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1

Evaluation of linear accelerator performance standards using an outcome oriented approach  

International Nuclear Information System (INIS)

Radiation therapy, along with other branches of medicine, is moving towards a firmer basis in evidence to optimally utilize resources. As new treatment technology and strategies place greater demands on quality assurance resources, the need to objectively evaluate equipment and process performance standards from the perspective of predicted clinical impact becomes more urgent. This study evaluates the appropriateness of recommended quality control tolerance and action levels for linear accelerators based on the calculated dosimetric impact of suboptimal equipment performance. A method is described to quantify the dosimetric changes, as reflected by the changes in the outcome surrogate, equivalent uniform dose (EUD), of machine performance deviations from the optimal, specifically in the range of tolerance and action levels promulgated by the Canadian Association of Provincial Cancer Agencies (CAPCA). Linear accelerator performance deviations were simulated for the treatment of prostate, breast, lung, and brain using 3D conformal techniques, and the impact evaluated in terms of the changes in the EUD of the target volumes and two principal organs at risk (OARs) per site. The eight key performance characteristics examined are: Output constancy, beam flatness, gantry angle, collimator angle, field size indicator, laser alignment (three directions) and, by inference, the optical distance indicator. Currently accepted CAPCA tolerance levels for these eight performance characteristics are shown to maintain average EUD deviations to within 2% for the targets and 2 Gy for the OARs. However, within the 2% or 2 Gy range, the recommended tolerance levels are found to have markedly different effects on the EUDs of the structures of interest.

2008-01-01

2

Agent Oriented Software Testing – Role Oriented approach  

Directory of Open Access Journals (Sweden)

Full Text Available Several Agent Oriented Software Engineering (AOSE) methodologies were proposed to build open, heterogeneous and complex internet based systems. AOSE methodologies offer different conceptual frameworks, notations and techniques, thereby provide a platform to make the system abstract, generalize, dynamic and autonomous. Lifecycle coverage is one of the important criteria for evaluating an AOSE methodology. Most of the existing AOSE methodologies focuses only on analysis, design, implementation and disregarded testing, stating that the testing can be done by extending the existing objectoriented testing techniques. Though objects and agents have some similarities, they both differ widely. Role is an important attribute of an agent that has a huge scope and support for the analysis, design and implementation of Multi-Agent System (MAS). The main objective of the paper is to extend the scope and support of role towards testing, thereby the vacancy for software testing perception in the AOSE series will be filled up. This paper presents an overview of role based testing based on the V-Model in order to add the next new component as of AgentOriented Software testing in the agent oriented development life cycle.

N.Sivakumar; K.Vivekanandan

2013-01-01

3

How does a risk-oriented "future self" influence behavior? A structural-equation-modeling approach with marijuana-related outcomes.  

UK PubMed Central (United Kingdom)

A study was conducted to examine the influence of a risk-oriented future self on self-reported marijuana use among college students. Drawing on theoretical work on possible selves, it was hypothesized that the extent to which a future self is viewed as risk-oriented will be associated with reported marijuana use and that effects of a risk-oriented future self on use would be partially mediated by risk-oriented attitudes and perceived attractiveness of users. Analysis of data from an online survey of college students supported hypotheses, with the additional finding that the effect of user attractiveness on use is mediated by attitudes.

Comello ML

2013-08-01

4

Market oriented approach by public utilities  

Energy Technology Data Exchange (ETDEWEB)

Public utilities, especially the larger ones, have an image of being inefficient, technocratic and bureaucratic institutions, unresponsive to modern lifestyles, growing consumerism, differentiated customer needs and changing social values. Improving this image and increasing customer satisfaction requires the adoption of a systematic market oriented approach, based on an appropriate segmentation of the client and general public. This article gives the broad outline of such an approach followed by some generally applicable practical recommendations. Finally it stresses the importance of human aspects of organizational behaviour and, consequently, the crucial part of corporate culture. 2 figs., 1 tab.

Mantel, J.J.; Verkuil, J.M.

1989-08-01

5

Outcome Orientated Child and Adolescent Mental Health Services (OO-CAMHS): a whole service model.  

UK PubMed Central (United Kingdom)

The international evidence base on factors that most influence outcomes in mental health care finds that matching therapeutic intervention to diagnosis has a clinically insignificant impact on outcomes. Decades of outcome research into treatment of psychiatric disorders shows that, despite the development of many new techniques, the outcomes being achieved in studies 30 years ago are similar to those being achieved now. In the last few years, new service models that incorporate systems of feedback on progress and alliance have emerged and show promise with regards improving overall outcomes for mental health service users. Growing familiarity with this outcome literature, together with a desire to be part of a service that can continue to improve patient outcomes, led a small community Child and Adolescent Mental Health Services team to develop a new whole service model - Outcome Orientated Child and Adolescent Mental Health Services (OO-CAMHS). OO-CAMHS incorporates key aspects of the evidence base on what could make a differential positive impact on outcomes and relinquishes those aspects that do not. In this paper, we outline the evidence base on which OO-CAMHS is built, describe the key features of the approach and present some of the early findings on its impact.

Timimi S; Tetley D; Burgoine W; Walker G

2013-04-01

6

An Heuristic Approach To Object Oriented Paradigm  

Directory of Open Access Journals (Sweden)

Full Text Available Quality of software is increasingly important and testing related issues are becoming crucial for software. In order to measure and understand quality, it is necessary to relate it to measurable quantities. Heuristics provide a link between sets of abstract design principles and quantitative software metrics. The aim of object oriented software metrics is to predict quality and improve productivity of the software products. Object-orientation (OO) allows software to be structured in a way that helps to manage complexity and change. This paper shows role of heuristics in object oriented software engineering and how object oriented paradigm differentiate from conventional function oriented paradigm.

Deepali Gupta; Rakesh Kumar

2011-01-01

7

An object-oriented approach to energy-economic modeling  

Energy Technology Data Exchange (ETDEWEB)

In this paper, the authors discuss the experiences in creating an object-oriented economic model of the U.S. energy and agriculture markets. After a discussion of some central concepts, they provide an overview of the model, focusing on the methodology of designing an object-oriented class hierarchy specification based on standard microeconomic production functions. The evolution of the model from the class definition stage to programming it in C++, a standard object-oriented programming language, will be detailed. The authors then discuss the main differences between writing the object-oriented program versus a procedure-oriented program of the same model. Finally, they conclude with a discussion of the advantages and limitations of the object-oriented approach based on the experience in building energy-economic models with procedure-oriented approaches and languages.

Wise, M.A.; Fox, J.A.; Sands, R.D.

1993-12-01

8

General text line extraction approach based on locally orientation estimation  

Digital Repository Infrastructure Vision for European Research (DRIVER)

This paper presents a novel approach for the multi-oriented text line extraction from historical handwritten Arabic documents. Because of the multi-orientation of lines and their dispersion in the page, we use an image paving allowing us to progressively and locally determine the lines. The paving i...

Ouwayed, Nazih; Belaïd, Abdel; Auger, François

9

APE (state-oriented approach) centralized control procedures  

International Nuclear Information System (INIS)

[en] This article presents the progressive implementation of the state-oriented approach (APE) for centralized control procedures in French nuclear power plants. The implementation began in the years 1982-83 and it concerned only the circuits involved in engineered safeguard systems such IS (safety injection), EAS (containment spray system) and GMPP (reactor coolant pump set). In 2003 the last PWR unit switched from the event oriented approach to APE for post-accidental situations

2004-01-01

10

THE SUCCESSION OF DATA WAREHOUSE USING OBJECT ORIENTED APPROACH  

Directory of Open Access Journals (Sweden)

Full Text Available This paper describes techniques for designing both front & back end of a data warehouse in such a way that companies can continue to progress their warehouse and query tools as their business changes,customer demands changes, instead of continuously having to estructure and rewrite their existing tools. Object –Oriented approach are driving the current development of ODBMS that will handle complex objects, inheritance and other features that enable direct implementation technology that is being extended to combine data management capabilities with application of logical rules to provide more refined information to management. Object-oriented approach is used in different areas i.e Software Engg, Database Management System and Latest Approach is used in Data warehouse. Object-Oriented envelopment involves more than learning a program, it includes capability for development. A purely Object –Oriented tool like Java, Smalltalk , or the object –oriented use of C++ requires that problem domains be conceptualized in terms of the paradigm inherent in object technology. Most research in Object-oriented programming (OOP) including object –oriented database Management systems (OODBMS), is concerned with supporting users which are not served well by more conventional technology. Our research has been from a different point of view – our primary motivating factor is toshow how existing applications can be enhanced using object –oriented Technology.

DR. PUSHPA SURI; MEENAKSHI SHARMA

2011-01-01

11

Risk evaluation: A cost-oriented approach  

International Nuclear Information System (INIS)

This method provides a structured and cost-oriented way to determine risks associated with loss and destruction of industrial security interests consisting of material assets and human resources. Loss and destruction are assumed to be adversary perpetrated, high-impact events in which the health and safety of people or high-value property is at risk. This concept provides a process for: (1) assessing effectiveness of all integrated protection system, which includes facility operations, safety, emergency and security systems, and (2) a qualitative prioritization scheme to determine the level of consequence relative to cost and subsequent risk. The method allows managers the flexibility to establish asset protection appropriate to programmatic requirements and priorities and to decide if funding is appropriate. The evaluation objectives are to: (1) provide for a systematic, qualitative tabletop process to estimate the potential for an undesirable event and its impact; and (2) identify ineffective protection and cost-effective solutions

1998-03-25

12

Risk evaluation: A cost-oriented approach  

Energy Technology Data Exchange (ETDEWEB)

This method provides a structured and cost-oriented way to determine risks associated with loss and destruction of industrial security interests consisting of material assets and human resources. Loss and destruction are assumed to be adversary perpetrated, high-impact events in which the health and safety of people or high-value property is at risk. This concept provides a process for: (1) assessing effectiveness of all integrated protection system, which includes facility operations, safety, emergency and security systems, and (2) a qualitative prioritization scheme to determine the level of consequence relative to cost and subsequent risk. The method allows managers the flexibility to establish asset protection appropriate to programmatic requirements and priorities and to decide if funding is appropriate. The evaluation objectives are to: (1) provide for a systematic, qualitative tabletop process to estimate the potential for an undesirable event and its impact; and (2) identify ineffective protection and cost-effective solutions.

