927 resultados para Being towards death


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The value of information technology (IT) is often realized when continuously being used after users’ initial acceptance. However, previous research on continuing IT usage is limited for dismissing the importance of mental goals in directing users’ behaviors and for inadequately accommodating the group context of users. This in-progress paper offers a synthesis of several literature to conceptualize continuing IT usage as multilevel constructs and to view IT usage behavior as directed and energized by a set of mental goals. Drawing from the self-regulation theory in the social psychology, this paper proposes a process model, positioning continuing IT usage as multiple-goal pursuit. An agent-based modeling approach is suggested to further explore causal and analytical implications of the proposed process model.

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Australia has a significantly higher suicide rate than England. Rather than accepting that this ‘statistical fact’ is a direct reflection of some positivist truth, this paper begins with the premise that how suicide is counted depends upon what counts as suicide. This study involves semi-structured interviews with coroners both in Australia and England, as well as observations at inquests. Important differences between the two coronial systems include: first, quite different logics of operation; second, the burden of proof for reaching a finding of suicide is significantly higher in England; and third, the presence of family members at English inquests results in far greater pressure being brought to bear upon coroners. These combined factors result in a reduced likelihood of English coroners reaching a finding of suicide. The conclusions are twofold. First, this research supports existing criticisms of comparative suicide statistics. Second, this research adds theoretical weight to criticisms of positivist analyses of social phenomena.

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In current practice, urban-rural development has been regarded as one of the key pillars in driving regenerative development that includes economic, social, and environmental balance. In association with rapid urbanization, an important contemporary issue in China is that its rural areas are increasingly lagging behind urban areas in their development and a coordinated provision of public facilities in rural areas is necessary to achieve a better balance. A model is therefore introduced for quantifying the effect of individual infrastructure projects on urban-rural balance (e-UR) by focusing on two attributes, namely, efficiency and equity. The model is demonstrated through a multi-criteria model, developed with data collected from infrastructure projects in Chongqing, with the criteria values for each project being scored by comparing data collected from the project involved with e-UR neutral “benchmark” values derived from a survey of experts in the field. The model helps evaluate the contribution of the projects to improving rural-urban balance and hence enable government decision-makers for the first time to prioritize future projects rigorously in terms of their likely contribution too.

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This paper considers the epistemological life cycle of the camera lens in documentary practices. The 19th century industrial economies that manufactured and commercialised the camera lens have engendered political and economic contingencies on documentary practices to sustain a hegemonic and singular interpretive epistemology. Colonial documentary practices are considered from the viewpoint of manipulative hegemonic practices - all of which use the interpretive epistemology of the camera lens to capitalise a viewpoint which is singular and possesses the power to sustain its own status and economic privilege. I suggest that decolonising documentary practices can be nurtured in what Boaventura de Sousa Santos proposes as an 'ecology of knowledges' (Andreotti, Ahenakew, & Cooper 2011) - a way of including the epistemologies of cultures beyond the 'abyssal' (Santos), outside the limits of epistemological dominance. If an 'epistemicide' (Santos) of indigenous knowledges in the dominant limits has occurred then in an ecology of knowledges the limits become limitless and what were once invisible knowledges, come into their own ontological and epistemological being: as free agents and on their own terms. In an ecology of knowledges, ignorance and blindness may still exist but are not privileged. The decolonisation of documentary practices inevitably destabilises prevailing historicities and initiates ways for equal privilege to exist between multiple epistemologies.

