Objectives Social goal orientations, which reflect ways of conceptualizing competence in terms of social relationships with others, have been researched minimally in the physical domain. While the relationship between task and ego orientations and motivational outcomes has been well-studied, the link of friendship, group acceptance, and coach praise orientations with enjoyment, perceived physical competence, and intrinsic motivation warrants further study. Method Male and female middle-school students (N=303) completed questionnaires assessing task, ego, coach praise, friendship, and group acceptance orientations; enjoyment; perceived physical competence; and motivation. Two approaches to data analysis (variable-centered, person-centered) examined whether social orientations were significa...

Abstract Using aggregated national data, this paper compares outcomes of Australian -child protection- (CP) and Norwegian -child welfare services- (CWS). We highlight each nation's context and key elements of their CP/CWS organizations, with emphasis on policy and programme orientation. System outcomes are examined along with the implications of their different approaches. The main policy focus in Australia is protection and risk, while Norway's systemic approach stresses prevention, early intervention and support. These differences influence practitioner's intervention strategies and how the needs of children and parents are met. In Norway, approximately 80% of the children in the CWS receive some sort of supportive services. In contrast, Australian services for supporting families are na...

A person-oriented approach examined patterns of functioning in social and executive function domains at 54-months and in turn forecasted 5th-grade socioemotional and achievement outcomes for 944 children. Six distinct profiles of 54-month school readiness patterns predicted outcomes in 5th grade with indications of cross-domain association between 54-month performance and later functioning. A group of children at 54-months characterized by low working memory exhibited elevated levels of socioemotional problems and low achievement in 5th grade. Patterns in which high social competence or high working memory were prominent predicted high 5th-grade achievement. Unexpectedly, a group distinguished by attention problems performed well on later achievement outcomes. After controlling for childre...

This paper presents a logic based approach to debugging Java programs. In contrast with traditional debugging we propose a debugging methodology for Java programs using logical queries on individual execution states and also over the history of execution. These queries were arrived at by a systematic study of errors in object-oriented programs in our earlier research. We represent the salient events during the execution of a Java program by a logic database, and implement the queries as logic programs. Such an approach allows us to answer a number of useful and interesting queries about a Java program, such as the calling sequence that results in a certain outcome, the state of an object at a particular execution point, etc. Our system also provides the ability to compose new queries during a debugging session. We believe that logic programming offers a significant contribution to the art of object-oriented programs debugging.

The purpose of this article is to provide specific guidelines for child-centered play therapists to set behavioral outcome goals to effectively work with families and to meet the demands for accountability in the managed care environment. The child-centered play therapy orientation is the most widely practiced approach among play therapists who identify a specific theoretical orientation. While information about setting broad objectives is addressed using this approach to therapy, explicit guidelines for setting behavioral goals, while maintaining the integrity of the child-centered theoretical orientation, are needed. The guidelines are presented in three phases of parent consultation: (a) the initial engagement with parents, (b) the ongoing parent consultations, and (c) the termination phase. In keeping with the child-centered approach, the authors propose to work with parents from a person-centered orientation and seek to appreciate how cultural influences relate to parents' concerns and goals for their children. A case example is provided to demonstrate how child-centered play therapists can accomplish the aforementioned goals.

This article proposes psychological empowerment as an orientation and targeted outcome for community development efforts. Psychological empowerment has been the focus of many studies in community psychology, where it has been defined as the psychological aspects of processes through which people, organizations, and communities take greater control over their affairs. Psychological empowerment has been found to increase with greater levels of community participation, and to have protective mental health effects. Community and organizational processes that are psychologically empowering are promising as approaches to sustainably promote both subjective well-being and objective changes in local systems. The case is made in this article for more widespread use of empowerment theory, at multipl...

The primary purpose of this study was to investigate the roles of two moderators - perceived competence and perceived autonomy - in the relationships of achievement goal orientations with a broad range of learning-related variables, including interest, effort, learning strategy use and academic achievement. Perceived competence and autonomy played roles as moderators by strengthening the positive effects of a mastery goal pursuit on outcome measures of adaptive use of learning strategies and effort, respectively. However, no moderating role of either perceived competence or perceived autonomy was found for the effect of a performance-approach and performance-avoidance goal pursuit. In addition, perceived competence played a significant role in determining the level of academic achievement ...

The effects of dynamic and static visualizations in understanding physical principles of fish locomotion were investigated. Seventy-five students were assigned to one of three conditions: a text-only, a text with dynamic visualizations, or a text with static visualizations condition. During learning, subjects were asked to think aloud. Learning outcomes were measured by tests assessing verbal factual knowledge, pictorial recall as well as transfer. Learners in the two visualization conditions outperformed those in the text-only condition for transfer and pictorial recall tasks, but not for verbal factual knowledge tasks. Analyses of the think-aloud protocols revealed that learners had generated more inferences in the visualization conditions as opposed to the text-only condition. These results were mirrored by students' self-reported processing demands. No differences were observable between the dynamic and the static condition concerning any of the learning outcome measures. However, think-aloud protocols revealed an illusion of understanding when learning with dynamic as opposed to static visualizations. Furthermore, learners with static visualizations tended to play the visualizations more often. The results stress the importance of not only using outcome-oriented, but also process-oriented approaches to gain deeper insight into learning strategies when dealing with various instructional materials. (Contains 3 tables and 2 figures.)

Purpose - The purpose of this paper is to report the outcome of a city-wide survey of teenagers' views on their health, and compare this with the outcomes of a science-oriented health intervention called LifeLab, a hospital-based classroom aimed at developing teenagers' attitudes towards their health and that of their future children. Design/methodology/approach - A questionnaire survey of 597 14-year olds across the city of Southampton was conducted to gauge their views and behaviour in relation to their own health. The views of 37 students who took part in innovative, hospital-based, hands-on LifeLab activities were compared with those of their peers six months after the intervention to analyse long-term impacts of the experience. Interviews were carried out with ten LifeLab students to ...

Over the past two years, the U.S. Department of Energy (DOE) Richland Operations Office (RL) has formulated a focused, outcomes-based vision for accelerated cleanup of the Hanford Site. The primary elements, or outcomes, of this vision are to (1) accelerate restoration of the Columbia River Corridor, (2) transition the Central Plateau to long-term waste management, thereby shrinking the footprint of active site cleanup and operations, and (3) prepare for the future. The third outcome includes operation of the Pacific Northwest National Laboratory (PNNL), a key element of the foundation for Hanford's future; leveraging DOE's assets; and working with the community to understand their vision and reflect it as appropriate in the execution of the Hanford 2012 Vision. The purpose of these three outcomes is to provide a near term focus, aimed at achieving definitive end points over the next decade, while not precluding any long-term end-state associated with the completion of the Environmental Management (EM) mission at Hanford. The sheer expanse of the Hanford Site, the inherent hazards associated with the significant inventory of nuclear materials and wastes, the large number of aging contaminated facilities, the diverse nature and extent of environmental contamination, and the proximity to the Columbia River make the Hanford Site arguably the world's largest and most complex environmental cleanup project. Current projections are that it will cost over $80 billion and take over four decades to complete the cleanup at Hanford. Accelerated cleanup of the River Corridor portion of the Site will allow the remediation effort to focus on specific, near-term outcomes. Hanford's success in achieving these outcomes will reduce urgent risk, shrink the Site, remove contamination and wastes from the proximity of the river, and consolidate waste management activities on the Central Plateau. Hanford has begun implementation of this vision. Performance-based contracts are being realigned to reflect the outcome orientation, including issuing a new River Corridor closure contract. This paper summarizes the outcome-based planning approach for other sites and interested parties. A brief introduction to the Hanford Site, along with detailed descriptions of the three outcomes is provided. This paper also summarizes the analyses and resulting products that were prepared in shifting to an outcome-based approach for closing the Hanford Site.

Purpose: Qualitative research in the field of entrepreneurship has a history of being questioned as a proper research method; and this in spite of the call from many acknowledged researchers for more process-oriented and in-depth understandings of entrepreneurship which are best created through a qualitative approach to entrepreneurship. In this article we respond to the lack of clear approaches to qualitative entrepreneurship research, yet apparent need hereof by developing concrete examples of how to best perform qualitative research within the entrepreneurship field. Design/methodology: Findings: Operationalizing and expanding on Pettigrew’s ideas of process-oriented methods of analysis, the article presents a guiding, stepwise and pragmatic research design useful to grasp the entrepreneurial process from a qualitative and process-oriented angle. The design guide includes multi-level analysis; merges past, present and future; creates holistic insights into the entrepreneurial process; gives individual action as well as context a role in understanding entrepreneurship; and links the analysis to a specific outcome. These aspects are all substantiated through discussion as vital to capture the dynamics of the entrepreneurial process. Practical implications: The lack of common understanding of how to most appropriately conduct qualitative research in the field of entrepreneurship is the origin of much criticism of the qualitative approaches. The proposed research design provides researchers with a structured and manageable research design to create qualitative, contextualized, process-oriented, time-related and holistic knowledge about entrepreneurial processes. Originality: The originality of the research is found in its direct response to a call for not only more, but better and more solid qualitative studies in the field of entrepreneurship. Few have until now provided specific measures on how qualitative research is best performed in this specific field of research

Recognition of the interplay between nature and nurture is decades old in fields such as psychiatry, but other fields in the social sciences continue to be hampered by the idea that social and biological variables compete for explanatory relevance. In a recent study of the adolescent brain and risk taking, Males critiqued biologically oriented approaches as "biodeterminist" compared to environmentally friendly approaches. Here the authors suggest that the use of biological and social variables, or nature and nurture, is not only uncontroversial but also essential for understanding psychopathology, externalizing, and antisocial behaviors. Moreover, biosocial scientific inquiry has led to progressive state policy in the case of "Roper v. Simmons", precisely the opposite outcome that critics of biologically friendly research often claim.

Student motivation may have significant influences on essential academic outcomes. However, students' motivation may decline as they grow older. This study examined six motivation constructs (self-efficacy, interest, mastery goal orientation, engagement, avoidance coping, and effort withdrawal) of s...

Recovery-concepts have travelled from margin movements into mainstream psychiatry rapidly in recent years. Recovery advocacy has been joined by recovery research resulting in new information on the long-term perspectives of people experiencing severe mental health problems. Emerging data on recovery outcomes as well as processes bring on a paradigm shift from prognostic scepticism and focus on maintenance therapies towards an optimistic outlook and recovery-oriented interventions and services. The emerging evidence-base for recovery-orientation essentially includes the urgent call for a partnership approach allowing the full involvement of users and their families and friends and the exploit of their expertise. Patient self-determination, individual choice of flexible support and opportunities, intervenetions to promote empowerment and hope also in the long-term, as well as assistance in situations of calculated risk are new indicators of quality of services. The dynamic complexities of recovery and resilience have the ability to capture the progress in biological, psychological, social and political advances in the direction of modern integrated and subject-oriented psychiatry. Cooperative and coordinated efforts together with consumers, carers, their spokespersons and public health advocates offer formidable chances to reduce stigma, discrimination and social exclusion, currently seriously limiting clinical and other efforts towards recovery. PMID:23132196

This study examined mindful awareness in body-oriented therapy (MABT) feasibility as a novel adjunct to women's substance use disorder (SUD) treatment. As an individual therapy, MABT combines manual and mind-body approaches to develop interoception and self-care tools for emotion regulation. A 2-group randomized controlled trial repeated-measures design was used, comparing MABT to treatment as usual (TAU) on relapse to substance use and related health outcomes. Sixty-one women were screened for eligibility, and 46 enrolled. Participants randomized to MABT received 8 weekly MABT sessions. Results showed moderate to large effects, including significantly fewer days on substance use, the primary outcome, for MABT compared with TAU at posttest. Secondary outcomes showed improved eating disorder symptoms, depression, anxiety, dissociation, perceived stress, physical symptom frequency, and bodily dissociation for MABT compared with TAU at the 9-month follow-up. In conclusion, it is feasible to implement MABT in women's SUD treatment, and results suggest that MABT is worthy of further efficacy testing. PMID:22119181

Abstract Objectives: The purpose of this study was to examine the implementation and acceptability of Mindful Awareness in Body-oriented Therapy (MABT), a novel adjunctive approach to substance use disorder (SUD) treatment. The primary aims of the study were to examine implementation of MABT as an adjunct to addiction treatment, and MABT acceptability to study participants and treatment staff. Methods: MABT was delivered to participants randomly assigned to the intervention in a larger ongoing trial. This study focuses only on the implementation and acceptability of the intervention, as outcomes are not yet available. MABT was delivered once weekly for 8 weeks (1.5-hour sessions) and spanned inpatient and outpatient programs at a women-only treatment facility. Descriptive statistics were u...

We investigate the efficiency of domain-specific heuristic strategies in mastering and predicting pericyclic six-electron rearrangements. Based on recent research findings on these types of reactions a new concept has been developed that should help students identify and describe six-electron rearrangements more readily in complex molecules. The goal of this qualitative study with chemistry majors is to understand the way students cope with this new concept depending on their prior knowledge, and to reveal the merits and limitations of this approach. The results suggest that the use of domain-specific heuristic strategies provides the students with process-orientated thinking skills to identify six-electron rearrangements and to determine as well as predict reaction mechanisms and outcomes. The explicit emphasis on recurrent patterns and structure-property relationship fosters the conceptual thinking of the learner. (Contains 1 table, 1 scheme, and 10 figures.)

Distinct clinicopathologic acute lymphoblastic leukemia (ALL) entities have been identified, resulting in the adoption of risk-oriented treatment approaches. In Philadelphia chromosome-positive (Ph(+)) ALL, the optimal treatment requires the addition of BCR-ABL tyrosine kinase inhibitors, as imatinib. However, the outcome remains poor in absence of allogeneic stem cell transplantation, and novel agents are desperately required. Resistance attributable to kinase domain mutations can lead to relapse despite the development of second-generation compounds, including dasatinib and nilotinib. Despite these therapeutic options, the cross-resistant BCR-ABL (T315I) mutation remains a major clinical challenge. The first evaluations of AP24534 present this drug as a potent multi-targeted kinase inhibitor active against T315I and all other BCR-ABL mutants. AP24534 could be the next treatment of choice in hematological malignancies with Philadelphia-positive chromosome, particularly Ph(+) ALL known for its frequent occurrence of T315I mutation. PMID:21700550

Longitudinal panel studies of large, random samples of business start-ups captured at the pre-operational stage allow researchers to address core issues for entrepreneurship research, namely, the processes of creation of new business ventures as well as their antecedents and outcomes. Here, we perform a methods-orientated review of all 83 journal articles that have used this type of data set, our purpose being to assist users of current data sets as well as designers of new projects in making the best use of this innovative research approach. Our review reveals a number of methods issues that are largely particular to this type of research. We conclude that amidst exemplary contributions, much of the reviewed research has not adequately managed these methods challenges, nor has it made use...

