916 resultados para evidence-in-chief


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This report summarizes the data, observations, methods, assumptions, and decisions for the design of the Relief Well Rehabilitation Project in the Right Abutment Drainage Tunnel at Chief Joseph Dam. Chief Joseph Dam (CJD) is a dam on the Columbia River and is owned and operated by the U.S. Army Corps of Engineers (USACE). It is the second only to Grand Coulee dam as the largest producer of hydropower in the United States. The right abutment drainage tunnel contains wooden stave relief wells. Water flows from these wells which reduces the hydrostatic pressure in the right abutment of the dam. The 22 wells in the floor of the tunnel are 60 years old and are in need of rehabilitation. The objective of this project is to control the groundwater gradient, prevent the movement of sediment, stop total screen collapse, and prevent initiation of backwards erosion and piping in the abutment. The rehabilitation solution is to install new stainless steel screens into the existing wells, backfill the annular space between the old wooden screen and the new stainless steel screens with a 3/8-inch pea gravel filter pack, and install a new top cap to hold the new screen in place. This report documents the data, observations, and methods used to complete the final design. During tunnel inspections USACE geologists observed dislodged end plugs and evidence of sediment movement out of the formation. The relief wells have historically high flows between 6,000 gallons per minute (gpm) to 9,000 gpm. New screens are designed based on as-built data and historic tunnel flow. The new screens are 8-in diameter, 100 slot (0.10-inch) screens. We found that screen diameter and slot size would provide adequate transmitting capacity for most of the relief wells. The filter pack gradation is based on descriptions from foundation construction reports. I found that 3/8-inch pea gravel is appropriate for the abutment material. During design, I also considered an option to install the screens into the relief wells without filter pack. I eliminated this option because it did not meet our rehabilitation objective to prevent total failure of the wooden screens.

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This paper reports on the opportunities for transformational learning experienced by a group of pre-service teachers who were engaged in service-learning as a pedagogical process with a focus on reflection. Critical social theory informed the design of the reflection process as it enabled a move away from knowledge transmission toward knowledge transformation. The structured reflection log was designed to illustrate the critical social theory expectations of quality learning that teach students to think critically: ideology critique and utopian critique. Butin's lenses and a reflection framework informed by the work of Bain, Ballantyne, Mills and Lester were used in the design of the service-learning reflection log. Reported data provide evidence of transformational learning and highlight how the students critique their world and imagine how they could contribute to a better world in their work as a beginning teacher.

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An important trend in Chilean retailing industry is the increase in channel blurring. This investigation attempts to identify the relevant store attributes for different retail formats (grocery, department store, drug store, and home improvement). Do consumer store attribute saliency vary for different retail formats? Interviews identified twelve salient store attributes for the different retail formats. Survey results showed differences in store attribute saliencies for consumers when shopping at different formats. Seven of the twelve variables showed significant differences across formats. However, two attributes were relatively important for all four retail formats: product quality and responsiveness of employees.

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A persistent question in the development of models for macroeconomic policy analysis has been the relative role of economic theory and evidence in their construction. This paper looks at some popular strategies that involve setting up a theoretical or conceptual model (CM) which is transformed to match the data and then made operational for policy analysis. A dynamic general equilibrium model is constructed that is similar to standard CMs. After calibration to UK data it is used to examine the utility of formal econometric methods in assessing the match of the CM to the data and also to evaluate some standard model-building strategies. Keywords: Policy oriented economic modeling; Model evaluation; VAR models