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Background Up-to-date evidence on levels and trends for age-sex-specific all-cause and cause-specific mortality is essential for the formation of global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013) we estimated yearly deaths for 188 countries between 1990, and 2013. We used the results to assess whether there is epidemiological convergence across countries. Methods We estimated age-sex-specific all-cause mortality using the GBD 2010 methods with some refinements to improve accuracy applied to an updated database of vital registration, survey, and census data. We generally estimated cause of death as in the GBD 2010. Key improvements included the addition of more recent vital registration data for 72 countries, an updated verbal autopsy literature review, two new and detailed data systems for China, and more detail for Mexico, UK, Turkey, and Russia. We improved statistical models for garbage code redistribution. We used six different modelling strategies across the 240 causes; cause of death ensemble modelling (CODEm) was the dominant strategy for causes with sufficient information. Trends for Alzheimer's disease and other dementias were informed by meta-regression of prevalence studies. For pathogen-specific causes of diarrhoea and lower respiratory infections we used a counterfactual approach. We computed two measures of convergence (inequality) across countries: the average relative difference across all pairs of countries (Gini coefficient) and the average absolute difference across countries. To summarise broad findings, we used multiple decrement life-tables to decompose probabilities of death from birth to exact age 15 years, from exact age 15 years to exact age 50 years, and from exact age 50 years to exact age 75 years, and life expectancy at birth into major causes. For all quantities reported, we computed 95% uncertainty intervals (UIs). We constrained cause-specific fractions within each age-sex-country-year group to sum to all-cause mortality based on draws from the uncertainty distributions. Findings Global life expectancy for both sexes increased from 65·3 years (UI 65·0–65·6) in 1990, to 71·5 years (UI 71·0–71·9) in 2013, while the number of deaths increased from 47·5 million (UI 46·8–48·2) to 54·9 million (UI 53·6–56·3) over the same interval. Global progress masked variation by age and sex: for children, average absolute differences between countries decreased but relative differences increased. For women aged 25–39 years and older than 75 years and for men aged 20–49 years and 65 years and older, both absolute and relative differences increased. Decomposition of global and regional life expectancy showed the prominent role of reductions in age-standardised death rates for cardiovascular diseases and cancers in high-income regions, and reductions in child deaths from diarrhoea, lower respiratory infections, and neonatal causes in low-income regions. HIV/AIDS reduced life expectancy in southern sub-Saharan Africa. For most communicable causes of death both numbers of deaths and age-standardised death rates fell whereas for most non-communicable causes, demographic shifts have increased numbers of deaths but decreased age-standardised death rates. Global deaths from injury increased by 10·7%, from 4·3 million deaths in 1990 to 4·8 million in 2013; but age-standardised rates declined over the same period by 21%. For some causes of more than 100 000 deaths per year in 2013, age-standardised death rates increased between 1990 and 2013, including HIV/AIDS, pancreatic cancer, atrial fibrillation and flutter, drug use disorders, diabetes, chronic kidney disease, and sickle-cell anaemias. Diarrhoeal diseases, lower respiratory infections, neonatal causes, and malaria are still in the top five causes of death in children younger than 5 years. The most important pathogens are rotavirus for diarrhoea and pneumococcus for lower respiratory infections. Country-specific probabilities of death over three phases of life were substantially varied between and within regions. Interpretation For most countries, the general pattern of reductions in age-sex specific mortality has been associated with a progressive shift towards a larger share of the remaining deaths caused by non-communicable disease and injuries. Assessing epidemiological convergence across countries depends on whether an absolute or relative measure of inequality is used. Nevertheless, age-standardised death rates for seven substantial causes are increasing, suggesting the potential for reversals in some countries. Important gaps exist in the empirical data for cause of death estimates for some countries; for example, no national data for India are available for the past decade.

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Objectives Medical and dental students experience poor psychological well-being relative to their peers. This study aimed to assess the psychological well-being among medical and dental students in Saudi Arabia, identify the high-risk groups and assess the association between the psychological well-being and the academic performance. Methods In this cross-sectional study, 422 preclinical medical and dental students at Umm Al-Qura University, Saudi Arabia, were recruited to assess their depression, anxiety, stress, self-efficacy and satisfaction with life levels using 21-items Depression Anxiety Stress Scale (DASS-21), General Self-Efficacy (GSE) scale and Satisfaction With Life Scale (SWLS). Students’ academic weighted grades were obtained later. Descriptive statistics and univariate general linear model were used to analyse data. Results High levels of depression (69.9%), anxiety (66.4%) and stress (70.9%) were indicated, whereas self-efficacy (mean = 27.22, sd = 4.85) and life satisfaction (mean = 23.60, sd = 6.37) were within the normal range. Female medical students had higher psychological distress in contrast to dental students. In general, third-year students were more depressed and stressed in comparison with second-year students, except for stress among dental students. Moreover, all females had higher self-efficacy than males. Life satisfaction was higher within the second-year and high family income students. Depression was the only psychological variable correlated with the academic performance. Conclusion High levels of psychological distress were found. Female medical students had higher psychological distress than males, whereas male dental students had higher distress than female. Medical students at third year were more depressed and stressed. Dental students were more depressed in the third year, but more stressed in the second year. Attention should be directed towards reducing the alarming levels of depression, anxiety and stress among medical and dental students.

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Role congruity theory predicts prejudice towards women who meet the agentic requirements of the leader role. In line with recent findings indicating greater acceptance of agentic behaviour from women, we find evidence for a more subtle form of prejudice towards women who fail to display agency in leader roles. Using a classic methodology, the agency of male and female leaders was manipulated using assertive or tentative speech, presented through written (Study 1, N = 167) or verbal (Study 2, N = 66) communications. Consistent with predictions, assertive women were as likeable and influential as assertive men, while being tentative in leadership reduced the likeability and influence of women, but not of men. Although approval of agentic behaviour from women in leadership reflects progress, evidence that women are quickly singled out for disapproval if they fail to show agency is important for understanding how they continue to be at a distinct disadvantage to men in leader roles.