This paper encourages readers to experiment with inquiry-based learning (IBL) in their courses in the interest of identifying more diverse styles of instruction, and developing a wider understanding of the advantages and disadvantages of the methodology. The aims of the paper are to unpack the meanings of IBL, describe some uses of IBL in geography, and discuss their benefits and challenges for students and teachers. IBL is essentially a question-driven, philosophical approach to teaching that involves active, student-centred learning. The teacher acts principally as a facilitator or mentor, guiding and encouraging students through the inquiry process. Examples of IBL are presented, ranging from questioning exercises embedded in the class, through to entire courses or degrees using an inquiry-based approach. Students can benefit greatly from IBL since they are active in the learning process, can have improved understanding, more enjoyable learning, develop valuable research skills, achieve higher-order learning outcomes and perform better academically. Teachers can also benefit through a strengthening of teaching-research links and the clear gains in student engagement and learning. However, in order for IBL to be effective, teachers must be encouraged and supported to take on this facilitating role. When IBL elements are embedded in a more traditional curriculum, particular care needs to be taken so that students and teachers are carefully oriented to the expectations regarding the outcome of learning and teaching in this mode. (Contains 1 table and 2 figures.)

With a view to understand the influence of culture on achievement motivation, the study aimed to test the hypothesized mediating role of individual-oriented and social-oriented achievement motives in linking value orientations (e.g. achievement, security, conformity, hedonism) to achievement goals (i.e. mastery-approach, mastery-avoidance, performance-approach, and performance-avoidance goals) as predictors of English and mathematics achievements. These hypothesized relationships were tested in the one-path analytic model with a sample of Indonesian high-school students (n-=-356; 46% girls, M age-=-16.20-years). The findings showed that security and conformity values positively predicted social-oriented achievement motive; self-direction values positively predicted individual-oriented achi...

HypothesisGlenoid orientation likely plays an important role in shoulder mechanics and has been associated with glenohumeral instability, rotator cuff tears, and total shoulder arthroplasty outcome. Glenoid version and inclination measurements are widely used, but these measurements are 2-dimensional, and orientation of the central face must be inferred from 2 points on the outer rim. This study tested the hypothesis that sphere fitting provides an optimal assessment of glenoid face 3-dimensional orientation, and clinically important differences will exist in some individuals between sphere fit orientation and traditional version measurement. Materials and methodsComputed tomography scans of 20 normal glenoids were obtained. Glenoid version was measured from resliced, pure transverse image...

Abstract in spanish El artículo ubica el análisis de los resultados en salud dentro del conjunto de elementos que comprende la evaluación de la equidad en salud y sugiere algunas orientaciones para ese análisis. Toma como punto de referencia el modelo de análisis para el examen de la equidad en salud que ha adoptado el Observatorio de Equidad en Calidad de Vida y Salud de Bogotá, en el cual participa el autor. El texto aborda las siguientes preguntas: ¿Cuál es el papel que juega la e (more) valuación de resultados en el contexto de la equidad en salud? ¿Cómo evaluar las inequidades en los resultados de salud? ¿Qué evaluar en torno a los resultados en salud? En la parte final señala cómo el tema de la equidad en salud no se agota en el examen de las desigualdades injustas entre individuos o grupos. Abstract in english The article locates analysing health outcomes within a set of elements covering evaluating equity in health and suggests some orientations for such analysis. The model of analysis for examining equity in health which has been adopted by the «Observatory for Bogotá?s Equity in Quality of Life and Health» has been taken as a point of reference. The text approaches the following questions: What is the role played by evaluating health outcomes within the context (more) of equity in health? How can inequities in health outcomes be evaluated? What should be evaluated regarding health outcomes? The final part deals with how the topic of equity in health does not become exhausted in examining unjust inequalities between individuals or groups.

AIM: To evaluate the clinical characteristics of splenic marginal-zone lymphoma (SMZL) following antigen expression and the influence of therapeutic approaches on clinical outcome and overall survival (OS).

This study evaluated the effectiveness of 6 to 10 sessions of Acceptance and Commitment Therapy (ACT) for self-stigma around sexual orientation linked to same-sex attraction (what has generally been referred to as internalized homophobia; IH) in a concurrent multiple-baseline across-participants design. Three men and 2 women showed sizeable reductions from baseline to posttreatment and to 4- and 12-week follow-ups in daily reports of the degree to which thoughts about sexual orientation interfered in their lives; distress associated with these thoughts also decreased. Positive changes were observed in self-report measures of IH, depression, anxiety, stress, quality of life, and perceived social support. Consistent with the theory underlying ACT, reductions in daily ratings of the believability of thoughts about same-sex attraction (a process variable) were greater than those observed for frequency of such thoughts. Improvements were also observed in questionnaires measuring ACT processes. Mixed regression analyses confirmed outcome and process effects that were apparent through visual inspection. Implications and the distinctiveness of ACT as an approach are discussed. (Contains 3 tables and 2 figures.)

Non-government organisations (NGOs) are big players in international development, critical to the achievement of the Millennium Development Goals (MDGs) and constantly under pressure to "achieve more". Scaling-up their initiatives successfully and sustainably can be an efficient and cost effective way for NGOs to increase their impact across a range of developmental outcomes, but relatively little attention has been paid in the education sector to how best this may be done and debates appear to have stalled. One approach to scaling-up is replication, on which this paper focuses. While there is no one universally applicable path through which an educational NGO can achieve successful replication, more can be done to support choice of the best path to follow, with respect to specific NGO circumstances and the context within which it operates--and hopes to operate in future. This paper presents four known paths to replication alongside new illustrative diagrams to explore their advantages and disadvantages, and highlights the need for a fifth approach that does not appear in current literature. "Network replication" is proposed as new pathway that draws on known strengths of networks and offers a learning-oriented approach to scaling-up. While inevitably not without its potential problems, Network replication is a scaling-up option that deserves consideration. (Contains 5 figures.)

Molecular dynamics are often used to analyze and interpret fluorophore motions in relation to observed fluorescence anisotropy measurements. The Soleillet method allows computation of fluorescence anisotropy from molecular dynamics for isotropically oriented fluorophores, but not for oriented fluorophores, such as might be used to study oriented bacterial cultures, oriented, functionalized nanotubes, or oriented, stacked planar bilayers. A numerical approach to distribute molecular dynamics systems appropriately into a larger experimental frame context, allowing prediction of time-resolved and steady-state anisotropies for fluorophores distributed in the crystal-like arrays, is presented. The classical principles of absorption selectivity and motional effects on fluorescence anisotropy for...

Multiple binary outcomes occur quite frequently in oral health research, as well as other areas of health care research. When there is interest in comparing whether covariates influence one outcome more than another, statistical methods that adjust for the correlation that may exist between outcomes are warranted. Available software is limited to the extent that some pre-processing of the data is required. The main objective of this paper is to describe a SAS macro that can be used to estimate separate covariate effects on multiple, correlated binary outcomes. We demonstrate the utility of the macro by applying it to fit a trivariate logistic regression model using GEE where the three correlated longitudinal outcomes of interest include whether a subject had a problem-oriented visit, a dental cleaning, or a routine check-up, or some combination thereof. All three outcomes were measured at four 6-monthly intervals (0-24 months). Estimates from the trivariate logistic regression model are compared to results obtained by fitting three separate binary longitudinal models using GEE for each oral health outcome. The odds of having a problem-oriented visit were greater for males compared to females as estimated from the multivariate model (P = 0.0407), but the odds were not significant in the univariate model (P = 0.0641). The multivariate model also aided in confirming expected results that consistent regular attenders (compared to consistent problem-oriented attenders) had greater odds of having received dental cleaning and check-ups relative to having problem-oriented visits (chi2 = 33.47, P < 0.01), and that those with broken teeth or broken filling (compared to those without) are at greater odds of having a problem-oriented visit relative to having dental cleaning or checkups (chi2 = 34.12, P < 0.01 and chi2 = 17.11, P < 0.01). PMID:15451165

When estimating the association between an exposure and outcome, a simple approach to quantifying the amount of confounding by a factor, Z, is to compare estimates of the exposure–outcome association with and without adjustment for Z. This approach is widely believed to be problematic due to the non...

Satellite altimetry allows a direct computation of geostrophic velocity anomalies. However, conventional altimetry measurements remain largely spurious in coastal zone, due to several factors such as inaccurate geophysical corrections (e.g. atmospheric and tidal signals) as well as environmental issues (land contamination in the altimetric and radiometric footprints). At the present time and in the attempt of future relevant technologies (cf. SWOT satellite), experimen-tal coastal altimeter products are under development (XTRACK, PISTACH, COASTALT. . . ). The main efforts consist in the application of coastal-oriented corrections and the review of the data recovery strategies near the coast. The new coastal altimetric products need to be assessed with independent data before to be used in synergy with other measurements and fully exploited for scientific applications. This is the frame of this study as part of an intensive observational program conducted in the Western Mediterranean Sea. We present here the main outcomes resulting from the combination of coastal altimetry and gliders. Gliders -autonomous underwater vehicles -allow to provide precise and high resolution data complementary to altimetry (temperature, salinity, pressure, velocity. . . ) both at surface and over the whole water column. Since July 2007, several glider missions have been performed along Jason-1, Jason-2 and ENVISAT altimeters. The altimetric sea level anomalies have been processed from both standard and coastal-oriented strategies. Furthermore, new methodologies have also been developed in order to combine surface glider geostrophic velocities (derived from CTD measurements) with integrated currents estimated by the glider (derived from GPS locations every 6 hours). These approaches prove to be very efficient to improve the budget errors and homogenize the physical contents of altimetry and glider data. Further, the combined analysis of the two datasets provides interesting insights of the oceanic circulation characteristics at the regional scales. In summary, these studies highlight the relevance of multi-sensor approaches and the need of oceanic topography measurements at several spatial/temporal sampling requirements in view of the coastal and mesoscale dynamics characterizations.

A dual executive leadership structure aspires to shape an executive constellation where both executives have different orientations that they use to assess the world around them, process information to make decisions, and evaluate outcomes. By separating the executive position into two functionally different roles, pluralistic organisations such as high art organisations, intend to balance multiple organisational objectives. Using dyadic data from both the artistic and managing directors of 51 (subsidised) theatre and dance companies with dual leadership structures, we study the drivers of a particular selection system orientation (peer, expert or market) and the effects of possible heterogeneity in orientation between the dual leaders. We find that functional roles are related to selectio...

Purpose: The purpose of this paper is to report the outcome of a city-wide survey of teenagers' views on their health, and compare this with the outcomes of a science-oriented health intervention called LifeLab, a hospital-based classroom aimed at developing teenagers' attitudes towards their health and that of their future children. Design/methodology/approach: A questionnaire survey of 597 14-year olds across the city of Southampton was conducted to gauge their views and behaviour in relation to their own health. The views of 37 students who took part in innovative, hospital-based, hands-on LifeLab activities were compared with those of their peers six months after the intervention to analyse long-term impacts of the experience. Interviews were carried out with ten LifeLab students to gain further insights. Findings: The intervention created a wider appreciation among students that food they eat now could affect their long-term health and the health of their future children. Students became significantly more interested in studying science beyond compulsory schooling, and in considering science and healthcare career options. Research limitations/implications: Although results were statistically significant, the intervention sample was quite small, and further data collection is ongoing. The city-wide student response rate of 29 per cent was fairly low. Social implications: This study has shown that a carefully structured hospital-based classroom visit, and associated science lessons can have a marked effect on student engagement with health-related issues, and an impact on their consideration of their career choices. Originality/value: The hospital-based classroom is an innovative approach to improving teenagers' knowledge and attitudes towards their health. The paper's findings should be of interest to a range of educational stakeholders including teachers, local education authorities and local politicians concerned with health education matters. (Contains 1 table.)

Effective interventions are needed to address the growing epidemic of childhood obesity. In the past 35 years, family-based approach has gradually developed as a preferred intervention. This review aimed to examine the methodological rigour and treatment effectiveness of family-based interventions according to intervention types and theoretical orientations. A total of 15 randomized controlled trials (RCTs) of family-based lifestyle interventions for children and adolescents aged 2-19 years were included. The adapted Methodological Quality Rating Scales (MQRS) and a four-grade qualitative scoring scheme were adopted to evaluate the methodological rigour and the effectiveness of treatment, respectively. The average MQRS score was 7.93 out of 14 points. Ten of the 15 RCTs had well aligned their research questions with appropriate research methods. The overall short-term outcome of the15 RCTs were satisfactory with an average score of 3.1. Family-based interventions rooted in behaviour theory achieved better results than those theoretically connected to family systems theory in terms of treatment effectiveness. Results suggest future studies to improve the methodological design and continue to explore the potential of the family systems approach. PMID:23136914

Systemic sclerosis (SSc) is a chronic autoimmune disease with clinical manifestations resulting from immune activation, fibrosis development, and damage of small blood vessels. Our aim was to critically illustrate the available data on the new treatments proposed for SSc to provide a clinically oriented overview of the current evidence. PubMed was used for literature search using "scleroderma" and "therapy" to identify all articles published on indexed journals between 1972 and 2008. The search was limited to publications in English and produced a total of 3,441 references, which included 735 review articles. These citations were then screened for articles dealing with the most recent therapy options for SSc, and 214 articles were selected for evaluation and discussion. Methotrexate, cyclophosphamide, calcium channel blockers, angiotensin converting enzyme inhibitors, prostacyclin analogues, D-penicillamine, and extracorporeal photopheresis are the most widely studied treatments for SSc and were considered as practiced treatments. Other therapeutic approaches have been developed more recently and include endothelin receptor antagonists and phosphodiesterase-5 inhibitors for pulmonary arterial hypertension and peripheral vascular disease. High-dose immunosuppression and stem cell transplantation constitute a promising treatment and data from randomized controlled trials are awaited. Intravenous gamma globulins, mycophenolate mophetil, collagen tolerance induction, rituximab, fluoxetine, pirfenidone, relaxin, halofuginone, anti-TGF-beta antibodies, and tyrosine kinase inhibitors awaits more solid data. The clinical management of patients with SSc remains a challenge and currently involves practiced and newly proposed therapeutic approaches. The disease pleiomorphism poses numerous difficulties to determine ideal outcomes to be used in clinical trials. PMID:19132559

Current understanding of brain plasticity has lead to new approaches in ischemic stroke rehabilitation. Stroke units that combine good medical and nursing care with task-oriented intense training in an environment that provides confidence, stimulation and motivation significantly improve outcome. Repetitive trans-cranial magnetic stimulation (rTMS), and trans-cranial direct current stimulation (tDCS) are applied in rehabilitation of motor function. The long-term effect, optimal way of stimulation and possibly efficacy in cognitive rehabilitation need evaluation. Methods based on multisensory integration of motor, cognitive, and perceptual processes including action observation, mental training, and virtual reality are being tested. Different approaches of intensive aphasia training are described. Recent data on intensive melodic intonation therapy indicate that even patients with very severe non-fluent aphasia can regain speech through homotopic white matter tract plasticity. Music therapy is applied in motor and cognitive rehabilitation. To avoid the confounding effect of spontaneous improvement, most trials are preformed ?3 months post stroke. Randomized controlled trials starting earlier after strokes are needed. More attention should be given to stroke heterogeneity, cognitive rehabilitation, and social adjustment and to genetic differences, including the role of BDNF polymorphism in brain plasticity. PMID:20726844

The domain theory is described in this chapter. By a strict distinction between the structural characteristics and the behavioural properties of a mechanical artefact, each domain, i.e. transformation-, organ-, and part domain, becomes a productive view for design of mechanical artefacts. The functional reasoning within each domain and between the domains seems to be ruled by the function-means law (Hubka´s law). On the basis of the domain theory and the function-means law we present two formal approaches to the synthesis of mechanical artefacts, namely a design-process-oriented approach and an artefact-oriented approach. The design-process-oriented synthesis approach can be seen as a basic design step for composite mechanical artefacts. The artefact-oriented approach has been utilised for the development of computer-based design support systems.