Rogers, B.H.

1998-02-03

13

Object-Oriented Software Development Environments : The Mjølner Approach  

DEFF Research Database (Denmark)

The book "Object-Oriented Environments - The Mjølner Approach" presents the collective results of the Mjølner Project. The project was set up to work on the widely recognized problems of developing, maintaining and understanding large software systems. The starting point was to use object-orientation in making advances in methods, languages and tools for this purpose. The environments combine object-orientations with tight integration and incremental techniques to realize highly interactive environments for strongly typed block structures languages. This book describes the developed techniques as well as the developed environments (the Mjølner Orm System, the Mjølner System and tools for O-O SDL). Features include: Object-Oriented modeling, concepts and OSDL Object-oriented programming languages: BETA and Simula Programming in the large: concepts, techniques and realizations Persistence: concepts, techniques and realizations User interfaces for environments and realizations Grammar-based software architectures Structure-based editing Language implementation, runtime organization, garbage collection Incremental compilation techniques

1994-01-01

14

Achieving service-oriented architecture applying an enterprise architecture approach  

CERN Document Server

A complete, comprehensive methodology and framework for adopting and managing a successful service oriented architecture environment Achieving Service-Oriented Architecture helps to set up an SOA Architecture Practice defining the policies, procedures, and standards that apply not just to IT developers but to the entire corporation as it relates to business applications.Why a new architectural approach is necessary for your business to achieve all the value SOA has to offerFocuses on setting up an enterprise architecture practice for service-oriented architectureDiscus

Sweeney, Rick

2010-01-01

15

[A recovery oriented research approach to a Day Hospital program].  

UK PubMed Central (United Kingdom)

We are at a turning point for psychiatric practice brought on by the consolidation of the recovery paradigm. Both mental health interventions and research will have to adapt in order to promote recovery. Interventions will tend to focus in the community, and day hospital programs will have to be more versatile and also community oriented. The appropriate research approach for recovery oriented interventions has to combine quantitative and qualitative methods, in order to complementarily inform any given subject. Current hierarchy proposed by the evidence based medicine model will have to comply with recovery oriented practices, including and adequately appraising qualitative approaches and mixed methods. The results of a mixed methods approach to a day hospital program is presented, which includes assessment of: clinical state, functionality, quality of life, family burden, types of interventions, users and carers perspectives.

Vigo DV

2012-03-01

16

A reward prediction error for charitable donations reveals outcome orientation of donators.  

UK PubMed Central (United Kingdom)

The motives underlying prosocial behavior, like charitable donations, can be related either to actions or to outcomes. To address the neural basis of outcome orientation in charitable giving, we asked 33 subjects to make choices affecting their own payoffs and payoffs to a charity organization, while being scanned by functional magnetic resonance imaging (fMRI). We experimentally induced a reward prediction error (RPE) by subsequently discarding some of the chosen outcomes. Co-localized to a nucleus accumbens BOLD signal corresponding to the RPE for the subject's own payoff, we observed an equivalent RPE signal for the charity's payoff in those subjects who were willing to donate. This unique demonstration of a neuronal RPE signal for outcomes exclusively affecting unrelated others indicates common brain processes during outcome evaluation for selfish, individual and nonselfish, social rewards and strongly suggests the effectiveness of outcome-oriented motives in charitable giving.

Kuss K; Falk A; Trautner P; Elger CE; Weber B; Fliessbach K

2013-02-01

17

Aspect Oriented Software Development vs. other Techniques (Structured Approach and Object Oriented Approach)  

Directory of Open Access Journals (Sweden)

Full Text Available Aspects are a natural evolution of the object-oriented paradigm. They provide a solution to some difficulties you may have encountered with modularizing your object-oriented code: sometimes functionality just doesn't fit! You've probably found yourself repeating the same lines of code in lots of different object-oriented classes because those classes each need that functionality, and so you can't easily wrap it up in a single place. Good examples of this kind of code are audit trails, transaction handling, concurrency management, and so on. You can now modularize such code with aspects. Aspect-Oriented Software Development (AOSD). Provides unique and advanced program structuring and modularization techniques. The implementation of software applications using AOSD techniques results in a better implementation structure which has an impact on many important software qualities such as enhanced reusability and reduced complexity. In turn, these software qualities lead to an improved software development lifecycle and, hence, to better software.

Ahmed Yakout A. Mohamed; Abd El Fatah .A. Hegazy; Ahmed R.Dawood

2010-01-01

18

Business and scientific workflows a web service-oriented approach  

CERN Document Server

Focuses on how to use web service computing and service-based workflow technologies to develop timely, effective workflows for both business and scientific fields Utilizing web computing and Service-Oriented Architecture (SOA), Business and Scientific Workflows: A Web Service-Oriented Approach focuses on how to design, analyze, and deploy web service-based workflows for both business and scientific applications in many areas of healthcare and biomedicine. It also discusses and presents the recent research and development results. This informative reference features app

Tan, Wei

2013-01-01

19

A Database Evolution Approach for Object-Oriented Databases  

UK PubMed Central (United Kingdom)

This paper describes a composite evolution approachwhich integrates the evolution of the various types ofentities in an object-oriented database into one model.The approach provides maintainers with a coherent andcomprehensible view of the system and at the same timemaintains change histories at a fine granularity. Linksamong meta-objects are implemented using dynamicrelationships which are semantic constructs and firstclassobjects. Referential integrity is maintained by therelationships architecture reducing the evolutioncomplexity at the meta-object level. A customisable andexchangeable instance adaptation approach is proposed.The approach is based on separating the instanceadaptation code from class versions using aspects,abstractions used in Aspect-Oriented Programming tolocalise crosscutting concerns. A high level objectorientedmodel offering transparent access to theproposed evolution functionality is provided.

Awais Rashid

20

An Approach to Generation of Process-Oriented Requirements Specification  

Directory of Open Access Journals (Sweden)

Full Text Available In service-oriented computing, process model may serve as a link to connect users’ requirements with Web Services. In this paper, we propose an approach and related key techniques to generate process-oriented requirements specification from user’s goal. For this purpose, a requirements description language named SORL will be provided to capture users’ requirements. Then, a unified requirements meta-modeling frame RPGS will be used to construct reusable domain assets, which is the basis of generating requirements specifications. Finally, a set of rules are defined to extract process control structures from users’ requirements described with SORL, so that we can convert requirements description into process-oriented requirements specification smoothly.

Jingbai Tian; Keqing He; Chong Wang; Huafeng Chen

2009-01-01

 
 
 
 
21

DATA PUBLISHING AND PRIVACY MAINTENANCE BY AN APPROACH ORIENTED SLICING  

Directory of Open Access Journals (Sweden)

Full Text Available Many of the Techniques based on the some of the oriented strategy and are completely reliable on these particular phenomena for the purpose of the accurate analysis takes place in a well effective manner respectively. A lot of analysis has been made on a present technique where the extraction of the performance is a key role it is quite effective on comparison to that of the several previous existing techniques in a well effective manner where it is further used in the real time scenario respectively. Here the designed strategy is done or implemented by the technically oriented method naming strategy based on the slicing where it is implemented where the accurate classification of the data takes place in a well effective manner both with respect to the row wise as well as the column wise respectively. Here there is a huge challenge to overcome the above mentioned drawbacks or the problems which is mainly used for the degradation of the performance takes place. Where there is no relation between the extracted data based on the properties related to that particular technique in an accurate oriented fashion. From the other end when the application of the other alternative technique as mentioned above the name of the bucket oriented strategy there is no similarity between the data take place and also the minute oriented operations it is a failure based approach respectively. Here by the above generalized technique there may be complete loss o the data therefore there is no sought of the efficiency in the system takes place in an effective manner so that the performance can be reduced in an effective manner where the consideration of the data related to the high dimension oriented approach. There are some of the previously implemented which are implemented in a well efficient manner and its oriented techniques are implemented beyond the security oriented aspect includes method of generalization followed by the phenomena oriented buckets in a quite respective fashion. Actually here the transmission of the data takes place in a environment based on the wireless based strategy in a well efficient manner. The user is very much concerned and frustrated about his own data in the well efficient manner that is either data is completely transferred from one to other end vice versa or not.

Addagarla Harica; G. Minni

2013-01-01

22

Multisensory processing in spatial orientation: an inverse probabilistic approach.  

Science.gov (United States)

Most evidence that the brain uses Bayesian inference to integrate noisy sensory signals optimally has been obtained by showing that the noise levels in each modality separately can predict performance in combined conditions. Such a forward approach is difficult to implement when the various signals cannot be measured in isolation, as in spatial orientation, which involves the processing of visual, somatosensory, and vestibular cues. Instead, we applied an inverse probabilistic approach, based on optimal observer theory. Our goal was to investigate whether the perceptual differences found when probing two different states--body-in-space and head-in-space orientation--can be reconciled by a shared scheme using all available sensory signals. Using a psychometric approach, seven human subjects were tested on two orientation estimates at tilts < 120°: perception of body tilt [subjective body tilt (SBT)] and perception of visual vertical [subjective visual vertical (SVV)]. In all subjects, the SBT was more accurate than the SVV, which showed substantial systematic errors for tilt angles beyond 60°. Variability increased with tilt angle in both tasks, but was consistently lower in the SVV. The sensory integration model fitted both datasets very nicely. A further experiment, in which supine subjects judged their head orientation relative to the body, independently confirmed the predicted head-on-body noise by the model. Model predictions based on the derived noise properties from the various modalities were also consistent with previously published deficits in vestibular and somatosensory patients. We conclude that Bayesian computations can account for the typical differences in spatial orientation judgments associated with different task requirements. PMID:21471371

Clemens, Ivar A H; De Vrijer, Maaike; Selen, Luc P J; Van Gisbergen, Jan A M; Medendorp, W Pieter

2011-04-01

23

Multisensory processing in spatial orientation: an inverse probabilistic approach.  