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Driver cognitions about aggressive driving of others are potentially important to the development of evidence-based interventions. Previous research has suggested that perceptions that other drivers are intentionally aggressive may influence recipient driver anger and subsequent aggressive responses. Accordingly, recent research on aggressive driving has attempted to distinguish between intentional and unintentional motives in relation to problem driving behaviours. This study assessed driver cognitive responses to common potentially provocative hypothetical driving scenarios to explore the role of attributions in driver aggression. A convenience sample of 315 general drivers 16–64 yrs (M = 34) completed a survey measuring trait aggression (Aggression Questionnaire AQ), driving anger (Driving Anger Scale, DAS), and a proxy measure of aggressive driving behaviour (Australian Propensity for Angry Driving AusPADS). Purpose designed items asked for drivers’ ‘most likely’ thought in response to AusPADS scenarios. Response options were equivalent to causal attributions about the other driver. Patterns in endorsements of attribution responses to the scenarios suggested that drivers tended to adopt a particular perception of the driving of others regardless of the depicted circumstances: a driving attributional style. No gender or age differences were found for attributional style. Significant differences were detected between attributional styles for driving anger and endorsement of aggressive responses to driving situations. Drivers who attributed the on-road event to the other being an incompetent or dangerous driver had significantly higher driving anger scores and endorsed significantly more aggressive driving responses than those drivers who attributed other driver’s behaviour to mistakes. In contrast, drivers who gave others the ‘benefit of the doubt’ endorsed significantly less aggressive driving responses than either of these other two groups, suggesting that this style is protective.

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The Australian water sector needs to adapt to effectively deal with the impacts of climate change on its systems. Challenges as a result of climate change include increasingly extreme occurrences of weather events including flooding and droughts (Pittock, 2011). In response to such challenges, the National Water Commission in Australia has identified the need for the water sector to transition towards being readily adaptable and able to respond to complex needs for a variety of supply and demand scenarios (National Water Commission, 2013). To successfully make this transition, the sector will need to move away from business as usual, and proactively pursue and adopt innovative approaches and technologies as a means to successfully address the impacts of climate change on the Australian water sector. In order to effectively respond to specific innovation challenges related to the sector, including climate change, it is first necessary to possess a foundational understanding about the key elements related to innovation in the sector. This paper presents this base level understanding, identifying the key barriers, drivers and enablers, and elements for innovative practise in the water sector. After initially inspecting the literature around the challenges stemming from climate change faced by the sector, the paper then examines the findings from the initial two rounds of a modified Delphi study, conducted with experts from the Australian water sector, including participants from research, government and industry backgrounds. The key barriers, drivers and enablers for innovation in the sector identified during the initial phase of the study formed the basis for the remainder of the investigation. Key elements investigated were: barriers – scepticism, regulation systems, inconsistent policy; drivers – influence of policy, resource scarcity, thought leadership; enablers – framing the problem, effective regulations, community acceptance. There is a convincing argument for the water sector transitioning to a more flexible, adaptive and responsive system in the face of challenges resulting from climate change. However, without first understanding the challenges and opportunities around making this transition, the likelihood of success is limited. For that reason, this paper takes the first step in understanding the elements surrounding innovation in the Australian water sector.