This thesis explores the execution of object-oriented code on an embedded Java platform. It presents established and derives new approaches for the implementation of high-level object-oriented functionality and commonly expected system services. The goal of the developed techniques is the provision ...

REMOS is an object oriented multiprocessor environment that extends the inter process communication facilities of a single processor multi tasking kernel. A micro kernel approach has been followed to achieve modularity and real time performance. Object oriented design has been extensively used across the whole system, obtaining a high degree of integration with the native operating system.

OBJECTIVE: It is unclear whether the personality trait of dispositional optimism, defined in terms of generalized positive outcome expectancies, life engagement, and a future orientation, has a protective effect on the development of depression in community-dwelling elderly men. METHODS: We included...

This study aimed to provide an account of how learning takes place in problem-based learning (PBL), and to identify the relationships between the learning-oriented activities of students with their learning outcomes. First, the verbal interactions and computer resources studied by nine students for ...

This investigation distinguishes interpersonally oriented social competence from intrapersonally oriented competence. It examines the influence of voters' individualism and collectivism orientation in affecting the roles of these two dimensions in predicting electoral outcomes. Participants made judgments of personality traits based on inferences from faces of political candidates in the U.S. and Taiwan. Two social outcomes were examined: actual election results and voting support of the participants. With respect to actual electoral success, perceived competence is more important for the candidates in the U.S. than for those in Taiwan, whereas perceived social competence is more important for the candidates in Taiwan than for those in the U.S. With respect to subjective voting support, wi...

Software product line (SPL) and service-oriented architecture (SOA) approaches both enable an organization to reuse existing assets and capabilities rather than repeatedly redeveloping them for new systems. Organizations can capitalize on such reuse in so...

The contrasting approaches to death and bereavement found in classical Confucianism and Daoism epitomize the fundamentally different orientations of the two ethical traditions. Confucianism, here represented by Xúnz?, interprets and seeks to manage death and bereavement through distinctive cultural ...

One aspect of the system-hierarchical organization is described in detail. Introduction ... with our long-term plan for creating knowledge-based tools to support ... paradox of object-oriented approaches that well-adapted structures are not ...

This is an extended and pedagogically oriented version of our recent work, in which we proposed an improvement of the splitting functions at small x which overcomes the apparent problems encountered by the BFKL approach.

The complexity in handling product aspects in design and production may be reduced by using approaches, which are applied in the field of modular engineering. This unit-oriented "spelling" of products, leading to product models with encapsulation, is introduced.

A principled approach to the design of problem-oriented, web-based learning at the university level is presented. The principles include providing authentic contexts with multimedia, supporting collaborative knowledge construction, making thinking visible with dynamic visualisation, quick access to ...

A CLIMATE-ORIENTED APPROACH FOR LEARNERS OF ALL AGES Climate Literacy The Essential Principles of Climate Sciences A Guide ... Communities Second Version: March 2009 www.climatescience.gov CLIMATE CHANGES Throughout its history, Earth’s climate has varied, ...

Using multiple constituencies approach, variances in competencies in human resource leadership have been studied as this is becoming highly significant in India's globalisation efforts. Previous research in leadership orientation focused on localisation of human resource competencies rather than its globalisation. For this, human resource professionals are expected to acquire high level of competencies and leadership orientation. Statistical analyses of multiple constituencies were carried out for three case studies of multinational companies. The results show that strategic, professional, administrative and interpersonal competencies have significant influence towards leadership orientation. Among these, one of the most critical factors that influence leadership orientation is found to be strategic competencies. (Contains 5 tables and 1 figure.)

Purpose - The purpose of this paper is to explain the implications of different entrepreneurial orientations on business start-up and development challenges. Design/methodology/approach - This research reflects surveys of 1,075 experienced entrepreneurs and business and entrepreneurship students in Estonia during the years 2005-2010. An additional method is action learning and reflections of training focused on recognising new business opportunities during the economic crises. Findings - Combinations of co-creative and innovative entrepreneurial orientations are more popular than the imitative entrepreneurial orientation. There is, however, an essential contradiction between stressing the principles of co-creative orientation at the first stages of business opportunity identification and t...

College freshmen face a variety of academic and social challenges as they adjust to college life that can place them at risk for a number of negative outcomes, including depression and alcohol-related problems. Orientation classes that focus on teaching incoming students how to better cope with college-oriented stress may provide an opportunity to prevent the development of these adjustment problems. This article outlines a program based on behavioral activation that can be integrated into college orientation programs to provide a more comprehensive orientation experience. Data are presented from an initial pilot study in which 71 first-semester freshman at the University of Maryland participated in a 15-week, 2 hr per week orientation class (n = 37 in the behavioral activation-enhanced orientation classes and n = 34 in the control orientation as usual classes). Students' depression and alcohol use were evaluated at the beginning, middle, and end of the course. Results indicated a Time x Group interaction such that problem drinking (but not consumption) was significantly reduced across assessments in the behavioral activation classes and largely unchanged in the standard classes. No difference was observed in depression scores; however, fairly low depression scores across the 3 time points may have limited the opportunity to observe any meaningful impact of the orientation classes on depression. The authors conclude with a discussion of the implications of their findings for preventing adjustment problems among incoming college students and future directions. (Contains 2 figures, 2 tables, and 1 footnote.)

In this literature study the task of usability evaluation is approached through recent publications and known practises. The scope of the reviewed literature and the overall problematic of evaluating complex systems are first defined. Then existing evaluation methods and tools and a set of design guidelines and standards is introduced. In there view the distinction between the evaluation of the design process and evaluation of the outcome of the design process is made. Also the existing criteria for usability is provided. These criteria can be used as measures in the evaluation procedures described in the previous chapter. Then, the problem of validity in the evaluation and validation procedures of complex cognitive systems is shortly discusses. The final chapter covers the conclusions of the literature review. There is a need for deepening the relationship between usage and design. Usage must be the driver also in the design of process technology, plant's safety, and instrumentation and control as well as that of the design of man-machine interface. The collaborative activity is called activity-oriented design. In order to enable activity-oriented design we need to create design methods that drive the design activity into this direction. Criteria for evaluating what is good design are not available in present standards. Criteria for good tools and practices must consider human in a favourable role in the various tasks of operating an industrial plant as opposed to the view of human as a source of error. This is the way to create an optimal system, which takes advantage of the unique capabilities of both the human operators and the automation systems. (orig.)

Abstract in english Design patterns offer flexible solutions to common problems in software development. Recent studies have shown that several design patterns involve crosscutting concerns. Unfortunately, object-oriented (OO) abstractions are often not able to modularize those crosscutting concerns, which in turn decrease the system reusability and maintainability. Hence, it is important verifying whether aspect-oriented approaches support improved modularization of crosscutting concerns re (more) lative to design patterns. Ideally, quantitative studies should be performed to compare object-oriented and aspect-oriented implementations of classical patterns with respect to important software engineering attributes, such as coupling and cohesion. This paper presents a quantitative study that compares aspect-based and OO solutions for a representative set of design patterns. We have used stringent software engineering attributes as the assessment criteria. We have found that most aspect-oriented solutions improve separation of pattern-related concerns, although some aspect-oriented implementations of specific patterns resulted in higher coupling and more lines of code.

Aspect oriented programming aims at achieving better modularization for a system's crosscutting concerns in order to improve its key quality attributes, such as evolvability and reusability. Consequently, the adoption of aspect-oriented techniques in existing (legacy) software systems is of interest to remediate software aging. The refactoring of existing systems to employ aspect-orientation will be considerably eased by a systematic approach that will ensure a safe and consistent migration. In this paper, we propose a refactoring and testing strategy that supports such an approach and consider issues of behavior conservation and (incremental) integration of the aspect-oriented solution with the original system. The strategy is applied to the JHotDraw open source project and illustrated on a group of selected concerns. Finally, we abstract from the case study and present a number of generic refactorings which contribute to an incremental aspect-oriented refactoring process and associate particular types of cr...

Intersectionality is a term used to describe the intersecting effects of race, class, gender, and other marginalizing characteristics that contribute to social identity and affect health. Adverse health effects are thought to occur via social processes including discrimination and structural inequalities (i.e., reduced opportunities for education and income). Although intersectionality has been well-described conceptually, approaches to modeling it in quantitative studies of health outcomes are still emerging. Strategies to date have focused on modeling demographic characteristics as proxies for structural inequality. Our objective was to extend these methodological efforts by modeling intersectionality across three levels: structural, contextual, and interpersonal, consistent with a social-ecological framework. We conducted a secondary analysis of a database that included two components of a widely used survey instrument, the Everyday Discrimination Scale. We operationalized a meso- or interpersonal-level of intersectionality using two variables, the frequency score of discrimination experiences and the sum of characteristics listed as reasons for these (i.e., the person's race, ethnicity, gender, sexual orientation, nationality, religion, disability or pregnancy status, or physical appearance). We controlled for two structural inequality factors (low education, poverty) and three contextual factors (high crime neighborhood, racial minority status, and trauma exposures). The outcome variables we modeled were posttraumatic stress disorder symptoms and a quality of life index score. We used data from 619 women who completed the Everyday Discrimination Scale for a perinatal study in the U.S. state of Michigan. Statistical results indicated that the two interpersonal-level variables (i.e., number of marginalized identities, frequency of discrimination) explained 15% of variance in posttraumatic stress symptoms and 13% of variance in quality of life scores, improving the predictive value of the models over those using structural inequality and contextual factors alone. This study's results point to instrument development ideas to improve the statistical modeling of intersectionality in health and social science research. PMID:23089613

Abstract in portuguese O Outcome Questionnaire (OQ-45) é um instrumento desenvolvido com a finalidade de avaliar o progresso do paciente, repetidamente, durante a psicoterapia. Não é um instrumento teoricamente orientado, podendo ser aplicado a psicoterapias de diferentes fundamentações teóricas. Apresenta evidências de validade e consistência interna, em sua versão original. O objetivo geral deste trabalho foi traduzir e adaptar culturalmente o OQ-45 para o contexto da cultura brasile (more) ira. O processo consistiu de cinco estágios: tradução, síntese, back-translation ou tradução regressiva, revisão por especialistas e pré-teste. Teve como base duas versões: a original, em inglês e a portuguesa. Os resultados sugerem que o OQ-45 é um instrumento de fácil compreensão e aplicação, mesmo em pessoas com baixo grau de instrução escolar formal. Serão necessários estudos de validade e precisão da versão brasileira, comparando-se amostras clínicas com não-clínicas. Abstract in english The Outcome Questionnaire (OQ-45) is an instrument designed to measure client's progress in therapy, repeatedly, during psychotherapy. It is not a theoretically oriented, and can be applied to psychotherapy of different theoretical approaches. It shows evidence of validity and internal consistency, in its original version. The aim of this work was to translate and culturally adapt the OQ-45 to the context of Brazilian culture. The process consists of five stages: translat (more) ion, synthesis, back-translation, review by experts and pre-test. It was based on two versions: the original, in English and the Portuguese. The results suggest that the OQ-45 is an easy test to understand and to apply, even in people with low educational level. Validity and reliability studies will be needed for the Brazilian version, comparing clinical with non-clinical samples.

Two studies were conducted investigating the relationship between the Zimbardo Time Perspective Inventory (ZTPI) scales and well-being measures in British (N = 179) and Russian (N = 289) student samples. On the basis of person-oriented approach, a cluster-analysis operationalization of Balanced Time Perspective (BTP) using ZTPI was proposed and validated, demonstrating more evidence for its validity than the previously suggested cut-off-point approach. Four distinct time perspective patterns were discovered in both samples: future-oriented, present-oriented, balanced and negative. The clusters revealed significant differences in well-being, with members of the BTP cluster demonstrating the highest scores in both samples. The relationship between ZTPI and Temporal Life Satisfaction Scale in...

As existing technologies are refined and novel microbial inactivation technologies are developed, there is a growing need for a metric that can be used to judge equivalent levels of hazard control stringency to ensure food safety of commercially sterile foods. A food safety objective (FSO) is an output-oriented metric that designates the maximum level of a hazard (e.g., the pathogenic microorganism or toxin) tolerated in a food at the end of the food supply chain at the moment of consumption without specifying by which measures the hazard level is controlled. Using a risk-based approach, when the total outcome of controlling initial levels (H(0)), reducing levels (?R), and preventing an increase in levels (?I) is less than or equal to the target FSO, the product is considered safe. A cross-disciplinary international consortium of specialists from industry, academia, and government was organized with the objective of developing a document to illustrate the FSO approach for controlling Clostridium botulinum toxin in commercially sterile foods. This article outlines the general principles of an FSO risk management framework for controlling C. botulinum growth and toxin production in commercially sterile foods. Topics include historical approaches to establishing commercial sterility; a perspective on the establishment of an appropriate target FSO; a discussion of control of initial levels, reduction of levels, and prevention of an increase in levels of the hazard; and deterministic and stochastic examples that illustrate the impact that various control measure combinations have on the safety of well-established commercially sterile products and the ways in which variability all levels of control can heavily influence estimates in the FSO risk management framework. This risk-based framework should encourage development of innovative technologies that result in microbial safety levels equivalent to those achieved with traditional processing methods. PMID:22054200

Australia has a federal system, comprising the national Commonwealth government and eight state and territory governments. At the Commonwealth level, the ministries of Education, Training and Youth Affairs, and Employment, Workplace Relations and Small Business have primary roles in the career information and services field. Education and training system is provided by the Australian Qualifications Framework, which provides a comprehensive nationally consistent framework for all qualifications in post-compulsory education and training. Vocational education and training is offered by a wide variety of providers. Although there is no national policy on career guidance services, the Australian government has adopted a number of strategies to improve outcomes for young people. They include focusing on achievement of minimum standard by all students in basic skills; increasing quality of vocational orientation for young people to gain experience in business while at school; and broadening the role of schools so that they are better equipped to assist students suffering multiple obstacles to success. Use of information technology in the career delivery system is constantly expanding. The recommendation for the future is for a more consistent approach to career guidance services to enhance employment, education, and training. (JDM)

