Katz’s (1960) four functions of attitudes (utilitarian, knowledge, value-expression, ego-defence) to investigate this question. Surveys using a convenience sample were completed by 268 consumers in two metropolitan cities on a variety of goods, services and durable products. The relationship between the functions and dimensions of loyalty were examined using MANOVA. The results show that both the utilitarian and knowledge functions of loyalty are significantly positively related to cognitive loyalty while the ego-defensive function of loyalty is significantly positively related to emotional loyalty. The results for the value-expressive function of loyalty were nonsignificant.

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Managing through projects has become important for generating new knowledge to cope with technological and market discontinuities. This paper examines how the fit between the creation of technological and market knowledge and important project management characteristics, i.e. project autonomy and completion criteria, influences the success of new business development (NBD) projects. In-depth longitudinal case research on NBD projects commercialised from 1993 to 2003 in the consumer electronics industry highlights that project management characteristics focusing only on the creation of technological knowledge contributed to the failure of those NBD projects that required new market knowledge as well. The findings indicate that senior management support and engaging in an alliance with partners possessing complementary market knowledge can offset this misalignment of the organisation of NBD projects.

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This document contains a creative work – the text of a young adult novel, Skydweller – and an exegesis discussing the ways in which identity and the adolescent crisis of group identity versus alienation are represented in young adult science fiction/fantasy novels.

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In their studies, Eley and Meyer (2004) and Meyer and Cleary (1998) found that there are sources of variation in the affective and process dimensions of learning in mathematics and clinical diagnosis specific to each of these disciplines. Meyer and Shanahan (2002) argue that: General purpose models of student learning that are transportable across different discipline contexts cannot, by definition, be sensitive to sources of variation that may be subject-specific (2002. p. 204). In other words, to explain the differences in learning approaches and outcomes in a particular discipline, there are discipline-specific factors, which cannot be uncovered in general educational research. Meyer and Shanahan (2002) argue for a need to "seek additional sources of variation that are perhaps conceptually unique ... within the discourse of particular disciplines" (p. 204). In this paper, the development of an economics-specific construct (called economic thinking ability) is reported. The construct aims to measure discipline-sited ability of students that has important influence on learning in economics. Using this construct, economic thinking abilities of introductory and intermediate level economics students were measured prior to the commencement, and at the end, of their study over one semester. This enabled factors associated with students' pre-course economic thinking ability and their development in economic thinking ability to be investigated. The empirical findings will address the 'nature' versus 'nurture' debate in economics education (Frank, et aI., 1993; Frey et al., 1993; Haucap and Tobias 2003). The implications for future research in economics education will also be discussed.

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Background: The Functional Capacity Index (FCI) was designed to predict physical function 12 months after injury. We report a validation study of the FCI. Methods: This was a consecutive case series registered in the Queensland Trauma Registry who consented to the prospective 12-month telephone-administered follow-up study. FCI scores measured at 12 months were compared with those originally predicted. Results: Complete Abbreviated Injury Scale score information was available for 617 individuals, of whom 587 (95%) could be assigned at least one FCI score (range, 1-17). Agreement between the largest predicted FCI and observed FCI score was poor ([kappa] = 0.05; 95% confidence interval, 0.00-0.10) and explained only 1% of the variability in observed FCI. Using an encompassing model that included all FCI assignments, agreement remained poor ([kappa] = 0.05; 95% confidence interval, -0.02-0.12), and the model explained only 9% of the variability in observed FCI. Conclusion: The predicted functional capacity poorly agrees with actual functional outcomes. Further research should consider including other (noninjury) explanatory factors in predicting FCI at 12 months.