UK PubMed Central (United Kingdom)

Most evidence that the brain uses Bayesian inference to integrate noisy sensory signals optimally has been obtained by showing that the noise levels in each modality separately can predict performance in combined conditions. Such a forward approach is difficult to implement when the various signals cannot be measured in isolation, as in spatial orientation, which involves the processing of visual, somatosensory, and vestibular cues. Instead, we applied an inverse probabilistic approach, based on optimal observer theory. Our goal was to investigate whether the perceptual differences found when probing two different states--body-in-space and head-in-space orientation--can be reconciled by a shared scheme using all available sensory signals. Using a psychometric approach, seven human subjects were tested on two orientation estimates at tilts < 120°: perception of body tilt [subjective body tilt (SBT)] and perception of visual vertical [subjective visual vertical (SVV)]. In all subjects, the SBT was more accurate than the SVV, which showed substantial systematic errors for tilt angles beyond 60°. Variability increased with tilt angle in both tasks, but was consistently lower in the SVV. The sensory integration model fitted both datasets very nicely. A further experiment, in which supine subjects judged their head orientation relative to the body, independently confirmed the predicted head-on-body noise by the model. Model predictions based on the derived noise properties from the various modalities were also consistent with previously published deficits in vestibular and somatosensory patients. We conclude that Bayesian computations can account for the typical differences in spatial orientation judgments associated with different task requirements.

Clemens IA; De Vrijer M; Selen LP; Van Gisbergen JA; Medendorp WP

2011-04-01

24

KNOWLEDGE MANAGEMENT, MARKET ORIENTATION, INNOVATIVENESS AND ORGANIZATIONAL OUTCOMES: A STUDY IN COMPANIES INSTALLED IN BRAZIL  

Directory of Open Access Journals (Sweden)

Full Text Available This article examines the relationships between knowledge management, market orientation, innovativeness and organizational outcomes. The research was conducted from a survey of 241 executives from companies in Brazil. The evidence found indicated that knowledge management contributes directly to the market orientation, but requires a clearly defined strategic direction to achieve outcomes and innovativeness. It was also concluded that knowledge, as a resource, has affect on other enterprise's resources, and it needs a direction to organizational goals in order to be effective.

Alex Antonio Ferraresi; Slvio Aparecido Santos; José Roberto Frega; Heitor José Pereira

2012-01-01

25

A study on different approaches towards Aspect Oriented Requirements Engineering  

Directory of Open Access Journals (Sweden)

Full Text Available Requirements and their quality are very important for the success and on time delivery of a project. However, Requirement Elicitation is not an easy and small task to begin with. Conflicts arise in various ways such as way of looking at things and analyzing them, differences in expectation, mental model and many more. In many cases, clients and users are not completely sure about their actual needs in the beginning. Hence the actual solution for all such problems and conflicts is a step by step process called Requirements Engineering (RE). RE aids us in identifying, analyzing and documenting system requirements. This is an important task because it helps to eradicate mistakes and conflicts, if any, in the very early stage of development. In any approach of Software Development, RE is a very important step. Aspect Oriented Software Development is not an exception to this. Aspect Oriented Requirements Engineering (AORE) helps in providing better solution by offering new methods and approaches for separation of requirements. Several AORE approaches have emerged over the years. In this paper, we try to summarise the various approaches of AORE with a brief explanation to each ofthese approaches.

Suchetha Vijay; Annapoorna Shetty

2011-01-01

26

Statistical Approaches to Modeling Multiple Outcomes In Psychiatric Studies  

Science.gov (United States)

Increasingly, multiple outcomes are collected in order to characterize treatment effectiveness or to evaluate risk factors. These outcomes tend to be correlated because they are measuring related quantities in the same individuals. While the analysis of outcomes measured in the same scale (commensurate outcomes) can be undertaken with standard statistical methods, outcomes measured in different scales (non-commensurate outcomes), such as mixed binary and continuous outcomes, present more difficult challenges. In this paper we contrast some statistical approaches to analyze non-commensurate multiple outcomes. We discuss the advantages of a multivariate method for the analysis of non-commensurate outcomes including situations of missing data. A real data example from a clinical trial, comparing different treatments for depression in low-income women, is used to illustrate the differences between the statistical approaches.

Teixeira-Pinto, Armando; Siddique, Juned; Gibbons, Robert; Normand, Sharon-Lise

2009-01-01

27

Forward-oriented design for learning: illustrating the approach  

Directory of Open Access Journals (Sweden)

Full Text Available This paper concerns sustainable approaches to design for learning, emphasising the need for designs to be able to thrive outside of the protective niches of project-based innovation. It builds on the “in medias res” framework and more specifically on a forward-oriented approach to design for learning: one that takes a pro-active design stance with respect to each of the phases of an extended lifecycle. We draw on fieldwork notes and interview data to describe two cases that illustrate some of the key features of the approach. Recommendations for further R&D in the area of design for learning are provided, derived from the theoretical framework, and illustrated in this paper.

Yannis Dimitriadis; Peter Goodyear

2013-01-01

28

A New Model Using Auction Oriented Approach in Grid Computing  

Directory of Open Access Journals (Sweden)

Full Text Available Grids are emerging as the infrastructure for next generation computing. The resources in the Grid are heterogeneous and geographically distributed. The management of resources in such a large and distributed environment is a complex task. In this paper a model has been proposed using auction oriented approach. In thisauction model each bidder offers a bid for a collection ofresources rather than placing a bid on each item separately.This enables the bidder to express dependencies and complementarities between various resources. It can havevarious types selection such as Telecom Spectrum, BusRoutes and Industrial Procurement. This model has alsobeen implemented.

Surbhi Sangwan

2012-01-01

29

Auction Oriented Approach for Resource Management in Grid Computing  

Directory of Open Access Journals (Sweden)

Full Text Available Grid computing, emerging as a new paradigm for next-generationcomputing, enables the sharing, selection, and aggregation ofgeographically distributed heterogeneous resources for solvinglarge-scale problems in science, engineering, and commerce. Theresources in the Grid are heterogeneous and geographicallydistributed. The paper demonstrates the capability of economicbasedsystems for wide-area parallel and distributed computingby using auction-oriented approach. In this paper implementationof the various auction models-English Auction, Dutch Auction,First-Price Sealed Auction, Continuous Double Auction is done.Also these models are compared.

Surbhi Sangwan

2012-01-01

30

A Service Oriented Approach to Modeling Interdisciplinary Environmental Systems  

Science.gov (United States)

Interdisciplinary research often requires the use of multiple data sources, models, and analysis routines coupled together in a workflow to answer a single research question. Coupling these computational resources into a workflow can be accomplished using various tools, but each of these tools requires the developer to follow a specific interface protocol to ensure that all components within the system remain compliant. Unfortunately, not all of the resources required for an analysis can be easily "wrapped" into a compliant form due to platform dependencies, computer architecture requirements, or programming language incompatibilities. Therefore, a more generic, service-oriented approach is needed that enables individual models to operate as intended and interact with other models through web service calls. This work presents a method for coupling independent models using web services to meditate communication. It consists of both client and server-side software. The client-side software extends a loosely integrated modeling environment for coupling data and models into configurations. The server-side software consists of software required for exposing datasets and models as web services. We build from the Open Modeling Interface (OpenMI) version 2.0 standard and demonstrate how it can be used to perform service-oriented simulations. We describe the design and implementation of both server and client-side software, the application of the software as part of an urban flood warning system, and offer suggestions for future work needed to advance service-oriented modeling of interdisciplinary environmental systems.

Castronova, A. M.; Goodall, J. L.

2011-12-01

31

Mapping peatland disturbance in Ireland: an object oriented approach  

Science.gov (United States)

Peatlands contain large amounts of soil organic carbon. In a pristine state they sequester atmospheric carbon dioxide (CO2), however, when they are disturbed they emit it. In Ireland peatlands are extensive and cover 20% of the national land area. They contain between 53% and 62% of the total national soil organic carbon. However, large areas of Irish peatlands have been disturbed by anthropogenic activity. This activity includes drainage, mechanical extraction and burning. These activities lead to the reduction of the resilience of the peatland to climate and environmental change and can lead to the increased vulnerability of the peatland carbon stock. In this research an object oriented approach is used to examine high resolution imagery of a raised bog in Ireland and to extract a map of disturbed peatlands. The object oriented approach is implemented in ArcGIS with high resolution Geoeye-1 satellite imagery. The main disturbance classes identified were rough grazing, pasture, molinia, coniferous forest, high bog, drained bog and scrub. The users accuracy for each individual class ranged from 66% to 92% and the overall accuracy assessment for the disturbance map 85%.

Connolly, J.; Holden, N. M.

2011-10-01

32

Orbital lymphoma: diagnostic approach and treatment outcome.  

UK PubMed Central (United Kingdom)

BACKGROUND: Lymphomas of the orbit and orbital adnexae are rare tumors, comprising only 1% of all non-Hodgkin's lymphoma. The majority of non-Hodgkin's lymphomas of the orbit are extranodal marginal-zone B-cell lymphomas of mucosa-associated lymphoid tissue type. Because of nonspecific clinical signs and symptoms, some diagnostic delay may occur. The purpose of the study was to evaluate the diagnostic approach in orbital lymphomas and to analyze their treatment outcome. METHODS: In the period from 2005 to 2012, from a group of 135 patients with tumors of the orbit, we identified 11 patients diagnosed with orbital lymphoma. This patient cohort was reviewed retrospectively. RESULTS: The patient group consisted of 11 patients (seven females, male males) with a median age of 57.7 years (range 42 to 88 years). Orbital swelling, pain and motility impairment were the leading clinical symptoms. Diagnosis was confirmed by surgical biopsy. Depending on the anatomic location of the tumor, a surgical biopsy was taken using a blepharoplasty incision, a lateral orbitotomy or a navigation-guided biopsy. The predominant histology was extranodal non-Hodgkin's lymphoma of mucosa-associated lymphoid tissue type (82%). All patients underwent complete clinical staging. These were clinical stage IEA in seven patients, and stages IIEA (n = 2) and IIIEA (n = 2) in four patients . Patients in stage IEA were treated with radiation therapy alone, with radiation doses between 25 and 40 Gy, and patients with stage IIEA received systemic chemotherapy with bendamustin/rituximab. Those two patients diagnosed with diffuse large B-cell lymphoma and mantle cell lymphoma received systemic chemotherapy according to the R-CHOP protocol. CONCLUSIONS: Owing to unspecific clinical symptoms, some diagnostic delay may occur in orbital lymphoma. If unspecific orbital symptoms are present, adequate imaging studies followed by early surgical biopsy will contribute to early diagnosis. Once diagnosis is established and staging is complete, radiation therapy is the recommended treatment for stage IEA patients. Systemic chemotherapy is indicated in selected stage IIEA patients and in patients with stage IIIEA disease.