Instructional systems development (ISD) is a systems approach to curriculum development and instructional delivery. It is oriented toward occupational needs with an emphasis on what it is that students must learn to perform specific tasks, what facilities best provide a setting for the neccessary learning, and what instructional methods and media best facilitate learning. There are four important differences between ISD and more traditional forms of instruction: (1) the requirement, through job analyses, occupational surveys, and feedback from graduates, of the thoughtful selection of what is to be taught based on data from the field; (2) attention given to how training is to be conducted, especially consideration of innovative alternatives; (3) use of test data based on absolute standards of performance to grade students and judge quality of instruction; and (4) application of contemporary technology to optimize instructional effectiveness, efficiency, and cost. Following the narrative discussion, the report describes the five phases of ISD--analysis, design, development, implementation, and control/evaluation--through text and accompanying charts showing the sequence of events. Event outcomes are also listed. A six-page glossary is appended. (YLB)

Our aim in this paper was to investigate active coping in relation to optimism, dental health behavior and self-reported dental health among 31-yr-old men and women born in Northern Finland in 1966. Connecting coping strategies and optimism with health behavior is an unexplored approach in dentistry, even though both coping strategies and optimism are known to be associated with many health outcomes. The data were based on a postal questionnaire, which was sent to the Northern Finland 1966 Birth Cohort at age 31 yr (n = 11 541). The number of replies was 8690, with a 75.3% response rate. Active coping was measured using the Ways of Coping Checklist and optimism using a revised Life Orientation Test. Prevalence proportion ratios were estimated by applying a log-binomial regression models. The results showed a correlation between active coping and optimism. Both active coping and optimism were related to different dental health behaviors. The effect of active coping on dental health behavior disappeared by adjusting for optimism, education and gender. The results support the previous findings that active coping acts as a mediator between optimism and health. Optimism was also related to self-reported dental health, which supports the comprehensiveness of optimism as a determinant for health. PMID:14632683

Crystalline (monomeric) soybean and (tetrameric) sweet potato {beta}-amylase were shown to catalyze the cis hydration of maltal ({alpha}-D-glucopyranosyl-2-deoxy-D-arabino-hex-1-enitol) to form {beta}-2-deoxymaltose. As reported earlier with the sweet potato enzyme, maltal hydration in D{sub 2}O by soybean {beta}-amylase was found to exhibit an unusually large solvent deuterium kinetic isotope effect (V{sub H}/V{sub D}=6.5), a reaction rate linearly dependent on the mole fraction of deuterium, and 2-deoxy-(2(a)-{sup 2}H)maltose as product. These results indicate (for each {beta}-amylase) that protonation is the rate-limiting step in a reaction involving a nearly symmetric one-proton transition state and that maltal is specifically protonated from above the double bond. That maltal undergoes cis hydration provides evidence in support of a general-acid-catalyzed, carbonium ion mediated reaction. Of fundamental significance is that {beta}-amylase protonates maltal from a direction opposite that assumed for protonating strach, yet creates products of the same anomeric configuration from both. Such stereochemical dichotomy argues for the overriding role of protein structures is dictating the steric outcome of reactions catalyzed by a glycosylase, by limiting the approach and orientation of water or other acceptors to the reaction center.

Augmentation of endoscopic video with preoperative or intraoperative image data [e.g., planning data and/or anatomical segmentations defined in computed tomography (CT) and magnetic resonance (MR)], can improve navigation, spatial orientation, confidence, and tissue resection in skull base surgery, especially with respect to critical neurovascular structures that may be difficult to visualize in the video scene. This paper presents the engineering and evaluation of a video augmentation system for endoscopic skull base surgery translated to use in a clinical study. Extension of previous research yielded a practical system with a modular design that can be applied to other endoscopic surgeries, including orthopedic, abdominal, and thoracic procedures. A clinical pilot study is underway to assess feasibility and benefit to surgical performance by overlaying CT or MR planning data in realtime, high-definition endoscopic video. Preoperative planning included segmentation of the carotid arteries, optic nerves, and surgical target volume (e.g., tumor). An automated camera calibration process was developed that demonstrates mean re-projection accuracy (0.7+/-0.3) pixels and mean target registration error of (2.3+/-1.5) mm. An IRB-approved clinical study involving fifteen patients undergoing skull base tumor surgery is underway in which each surgery includes the experimental video-CT system deployed in parallel to the standard-of-care (unaugmented) video display. Questionnaires distributed to one neurosurgeon and two otolaryngologists are used to assess primary outcome measures regarding the benefit to surgical confidence in localizing critical structures and targets by means of video overlay during surgical approach, resection, and reconstruction.

Objective: The authors performed a group-based program for obese children and adolescents in Bavaria, Germany to enable them to establish a health-oriented lifestyle and to reduce overweight. The authors compared this program with a control approach based on the patients' own initiative. Design: This is a controlled clinical trial. Setting: A nutrition program for outpatients in a German university hospital. Participants: Seventy-three obese patients aged 7 to 15 years (mean 11.2 years) were recruited by pediatricians and local newspaper reports and randomized into intervention and control groups. Children and adolescents in each group were divided into 3 groups according to age--7-8 years, 9-10 years, and 11-13 years. Children were classified overweight (defined as body mass index (BMI) greater than 90th percentile for age and gender), obese (BMI greater than 97th percentile), and extremely obese (BMI greater than 99.5th percentile), according to the European Childhood Obesity Group and the German Working Group on Pediatric Obesity, congruent with adult standards used to assess overweight and obesity. Intervention: Thirty-seven patients (age 7-13 years, mean 10.9 years) for the 1-year intervention. This intervention consisted of modules for physical activity, nutritional education, and coping strategies. The program was performed twice each week and incorporated parental participation and medical supervision, including laboratory tests. The obese controls (n = 36, age 8-15 years, mean 11.6 years) received written therapeutic advice during a visit at 0 and 6 months in the outpatient clinic. Main Outcome Measure: The primary outcome variable was the body mass index (BMI) z score. Analysis: Analysis of variance and t test were used, and a P value less than 0.05 was considered significant. Results: There was a reduction of BMI z score in the active treatment group (P less than 0.05), but not for controls. Moreover, the active group showed beneficial effects for body mass index (BMI), fat mass, and systolic blood pressure 12 months after beginning the intervention. Conclusions and Implications: Group-based programs for young, obese patients can be effective tools for establishing a health-oriented lifestyle and reducing the burden of obesity. (Contains 1 table.)

This article reports on the early experience with the 1440-nm wavelength, using a specially designed side-firing fiber, in a four-step approach, primarily to the lower third of the midface and neck. The author presents the clinical protocol, procedure steps, outcomes, and adverse events of use of the laser. Outcomes are described at 3 months, 6 months, and 18 months. PMID:23036291

The study reported here compares outcomes of three approaches to minimally invasive hysterectomy for benign indications, namely, robotic-assisted laparoscopic (RALH), laparoscopic-assisted vaginal (LAVH) and laparoscopic supracervical (LSH) hysterectomy. The total patient cohort comprised the first ...

Transplantation of neural progenitors remains a promising therapeutic approach to spinal cord injury (SCI), but the anatomical and functional evaluation of their effects is complex, particularly when using human cells. We investigated the outcome of transplanting human glial-restricted progenitors (...

The program has showed the effectiveness of a multidisciplinary team approach to address the issues of variability in proteomic technologies. A key outcome of the program was the improvement of the proteomic biomarker development pipeline.

1 Traditional and Modern Approaches to Outcomes Measurement Ronald K. Hambleton University of Massachusetts at Amherst Summary I have four goals in mind for this introductory presentation about item response theory and applications: 1.

This study aimed to characterize outcome measures used in trials of rehabilitation for stroke patients using the "International Classification of Functioning, Disability, and Health (ICF)". We investigated descriptions of randomized controlled trials (RCTs) published between 1996 and 2005. We then identified and classified outcome measures into three ICF-based categories: "body functions and structure," "activities and participation," and "other." Within rehabilitation RCTs, 21 focused on community residents and 20 focused on hospitalized patients. We identified 215 mentions of the measures in total and 103 types were used in 41 stroke rehabilitation RCTs from 1996-2005. Of the 41 articles, 7 were RCTs of occupational therapy while 6 RCTs focused on community residents. The percentage of outcome measures in the domain of "body functions and structures" has increased since ICF adoption. It is necessary to demonstrate evidence that outcome measures are useful in patient-oriented decision-making in occupational therapy and rehabilitation.   

In recent years, the health care reform discussion in the United States has focused increasingly on the dual goals of cost-effective delivery and better patient outcomes. A number of new conceptual models for health care have been advanced to achieve these goals, including two that are well along in terms of practical development and implementation-the patient-centered medical home (PCMH) and accountable care organizations (ACOs). At the core of these two emerging concepts is a new emphasis on encouraging physicians, hospitals, and other health care stakeholders to work more closely together to better coordinate patient care through integrated goals and data sharing and to create team-based approaches that give a greater role to patients in health care decision-making. This approach aims to achieve better health outcomes at lower cost. The PCMH model emphasizes the central role of primary care and facilitation of partnerships between patient, physician, family, and other caregivers, and integrates this care along a spectrum that includes hospitals, specialty care, and nursing homes. Accountable care organizations make physicians and hospitals more accountable in the care system, emphasizing organizational integration and efficiencies coupled with outcome-oriented, performance-based medical strategies to improve the health of populations. The ACO model is meant to improve the value of health care services, controlling costs while improving quality as defined by outcomes, safety, and patient experience. This document urges adoption of the PCMH model and ACOs, but argues that in order for these new paradigms to succeed in the long term, all sectors with a stake in health care will need to become better aligned with them-including the employer community, which remains heavily invested in the health outcomes of millions of Americans. At present, ACOs are largely being developed as a part of the Medicare and Medicaid systems, and the PCMH model is still gathering momentum and evolving among physicians. But, the potential exists for implementation of both of these concepts across a much broader community of patients. By extending the well-conceived integrative concepts of the PCMH model and ACOs into the workforce via occupational and environmental medicine (OEM) physicians, the power of these concepts would be significantly enhanced. Occupational and environmental medicine provides a well-established infrastructure and parallel strategies that could serve as a force multiplier in achieving the fundamental goals of the PCMH model and ACOs. In this paradigm, the workplace-where millions of Americans spend a major portion of their daily lives-becomes an essential element, next to communities and homes, in an integrated system of health anchored by the PCMH and ACO concepts. To be successful, OEM physicians will need to think and work innovatively about how they can provide today's employer health services-ranging from primary care and preventive care to workers' compensation and disability management-within tomorrow's PCMH and ACO models. PMID:22453809

Context: For the treatment of localised renal cell carcinoma (RCC), uncertainties remain over the perioperative and quality-of-life (QoL) outcomes for the many different surgical techniques and approaches of nephrectomy. Controversy also remains on whether newer minimally invasive nephron-sparing interventions offer better QoL and perioperative outcomes, and whether adrenalectomy and lymphadenectomy should be performed simultaneously with nephrectomy. These non-oncological outcomes are important because they may have a considerable impact on localised RCC treatment decision making. Objective: To review systematically all the relevant published literature comparing perioperative and QoL outcomes of surgical management of localised RCC (T1-2N0M0). Evidence acquisition: Relevant databases inc...

The results of orthognathic surgery may differ significantly from the planned outcome using dental models. The orientation of dental models mounted on articulators using conventional face bows does not accurately replicate the orientation of the patients? teeth and jaws, but introduces a systematic error. A mathematical analysis showed that the misalignment of the maxillary model introduces errors in the perioperative wafers, which may lead to the incorrect surgical positioning of the maxilla reported in the literature. The results of the mathematical analysis were validated by image analysis of photographs of mounted maxillary models, used to simulate five orthognathic procedures. No significant difference between the experimental results and the theoretical predictions from the mathemati...

Background:- A dimension of negatively oriented affect within oppositional defiant disorder (ODD) symptoms, which has been described as irritability, has been shown to predict depression and anxiety. Related constructs have been linked to temperament and personality constructs. However, only a few studies have examined the prediction from irritability within ODD to psychopathology or personality outcomes. Further, no studies have investigated whether irritability distinguishes among classes of youth. Methods:- Data from a clinic-referred sample of 7-12-year-old boys followed up to age 18 were used. Measures included structured clinical interviews with parents through adolescence, and youth self-report of depression and personality domains at age 18. Results:- Variable-oriented analyses fou...

Previous studies have suggested that Western constructs of academic motivation may operate in different ways in Asian contexts due to differences in the cultural environment. In the present study, the integrative effects of achievement goals, strategy orientations, and effort expenditure on achievement outcomes were examined among 1950 seventh-grade Chinese students in Hong Kong. Participants completed separate questionnaires for mathematics and English. Results for the two subjects were largely similar. There were significant positive relationships between mastery and performance goals, between cooperative and competitive orientations, as well as between understanding and memorizing strategies. Regression analyses further revealed that goals and strategies were highly predictive of effort...

Abstract in english This article analyzes the study of the relationship among knowledge management, the company's market orientation, innovativeness and organizational outcomes. The survey was conducted based on a survey held with executives from 241 companies in Brazil. The evidence found indicates that knowledge management directly contributes to market orientation, but it requires a clearly defined strategic direction to achieve results and innovativeness. It was also concluded that knowl (more) edge, as a resource, leverages other resources of the company, while it requires a direction in relation to the organizational goals in order to be effective.

Randomized trials of complex public health interventions generally aim to identify what works, accrediting specific intervention 'products' as effective. This approach often fails to give sufficient consideration to how intervention components interact with each other and with local context. 'Realists' argue that trials misunderstand the scientific method, offer only a 'successionist' approach to causation, which brackets out the complexity of social causation, and fail to ask which interventions work, for whom and under what circumstances. We counter-argue that trials are useful in evaluating social interventions because randomized control groups actually take proper account of rather than bracket out the complexity of social causation. Nonetheless, realists are right to stress understanding of 'what works, for whom and under what circumstances' and to argue for the importance of theorizing and empirically examining underlying mechanisms. We propose that these aims can be (and sometimes already are) examined within randomized trials. Such 'realist' trials should aim to: examine the effects of intervention components separately and in combination, for example using multi-arm studies and factorial trials; explore mechanisms of change, for example analysing how pathway variables mediate intervention effects; use multiple trials across contexts to test how intervention effects vary with context; draw on complementary qualitative and quantitative data; and be oriented towards building and validating 'mid-level' program theories which would set out how interventions interact with context to produce outcomes. This last suggestion resonates with recent suggestions that, in delivering truly 'complex' interventions, fidelity is important not so much in terms of precise activities but, rather, key intervention 'processes' and 'functions'. Realist trials would additionally determine the validity of program theory rather than only examining 'what works' to better inform policy and practice in the long-term. PMID:22989491

Background Transperitoneal (TP) and retroperitoneal (RP) approaches have equal efficacy in elective open abdominal aortic aneurysm (AAA) repair. The effect of open operative approach on patient-specific outcomes after AAA repair was tested. Methods Consecutive patients undergoing open AAA repair at the Veterans Affairs Tennessee Valley Healthcare System between January 2000 and August 2008 were retrospectively reviewed. Analysis was performed to examine the effects of demographic and clinical covariates on postoperative outcomes. Results A total of 106 patients were identified: 54 with TP approach and 52 with RP approach. Demographics and preoperative comorbidities were equivalent (p ? 0.10), with the exception of chronic obstructive pulmonary disease which was more prevalent in the TP ...