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Purpose: To provide an overview and a critical appraisal of systematic reviews (SRs) of published interventions for the prevention/management of radiation dermatitis. Methods and Materials: We searched Medline, CINAHL, Embase, and the Cochrane Library. We also manually searched through individual reference lists of potentially eligible articles and a number of key journals in the topic area. Two authors screened all potential articles and included eligible SRs. Two authors critically appraised and extracted key findings from the included reviews using AMSTAR (the measurement tool for “assessment of multiple systematic reviews”). Results: Of 1837 potential titles, 6 SRs were included. A number of interventions have been reported to be potentially beneficial for managing radiation dermatitis. Interventions evaluated in these reviews included skin care advice, steroidal/nonsteroidal topical agents, systemic therapies, modes of radiation delivery, and dressings. However, all the included SRs reported that there is insufficient evidence supporting any single effective intervention. The methodological quality of the included studies varied, and methodological shortfalls in these reviews might create biases to the overall results or recommendations for clinical practice. Conclusions: An up-to-date high-quality SR in the prevention/management of radiation dermatitis is needed to guide practice and direction for future research. We recommend that clinicians or guideline developers critically evaluate the information of SRs in their decision making.

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Evidence from economic evaluations is often not used to inform healthcare policy despite being well regarded by policy makers and physicians. This article employs the accessibility and acceptability framework to review the barriers to using evidence from economic evaluation in healthcare policy and the strategies used to overcome these barriers. Economic evaluations are often inaccessible to policymakers due to the absence of relevant economic evaluations, the time and cost required to conduct and interpret economic evaluations, and lack of expertise to evaluate quality and interpret results. Consistently reported factors that limit the translation of findings from economic evaluations into healthcare policy include poor quality of research informing economic evaluations, assumptions used in economic modelling, conflicts of interest, difficulties in transferring resources between sectors, negative attitudes to healthcare rationing, and the absence of equity considerations. Strategies to overcome these barriers have been suggested in the literature, including training, structured abstract databases, rapid evaluation, reporting checklists for journals, and considering factors other than cost effectiveness in economic evaluations, such as equity or budget impact. The factors that prevent or encourage decision makers to use evidence from economic evaluations have been identified, but the relative importance of these factors to decision makers is uncertain.

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Universal application of evidence-based practice (EBP) is far from a reality with many clinicians feeling ill equipped to adopt this approach in their clinical practice (Melnyk Fineout- Overholt, Feinstein, Sadler, & Green-Hernandez, 2008; Sherriff, Wallis, & Chaboyer, 2007) and, thus, to be an intelligent consumer of evidence (Ciliska, 2005). While recognizing the benefit of EBP, many health professionals have low confidence in their skills for using evidence in clinical settings (Nagy, Lumby, McKinley, &Macfarlane, 2001). Educational initiatives are often recommended for promoting adoption of EBP with much of the focus being on providing knowledge of associated processes. Levin, Melnyk, Fineout-Overholt, Barnes, and Vetter (2011) demonstrated that providing knowledge of EBP process alone does not increase clinicians’ confidence in their ability to apply EBP to their practice...

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In medical negligence litigation expert evidence has long played a dominant role. The trend towards the use of concurrent expert evidence is now well underway. However, for the lawyers and the doctors involved, the pathway is not yet familiar. Disputes have frequently arisen in the context of pre-hearing expert conclaves, given the adversarial nature of litigation and perhaps fuelled by fears of a less transparent process at this increasingly important stage. This article explains the concurrent expert evidence framework and examines areas of common dispute both in the conclaves and at trial, with a view to providing assistance to legal practitioners working in this area and the medical practitioners called upon to provide expert evidence in such litigation.

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The standard free energies of formation of CaO derived from a variety of high-temperature equilibrium measurements made by seven groups of experimentalists are significantly different from those given in the standard compilations of thermodynamic data. Indirect support for the validity of the compiled data comes from new solid-state electrochemical measurements using single-crystal CaF2 and SrF2 as electrolytes. The change in free energy for the following reactions are obtained: CaO + MgF2 --> MgO + CaF2 Delta G degrees = -68,050 -2.47 T(+/-100) J mol(-1) SrO + CaF2 --> SrF2 + CaO Delta G degrees = -35,010 + 6.39 T (+/-80) J mol(-1) The standard free energy changes associated with cell reactions agree with data in standard compilations within +/- 4 kJ mol(-1). The results of this study do not support recent suggestions for a major revision in thermodynamic data for CaO.