Eckardt AM; Lemound J; Rana M; Gellrich NC

2013-01-01

33

Study of Object Oriented Analysis and Design Approach  

Directory of Open Access Journals (Sweden)

Full Text Available Problem statement: Object and component technologies, rapidly maturing branches of information technology, have been becoming pervasive elements of systems development, especially the recently popular Internet applications and thus leading to increased complexity and at the same time broader range of applications. Approach: This needs to be understood in order to maximize its benefits and applications with consistent results. However, mainstream Object Oriented Systems Development (OOSD), consisting of Object Oriented Analysis and Design (OOAD) and Object- Oriented Programming (OOP), has a history of difficulties and is still struggling to gain prevalent acceptance. Results: There have been number of studies and experiments conducted by experts and researchers in the past which provides a solid base to take up this study and look into various intricacies present. There have been several studies and focused efforts in this direction which laid down the basis for a segment of people to form the opinion as ?technology adoption is mostly the result of marketing forces, not scientific evidence? whereas there have been another segment that believes that object technology is ?still long on hype and short on results ...?. The gurus of OOSD continue to tout its vast superiority over conventional systems development, even to the extent of developing a unified software development process. Conclusion: The advocates of OOSD claim many advantages including easier modeling, increased code reuse, higher system quality and easier maintenance. It is well understood that analysis and design are extremely critical aspects of successful systems development especially in the case of OOSD. As the development of any successful information system must begin with a well-conceived and implemented analysis and design, this study will focus on the most recent empirical evidence on the pros and cons of OOAD.

Sunil K. Pandey; G. P. Singh; Dr. V. Kansal

2011-01-01

34

Personal health and consumer informatics. The impact of health oriented social media applications on health outcomes.  

UK PubMed Central (United Kingdom)

OBJECTIVES: The rapid evolution in the world-wide use of Social Media tools suggests the emergence of a global phenomenon that may have implications in the Personal Health and Consumer Health Informatics domains. However the impact of these tools on health outcomes is not known. The goal of this research was to review the randomized controlled trial (RCT) evidence of the impact of health oriented Social Media informatics tools on health outcomes. METHODS: Evaluations of Social Media consumer health tools were systematically reviewed. Research was limited to studies published in the English language, published in Medline, published in the calendar year 2012 and limited to studies that utilized a RCT methodological design. RESULTS AND CONCLUSIONS: Two high quality Randomized Controlled Trials among over 600 articles published in Medline were identified. These studies indicate that Social Media interventions may be able to significantly improve pain control among patients with chronic pain and enhance weight loss maintenance among individuals attempting to lose weight. Significantly more research needs to be done to confirm these early findings, evaluate additional health outcomes and further evaluate emerging health oriented Social Media interventions. Chronic pain and weight control have both socially oriented determinants. These studies suggest that understanding the social component of a disease may ultimately provide novel therapeutic targets and socio-clinical interventional strategies.

Gibbons MC

2013-01-01

35

Game Portability Using a Service-Oriented Approach  

Directory of Open Access Journals (Sweden)

Full Text Available Game assets are portable between games. The games themselves are, however, dependent on the game engine they were developed on. Middleware has attempted to address this by, for instance, separating out the AI from the core game engine. Our work takes this further by separating the game from the game engine, and making it portable between game engines. The game elements that we make portable are the game logic, the object model, and the game state, which represent the game's brain, and which we collectively refer to as the game factor, or G-factor. We achieve this using an architecture based around a service-oriented approach. We present an overview of this architecture and its use in developing games. The evaluation demonstrates that the architecture does not affect performance unduly, adds little development overhead, is scaleable, and supports modifiability.

Ahmed BinSubaih; Steve Maddock

2008-01-01

36

Work Orientation vs. Hygienic Orientation: A Bi-Polar Approach to the Study of Work Motivation  

Science.gov (United States)

Based on work of Herzberg and associates (1959), a pi-polar measure of work orientation vs. hygienic orientation was constructed. Validity is shown through correlation with other measures of work motivation, personality measures, values, and abilities. The new measure is also correlated with supervisor's ratings of how long it will take newly…

Borgatta, Edgar F.; And Others

1973-01-01

37

RF control at SSCL - an object oriented design approach  

International Nuclear Information System (INIS)

The Superconducting Super Collider (SSC) in Texas, the construction of which was stopped in 1994, would have represented a major challenge in accelerator research and development. This paper addresses the issues encountered in the parallel design and construction of the control systems for the RF equipment for the five accelerators comprising the SSC. An extensive analysis of the components of the RF control systems has been undertaken, based upon the Schlaer-Mellor object-oriented analysis and design (OOA/OOD) methodology. The RF subsystem components such as amplifiers, tubes, power supplies, PID loops, etc. were analyzed to produce OOA information, behavior and process models. Using these models, OOD was iteratively applied to develop a generic RF control system design. This paper describes the results of this analysis and the development of 'bridges' between the analysis objects, and the EPICS-based software and underlying VME-based hardware architectures. The application of this approach to several of the SSCL RF control systems is discussed. ((orig.)).

1994-01-01

38

Approaches Regarding Business Logic Modeling in Service Oriented Architecture  

Digital Repository Infrastructure Vision for European Research (DRIVER)

As part of the Service Oriented Computing (SOC), Service Oriented Architecture (SOA) is a technology that has been developing for almost a decade and during this time there have been published many studies, papers and surveys that are referring to the advantages of projects using it. In this article...

Alexandra Maria Ioana FLOREA; Anca Ioana ANDREESCU; Vlad DIACONITA; Adina UTA

39

Comparison of Advanced Pixel Based (ANN and SVM) and Object-Oriented Classification Approaches Using Landsat-7 Etm+ Data  

Directory of Open Access Journals (Sweden)

Full Text Available In this study, the pixel-based and object-oriented image classification approaches were used for identifying different land use types in Karnal district. Imagery from Landsat-7 ETM with 6 spectral bands was used to perform the image classification.Ground truth data were collected from the available maps, personal knowledge and communication with the local people. In order to prepare land use map different approaches: Artificial Neural Network(ANN) and Support Vector Machine (SVM) were used. For performing object oriented classification eCognition software was used. During the object oriented classification, in first step several differentsets of parameters were used for image segmentation and in second step nearest neighbor classifier was used for classification. Outcome from the classification works show that the object-oriented approach gave more accurate results (including higher producer’s and user’s accuracy for most of the land cover classes) than those achieved by pixelbased classification algorithms. It is also observed that ANN performed better as compared to SVM classification approach.

Gaurav Kalidas Pakhale; Prasun Kumar Gupta

2010-01-01

40

A new approach to evaluate multimodal orientation behaviour of migratory passerine birds recorded in circular orientation cages.  

UK PubMed Central (United Kingdom)

Circular orientation cages have been used for several decades to record the migratory orientation of passerine migrants, and have been central when investigating of the functional characteristics of the biological compasses used for orientation. The technique offers unique possibilities to study the migratory behaviour of songbirds, but suffers from statistical limitations to evaluate the directions of the activity recorded in the cages. The migratory activity has been reported to vary, including complex multimodal orientation of migratory passerines tested in orientation cages irrespective of species studied. The currently applied circular statistical methods fail to describe orientation responses differing from unimodal and axial distributions. We propose for the first time a modelling procedure enabling the analyses of multimodal distributions either at an individual or group level. In this paper we compare the results of conventional methods and the recommended modelling approach. Migratory routes may be more complex than a simple migratory direction and multimodal behaviour in migratory species at the individual and population levels can be advantageous. Individuals may select the expected migratory direction, but may also return to more safe sites en route, i.e. sites already known, which provide food and/or shelter in reverse directions. In individual birds several directions may be expressed in the same test hour. At the species level multimodal orientation may give an opportunity to expand the range or may refer to differential migration route preferences in different populations of birds. A conflicting experimental situation may also result in different preferential orientation. In this paper we suggest a statistical solution to deal with these types of variations in orientation preferences.

Ozarowska A; Ilieva M; Zehtindijev P; Akesson S; Mus K

2013-07-01

 
 
 
 
41

APPROACHES TO STUDY EDUCATIONAL AND OCCUPATIONAL TRAJECTORIES AND OUTCOMES  

Directory of Open Access Journals (Sweden)

Full Text Available This article analyzes the main approaches to study educational and occupational outcomes and trajectories. Young people have to decide when and what to study, later on, where to work. Their life levels will depend on those decisions, but the different ways that in both areas they are able to take and their outcomes in education and in the labor market depend on various factors. Among explications it is possible to identify six large approaches: human capital from economics, cultural and social capital from sociology, the socioeconomic status or familiar background approach and the educational and psychological approaches. These approaches are not contrary necessarily, they can be complementary, and their explanatory power depends on place and time, however, the literature does not have an effort to present together their contributions, methodologies and empirical results. This work seeks to remedy that situation and to point out some methodological and empirical weakness.

Tovar-García, Edgar Demetrio

2012-01-01

42

Recent advances in the compound-oriented and pattern-oriented approaches to the quality control of herbal medicines  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract The current approaches to the quality control of herbal medicines are either compound-oriented or pattern-oriented, the former targeting specific components with some known chemical properties and the latter targeting all detectable components. The marker approach uses specific chemical compounds with known molecular structures, while the multi-compound approach uses both chemical compounds with known structures and those with partial chemical information e.g. retention times, mass spectra and ultraviolet spectra. Apart from chromatographic techniques, new techniques such as oscillating and electrochemistry fingerprints have been developed for quality control. Chemometric resolution methods are widely used for component deconvolution and data comparison. Pattern recognition techniques are used for authentication of herbal medicines.

Zeng Zhongda; Chau Foo-tim; Chan Hoi-yan; Cheung Chui-yee; Lau Tsui-yan; Wei Shuiyin; Mok Daniel; Chan Chi-on; Liang Yizeng

2008-01-01

43

Pedagogical conditions of implementation of personality-oriented approach in the process of exercise of power orientation.  