The importance of the relationship between parents is frequently underestimated by those designing and developing services to support parents in bringing up their children. Instead, the primary focus of recent family support initiatives in the United Kingdom has been on improving parenting skills. This article describes the outcomes of a project designed to maximize the effectiveness of parenting support to vulnerable families through sensitizing the workforce of a community-based adult mental health agency to take account of the parental couple in providing postnatal support groups, parenting workshops and relationship counselling. Evaluating outcomes from these services suggests that a couple orientation adds significant value to the effectiveness of parenting support.

Purpose The authors performed this study to compare the outcomes of robotic-assisted and conventional TKA in same patient simultaneously. It was hypothesized that the robotic-assisted procedure would produce better leg alignment and component orientation, and thus, improve patient satisfaction and clinical and radiological outcomes. Methods Thirty patients underwent bilateral sequential total knee replacement. One knee was replaced by robotic-assisted implantation and the other by conventional implantation. Results Radiographic results showed significantly more postoperative leg alignment outliers of conventional sides than robotic-assisted sides (mechanical axis, coronal inclination of the femoral prosthesis, and sagittal inclination of the tibial prosthesis). Robotic-assisted sides had n...

The objectives of this study were to describe the socially based emotions and behaviors of 33 orphans in Uganda and to examine social history correlates of variability in the outcome measures. The toddlers were generally not very aggressive or prosocially oriented, and they displayed rather limited affect. More time was spent alone than with others and there was a preference for interacting in groups over one-on-one. A few significant effects were observed with duration of institutionalization, contact with relatives and previous hospitalization(s) serving as independent variables and the various socially based emotions and behaviors as the outcome measures.

This paper explores the use of the optimization procedures in SAS/OR software with application to the contemporary logistics distribution network design using an integrated multiple criteria decision making approach. Unlike the traditional optimization techniques, the proposed approach, combining analytic hierarchy process (AHP) and goal programming (GP), considers both quantitative and qualitative factors. In the integrated approach, AHP is used to determine the relative importance weightings or priorities of alternative warehouses with respect to both deliverer oriented and customer oriented criteria. Then, a GP model incorporating the constraints of system, resource, and AHP priority is formulated to select the best set of warehouses without exceeding the limited available resources. To...

This article reviews the changing nature of contemporary tourism and sociological approaches to its study. We examine the broad social trends and specific historical events that recently affected tourism and discuss how the focus of sociological inquiry in tourism studies shifted from earlier discourses of authenticity and the tourist gaze to three novel theoretical approaches, the mobilities "paradigm", the performativity approach and actor-network theory (ANT), which each reflect a broader meta-theoretical re-orientation in contemporary philosophy and sociology. We appraise these conceptual developments and discuss their limitations. We then identify several current research issues as important areas for problem-oriented work at the intersections of tourism and contemporary society: soci...

Purpose - The primary purpose of this research is to draw out in-depth lifestyle characteristics which can be used in new product development and marketing. To achieve this goal, this research aims to explore US female household consumers' lifestyle structures regarding food-related AIO and identify the values that discriminate best among different consumer segments. Design/methodology/approach - A total of 518 US female consumers aged between 20 and 65 participated based on multi-stage stratified random selection of age. The cluster analysis was performed to identify meaningful segments. Findings - Six segments of Wellbeing-oriented, Social- and dining-oriented, Family-oriented, Innovation- and action-oriented, Price-conscious, and Convenience-oriented were found. These segments show diff...

An application security has two primary goals: first, it is intended to prevent unauthorised personnel from accessing information at higher classification than their authorisation. Second, it is intended to prevent personnel from declassifying information. Using an object oriented approach to implementing application security results not only with the problem of code scattering and code tangling, but also results in weaker enforcement of security. This weaker enforcement of security could be due to the inherent design of the system or due to a programming error. Aspect Oriented Programming (AOP) complements Object-Oriented Programming (OOP) by providing another way of thinking about program structure. The key unit of modularity in OOP is the class, whereas in AOP the unit of modularity is the aspect. The goal of the paper is to present that Aspect Oriented Programming AspectJ integrated with Spring AOP provides very powerful mechanisms for stronger enforcement of security.Aspect-oriented programming (AOP) all...

This study investigates the impact of the first-year program on the initial practice orientations of 2 distinct, equal-sized clusters of entering BSW students: micro-oriented and macro-oriented students. Results indicate that the proportion of students reporting a micro-practice orientation increased from 53.2% to 62.4% between the beginning and end of the year, whereas the proportion of students expressing a strong interest in macro-level practice decreased from 46.8% to 37.6%. At the end of the year, students interested in macro-level practice were also found to be interested in micro-level practice, indicating their generalist practice orientation. The findings are discussed in the light of 3 different approaches, which together provide a deeper understanding of the factors associated with students' professional socialization. (Contains 2 tables and 8 figures.)

The traditional approach to measuring allocative efficiency is based on input prices, which are rarely known at the firm level. This paper proposes a new approach to measure allocative efficiency which is based on the output-oriented distance to the frontier in a profit – technical efficiency space ...

Aspects have gained attention in the earlier steps of the software life-cycle leading to the creation of numerous ad- hoc Aspect-Oriented Modeling (AOM) approaches. These approaches mainly focus on architecture diagrams, class diagrams, state-charts, scenarios or requirements and generally propose A...

Aspect-Oriented Modeling approaches propose to model reusable aspects, or cross-cutting concerns, that can be later on composed into various base systems. These approaches are often limited to a particular domain: UML class diagrams, UML sequence diagrams, ... and therefore they cannot easily be ada...

In this paper, we present an approach to develop parallel applications based on aspect oriented programming. We propose a collection of aspects to implement group communication mechanisms on parallel applications. In our approach, parallelisation code is developed by composing the collection into th...

Cu metallization of AlN substrates was performed using a nonaqueous, electroless, alcohol based approach known as the polyol method. The concentration of Cu{sub 2}O in the film depended on the orientation of the substrates during deposition. This approach is very attractive for metallizing electronic substrates which are susceptible to hydrolytic degradation. {copyright} {ital 1997 American Institute of Physics.}

The system-wide usability of complex technical systems and particularly the complexity approach is not very visible in usability literature. The reason might be that the usability theories were originally created for computer systems, and ever since this user interface oriented approach has been use...

This paper presents a model-based approach that combines the data-flow and object-oriented computing paradigms to model embedded systems. The rationale behind the approach is that both views are important for modelling purposes in embedded systems environments, and thus a combined and integrated usa...

Fiscal Year 1998 represents the second full year utilizing a results-oriented, performance-based contract. This document describes the critical outcomes, objectives, performance indicators, expected levels of performance, and the basis for the evaluation of the Contractors performance for the period October 1, 1997 through September 30, 1998, as required by Articles entitled Use of Objective Standards of Performance, Self Assessment and Performance Evaluation and Critical Outcomes Review of the Contract DE-AC06-76RL01830. In partnership with the Contractor and other key customers, the Department of Energy (DOE) Richland Operations Office has defined six critical outcomes that serve as the core for the Contractors performance evaluation. The Contractor also utilizes these outcomes as a basis for overall management of the Laboratory. The Critical Outcome system focuses all of the customer desires into specific objectives and performance indicators, with supporting measures to track and foster continued improvement in meeting the needs (outcomes) of the Laboratory`s customers. Section 1 provides information on how the overall performance rating for the Contractor will be determined. Section 2 provides the detailed information concerning critical outcomes, objectives, performance indicators and expectations of performance. Section 3 describes the commitments for documenting and reporting the Laboratory`s self-evaluation.

We compared the stability and discriminatory power of different methods of determining cardiac magnetic field map (MFM) orientation within the context of coronary artery disease (CAD). In 27 healthy subjects and 24 CAD patients, multichannel magnetocardiograms were registered at rest. MFM orientation was determined during QT interval using: (a) locations of the positive and negative centres-of-gravity, (b) locations of the field extrema and (c) the direction of the maximum field gradient. Deviation from normal orientation quantified the ability of each approach to discriminate between healthy and CAD subjects. Although the course of orientation was similar for all methods, receiver operating characteristic analysis showed the best discrimination of CAD patients for the centre-of-gravity approach (area-under-the-curve = 86%), followed by the gradient (84%) and extrema (76%) methods. Consideration of methodological and discriminatory advantages with respect to noninvasive diagnosis of CAD suggests that the centres-of-gravity method is the most suited one.

Initial research on loss and potentially traumatic events (PTEs) has been dominated by either a psychopathological approach emphasizing individual dysfunction or an event approach emphasizing average differences between exposed and nonexposed groups. We consider the limitations of these approaches and review more recent research that has focused on the heterogeneity of outcomes following aversive events. Using both traditional analytic tools and sophisticated latent trajectory modeling, this research has identified a set of prototypical outcome patterns. Typically, the most common outcome following PTEs is a stable trajectory of healthy functioning or resilience. We review research showing that resilience is not the result of a few dominant factors, but rather that there are multiple independent predictors of resilient outcomes. Finally, we critically evaluate the question of whether resilience-building interventions can actually make people more resilient, and we close with suggestions for future research on resilience. PMID:21091190

This study collected information on the acceptance rates, admission standards, financial assistance, student characteristics, theoretical orientations, and select outcomes of American Psychological Association-accredited counseling psychology programs (99% response rate). Results are presented collectively for all 66 counseling programs as well as separately for practice-oriented PhD, equal-emphasis PhD, and research-oriented PhD programs. Practice-oriented programs accepted more applicants (29%) than equal-emphasis or research-oriented programs (19% and 17%); however, they offered less full funding (30%) than equal-emphasis (72%) or research-oriented programs (83%). Average Graduate Record Examination scores (594 quantitative, 552 verbal) and average grade point averages (3.57) were strong and similar across programs. Approximately 70% of incoming students were women, 29% ethnic and racial minorities, and 8% international students. On average, 89% of students secured an accredited internship as part of their 5.5-year-long program. The research-driven portrait of doctoral training in counseling psychology is of highly competitive, multiculturally diverse, and theoretically pluralistic programs in which the training model does matter in several respects. (Contains 2 tables and 1 figure.)

Object orientation has been an influential approach in software engineering. Basically, an object is regarded as an entity that encapsulates states and behaviours. A system is a collection of objects which interact with others to accomplish some functionalities. Objects with the same attributes and behaviours are abstracted into a class. Classes with common attributes and behaviours are generalised to form an inheritance hierarchy. An object-oriented system is designed in accordance with these principles of encapsulation, inheritance and object interactions.

The introduction of Information and Communication Technologies in the print media industry has changed considerable the work process but it has also offered new paths for delivering its content. But trends in the worldwide media industry have clearly shown that in order to guarantee long-term success with audience in the future, it will be vital to change from a single product oriented to a multimedia content and user-oriented approach. This paper examines the use of transmedia reporting in news articles.

Aim? The aim of this study was to review systematically evidence about the efficacy of motor interventions for children with developmental coordination disorder (DCD), and to quantify treatment effects using meta-analysis. Method? Included were all studies published between 1995 and 2011 that described a systematic review, (randomized) clinical trial, or crossover design about the effect of motor intervention in children with DCD. Studies were compared on four components: design, methodological quality, intervention components, and efficacy. Twenty-six studies met the inclusion criteria for the review. Interventions were coded under four types: (1) task-oriented intervention, (2) traditional physical therapy and occupational therapy, (3) process-oriented therapies, and (4) chemical supplements. For the meta-analysis, effect sizes were available for 20 studies and their magnitude (weighted Cohen's d [d(w) ]) was compared across training types. Results? The overall effect size across all intervention studies was d(w) =0.56. A comparison between classes of intervention showed strong effects for task-oriented intervention (d(w) =0.89) and physical and occupational therapies (d(w) =0.83), whereas that for process-oriented intervention was weak (d(w) =0.12). Of the chemical supplements, treatment with methylphenidate was researched in three studies (d(w) =0.79) and supplementation of fatty acids plus vitamin E in one study (no effect). The post hoc comparison between treatment types showed that the effect size of the task-oriented approach was significantly higher than the process-oriented intervention (p=0.01) and comparison (p=0.006). No significant difference in the magnitude of effect size between traditional physical and occupational therapy approaches and any of the other interventions emerged. Interpretation? In general, intervention is shown to produce benefit for the motor performance of children with DCD, over and above no intervention. However, approaches from a task-oriented perspective yield stronger effects. Process-oriented approaches are not recommended for improving motor performance in DCD, whereas the evidence for chemical supplements for children with DCD is currently insufficient for a recommendation. PMID:23106530

Maltose binding protein (MBP) is a 370-residue two-domain molecule involved in bacterial chemotaxis and sugar uptake. Rotational diffusion tensors were calculated for a complex between MBP and {beta}-cyclodextrin using backbone {sup 15}N T{sub 1} and T{sub 1{rho}} relaxation times and steady state {sup 1}H-{sup 15}N NOE values. The tensors obtained for each of the two domains in the protein were subsequently used to determine the relative domain orientation in the molecule. The average domain orientation determined using this approach agrees well with results from dipolar coupling data, but differs significantly from the domain orientation deduced from X-ray studies of the complex.

A nonperturbative close-coupling technique is used to calculate differential cross sections for the electron-impact ionization of H{sub 2} at an energy of 35.4 eV. Our approach allows cross sections for any orientation of the molecule with respect to the incident electron beam to be analyzed. New features in the resulting cross sections are found compared with the case where the molecular orientation is averaged, and also with cross sections for He at equivalent electron kinematics. When averaged over all possible molecular orientations, good agreement is found with recent experimental results.

The crystal structure of a conjugated molecule containing thiophene and fluorenone residues has been determined from powder X-ray diffraction (XRD). Thin films (< 40 nm thick) of this molecule, grown in high vacuum (10{sup -5} Pa) onto oxidized silicon substrates, are oriented along with different crystallographic directions. A comparison of XRD in both Grazing Incidence and Bragg-Brentano geometries allowed to perform a quantitative analysis of the various orientations. This approach is generally applicable in the case of multi-oriented films. The results fully account for the poor performance of this molecule in p-type field effect transistor devices.

Grain fragmentation and local orientation gradients in deformed single crystals are characterized using electron backscatter diffraction (EBSD) to obtain statistically reliable information. Interrogation of the dislocation substructure is accomplished by extracting information gleaned from small point-to-point misorientations as measured by EBSD. Along with an estimate of the geometrically necessary dislocation (GND) content, the point-to-point deviation from an average grain orientation is described by an orientation difference vector defined in Rodrigues space. Mapping of parameters such as GND, and divergence and gradient fields created from analysis of the difference vectors provide an alternative approach to obtain quantitative information and images from EBSD data. PMID:15777598

This paper probes the issue of complexity. Grounded in profound oriental and western philosophies, it reflects on and outlines the limitations of two major complexity theories???complexity in systems and complexity in the mind. A further quest reveals that the entities involved in the two theories are not mutually exclusive. System and mind are different entities interacting with each other and displaying volatility. An inquiry into social problems rests on continuous learning, rather than the replication of experiment outcomes in natural science.