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BACKGROUND Quantification of the disease burden caused by different risks informs prevention by providing an account of health loss different to that provided by a disease-by-disease analysis. No complete revision of global disease burden caused by risk factors has been done since a comparative risk assessment in 2000, and no previous analysis has assessed changes in burden attributable to risk factors over time. METHODS We estimated deaths and disability-adjusted life years (DALYs; sum of years lived with disability [YLD] and years of life lost [YLL]) attributable to the independent effects of 67 risk factors and clusters of risk factors for 21 regions in 1990 and 2010. We estimated exposure distributions for each year, region, sex, and age group, and relative risks per unit of exposure by systematically reviewing and synthesising published and unpublished data. We used these estimates, together with estimates of cause-specific deaths and DALYs from the Global Burden of Disease Study 2010, to calculate the burden attributable to each risk factor exposure compared with the theoretical-minimum-risk exposure. We incorporated uncertainty in disease burden, relative risks, and exposures into our estimates of attributable burden. FINDINGS In 2010, the three leading risk factors for global disease burden were high blood pressure (7·0% [95% uncertainty interval 6·2-7·7] of global DALYs), tobacco smoking including second-hand smoke (6·3% [5·5-7·0]), and alcohol use (5·5% [5·0-5·9]). In 1990, the leading risks were childhood underweight (7·9% [6·8-9·4]), household air pollution from solid fuels (HAP; 7·0% [5·6-8·3]), and tobacco smoking including second-hand smoke (6·1% [5·4-6·8]). Dietary risk factors and physical inactivity collectively accounted for 10·0% (95% UI 9·2-10·8) of global DALYs in 2010, with the most prominent dietary risks being diets low in fruits and those high in sodium. Several risks that primarily affect childhood communicable diseases, including unimproved water and sanitation and childhood micronutrient deficiencies, fell in rank between 1990 and 2010, with unimproved water and sanitation accounting for 0·9% (0·4-1·6) of global DALYs in 2010. However, in most of sub-Saharan Africa childhood underweight, HAP, and non-exclusive and discontinued breastfeeding were the leading risks in 2010, while HAP was the leading risk in south Asia. The leading risk factor in Eastern Europe, most of Latin America, and southern sub-Saharan Africa in 2010 was alcohol use; in most of Asia, North Africa and Middle East, and central Europe it was high blood pressure. Despite declines, tobacco smoking including second-hand smoke remained the leading risk in high-income north America and western Europe. High body-mass index has increased globally and it is the leading risk in Australasia and southern Latin America, and also ranks high in other high-income regions, North Africa and Middle East, and Oceania. INTERPRETATION Worldwide, the contribution of different risk factors to disease burden has changed substantially, with a shift away from risks for communicable diseases in children towards those for non-communicable diseases in adults. These changes are related to the ageing population, decreased mortality among children younger than 5 years, changes in cause-of-death composition, and changes in risk factor exposures. New evidence has led to changes in the magnitude of key risks including unimproved water and sanitation, vitamin A and zinc deficiencies, and ambient particulate matter pollution. The extent to which the epidemiological shift has occurred and what the leading risks currently are varies greatly across regions. In much of sub-Saharan Africa, the leading risks are still those associated with poverty and those that affect children.

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India’s desire to transform itself into an international military power has brought about a rapid shift in its approach to procuring military hardware. The indigenization of India’s military manufacturing capacity forms an integral part of the strategic objectives of Indian military services, with its realization being a function of significant government investment in strategic technologies. This has a number of ramifications. An indigenous Indian military capacity, particularly in the field of aviation, forms a key part of India’s ambition of achieving regional air superiority, or even supremacy, and being capable of power projection. This is particularly in response to China’s increasing presence in South Asian airspace. A burgeoning Indian military manufacturing machine based on a comparative advantage in skilled technicians and lower-cost labour, together with strategic collaboration with foreign military hardware manufacturers, may also lead to neighbouring countries looking to India as a source of competitively priced military hardware. In short, this chapter seeks to analyse the rationale behind India’s attempt to become militarily self-sufficient in the field of aviation, discuss the technical, economic and political context in which it is achieving this transformation, and assess the potential outlook of success for India’s drive to achieve self-sufficiency in the arena of military aviation. This chapter will do so by using the case of India’s attempt to develop a fifth-generation fighter aircraft.

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Without question a child’s death is a devastating event for parents and their families. Health professionals working with the dying child and family draw upon their expertise and experience to engage with children, parents, and families on this painful journey. A delicate and sensitive area of practice, it has strong and penetrating effects on health professionals. They employ physical, emotional, spiritual and problem solving strategies to continue to perform this role effectively and to protect their continued sense of well-being. Aim To explore health professionals’ perceptions of bereavement support surrounding the loss of a child. Methods The research was underpinned by social constructionism. Semi-structured interviews were held with 10 health professionals including doctors, nurses and social workers who were directly involved in the care of the dying child and family in 7 cases of paediatric death. Health professional narratives were analysed consistent with Charmarz’s (2006) approach. Results For health professionals, constructions around coping emerged as peer support, personal coping strategies, family support, physical impact of support and spiritual beliefs . Analysis of the narratives also revealed health professionals’ perceptions of their support provision. Conclusion Health professionals involved in caring for dying children and their families use a variety of strategies to cope with the emotional and physical toll of providing support. They also engage in self-assessment to evaluate their support provision and this highlights the need for self-evaluation tools in paediatric palliative care.