Directory of Open Access Journals (Sweden)

Full Text Available The pedagogical conditions of personality-oriented approach in the exercise of power orientation. It is set that the problems of the modern system of physical education need changes of existing maintenance and forms of studies. It was found that the improvement of power abilities of students will be effective provided that the following teaching conditions: diagnosis of physical state of young people, choosing the optimal means and methods of law enforcement capabilities to the purpose, development of complex power loads, taking into account individual characteristics of students of diverse students technical equipment and sports equipment, encouraging motivation for sport and recreation and sports activities, activation of students' independent work, monitoring and evaluation of training activities boys and girls in the exercise of power orientation.

Gunko P. ?.

2012-01-01

44

Different roles and different results: how activity orientations correspond to relationship quality and student outcomes in school-based mentoring.  

UK PubMed Central (United Kingdom)

This prospective, mixed-methods study investigated how the nature of joint activities between volunteer mentors and student mentees corresponded to relationship quality and youth outcomes. Focusing on relationships in school-based mentoring programs in low-income urban elementary schools, data were obtained through pre-post assessments, naturalistic observations, and in-depth interviews with mentors and mentees. Adopting an exploratory approach, the study employed qualitative case study methods to inductively identify distinctive patterns reflecting the focus of mentoring activities. The activity orientations of relationships were categorized according to the primary functional role embodied by the mentor and the general theme of interactions: teaching assistant/tutoring, friend/engaging, sage/counseling, acquaintance/floundering. Next, these categories were corroborated by comparing the groups on quantitative assessments of relationship quality and change in child outcomes over time. Relationships characterized by sage mentoring, which balanced amicable engagement with adult guidance, were rated most favorably by mentees on multiple measures of relationship quality. Furthermore, students involved in sage mentoring relationships showed declines in depressive symptoms and aggressive behaviors. For disconnected pairs (acquaintances), students reported more negative relationship experiences. Findings suggest effective mentoring relationships represent a hybrid between the friendly mutuality of horizontal relationships and the differential influence of vertical relationships.

Keller TE; Pryce JM

2012-02-01

45

Approaches Regarding Business Logic Modeling in Service Oriented Architecture  

Directory of Open Access Journals (Sweden)

Full Text Available As part of the Service Oriented Computing (SOC), Service Oriented Architecture (SOA) is a technology that has been developing for almost a decade and during this time there have been published many studies, papers and surveys that are referring to the advantages of projects using it. In this article we discuss some ways of using SOA in the business environment, as a result of the need to reengineer the internal business processes with the scope of moving forward towards providing and using standardized services and achieving enterprise interoperability.

Alexandra Maria Ioana FLOREA; Anca Ioana ANDREESCU; Vlad DIACONITA; Adina UTA

2011-01-01

46

An intelligent dynamic simulation environment: An object-oriented approach  

Energy Technology Data Exchange (ETDEWEB)

This paper presents a prototype simulation environment for nuclear power plants which illustrates the application of object-oriented programming to process simulation. Systems are modeled using this technique as a collection of objects which communicate via message passing. The environment allows users to build simulation models by selecting iconic representations of plant components from a menu and connecting them with the aid of a mouse. Models can be modified graphically at any time, even as the simulation is running, and the results observed immediately via real-time graphics. This prototype illustrates the use of object-oriented programming to create a highly interactive and automated simulation environment. 9 refs., 4 figs.

Robinson, J.T.; Kisner, R.A.

1988-01-01

47

Neuropsychological outcome after selective amygdalohippocampectomy: subtemporal versus transsylvian approach.  

UK PubMed Central (United Kingdom)

OBJECTIVE: In the context of discussions on the optimal cognitive outcome of temporal lobe epilepsy surgery, and stimulated by recent reports on the beneficial effects of a selective subtemporal approach to memory function, this study evaluated the cognitive consequences of subtemporal versus transsylvian selective amygdalohippocampectomy (SAH) in patients with mesial temporal lobe epilepsy, taking verbal/figural memory and language functions into account. METHODS: We contrasted cognitive outcomes of 26 subtemporal SAH patients with those observed in a transsylvian SAH control group. The surgical groups were pairwise matched with regard to clinical and demographic characteristics. Preoperative and 1 year postoperative memory and language evaluations served as within group factors, and surgical approach (transsylvian vs subtemporal) and side of surgery (right vs left) as between group factors. RESULTS: Both surgical approaches caused decline in verbal memory to a similar degree. Differential effects were seen with regard to decline in verbal recognition memory (more affected by left transsylvian SAH) as well as in figural memory and verbal fluency (more affected by subtemporal SAH). INTERPRETATION: Different from previous optimistic reports, this study demonstrates that subtemporal surgery, such as transsylvian surgery, poses similar risks for verbal memory. Differences between the approaches appear to reflect the effect of different collateral temporal lobe lesions due to the approach. Different cognitive outcomes across studies on the subtemporal approach are discussed as being in part due to study design and the chosen dependent functional measures.

von Rhein B; Nelles M; Urbach H; Von Lehe M; Schramm J; Helmstaedter C

2012-09-01

48

Lecture-Free Biochemistry: A Process Oriented Guided Inquiry Approach  

Science.gov (United States)

|Biochemistry courses at Seattle University have been taught exclusively using process oriented guided inquiry learning (POGIL) without any traditional lecture component since 1997. In these courses, students participate in a structured learning environment, which includes a preparatory assignment, an in-class activity, and a follow-up skill…

Minderhout, Vicky; Loertscher, Jennifer

2007-01-01

49

Transfemoral amputations: the effect of residual limb length and orientation on gait analysis outcome measures.  

UK PubMed Central (United Kingdom)

BACKGROUND: The level of function achieved following a transfemoral amputation is believed to be affected by surgical attachment of the remaining musculature, resulting orientation of the femur, residual limb length, and eventual prosthetic fit. METHODS: Twenty-six subjects underwent gait analysis testing in the current preferred prosthesis more than twenty-four months postamputation. The femoral length and orientation angles of each subject were measured from standing postoperative radiographic scanograms. The subjects were separated into groups for analysis on the basis of the femoral shaft angles and the residual limb length ratios. Gait analysis was performed to collect kinematic and temporospatial parameters. RESULTS: A good correlation was observed between residual femoral length and trunk with regard to forward lean (r = -0.683) and lateral flexion (r = -0.628). A good correlation was also observed between residual femoral length and pelvic motion with regard to pelvic tilt (r = -0.691) and obliquity (r = -0.398). A moderate correlation was observed with speed (r = 0.550), indicating that subjects with shorter residual limbs experienced a greater excursion in the torso and pelvis, while walking at a slower self-selected pace. A significant correlation (r = 0.721, p < 0.001) was observed between the femoral shaft abduction angle and the residual femoral length; the shorter the residual limb, the more abducted it was. CONCLUSIONS: The length of the residual femur substantially influences temporospatial and kinematic gait outcomes following transfemoral amputation, and appears to be more important than femoral orientation with regard to these parameters.

Bell JC; Wolf EJ; Schnall BL; Tis JE; Tis LL; Potter BK

2013-03-01

50

Patient-centered medicine and patient-oriented research: improving health outcomes for individual patients.  

UK PubMed Central (United Kingdom)

BACKGROUND: Patient-centered medicine is developing alongside the concepts of personalized medicine and tailored therapeutics. The main objective of patient-centered medicine is to improve health outcomes of individual patients in everyday clinical practice, taking into account the patient's objectives, preferences, values as well as the available economic resources. DISCUSSION: Patient-centered medicine implies a paradigm shift in the relationship between doctors and patients, but also requires the development of patient-oriented research. Patient-oriented research should not be based on the evaluation of medical interventions in the average patient, but on the identification of the best intervention for every individual patient, the study of heterogeneity and the assignment of greater value to observations and exceptions. The development of information-based technologies can help to close the gap between clinical research and clinical practice, a fundamental step for any advance in this field. SUMMARY: Evidence-based medicine and patient centered medicine are not contradictory but complementary movements. It is not possible to practice patient-centered medicine that is not based on evidence, nor is it possible to practice evidence-based medicine at a distance from the individual patient.

Sacristán JA

2013-01-01

51

Making The Most of Medical orientation; A New Approach.  

Directory of Open Access Journals (Sweden)

Full Text Available Orientating new junior medical staff can be a complex and time consuming task. Traditional models have typically involved a day or longer of lectures. This involves a large number of senior staff being available on the first day of term. It also means that junior staff not present on the first day had any access to an orientation program at all. Evaluation of our program confirmed the belief that the day was dull and that there was simply too much information for new staff to absorb. As a result of this feedback we extensively updated our orientation program. Pre-reading of the junior staff manual became compulsory. We departed from the traditional lecture style program and devised a new ten- station scenario based interactive program. The stations were designed to cover aspects of the hospital?s mandatory education and key educational requirements in order to function effectively on our campus. Station leaders were selected and trained in the goals of the new process. Several of our secondment sites were engaged in the development of the project topics. We hoped that our secondment sites would be relieved of some orientation responsibility if core material was delivered centrally. The strength of the new orientation is that it is portable, reproducible and uniform. It is also available via video conferencing. A single person can educate new staff in three hours if the need arises. Most importantly all new staff will have access to the program within a week of starting a term at our hospital.

Dr Jonathan Taitz

2004-01-01

52

The standardized surgical approach improves outcome of gallbladder cancer  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background The objective of this study was to examine the extent of surgical procedures, pathological findings, complications and outcome of patients treated in the last 12 years for gallbladder cancer. Methods The impact of a standardized more aggressive approach compared with historical controls of our center with an individual approach was examined. Of 53 patients, 21 underwent resection for cure and 32 for palliation. Results Overall hospital mortality was 9% and procedure related mortality was 4%. The standardized approach in UICC stage IIa, IIb and III led to a significantly improved outcome compared to patients with an individual approach (Median survival: 14 vs. 7 months, mean+/-SEM: 26+/-7 vs. 17+/-5 months, p = 0.014). The main differences between the standardized and the individual approach were anatomical vs. atypical liver resection, performance of systematic lymph dissection of the hepaticoduodenal ligament and the resection of the common bile duct. Conclusion Anatomical liver resection, proof for bile duct infiltration and, in case of tumor invasion, radical resection and lymph dissection of the hepaticoduodenal ligament are essential to improve outcome of locally advanced gallbladder cancer.