The main subject of this thesis is to identify hidden failures in process control systems by developing and using a function-oriented system analysis method. Qualitative failure analysis and the characteristics of the classical failure analysis methods and function-oriented modelling methods are covered. The general limitations of the methods in connection with the identification and representation of hidden failures are discussed. The discussion has led to the justification of developing and using a function-oriented system analysis method to identify and represent the capabilities of the system components, which realize different sets of functions in connection with different sets of goals that the system must achieve. A terminology is introduced to define the basic aspects of technical systems including goals, functions, capabilities and physical structure. A function-oriented system analysis method using this terminology and a tailored combination of the two function-oriented modelling approaches, is also introduced. It is then explained how the method can be applied in the identification and representation of hidden failures. The building blocks of a knowledge-oriented system to perform the diagnosis on the basis of the developed method are equally described. A prototype of the knowledge-based system is developed to demonstrate the applicability of the function-oriented system analysis method and the knowledge-based system. The prototype is implemented within the object-oriented software environment G2. (au) 65 ills., 32 refs.

The aim of the study was to determine the effectiveness of an extension-oriented exercise program in the prevention and management of low back/neck pain in nursery school teachers. A Cluster Randomized Controlled Trial was utilized. Seventy-one nursery school teachers working in nine school buildings were randomly divided into two groups, with each school as a unit of randomization. All the teachers in both groups received an ergonomic brochure; teachers in the experimental group also received an extension-oriented exercise program, conducted by a physical therapist. Data were collected at baseline and at a two-month follow-up. The primary outcome measure recorded was the level of disability (Roland Morris Disability Questionnaire and Oswestry Disability Index), while secondary outcome measure included the evaluation of cervical and lumbar physical discomfort (Visual Analogue Scale). At follow-up, a significant improvement was registered in the experimental group as compared to the control group for all the outcomes evaluated. In conclusion an extension-oriented exercise program may be a useful strategy to prevent low back and neck complaints and to reduce consequent LBP functional disability among nursery school teachers.   

This paper describes the faculty enrichment activities and outcomes of a faculty orientation and development committee at a college of pharmacy. The committee used a continuous quality improvement (CQI) framework that included needs assessment, planning and implementation of programs and workshops, assessment of activities, and evaluation of feedback to improve future programming. Some of the programs established by the committee include a 3-month orientation process for new hires and development workshops on a broad range of topics including scholarship (eg, research methods), teaching (eg, test-item writing), and general development (mentorship). Evidence of the committee's success is reflected by high levels of faculty attendance at workshops, positive feedback on workshop evaluations, and overall high levels of satisfaction with activities. The committee has served as a role model for improving faculty orientation and retention. PMID:22412202

A firm's strategic innovation orientation, which is aimed at discovering and satisfying emerging customer needs with novel technological solutions, has repeatedly been shown to be crucial for firm innovativeness and firm performance. Despite its apparent importance, relatively little research has addressed antecedents of a firm's strategic orientation that help explain heterogeneity in innovation strategies across firms. Especially the influence of top management teams (TMT) should be critical, since innovation strategies are shaped at the top management level. Building on the theory of upper echelon, this study investigates how TMT characteristics affect a firm's strategic innovation orientation, and how this relates to innovation outcomes and firm performance. Hypotheses are tested on a sample of goods manufacturers using a combination of survey data, document analysis, and objective capital market data for firm performance. Results indicate that TMT diversity, measured as heterogeneity in educational, functional, industry, and organizational background, has a strong positive effect on a firm's innovation orientation. A strong proactive focus on emerging customer needs and on novel technologies then lead to a portfolio of new products with higher market newness and technology newness, which both increase firm performance. The results therefore emphasize the importance of TMT characteristics as antecedent for innovation strategy and innovation outcomes.

Abstract Objectives - This paper explores how entrepreneurial action can lead to environmental sustainability. It builds on the assumption that the creation of sustainble practices is one of the most important challenges facing the global society, and that entrepreneurial action is a vital instrument in the pursuit of sustainability.  Prior Work - Extant literature identifies two main approaches to sustainable entrepreneurship. (i) traditional exploitation of environmentally relevant opportunities and (ii) institutional entrepreneurship creating opportunities. We identify a novel form: resource oriented sustainable entrepreneurial action.  Approach - The paper uses a case study approach to build deeper theoretical knowledge of environmentally sustainable entrepreneurship.  Results - The paper identifies and analyses a distinct form of sustainable entrepreneurship -  resource oriented entrepreneurship - which uses bricolage in various ways to create sustainable solutions. Implications and value - The concept of resource oriented sustainable entrepreneurship contributes to the theoretical understanding of how entrepreneurial action can support sustainability, Furthermore the case study has significant learning points for practitioners and academics alike.

The coupling between arbitrarily positioned and oriented split ring resonators is investigated up to THz frequencies. Two different analytical approaches are used, one based on circuits and the other on field quantities that includes retardation. These are supplemented by numerical simulations and experiments in the GHz range, and by simulations in the THz range. The field approach makes it possible to determine separately the electric and magnetic coupling coefficients which, depending on orientation, may reinforce or may cancel each other. Maps of coupling are produced for arbitrary orientations of two co-planar split rings resonant at around 2 GHz and then with the geometry scaled down to be resonant at around 100 THz. We prove that the inertia of electrons at high frequencies results in a dramatic change in the maps of coupling, due to reduction of the magnetic contribution. Our approach could facilitate the design of metamaterials in a wide frequency range up to the saturation of the resonant frequency.

Multilimbed industrial robots that have at least one arm and two or more legs are suggested for enlarging robot workspace in industrial automation. To plan the motion of a multilimbed robot, the arm-leg motion-coordination problem is raised and task decomposition is proposed to solve the problem; that is, a given task described by the destination position and orientation of the end-effector is decomposed into subtasks for arm manipulation and for leg locomotion, respectively. The former is defined as the end-effector position and orientation with respect to the legged main body, and the latter as the main-body position and orientation in the world coordinates. Three approaches are proposed for the task decomposition. The approaches are further evaluated in terms of energy consumption, from which an optimal approach can be selected.

In this article, we discuss a dilemma consisting of the market-oriented perspective of users of medical technology versus the long-term technology foresight perspective. The context of medical technology is interesting, because we have to cope with complex future-oriented multi-level and multi-actor strategic decision making. In order to deal with this dilemma we suggest combining the results of a (group) expert opinion forecasting approach with a more market-oriented scenario-approach. More specifically, we use the results of the Delphi-technique as the main input for the development of various capacity (Market-based) scenarios. We exemplify this approach by a real life example directed at the future of imaging techniques for cancer care in The Netherlands and focus on a set of scenarios ...

The Wide-Awake Approach to Dupuytren's contracture involves fasciectomy under local anesthetic with epinephrine and no tourniquet. The goal of this study is to show that the Wide-Awake Approach produces equivalent outcomes to fasciectomy under general anesthetic with a tourniquet, with fewer risks t...

Students, whether they are academic or vocational-technical majors, need to interpret social studies problems by use of the scientific approach rather than by the use of fatalism, supernaturalism, and superstition. To ensure this outcome, secondary school curricula must provide enriching experiences through modern instructional techniques which develop the scientific approach. (CM)

Peripheral arterial disease (PAD) is common and carries an increased risk of morbidity and mortality. The level of knowledge among incoming medical trainees about PAD is unknown. During orientation to a single internal medicine residency program, incoming medical interns were given a 19-question multiple-choice questionnaire. The questions fell into 1 of 4 categories about PAD: (1) prevalence, (2) screening, (3) treatment, and (4) outcome. Sixty-two incoming interns were queried. The percentage of questions answered correctly overall was 41.7% (10.5%-73.7%). The percentage of questions answered correctly in the prevalence, screening, treatment, and outcome groups were 48.9% (0 to 100%), 33.8% (0 to 80%), 45.0% (0 to 87.5%), and 42.5% (0 to 100%), respectively. Internal medicine interns have poor knowledge about PAD including its prevalence, screening, treatment, and outcomes. Increased education during medical school is encouraged. PMID:22297038

This article examines the impact of a socially oriented public health media campaign that aims to influence social indicators among adults as a means to advances in youth health outcomes. Hierarchical regression analyses are conducted on telephone survey data from 18 weekly telephone surveys of adults in Kansas. Media campaign exposure was positively associated with two outcome measures: beliefs about youth development and behaviors toward youth development. In addition, these two outcome measures increased significantly over time, with the dissemination of the campaign's television and newspaper advertisements. Furthermore, these over-time increases were present only among respondents who were exposed to the media campaign. These findings offer support for the campaign's influence on the ...

A joint study between the Computer Working Group of the SSC Solenoidal Detector Collaboration (SDC) and IBM`s Federal Sector Division is focusing on the use of Object Oriented Analysis and Design on the SDC Offline Computing System. One key challenge of the analysis is to discover an efficient way to store and subsequently retrieve raw and reconstructed event data, estimated to be 2 petabytes per year. The Object Oriented approach being used during the analysis and early design is intended to yield a smooth transition to detailed design, prototyping and implementation. The object oriented approach is used as a subprocess of a larger process used by IBM FSD, i.e., a systematic approach to architecting and integrating large complex systems. A description of the overall process and early results are described in a study report produced jointly by the SDC and IBM FSD. The overall process focuses on requirements analysis, operational concept development, problem domain decomposition, development and selection of candidate architectures, automated performance modeling and software architecture. This paper will focus primarily on software architecture. The high level software architecture is viewed as a layered stack consisting of: system services, common physics application framework and unique physics applications. Object oriented analysis is being used to investigate the data storage and management of the event data. An object hierarchy is being created and operational concept scenarios are being used to validate the design. Several database prototypes can then be developed, e.g. object oriented or relational, to prove the concept. The object oriented development is fundamentally different from traditional approaches to design, such as those based exclusively on data flow. Object oriented decomposition more closely models a person`s perception of reality, hence the developed system is more understandable, extensible, and maintainable.

Purpose New surgical approaches based on natural orifice transluminal surgery (NOTES) have the potential to further decrease morbidity and hospital stay. However, a number of key challenges have been identified preventing its clinical adoption, including inadequate instrument design and spatial disorientation. Furthermore, retroflexion, missing fixed anatomical references, and limited field-of-view are key factors contributing to disorientation in NOTES. Methods A hybrid approach of integrated orientation sensing and real-time vision processing is proposed to restore orientation cues for improved surgical navigation. The distal tip of an articulated robotic endoscope is equipped with an inertial measurement unit (IMU) enabling video images to be reoriented and stabilized with respect to th...

A continuation of Part I, which introduced mental health recovery concepts to family therapists, Part II of this article outlines a collaborative, appreciative approach for working in recovery-oriented contexts. This approach draws primarily upon postmodern therapies, which have numerous social justice and strength-based practices that are easily adapted in recovery-oriented contexts. The model outlined in this article includes an overview of the recovery partnership (i.e., therapeutic relationship), mapping recovery (i.e., assessment and case conceptualization), recovery planning (i.e., treatment planning), facilitating recovery (i.e., intervention), accessing resources (i.e., case management), recovery maintenance, and service contexts as well as a case study. [For Part I, see EJ975850.

Currently there is no specific treatment for the brain insults leading to motor dysfunction in cerebral palsy. The available symptomatic therapeutic options place cerebral palsy among the costliest chronic childhood conditions. Therefore, it is necessary to make well-informed decisions in an effort to match cost-effectiveness with patient and family needs. This presentation aims to analyze the efficacy of rehabilitation therapy, orthoses, oral medications, botulinum toxin, intrathecal baclofen, complementary or alternative treatments and discuss guidelines for a goal oriented approach. Despite insufficient reporting of trials, physiotherapy has shifted from traditional to goal oriented approaches, based on principles of motor learning, strength and fitness training. Correct choice and use ...

Veterinarians working with dairy cows are suggested to refocus their efforts from being task-oriented providers of single-cow therapy and develop themselves into advice-oriented herd health management advisors. The practising cattle veterinarian's ability to translate knowledge into on-farm application requires a profound understanding of the dairy farm as an integrated system. Consequently, educating and motivating farmers are key issues. To achieve such insight the veterinarian needs to work with several scientific disciplines, especially epidemiology and (behavioural) economics. This trans-disciplinary approach offers new methodological possibilities and challenges to students of dairy herd health management. Advisors working with dairy herd health management may sometimes experience that farmers do not follow their advice. Potentially, this could lead to the interpretation that such farmers are behaving irrationally. However, farmers who are confronted with advice suggesting a change of behaviour are placed in a state of cognitive dissonance. To solve such dissonance they may either comply with the advice or reduce the dissonance by convincing themselves that the suggested change in management is impossible to implement. Consequently, herd health management advisors must understand the fundamental and instrumental relationships between individual farmers' values, behaviour and perception of risk, to stimulate and qualify the farmer's decision-making in a way that will increase the farmer's satisfaction and subjective well-being. Traditionally, studies on herd health economics have focussed on financial methods to measure the value of technical outcomes from suggested changes in management, following the basic assumption that farmers strive to maximise profit. Farmers, however, may be motivated by very different activities, e.g. animal health and welfare or other farmers' recognition, making it impossible to provide 'one-size-fts-all' consultancy because the best decision depends heavily on the internal logic and context-bound reality on each dairy farm. Relevant information may be available, but to be implemented at farm level it has to be communicated effectively. This requires a trustworthy communicator. Consequently, veterinarians are recommended to receive training in communication; keywords in this process are dialogue and reflection. An educational framework based on science and the authors' experience is presented. The aim is to guide practising cattle veterinarians into a personal learning process considered necessary for them to be recognised by farmers as trustworthy dairy herd health advisors. PMID:21328151

OBJECTIVE: /st>The study aim was twofold: to investigate and describe the organizational attributes of accreditation programmes in low- and middle-income countries (LMICs) to determine how or to what extent these differ from those in higher-income countries (HICs) and to identify contextual factors that sustain or are barriers to their survival. DESIGN: /st>Web-based questionnaire survey. PARTICIPANTS: /st>National healthcare accreditation providers and those offering international services. In total, 44 accreditation agencies completed the survey.Main outcome measure(s)Income distinctions, accreditation programme features, organizational attributes and cross-national divergence. RESULTS: /st>Accreditation programmes of LMICs exhibit similar characteristics to those of HICs. The consistent model of accreditation worldwide, centres on promoting improvements, applying standards and providing feedback. Where they do differ, the divergence is over specialized features rather than the general logic. LMICs were less likely than HICs to include an evaluation component to programmes, more likely to have certification processes for trainee surveyors and more likely to make decisions on the accreditation status based on a formulaic, mathematically oriented approach. Accreditation programme sustainability, irrespective of country characteristics, is influenced by ongoing policy support from government, a sufficient large healthcare market size, stable programme funding, diverse incentives to encourage participation in accreditation by Health Care Organizations as well as the continual refinement and improvement in accreditation agency operations and programme delivery. CONCLUSIONS: /st>Understanding the similarities, differences and factors that sustain accreditation programmes in LMICs, and HICs, can be applied to benefit programmes around the world. A flourishing accreditation programme is one element of the institutional basis for high-quality health care. PMID:23118095