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The last three decades have been difficult for companies and industry. In an increasingly competitive international business climate with shifting national environmental regulations, higher standards are being demanded by the consumer and community groups, not-to-mention the escalating cost of primary resources such as water, steel and minerals. The cause of these pressures is the traditional notion held by business executives and engineers that there is an inherent trade off between eco-efficiency and improving the economic bottom line. However there is significant evidence and examples of best practice to show that there is in fact no trade-off between the environment and the economy if sustainable development through continual improvement is adopted. It is highly possible therefore for companies to make a profitable transition towards sustainable business practice, where along the transition significant business opportunities can be taken advantage of. Companies are by their very nature dynamic, influential and highly capable of adapting to change. Making an organisational transformation to a sustainable business is not outside the capacity of the typical company, who know much of what is needed already to change their activities to satisfy current market demands while achieving competitiveness. However in order to make the transition towards sustainable business practice companies require some key mechanisms such as accurate information on methodologies and opportunities, understanding of the financial and non-financial incentives, permission from stakeholders and shareholders, understanding of the emerging market opportunities, a critical mass of leaders in their sector and demonstrated case studies, and awarding appropriate risk-taking activities undertaken by engineers and CEOs. Satisfying these requirements will adopt an innovative culture within the company that strives for continual improvement and successfully transforms itself to achieve competitiveness in the 21st Century. This paper will summarise the experiences of The Natural Edge Project (TNEP) and its partners in assisting organisations to make a profitable transition towards sustainable business practice through several initiatives. The Natural Advantage of Nations publication provides the critical information required by business leaders and engineers to set the context of sustainable business practice. The Profiting in a Carbon Constrained World report, developed with Natural Capitalism Inc led by Hunter Lovins, summarises the opportunities available to companies to take advantage of the carbon trading market mechanisms such as the Chicago Climate Exchange and European Climate Exchange. The Sustainability Helix then guides the company through the transition by identifying the key tools and methodologies required by companies to reduce environmental loading while dramatically improving resource productivity and achieving competitiveness. Finally, the Engineering Sustainable Solutions Program delivers the key engineering information required by companies and university departments to deliver sustainable engineering solutions. The initiatives are of varying complexity and level of application, however all are designed to provide key staff the critical information required to make a profitable transition towards sustainable business practice. It is then their responsibility to apply and teach their knowledge to the rest of the organisation.

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There have been recent improvements in the clinical understanding and definition of the major types of autoimmune liver disease. However, still lacking is knowledge of their prevalence and pathogenesis. Three areas of study are in progress in our laboratory. First, in type 1 autoimmune hepatitis, the search continues to identify a liver/disease-specific autoantigenic reactant. Using hepatocyte membrane preparations, immunoblotting has underlined the problem of distinguishing, among multiple reactants, those that may be causally rather than consequentially related to hepatocellular damage. Second, in primary biliary cirrhosis (PBC), the need for population screening to ascertain prevalence and detect preclinical cases can be met by a rapid automated procedure for detection, by specific enzyme inhibition in microtitre wells, of antibody (anti-M2) to the pyruvate dehydrogenase complex E2 subunit (PDC-E2). Third, the structure of the conformational epitope within the inner lipoyl domain of PDC-E2 is being investigated by screening random phage-displayed peptide libraries using PBC sera. This has yielded phage clones in which the sequence of the peptide insert portrays the structure of this epitope, as judged by clustering of PBC-derived sequences to particular branches of a guide-tree that shows relatedness of peptides, and by reactivity of selected phage clones with anti-PDC-E2. Thus phage display identifies a peptide 'mimotope' of the antibody epitope in the inner lipoyl domain of PDC-E2.

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Sustainable urban development, a major issue at global scale, will become more relevant according to population growth predictions in developed and developing countries. Societal and international recognition of sustainability concerns led to the development of specific tools and procedures, known as sustainability assessments/appraisals (SA). Their effectiveness however, considering that global quality life indicators have worsened since their introduction, has promoted a re-thinking of SA instruments. More precisely, Strategic Environmental Assessment (SEA), – a tool introduced in the European context to evaluate policies, plans, and programmes (PPPs), – is being reconsidered because of several features that seem to limit its effectiveness. Over time, SEA has evolved in response to external and internal factors dealing with technical, procedural, planning and governance systems thus involving a shift of paradigm from EIA-based SEAs (first generation protocols) towards more integrated approaches (second generation ones). Changes affecting SEA are formalised through legislation in each Member State, to guide institutions at regional and local level. Defining SEA effectiveness is quite difficult. Its’ capacity-building process appears quite far from its conclusion, even if any definitive version can be conceptualized. In this paper, we consider some European nations with different planning systems and SA traditions. After the identification of some analytical criteria, a multi-dimensional cluster analysis is developed on some case studies, to outline current weaknesses.