Scheingraber Stefan; Justinger Christoph; Stremovskaia Tatiana; Weinrich Malte; Igna Dorian; Schilling Martin K

2007-01-01

53

Sexual orientation and gender identity/expression related peer victimization in adolescence: a systematic review of associated psychosocial and health outcomes.  

Science.gov (United States)

This article reviews research on psychosocial and health outcomes associated with peer victimization related to adolescent sexual orientation and gender identity or expression. Using four electronic databases and supplementary methods, we identified 39 relevant studies. These studies were published between 1995 and 2012 and conducted in 12 different countries. The studies were diverse in terms of their approaches to sampling participants, assessing participants' sexual orientation, operationalizing peer victimization, and with regard to the psychosocial and health outcomes studied in relation to peer victimization. Despite the methodological diversity across studies, there is fairly strong evidence that peer victimization related to sexual orientation and gender identity or expression is associated with a diminished sense of school belonging and higher levels of depressive symptoms; findings regarding the relationship between peer victimization and suicidality have been more mixed. Peer victimization related to sexual orientation and gender identity or expression is also associated with disruptions in educational trajectories, traumatic stress, and alcohol and substance use. Recommendations for future research and interventions are discussed. PMID:23480074

Collier, Kate L; van Beusekom, Gabriël; Bos, Henny M W; Sandfort, Theo G M

2013-01-01

54

A systems approach in nursing administration: structure, process, and outcome.  

Science.gov (United States)

This article presents a systems approach for administrators to consider as they review structure, process, and outcome in their healthcare organization. Systems provide a way to access data, information, and knowledge. Systems organize and unify the complex world of nursing practice in healthcare systems. Use of King's conceptual system, Theory of Goal Attainment, and transaction process is presented as an example that helps the multiple individuals and groups use information and knowledge to structure nursing practice. The transaction process helps individuals and groups identify goals and outcomes that lead to effective nursing care, evidence-based practice, and cost-effectiveness. PMID:16648721

King, Imogene M

55

A systems approach in nursing administration: structure, process, and outcome.  

UK PubMed Central (United Kingdom)

This article presents a systems approach for administrators to consider as they review structure, process, and outcome in their healthcare organization. Systems provide a way to access data, information, and knowledge. Systems organize and unify the complex world of nursing practice in healthcare systems. Use of King's conceptual system, Theory of Goal Attainment, and transaction process is presented as an example that helps the multiple individuals and groups use information and knowledge to structure nursing practice. The transaction process helps individuals and groups identify goals and outcomes that lead to effective nursing care, evidence-based practice, and cost-effectiveness.

King IM

2006-04-01

56

Modules for Object Oriented Specification Languages: A Bipartite Approach  

UK PubMed Central (United Kingdom)

The general aim of our work is the specication of distributed informationsystems, that means reactive systems consisting of one or moredatabases and application programs. In this context the formal objectoriented specication language Troll was developed and is now goingto be extended by module concepts, which provide the possibilityto structure a specication horizontally as well as vertically and whichsupport the reuse of (parts of) specications.In this paper we give a short introduction in Troll and a survey, whichkind of module concepts is needed in our case. We discuss related workdone not only in the object oriented setting but also in the elds ofspecication languages in general, theory of abstract data types andparameterized programming.1 IntroductionThe main objective of the work presented in this paper is to nd a moduleconcept for an object oriented specication language which provides the possibilityto structure a specication horizontally as well as vert...

Silke Eckstein

57

Graduate interns’ experiences: A career success orientations approach  

Directory of Open Access Journals (Sweden)

Full Text Available Organisations are challenged to achieve optimal business results by specifically attracting and retaining talented human resources, while simultaneously creating environments where individuals feel their own personal career aspirations are fulfilled. This study examined graduate interns’ experiences using career success orientations as a framework. Data were collected using a card sorting technique and semi-structured interviews. The data were then analysed and used as a guide for internship programme design. Implications of the findings are discussed.

B Kanye; F Crous

2007-01-01

58

APE (state-oriented approach) centralized control procedures; Procedures de conduite APE (Approche Par Etats)  

Energy Technology Data Exchange (ETDEWEB)

This article presents the progressive implementation of the state-oriented approach (APE) for centralized control procedures in French nuclear power plants. The implementation began in the years 1982-83 and it concerned only the circuits involved in engineered safeguard systems such IS (safety injection), EAS (containment spray system) and GMPP (reactor coolant pump set). In 2003 the last PWR unit switched from the event oriented approach to APE for post-accidental situations.

Astier, D. [FRAMATOME ANP, 92 - Paris-La-Defence (France); Depont, G. [Electricite de France (EDF/DPN), 93 - Saint-Denis (France); Van Dermarliere, Y. [Electricite de France (EDF/SEPTEN), 69 - Villeurbanne (France)

2004-07-01

59

Analyzing Web Service Contracts : an aspect oriented approach  

DEFF Research Database (Denmark)

Web services should be dependable, because businesses rely on them. For that purpose the Service Oriented Architecture has standardized specifications at a syntactical level. In this paper, we demonstrate how such specifications are used to derive semantic models in the form of (timed) automata. These can be used to model check functional and behavioural properties of a given service. Since there might be several specifications dealing with different aspects, one must also check that these automata are consistent, where we propose to set up a suitable simulation relation. The proposed techniques are illustrated with a small case study

Cambronero, M.-Emilia; Okika, Joseph C.

2007-01-01

60

A family-oriented approach to pediatric care.  

UK PubMed Central (United Kingdom)

The REACH Centre in Vancouver offers an innovative approach to pediatric care. The child is considered to be part of an eco-system in which the family is of chief importance. Family centered care is the theme of the approach with a team of health professionals sharing responsibilities.

Seidelman WE; McMaster B; Thiel J

1974-09-01

 
 
 
 
61

Modules for Object Oriented Speci cation Languages: A Bipartite Approach  

UK PubMed Central (United Kingdom)

The general aim of our work is the specication of distributed informationsystems, that means reactive systems consisting of one or moredatabases and application programs. In this context the formal objectoriented specication language Troll was developed and is now goingto be extended by module concepts, which provide the possibilityto structure a specication horizontally as well as vertically and whichsupport the reuse of (parts of) specications.In this paper we give a short introduction in Troll and a survey, whichkind of module concepts is needed in our case. We discuss related workdone not only in the object oriented setting but also in the elds ofspecication languages in general, theory of abstract data types andparameterized programming.1

Silke Eckstein

62

A DICOM document-oriented approach to PACS infrastructure.  

UK PubMed Central (United Kingdom)

The need for long-term storage requires the future migration of image data from a PACS to its successor system. This paper considers the cost of such migration It is proposed that storage of data as "documents" in DICOM Part 10 formats on industry-standard media could reduce the time and cost of data migration relative to on-line DICOM transfer. The relation to present efforts in developing document-oriented electronic patient records is discussed. DICOM Part 10 files are found to be a sufficient representation of image documents, but additional software tools will be needed to reach its full potential. There is a significant cost benefit of the document storage method, but it is one of many factors which must be balanced in the selection of a PACS.

Behlen F

1998-08-01

63

Goal-oriented approach to diagnostics in management of an enterprise  

Directory of Open Access Journals (Sweden)

Full Text Available Problems which occur while performing diagnostics of the state of an enterprise and the results of its activity have been revealed. The inexpediency of using problem approach to diagnostics in management of an enterprise in modern conditions of economic management has been defined. The significance and essence of goal-oriented approach to diagnostics in management of an enterprise have been revealed. It has been set that the management decisions, developed using the goal-oriented approach to diagnostics, are more efficient.

I.M. Semenenko

2012-01-01

64

Ultra low power signal oriented approach for wireless health monitoring.  

UK PubMed Central (United Kingdom)

In recent years there is growing pressure on the medical sector to reduce costs while maintaining or even improving the quality of care. A potential solution to this problem is real time and/or remote patient monitoring by using mobile devices. To achieve this, medical sensors with wireless communication, computational and energy harvesting capabilities are networked on, or in, the human body forming what is commonly called a Wireless Body Area Network (WBAN). We present the implementation of a novel Wake Up Receiver (WUR) in the context of standardised wireless protocols, in a signal-oriented WBAN environment and present a novel protocol intended for wireless health monitoring (WhMAC). WhMAC is a TDMA-based protocol with very low power consumption. It utilises WBAN-specific features and a novel ultra low power wake up receiver technology, to achieve flexible and at the same time very low power wireless data transfer of physiological signals. As the main application is in the medical domain, or personal health monitoring, the protocol caters for different types of medical sensors. We define four sensor modes, in which the sensors can transmit data, depending on the sensor type and emergency level. A full power dissipation model is provided for the protocol, with individual hardware and application parameters. Finally, an example application shows the reduction in the power consumption for different data monitoring scenarios.

Marinkovic S; Popovici E

2012-01-01

65

Recent developments and object-oriented approach in FTU database  

Energy Technology Data Exchange (ETDEWEB)

During the last two years, the experimental database of Frascati Tokamak Upgrade (FTU) has been changed from several points of view, particularly: (i) the data and the analysis codes have been moved from the IBM main frame to Unix platforms making enabling the users to take advantage of the large quantities of commercial and free software available under Unix (Matlab, IDL, etc); (ii) AFS (Andrew File System) has been chosen as the distributed file system making the data available on all the nodes and distributing the workload; (iii) 'One measure/one file' philosophy (vs. the previous 'one pulse/one file') has been adopted increasing the number of files into the database but, at the same time, allowing the most important data to be available just after the plasma discharge. The client-server architecture has been tested using the signal viewer client jScope. Moreover, an object oriented data model (OODM) of FTU experimental data has been tried: a generalized model in tokamak experimental data has been developed with typical concepts such as abstraction, encapsulation, inheritance, and polymorphism. The model has been integrated with data coming from different databases, building an Object Warehouse to extract, with data mining techniques, meaningful trends and patterns from huge amounts of data.