Controversies exist regarding the best treatment for slipped capital femoral epiphysis (SCFE). Subcapital anatomical reorientation of the epiphysis by surgical dislocation and a retinacular soft tissue flap has been described recently as an effective approach. We evaluated the clinical and radiographic efficacy of this technique and compared these to published results. A series of 20 SCFE (18 stable, 2 unstable) treated by subcapital re-orientation through surgical hip dislocation and an extended retinacular soft tissue flap was reviewed retrospectively. Preoperatively and at most recent follow-up, patients were clinically examined with regard to pain and function according to the Harris hip score and to the Western Ontario and McMaster universities (WOMAC) score. Radiological examination included measurement of preoperative and postoperative anteroposterior (AP) and lateral (L) Southwick angles; and at follow-up the alpha angle was measured. The average follow-up time was 24 months. The mean WOMAC score was 2.80 post-operatively. The mean pre-operative slip angle was 40.2 degrees on the AP view and 50.65 degrees on the lateral view. Post-operatively, the mean values were 7,20 degrees on the AP view and 9,45 degrees on the lateral view. The mean post-operative average alpha angle was 43,11 degrees. No cases of avascular necrosis were seen. Our short term clinical and radiographic results are similar to outcomes published in the recent literature. The small number of technical complications appears favourable considering the surgical complexity of the procedure, and our technique offers clear advantages in treating these complex deformities. PMID:22505180

Australian Education Review (AER) 55 explores the goals of Australian education and of how schools should prepare young people for work and life. Section 1 provides an overview, discussing the nature of broad social and economic changes over the last 20 years, and their implications for the goals of Australian education systems today and for the future, and for what young people need to learn and why. Section 2 critically explores the assumptions which dominate current educational policies about the alignment of schooling with economic goals and work. Section 3 provides an analysis of the policy for social inclusion: the framing of educational goals that are oriented towards civic education, life skills and well-being. Developing curricula that equip young Australians for life involves confronting difficult questions about what kind of society Australia is now and should be in the future. Section 4 considers the nature of school knowledge and questions the learning outcomes traditionally measured. It argues that chronic inequalities experienced by some groups are the result of educational debts, accrued over time, through practices of social exclusion. National and international research indicates that addressing these inequalities will require different resourcing models and new teaching and learning approaches. Section 5 concludes that to prepare young Australians for the future, their education should be holistic and flexible, and encompass a commitment to learning for both work and life. In their "education for the future" young people should be provided with opportunities to engage in learning that has meaning to them and in which they can exercise active participation and decision making. [Foreword by Andy Furlong.

Abstract in portuguese Asma é uma doença com uma alta prevalência em nosso meio e ao redor do mundo. Embora novas opções terapêuticas tenham sido recentemente desenvolvidas, parece haver um aumento mundial na sua morbidade e mortalidade. Em muitas instituições, as exacerbações asmáticas ainda se constituem em uma emergência médica muito comum. As evidências têm demonstrado que o manejo da asma aguda na sala de emergência concentra decisões cruciais que podem determinar o desfec (more) ho desta situação clínica. Nesta revisão, enfocaremos a avaliação e o tratamento do paciente com asma aguda na sala de emergência, descrevendo uma estratégia apropriada para o seu manejo. Serão consideradas as seguintes etapas: diagnóstico, avaliação da gravidade, tratamento, avaliação das complicações, decisão sobre onde se realizará o tratamento adicional e orientações por ocasião da alta da emergência. Espera-se que estas recomendações contribuam para que o médico clínico tome as decisões apropriadas durante o manejo da asma aguda na sala de emergência. Abstract in english Asthma is a disease with high prevalence in our country and worldwide. Although new therapeutic approaches have been developed recently, there seems to be a global increase in morbidity and mortality from asthma. In many institutions, asthma exacerbation is still a common medical emergency. Clinical evidence demonstrates that management of acute asthma in the emergency room entails crucial decisions that could determine the clinical outcome. In this review, the authors fo (more) cus on assessment and treatment of patients with acute asthma and outline an appropriate management strategy. Diagnosis, severity assessment, treatment, complications, decision about where additional treatment will take place and orientations on discharge from the emergency will be considered. It is expected that these recommendations will help physicians to make the appropriate decisions about care of acute asthma in the emergency room.

ACCESSIBLE SUMMARY: •? The transitional relationship model (TRM) facilitates the discharge of psychiatric clients from hospital to community by providing hospital staff involvement until a therapeutic relationship has been established with a community care provider as well as peer support. •? Psychiatric wards at six hospital sites implemented the TRM in three waves. Monthly summaries, progress reports, meeting minutes and focus group discussions were reviewed in order to uncover facilitators and barriers to TRM implementation. •? Factors that facilitated TRM implementation included: educational modules for staff and peer training, the presence of on-site champions, and supportive documentation systems. Barriers included: feeling swamped/overwhelmed, death by process, team dynamics and changes in champions. •? Implementation strategies suggested by the initial hospital wards were used to enhance implementation on subsequent wards, leading to positive outcomes. This study highlights the need to address work environment issues when implementing healthcare interventions, particularly for interprofessional teams. ABSTRACT: The transitional relationship model (TRM) facilitates the discharge process by providing peer support and hospital staff involvement until a therapeutic relationship has been established with a community care provider. A quasi-experimental, action-oriented research design was employed in which psychiatric wards at six hospital sites implemented the model in three waves. Helpful strategies were identified by each wave of wards for consideration by subsequent wards. Using an ethnographic approach, qualitative data were examined to uncover experiences and perceptions of TRM implementation and to help identify key issues that were supporting or hampering implementation. Specific strategies that facilitate the implementation of TRM include: (1) the use of educational modules for on-ward hospital staff training and peer training; (2) presence of on-site champions; and (3) supportive documentation systems. Issues identified as barriers to implementation included: (1) feeling drowned, swamped and overwhelmed; (2) death by process; (3) team dynamics; and (4) changes in champions. Staged large-scale implementation of the TRM allowed for iterative improvements to the model leading to positive outcomes. This study highlights the need to address work environment issues, particularly interprofessional teams. PMID:22827453

Until very recently, the conceptual and technical approaches to assessing health outcomes have been grounded in classical psychometric theory and methods. It is only in the past few years that researchers have recognized the potential of modern test theory for advancing the field of health outcomes research, in general, and health-related quality of life (HRQL) research, in particular. The enthusiasm for applying item response theory (IRT) and its pragmatic companion, computer adaptive testing (CAT), in the health and clinical sciences is tangible.

Feature-oriented decomposition of software is known to improve a programmer's ability to understand and modify software during maintenance tasks. However, it is difficult to take advantage of this fact in case of object-oriented software due to lack of appropriate feature modularization mechanisms. In absence of these mechanisms, feature implementations tend to be scattered and tangled in terms of object-oriented abstractions, making the code implementing features difficult to locate and comprehend. In this paper we present a semi-automatic method for feature-oriented remodularization of Java programs. Our method uses execution traces to locate implementations of features, and Java packages to establish explicit feature modules. To evaluate usefulness of the approach, we present a case study where we apply our method to two real-world software systems. The obtained results indicate a significant improvement of feature representation in both programs, and confirm the low level of manual effort required by the proposed remodularization method.

Object-oriented programming has been referred to as a new style of computer programming that differs from conventional structured programming in that solutions to problems are obtained as more natural'' activity. Current implementations of traffic simulation models lack explicit representations of the assumptions made about the real world. Thus, they have become increasingly more difficult to understand as new changes are added or new modifications are made. An object-oriented approach to traffic simulation modeling will overcome some of these problems and promises to offer a new alternative solution. This paper introduces, by means of examples, the concepts of object-oriented programming and provides some starting considerations necessary to develop a general framework for building a traffic simulation tool based on the object-oriented paradigm of computer problem solving. 11 refs., 6 figs.

This paper presents an approach for fusion of the two major cardiovascular imaging modalities, angiography and intravascular ultrasound (IVUS). While the path of the IVUS catheter, which follows the vessel curvature during pullback, is reconstructed from biplane angiograms, cross-sectional information about the vessel is derived from IVUS. However, after mapping of the IVUS frames into their correct 3-D locations along the catheter path, their orientations remain ambiguous. We determine the relative catheter twisting analytically, followed by a statistical method for finding the absolute orientation from the out-of-center position of the IVUS catheter. Our results as obtained from studies with cadaveric pig hearts and from three patients undergoing routine coronary intervention showed a good match of the absolute orientation by the algorithm. In all tested cases, the method determined the visually correct orientations of the IVUS frames. Local distortions were reliably identified and discarded.

We review our novel simulation approach to model the effects of applied stress and wafer orientation by mapping detailed dependencies of long channel physics onto short channel device conditions in Silicon NMOS and PMOS. We use kp and Monte Carlo methods to show the long channel dependencies of these effects on gate fields, doping levels, extrinsic charges, and homogeneous driving fields. Our model predicts the reduced effect of wafer orientation on short channel linear and saturation current drives due to weak gate confinement, high carrier density, high stress, and high driving field prevalent in scaled devices. This reduces NMOS (110) wafer orientation loss compared to (100), while keeping PMOS (110) gains over (100) surface orientation in current drives in ?110? channels, consistent wi...

A two-level hierarchical approach for process fault diagnosis is an operating system employs a function-oriented approach at a first level and a component characteristic-oriented approach at a second level, where the decision-making procedure is structured in order of decreasing intelligence with increasing precision. At the first level, the diagnostic method is general and has knowledge of the overall process including a wide variety of plant transients and the functional behavior of the process components. An expert system classifies malfunctions by function to narrow the diagnostic focus to a particular set of possible faulty components that could be responsible for the detected functional misbehavior of the operating system. At the second level, the diagnostic method limits its scope to component malfunctions, using more detailed knowledge of component characteristics. Trained artificial neural networks are used to further narrow the diagnosis and to uniquely identify the faulty component by classifying the abnormal condition data as a failure of one of the hypothesized components through component characteristics. Once an anomaly is detected, the hierarchical structure is used to successively narrow the diagnostic focus from a function misbehavior, i.e., a function oriented approach, until the fault can be determined, i.e., a component characteristic-oriented approach.

Abstract Background:- To evaluate the visual outcomes of conductive keratoplasty for relief of symptomatic presbyopia of pseudophakia with monofocal intraocular lens implantation. Design:- It was a prospective clinical study and set in Eye Center, Second Affiliated Hospital, Zhejiang University. Participants:- This study comprised 27 eyes from 27 patients with presbyopia symptom. Methods:- The patients received conductive keratoplasty via monovision approach after monofocal intraocular lens implantation and were followed up at 1-week and 1, 3, 6 and 12-months postoperatively. Main Outcome Measures:- The main outcomes including uncorrected near visual acuity, uncorrected distance visual acuity, best spectacle-corrected visual acuity, manifest refraction spherical equivalent, keratometric as...

AbstractIntroduction: Although evaluating at multiple outcome levels has been proposed for continuing education activities and programs, it is a complex undertaking and is not done routinely, especially in collaborative, multicomponent programs. This article reports on strategies used and results obtained in an evaluation project that examined multiple outcomes of a US-based collaborative, multicomponent smoking cessation educational program for clinicians. Methods: Evaluation was organized conceptually around the 6 levels of an outcomes-based evaluation model and was conducted using registration data, postactivity evaluations, clinical vignettes with questions assessing knowledge and competence in participants and in a comparison group, a commitment to change approach, data from patient c...

Purpose. To investigate the personal experiences and perceived outcomes of a yoga programme for stroke survivors. Method. This article reports on a preliminary study using qualitative methods to investigate the personal experiences and perceived outcomes of a yoga programme. Nine individuals who had experienced stroke were interviewed following a 10-week yoga programme involving movement, breathing and meditation practices. An interpretative phenomenological approach was used to determine meanings attached to yoga participation as well as perceptions of outcomes. Results. Interpretative themes evolving from the data were organised around a bio-psychosocial model of health benefits from yoga. Emergent themes from the analysis included: greater sensation; feeling calmer and becoming connecte...

Purpose - The aim of this paper is the discussion and the dissemination of initiatives promoted by the Lombardy region for the construction of benchmarking systems between regional health structures of care utilizing administrative archives. Design/methodology/approach - The paper focuses on relative effectiveness (specific effect of care on patients) in a benchmarking framework, considering the dimension of sentinel outcomes. From Lombardy Hospital Discharge Cards proxies of sentinel outcomes are identified, defined as "context indicators" useful for a benchmarking analysis. Findings - First, the authors present outcomes and covariates at different levels (patient and healthcare structure) extracted from the Lombardy Hospital Discharge Cards for a benchmarking analysis. Second, empirical ...

Objectives Our aim was to investigate in-hospital outcomes of percutaneous coronary intervention (PCI) of chronic total occlusion (CTO) using contemporary techniques. Background Despite its increasing popularity and technical complexity, clinical outcomes of PCI for CTO using contemporary techniques have not been adequately evaluated. Methods The J-CTO registry (multicenter CTO registry in Japan) is a large scale, multicenter registry enrolling consecutive patients undergoing PCI for CTO from 12 Japanese centers. In-hospital clinical outcomes were evaluated in 498 patients with 528 CTO lesions. Results Multiple wiring strategies were frequently attempted (parallel wiring 31% and retrograde approach 25%) with relatively long guidewire manipulation time (median 30 min). Utilizing these compl...

INTRODUCTION: The assessment of sexual orientation is of importance to the diagnosis and treatment of sex offenders and paraphilic disorders. Phallometry is considered gold standard in objectifying sexual orientation, yet this measurement has been criticized because of its intrusiveness and limited reliability. AIM: To evaluate whether the spatial response pattern to sexual stimuli as revealed by a change in blood oxygen level-dependent (BOLD) signal can be used for individual classification of sexual orientation. METHODS: We used a preexisting functional MRI (fMRI) data set that had been acquired in a nonclinical sample of 12 heterosexual men and 14 homosexual men. During fMRI, participants were briefly exposed to pictures of same-sex and opposite-sex genitals. Data analysis involved four steps: (i) differences in the BOLD response to female and male sexual stimuli were calculated for each subject; (ii) these contrast images were entered into a group analysis to calculate whole-brain difference maps between homosexual and heterosexual participants; (iii) a single expression value was computed for each subject expressing its correspondence to the group result; and (iv) based on these expression values, Fisher's linear discriminant analysis and the kappa-nearest neighbor classification method were used to predict the sexual orientation of each subject. MEAN OUTCOME MEASURE: Sensitivity and specificity of the two classification methods in predicting individual sexual orientation. RESULTS: Both classification methods performed well in predicting individual sexual orientation with a mean accuracy of >85% (Fisher's linear discriminant analysis: 92% sensitivity, 85% specificity; kappa-nearest neighbor classification: 88% sensitivity, 92% specificity). CONCLUSION: Despite the small sample size, the functional response patterns of the brain to sexual stimuli contained sufficient information to predict individual sexual orientation with high accuracy. These results suggest that fMRI-based classification methods hold promise for the diagnosis of paraphilic disorders (e.g., pedophilia).