Bertocchi, A.; Bracco, G.; Buceti, G.; Centioli, C.; Iannone, F.; Manduchi, G.; Nanni, U.; Panella, M. E-mail: panella@frascati.enea.it; Stracuzzi, C.; Vitale, V

2001-10-01

66

Recent developments and object-oriented approach in FTU database  

International Nuclear Information System (INIS)

During the last two years, the experimental database of Frascati Tokamak Upgrade (FTU) has been changed from several points of view, particularly: (i) the data and the analysis codes have been moved from the IBM main frame to Unix platforms making enabling the users to take advantage of the large quantities of commercial and free software available under Unix (Matlab, IDL, etc); (ii) AFS (Andrew File System) has been chosen as the distributed file system making the data available on all the nodes and distributing the workload; (iii) 'One measure/one file' philosophy (vs. the previous 'one pulse/one file') has been adopted increasing the number of files into the database but, at the same time, allowing the most important data to be available just after the plasma discharge. The client-server architecture has been tested using the signal viewer client jScope. Moreover, an object oriented data model (OODM) of FTU experimental data has been tried: a generalized model in tokamak experimental data has been developed with typical concepts such as abstraction, encapsulation, inheritance, and polymorphism. The model has been integrated with data coming from different databases, building an Object Warehouse to extract, with data mining techniques, meaningful trends and patterns from huge amounts of data.

2001-01-01

67

Market-oriented ecological promotion - The Zurich approach  

International Nuclear Information System (INIS)

This article discusses the promotion of sustainable energy use and power-production from renewable resources. In particular, the approach adopted by the City of Zurich in Switzerland is discussed. Changes currently being experienced in the Swiss energy business are looked at. The approach adopted by the City of Zurich, which includes both rewards for increasing energy efficiency as well as the definition of criteria for the evaluation of measures and their effect, is discussed. Instruments and goals are looked at. Other topics discussed include the 'ecologicalisation' of electrical power production and economical incentives for industry. The role played by the labelling of ecologically-produced power is discussed and the economical advantages for the City of Zurich itself are examined

2005-01-01

68

An object-oriented approach to site characterization decision support  

International Nuclear Information System (INIS)

Effective decision support for site characterization is key to determining the nature and extent of contamination and the associated human and environmental risks. Site characterization data, however, present particular problems to technical analysts and decision-makers. Such data are four dimensional, incorporating temporal and spatial components. Their sheer volume can be daunting -- sites with hundreds of monitoring wells and thousands of samples sent for laboratory analyses are not uncommon. Data are derived from a variety of sources including laboratory analyses, non-intrusive geophysical surveys, historical information, bore logs, in-field estimates of key physical parameters such as aquifer transmissivity, soil moisture content, depth-to-water table, etc. Ultimately, decisions have to be made based on data that are always incomplete, often confusing, inaccurate, or inappropriate, and occasionally wrong. In response to this challenge, two approaches to environmental decision support have arisen, Data Quality Objectives (DQOS) and the Observational Approach (OA). DQOs establish criteria for data collection by clearly defining the decisions that need to be made, the uncertainty that can be tolerated, and the type and amount of data that needs to be collected to satisfy the uncertainty requirements. In practice, DQOs are typically based on statistical measures. The OA accepts the fact that the process of characterizing and remediating contaminated sites is always uncertain. Decision-making with the OA is based on what is known about a site, with contingencies developed for potential future deviations from the original assumptions about contamination nature, extent, and risks posed

1995-01-01

69

Towards a user-oriented analytical approach to learning design  

Directory of Open Access Journals (Sweden)

Full Text Available The London Pedagogy Planner (LPP) is a prototype for a collaborative online planning and design tool that supports lecturers in developing, analysing and sharing learning designs. The tool is based on a developing model of the components involved in learning design and the critical relationships between them. As a decision tool it makes the pedagogical design explicit as an output from the process, capturing it for testing, redesign, reuse and adaptation by the originator, or by others. The aim is to test the extent to which we can engage lecturers in reflecting on learning design, and make them part of the educational community that discovers how best to use technology-enhanced learning. This paper describes the development of LPP, presents pedagogical benefits of visual representations of learning designs and proposes an analytical approach to learning design based on these visual representations. The analytical approach is illustrated based on an initial evaluation with a small group of lecturers from two partner institutions.

Jonathan P. San Diego; Diana Laurillard; Tom Boyle; Claire Bradley; Dejan Ljubojevic; Tim Neumann; Darren Pearce

2008-01-01

70

An object-oriented approach to site characterization decision support  

Energy Technology Data Exchange (ETDEWEB)

Effective decision support for site characterization is key to determining the nature and extent of contamination and the associated human and environmental risks. Site characterization data, however, present particular problems to technical analysts and decision-makers. Such data are four dimensional, incorporating temporal and spatial components. Their sheer volume can be daunting -- sites with hundreds of monitoring wells and thousands of samples sent for laboratory analyses are not uncommon. Data are derived from a variety of sources including laboratory analyses, non-intrusive geophysical surveys, historical information, bore logs, in-field estimates of key physical parameters such as aquifer transmissivity, soil moisture content, depth-to-water table, etc. Ultimately, decisions have to be made based on data that are always incomplete, often confusing, inaccurate, or inappropriate, and occasionally wrong. In response to this challenge, two approaches to environmental decision support have arisen, Data Quality Objectives (DQOS) and the Observational Approach (OA). DQOs establish criteria for data collection by clearly defining the decisions that need to be made, the uncertainty that can be tolerated, and the type and amount of data that needs to be collected to satisfy the uncertainty requirements. In practice, DQOs are typically based on statistical measures. The OA accepts the fact that the process of characterizing and remediating contaminated sites is always uncertain. Decision-making with the OA is based on what is known about a site, with contingencies developed for potential future deviations from the original assumptions about contamination nature, extent, and risks posed.

Johnson, R.

1995-06-01

71

A Christian educational perspective on the process oriented approach to intrinsic motivation  

Directory of Open Access Journals (Sweden)

Full Text Available Within the classroom context, albeit school or university, intrinsic motivation can effectively be described and changed if a process-oriented approach is employed. The question is posed whether a process-oriented approach to motivation is acceptable to Christian education. To answer this question, intrinsic motivation and the process-oriented approach to motivation are described. A Christian view of self-knowledge and control, which are the main components of a process-oricnted approach to motivation, is subsequently given and the process-oriented approach to motivation is subjected to a Christian evaluation. The conclusions are drawn that this approach can fruitfully be used in Christian education, given that self-knowledge and control arc interpreted within the context of the concept of the student as God’s representative on earth and the fact that God equipped him adequately with cognitive, affective and conative abilities to respond to His call to discover, develop and rule the earth actively.

Mechaéla Scott

1992-01-01

72

PROPOSED MODEL FOR RESOURCE MANAGEMENT USING AUCTION ORIENTED APPROACH  

Directory of Open Access Journals (Sweden)

Full Text Available Grids are emerging as the infrastructure for next generationcomputing. In Grid environments, the resources areheterogeneous and geographically distributed with varyingavailability and a variety of usage and cost policies fordiverse users at different times and, priorities as well asgoals that vary with time. The management of resources insuch a large and distributed environment is a complex task.In this paper a model has been proposed using auctionoriented approach. This auction model allows bidders to bidon various attributes beyond the price. The auctioneerselects winners based on the price as well as on otherattributes. Thus, the overall utility of a deal for the buyermust consider not only the price of the auctioning item, butalso a combination of the different attributes. This model hasalso been implemented.

Surbi Sangwan

2012-01-01

73

The DPSIR Framework and a Pressure-Oriented Water Quality Monitoring Approach to Ecological River Restoration  

Directory of Open Access Journals (Sweden)

Full Text Available Without monitoring anthropogenic pressures on the water environment, it is difficult to set realistic river restoration targets in relation to water quality. Therefore a more holistic approach is needed to systematically explore the links between socio-economic drivers and observed water quality-related impacts on river ecosystems. Using the DPSIR (Drivers-Pressures-State of the Environment-Impacts-Responses) framework, this study linked ecological river restoration with the socio-economic sector, with the focus on promoting a pressure-oriented water quality monitoring system. Based on the European Water Framework Directive (WFD) and relevant literature, it was found that most water quality-related indicators employed today are state/impacts-oriented, while very few are pressure-oriented. As a response, we call for more attention to a DPR (Drivers-Pressures-Responses) framework in developing an industrial ecology-based pressure-oriented water quality monitoring system for aiding ecological river restoration planning. This approach is characterized in general by accounting for material-related flows throughout the socio-economic sector in relation to river ecosystem degradation. Then the obtained information would help decision makers take appropriate measures to alleviate various significant human-induced wastes and emissions at their sources. We believe that such a pressure-oriented monitoring system will substantially complement traditional state/impacts-oriented environmental and ecological monitoring and help develop more proactive planning and decision-making processes for specific river restoration projects and general water quality management.

Xingqiang Song; Björn Frostell

2012-01-01

74

Integrative Educational Approach Oriented Towards Software and System Development  

Directory of Open Access Journals (Sweden)

Full Text Available The paper is based on our academic teaching and research work in software and system engineering to effectively develop modern, complex real-life Web application systems. It bridges the gap between academic education and industry needs and illustrates how such collaboration can be successfully developed in the IT area where technology development is rapid. Its scope covers the processes, models, technologies, people, and knowledge that have the capability to contribute to developing such systems. The paper also relates to contributions of some of Harlan D. Mills award recipients for software engineering achievement, to address the needs to: i) improve the engineering education in an academic setting, and ii) develop real-life software and system projects. Hybrid educational methods are applied for student learning that combine class room approach of teaching fundamental theoretical concepts and practice via real world complex projects embedding intelligence in software and systems products. System thinking demanded by modern design philosophies is applied to interlink prod-ucts, software, and people. Student groups are developing their projects in an interactive and collaborative manner.

Anca Juliana Stoica; Shareeful Islam

2013-01-01

75

Approach/Avoidance Orientations Affect Self-Construal and Identification with In-group.  