The inverse problem of hovering flight, that is, the range of wing movements appropriate for sustained flight at a fixed position and orientation, was examined by developing a simulation of the hawkmoth Manduca sexta. Inverse problems arise when one is seeking the parameters that are required to achieve a specified model outcome. In contrast, forward problems explore the outcomes given a specified set of input parameters. The simulation was coupled to a microgenetic algorithm that found specific sequences of wing and body motions, encoded by ten independent kinematic parameters, capable of generating the fixed body position and orientation characteristic of hovering flight. Additionally, we explored the consequences of restricting the number of free kinematic parameters and used this information to assess the importance to flight control of individual parameters and various combinations of them. Output from the simulated moth was compared to kinematic recordings of hovering flight in real hawkmoths; the real and simulated moths performed similarly with respect to their range of variation in position and orientation. The simulated moth also used average wingbeat kinematics (amplitude, stroke plane orientation, etc) similar to those of the real moths. However, many different subsets of the available kinematic were sufficient for hovering flight and available kinematic data from real moths does not include sufficient detail to assess which, if any, of these was consistent with the real moth. This general result, the multiplicity of possible hovering kinematics, shows that the means by which Manduca sexta actually maintains position and orientation may have considerable freedom and therefore may be influenced by many other factors beyond the physical and aerodynamic requirements of hovering flight. PMID:16888060

New software engineering tools and object-oriented design have a great impact on the software development process. but in high energy physics all major packages were implemented in FORTRAN and porting of these codes to another language is rather complicated, primarily because of their huge size and heavy use of FORTRAN mathematical libraries. But some intrinsic accelerator concepts, such as nested structure of modern accelerators, look very pretty when implemented with the object-oriented approach. In this paper the authors present the object-oriented version of ZLIB, numerical library for differential algebra, and show how the modern approaches can simplify the development and support of accelerator codes, decrease code size, and allow description of complex mathematical transformations by simple language.

Dynamic software adaptability is one of the central features leveraged by autonomic computing. However, developing software that changes its behavior at run time adapting to the operational conditions is a challenging task. Several approaches have been proposed in the literature to attack this problem at different and complementary abstraction levels: software architecture, middleware, and programming level. We focus on the support that ad-hoc programming language constructs may provide to support dynamically adaptive behaviors. We introduce context-oriented programming languages and we present a framework that positions the supported paradigm in the MAPE-K autonomic loop. We discuss the advantages of using context-oriented programming languages instead of other mainstream approaches based on dynamic aspect oriented programming languages and present a case study that shows how the proposed programming style naturally fits dynamic adaptation requirements. Finally, we discuss some known problems and outline a n...

In this paper, an optimization procedure based on multi-phase topology optimization is developed to determine the optimal stacking sequence of laminates made up of conventional plies oriented at ?45?, 0?, 45 and 90?. The formulation relies on the SFP (Shape Functions with Penalization) parameterization, in which the discrete optimization problem is replaced by a continuous approach with a penalty to exclude intermediate values of the design variables. In this approach, the material stiffness of each physical ply is expressed as a weighted sum over the stiffness of the candidate plies corresponding to ?45?, 0?, 45 and 90? orientations. In SFP, two design variables are needed for each physical ply in the laminate to parameterize the problem with respect to the 4 candidate orientations. Even ...

In this paper, an optimization procedure based on multi-phase topology optimization is developed to determine the optimal stacking sequence of laminates made up of conventional plies oriented at ?45°, 0°, 45 and 90°. The formulation relies on the SFP (Shape Functions with Penalization) parameterization, in which the discrete optimization problem is replaced by a continuous approach with a penalty to exclude intermediate values of the design variables. In this approach, the material stiffness of each physical ply is expressed as a weighted sum over the stiffness of the candidate plies corresponding to ?45°, 0°, 45 and 90° orientations. In SFP, two design variables are needed for each physical ply in the laminate to parameterize the problem with respect to the 4 candidate orientations. Even ...

Three methods for multiplet deconvolution were tested using the 1995 IAEA reference spectra: Total area determination, iterative fitting and the library-oriented approach. It is concluded that, if statistical control (i.e. the ability to report results that agree with the known, true values to within the reported uncertainties) is required, the total area determination method performs the best. If high deconvolution power is required and a good, internally consistent library is available, the library oriented method yields the best results. Neither Erdtmann and Soyka's gamma-ray catalogue nor Browne and Firestone's Table of Radioactive Isotopes were found to be internally consistent enough in this respect. In the absence of a good library, iterative fitting with restricted peak width variation performs the best. The ultimate approach as yet to be implemented might be library-oriented fitting with allowed peak position variation according to the peak energy uncertainty specified in the library. (author)

Recent research has highlighted the relationships between impairments in cognitive functioning and poorer functional outcomes among people with schizophrenia (PWS). The purpose of this study was to replicate and extend this work by testing the relationships between cognition and functional outcome among deaf adults with schizophrenia. Empirical findings from deafness-oriented research reveals enhanced abilities in certain aspects of visual-spatial processing compared to hearing people. Sixty-five PWS (34 deaf, 31 hearing) were assessed using measures of verbal and visual memory, attention, and visual processing. The first hypothesis tested whether cognition predicted functional outcome in a similar fashion for both deaf and hearing subjects (n=63). For all subjects, higher levels of cognitive ability were associated with higher levels of functional outcome, and the strongest predictors of outcome were verbal memory and visual-spatial memory (recall condition) (VSM recall). However, the deaf and hearing groups did show different patterns of relationships between cognition and functioning when all cognitive variables were examined. The second hypothesis was that deaf subjects would display superior performance in early visual processing, visual-spatial memory (copy condition) (VSM copy), and VSM recall. Deaf subjects displayed superior performance on each task; however, no significant differences emerged. Deaf subjects outperformed hearing subjects in an unexpected domain (word memory/recognition). This study extends prior work in the area of cognition and schizophrenia and indicates that deaf and hearing subjects may benefit from interventions that address different domains of cognition. PMID:17560083

Research apprenticeships for secondary students provide authentic contexts for learning science in which students engage in scientific investigations with practicing scientists in working laboratory groups. Student experiences in these research apprenticeships vary depending on the individual nature of the laboratory in which students have been placed. This study explores potential relationships among student experiences in apprenticeship contexts and desired student outcomes (e.g. science content knowledge, understandings of nature of science, and aspirations for science oriented career plans). The following two research questions guided the study: How do participant experiences in and outcomes resulting from an authentic research program for high school students vary? How does variation in participant experiences in an authentic research program relate to participant outcomes? Primary data sources were student and mentor interviews in addition to student generated concept maps. Results indicated that the greatest variance in student experiences existed in the categories of collaboration, epistemic involvement, and understandings of the significance of research results. The greatest variation in desired student outcomes was observed in student understandings of nature of science and in students' future science plans. Results suggested that collaboration and interest in the project were experience aspects most likely to be related to desired outcomes. Implications for the design of research apprenticeships for secondary students are discussed.

Approach and avoidance are two basic behavioural principles. The current study investigated neuropsychological mechanisms underlying the influence of the personality characteristic goal-oriented pursuit on the efficiency of regulating such approach-avoidance reactions. Therefore, the P3 event-related potential (ERP) reflecting controlled attention allocation was assessed during the Approach-Avoidance Task (AAT) with positive and negative pictures in 36 healthy participants. For negative pictures, analyses revealed the neuropsychological mechanism of controlled attention allocation to mediate the relation between personality and behaviour: Stronger goal-oriented pursuit was associated with higher controlled attention allocation to the incompatible compared to the compatible condition and - thereby - with less automatic avoidance tendencies in response to negative pictures, i.e., with higher efficiency of regulation. Results are discussed in terms of their implications for future studies on mechanisms determining the influence of personality traits, situational factors and their interaction on approach-avoidance behaviour. PMID:22922017

This study examined the influences of online gaming on sociability and aggression in real life. It was hypothesized that the effects of online gaming would differ depending on the interaction style of the online-gamers. Online-gamers in Japan (n = 1 477) were asked to respond to questionnaires that measured interaction style during online gaming, the effects of sociability and aggression, as well as social and individual orientation in real life. Factor analysis of the scores for interaction style extracted five factors. Covariance structure analysis indicated that sociable interactions such as "Broadening relations" and "Feeling of belonging" promoted sociability in real life. In addition, "Release from daily hassles" promoted sociability and decreased aggression. In contrast, non-sociable and aggressive interactions decreased sociability and increased aggression. The results also suggested that a social orientation in real life promoted sociable interactions during game playing, while an individual orientation promoted non-sociable and aggressive interactions. These results supported the hypotheses and suggested that online gaming resulted in positive outcomes for those who are socially, but negative outcomes for those who are not. PMID:20235474

SIMULA was a language for modeling and programming and provided a unied approach to modeling and programming in contrast to methodologies based on structured analysis and design. The current development seems to be going in the direction of separation of modeling and programming. The goal of this paper is to go back to the future and get inspiration from SIMULA and propose a unied approach. In addition to reintroducing the contributions of SIMULA and the Scandinavian approach to object-oriented programming, we do this by discussing a number of issues in modeling and programming and argue3 why we consider a unied approach to be an advantage.

Application of bait spray to crop borders is a standard approach for suppression of melon fly, Bactrocera cucurbitae (Coquillett) (Diptera: Tephritidae) populations and may also be of value for suppression of oriental fruit fly, B. dorsalis (Hendel) populations. Establishment of preferred roosting h...

We examine the magnetic response of free clusters considering the spin direction and the cluster orientation as the only active degrees of freedom. The average magnetization in small fields approaches the Langevin value for paramagnets, depending on the degree to which the Hamiltonian preserves symmetries. Superparamagnetic behavior is not achievable within models considering only these degrees of freedom.

This article examines contrasting approaches to citizenship education in two schools in San Salvador, El Salvador, in the face of highly visible transnational migration. I argue that while transnational realities challenge education for democratic citizenship, educational processes that enable students to interrogate their own transnational realities--in particular, their relationship to macrostructural relations of inequality--facilitate the development of critical, action-oriented civic identities.

A concise collection of results on coincidence orientations of rhombohedral crystals is given with references to detailed presentations. The connection with the Bonnet-Durand approach is explained. This connection is valid also for hexagonal and tetragonal lattices. It is shown how the results can b...

A rigorous approach to simultaneously determine a Terrestrial Reference Frame (TRF) and Earth Orientation Parameters (EOP) is now currently applied on a routine basis in a coordinated project within the Groupe de Recherches de Géodésie Spatiale (GRGS) in France. Observations of the various space geo...

Studies were conducted in Hawaii to quantify attraction and feeding responses resulting in mortality of male oriental fruit fly, Bactrocera dorsalis (Hendel) (Diptera: Tephritidae), to SPLAT-MAT-methyl eugenol (ME) with spinosad in comparison with Min-U-Gel-ME with naled (Dibrom). Our approach invol...

In this paper, we propose a hybrid postural control approach taking advantage of data-driven and goal-oriented methods while overcoming their limitations. In particular, we take advantage of the latent space characterizing a given motion database. We introduce a motion constraint operating in the la...

The autoshaping procedure confounds the effects of pairing a keylight and food with the effect of adventitious food reinforcement of responses that typically occur before the pecking response. In Experiment I, acquisition of the orientation to the key, the approach toward the key, and the peck at th...

The diffractive and nondiffractive ..gamma gamma.. processes and in particular ..gamma gamma -->..rho/sup 0/..pi../sup +/ ..pi../sup -/ are studied in terms of a double-meson-exchange and a factorization model. The relative merits of this approach and the simple QCD-oriented treatment are discussed.

Since software systems need to be continuously available, their ability to evolve at runtime is a key issue. The emergence of models@runtime, combined with Aspect-Oriented Modeling techniques, is a promising approach to tame the complexity of adaptive systems. However, with no support for aspect unw...

The purpose of this paper is to give a short motivation for and an introduction to a novel approach of how to view and develop flexible open distributed systems of the future. We propose that the emerging style of Agent Oriented Sofnyare Engineering (AOSE) has high potentials as a candidate for f...

Quality requirements, i.e. those requirements that pertain to a system's quality attributes, are traditionally regarded to be useful only when they are represented quantitatively so that they can be measured. This article presents a value-oriented approach to specifying quality requirements that dev...

This paper describes a narrative-oriented approach to the design and analysis of a computational system and a set of activities for mathematical learning. Our central contention is that programming can offer a key to resolving the tension between the different representational structures of narrativ...

Motivation: Predicting how proteins interact at the molecular level is a computationally intensive task. Many protein docking algorithms begin by using fast Fourier transform (FFT) correlation techniques to find putative rigid body docking orientations. Most such approaches use 3D Cartesian grids an...

This paper is about colored object programming, a refinement of object oriented programming. In this approach, the answer of an object to an external event (message or generic function call) depends not only on its class, but also on its current state. The paper presents a visual formalism (a notati...

Characteristic figures have an important function in energy management systems. In breweries, the most common characteristic of energy consumption per liter of beer produced for sale permits no conclusions as to the production process. A process-oriented approach for obtaining characteristics for use in breweries is therefore presented. (orig.)

Market-oriented programming is a new approach to design and implementation of resource allocation mechanisms in computer systems. It has its roots in different disciplines, such as economics and computer science (in particular the area of multi-agent systems. This thesis is divided into two diffe...

The UNESCO International Centre for Engineering Education, Centre for Problem Based Learning (UCPBL) is based at Aalborg University, Denmark, known worldwide for its successful educational approach based on problem oriented project work. Due to more than 30 years of experience in utilising Problem-B...

Discusses coordinate systems, units of measure, scaling and levels as they relate to a database generated by a computer in a spatial rather than planer location. Describes geometric-oriented input, direct coordinates, transformations, annotation, editing and patterns. Stresses that hand drafting emulation is a short-sighted approach to computer-aided design. (CW)

Systematic process synthesis methods have been under investigation for thirty years with several techniques now developed to the point of serious industrial applicability. Here it described a number of industrial applications of the task-oriented systematic generation process synthesis approach, illustrating in particular the impact of task integration concepts including complementary task integration, consecutive task integration, task coordination, and synergistic technology integration. (au)

Polarization analysis in Raman spectroscopy provides a powerful tool in chemical physics to identify the symmetry of the vibration modes of the crystals, according to their crystallographic structure and local spatial orientation. In this paper we propose two new approaches in polarized Raman spectr...

A macro expander technique has been adopted to generate a machine independent single user version of ANSI Standard MUMPS running on an 8080 Microcomputer. This approach makes it possible to have the medically oriented MUMPS language available on inexpensive systems suitable for small group practice ...

This paper addresses the problem of rigid body orientation and Dynamic Body Acceleration (DBA) estimation. This work is applied in bio-logging, an interdisciplinary research area at the intersection of animal behavior and bioengineering. The proposed approach combines a quaternion-based nonlinear fi...