Science.gov (United States)

Approach and avoidance are two basic motivational orientations. Their activation influences cognitive and perceptive processes: Previous work suggests that an approach orientation instigates a focus on larger units as compared to avoidance. Study 1 confirms this assumption using a paradigm that more directly taps a person's tendency to represent objects as belonging to small or large units than prior studies. It was further predicted that the self should also be represented as belonging to larger units, and hence be more interdependent under approach than under avoidance. Study 2 supports this prediction. As a consequence of this focus on belonging to larger units, it was finally predicted that approach results in a stronger identification with one's in-group than avoidance. Studies 3 and 4 support that prediction. PMID:22844229

Nussinson, Ravit; Häfner, Michael; Seibt, Beate; Strack, Fritz; Trope, Yaacov

2011-09-15

76

Market oriented new product development: How can a means-end chain approach affect the process?  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Few disagree on the advantage of market oriented product development. However, can a well-known theory on consumer behaviour be used as a catalyst for achieving it? This paper describes a case study where means-end chain (MEC) approach was introduced to a cross-functional development team at two dif...

Søndergaard, Helle Alsted

77

METHODICAL APPROACH TO THE DEVELOPMENT OF THE ESTIMATED ENTERPRISE’S COMPETITIVENESS IN ITS MARKETING ORIENTATION ? ?????????? ????????????? ??????? ? ?????? ????????????????????? ??????????? ? ???????? ?? ????????????? ??????????  

Directory of Open Access Journals (Sweden)

Full Text Available The economic essence of the submissions of “market-ing orientation” and “enterprise’s competitiveness” is specified, classification of the basic approaches to an estimation of the enterprise’s competitiveness are given; in the article we are considered the factors to define on the competitiveness of the enterprises, the conception of the methodical approach to an estima-tion of the competitiveness of the enterprise

Shchepakin M. B.; Krivosheyev? E. V.; Tretyakov R. M.

2012-01-01

78

Sinonasal complications resulting from dental treatment: outcome-oriented proposal of classification and surgical protocol.  

UK PubMed Central (United Kingdom)

BACKGROUND: Odontogenic sinusitis is a relevant infectious condition of the paranasal sinuses. The widespread use of dental implants and reconstructive procedures for dental implant placement has led to new types of complication. To the authors' knowledge, no publication has extensively examined sinonasal complications resulting from dental treatment, and no classification system allowing standardization and comparison of results is currently available. This study was designed to (a) analyze the results obtained from surgical treatment of complications resulting from dental procedures combining functional endoscopic sinus surgery (FESS) and an intraoral approach and (b) propose a new classification system and standardized treatment protocols for sinonasal complications resulting from dental procedures. METHODS: A total of 257 patients consecutively treated with FESS (136 in conjunction with oral surgery) were included in the study. Different clinical situations were integrated into a new classification system based on the pathogenesis and clinical aspects of each case, with the aim of identifying homogenous treatment groups. Results were evaluated for each class. RESULTS: Of the 257 patients, 254 were successfully treated with surgery performed according to the proposed protocols. Three of 257 patients required a second surgery, after which they completely recovered. Complications of implant and preimplant surgery (maxillary sinus floor elevation) showed longer recovery times. CONCLUSION: The results obtained are very encouraging. The majority of patients (254/257; 98.8%) were successfully treated with the proposed protocols. These results seem to indicate that the rationalization of surgical treatment protocols according to the initial clinical situation may significantly improve the clinical outcome.

Felisati G; Chiapasco M; Lozza P; Saibene AM; Pipolo C; Zaniboni M; Biglioli F; Borloni R

2013-07-01

79

A Performance-Driven Approach for Restructuring Distributed Object-Oriented Software  

Directory of Open Access Journals (Sweden)

Full Text Available Object oriented techniques make applications substantially easier to build by providing a high-level platform for appli-cation development. There have been a large number of projects based on the Distributed Object Oriented approach for solving complex problems in various scientific fields. One important aspect of Distributed Object Oriented systems is the efficient distribution of software classes among different processors. The initial design of the Distributed Object Oriented application does not necessarily have the best class distribution and may require to be restructured. In this paper, we propose a methodology for efficiently restructuring the Distributed Object Oriented software systems to get better performance. We use Distributed Object-Oriented performance (DOOP) model as guidance for our restructuring methodology. The proposed methodology consists of two phases. The first phase introduces a recursive graph clustering technique to partition the OO system into subsystems with low coupling. The second phase is concerned with mapping the generated partitions to the set of available machines in the target distributed architecture.

Amal Abd El-Raouf; Tahany Fergany; Reda Ammar; Safwat Hamad

2009-01-01

80

An efficient block-oriented approach to parallel sparse Cholesky factorization  

Energy Technology Data Exchange (ETDEWEB)

This paper explores the use of a sub-block decomposition strategy for parallel sparse Cholesky factorization, in which the sparse matrix is decomposed into rectangular blocks. Such a strategy has enormous theoretical scalability advantages over more traditional column-oriented and panel-oriented decompositions. However, little progress has been made in producing a practical sub-block method. This paper proposes and evaluates an approach that is simple to implement, provides slightly higher performance than column (and panel) methods on small parallel machines, and has the potential to provide much higher performance on large parallel machines.

Rothberg, E. [Intel Supercomputer Systems Division, Beaverton, OR (United States); Gupta, A. [Stanford Univ., CA (United States). Computer Systems Lab.

1993-12-31

 
 
 
 
81

CULTURAL REFERENCES IN MEDICAL TEXTS: TOWARDS A SOURCE-ORIENTED TRANSLATION APPROACH  

Directory of Open Access Journals (Sweden)

Full Text Available The challenge of translating cultural references may involve coping with specific cultural phenomena in the source text, which are non-existent in the target language and culture. This paper focuses on the issue of translating cultural references in medical texts, which cannot be easily replaced through the use of the cultural equivalent strategy (Baker, 1992). Sample medical texts with cultural references were chosen and analyzed to gain insight into whether they were oriented towards the choice of formal correspondence or dynamic equivalence. Findings show that, despite the predominant use of formal equivalence, the cultural features of medical texts may need to be treated from a source-oriented approach.

Fabrizia Del Vecchio

2011-01-01

82

A Systematic Knowledge Management Approach Using Object-Oriented Theory in Customer Complaint Management  

Directory of Open Access Journals (Sweden)

Full Text Available Research into the effectiveness of customer complaint management has attracted researchers, yet there has been little discussion on customer complaint management in the context of systematic knowledge management approach particularly in the domain of hotel industry. This paper aims to address such gap through the application of object-oriented theory for which the notation of unified modelling language has been adopted for the representation of the concepts, objects, relationships and vocabularies in the domain. The paper used data from forty seven hotel management staff and academics in hospitalitymanagement to investigate lessons learned and best practices in customer complaint management and knowledge management. By providing insights into the potential of a knowledge management approach using object oriented theory, this study advances our understanding on how a knowledge management approach can systematically support the management of hotel customer complaints.

Wusheng Zhang; Mikyung Kim

2010-01-01

83

Improving the spatial orientation of human teeth using a virtual 3D approach.  

UK PubMed Central (United Kingdom)

Since teeth are resistant to decomposition processes, they provide important and at times unique sources of information about fossil humans. Fortunately, dental remains reflect significant evolutionary changes. These changes make a very important and often exclusive contribution to the definition of new taxa or the attribution of fossil specimens to existing taxa. The traditional approach to dental morphometric analyses usually focuses on the recording of several measures of the tooth with calipers, especially the two basic crown diameters (buccolingual and mesiodistal). However, since these measures do not adequately represent the complex morphology of the tooth, 2D images and 3D digital models of dental morphology have been used. For both types of analysis, the possibility of correctly comparing homologous teeth depends on the adoption of a common orientation system. The lack of such a system makes it difficult to compare the results of different studies. Here we describe a new method for orienting teeth specifically devised for the upper and lower first molar (M1). Samples of unworn maxillary (n=15) and mandibular (n=15) first molars of modern humans were scanned with a Roland Picza 3D digitizer. The 3D virtual models were used to compare our new orientation method with those proposed in the literature. The new orientation system, which meets a geometric criterion, is based on three points identified on the cervical line and ensures acceptable repeatability of the spatial positioning and orientation independent of the shape and wear of the first molar under investigation. This orientation system is a first step toward the creation of a virtual set of hominid and fossil human first molars, which will allow us to make comparisons via a sophisticated and noninvasive approach. This pilot study also provides guidelines to extend the new methodology to the other types of teeth.

Benazzi S; Fantini M; De Crescenzio F; Persiani F; Gruppioni G

2009-03-01

84

Validity of the risk adjustment approach to compare outcomes  

Directory of Open Access Journals (Sweden)

Full Text Available This paper focuses on the issue of the extent to which the present mainstream risk adjustment (RA) methodology for measuring outcomes is a valid and useful tool for quality-improvement activities. The method's predictive and attributional validity are discussed, considering the confounding and effect modification produced by medical care over risk variables' effect. For this purpose, the sufficient-cause model and the counterfactual approach to effect and interaction are tentatively applied to the relationships between risk (prognostic) variables, medical technology, and quality of care. The main conclusions are that quality of care modifies the antagonistic interaction between medical technologies and risk variables, related to different types of responders, as well as the confounding of the effect of risk variables produced by related medical technologies. Thus, confounding of risk factors in the RA method, which limits the latter's predictive validity, is related to the efficacy and complexity of associated medical technologies and to the quality mix of services. Attributional validity depends on the validity of the probabilities estimated for each subgroup of risk (predictive validity) and the percentage of higher-risk patients at each service.

Silva Leticia Krauss

2003-01-01

85

An approach to managing depression. Defining and measuring outcomes.  

Directory of Open Access Journals (Sweden)

Full Text Available OBJECTIVE: To provide family physicians with a contemporary approach to formulating a treatment model for major depressive disorder that integrates definitions of new therapeutic end points, familiarizes them with tools for assessing these end points, and describes newer methods for enhancing outcome. SOURCES OF INFORMATION: Canadian Psychiatric Association Guidelines for the Treatment of Depressive Disorders, relevant articles from a MEDLINE search using the MeSH headings"full remission" and "depression," and the authors' clinical experience. MAIN MESSAGE: Major depressive disorder is an episodic, relapsing, and sometimes chronic illness. Depressive symptoms in primary care settings are often vague reports of anhedonia, anxiety, and nonspecific somatic complaints. Therapeutic objectives in depression are full remission of depressive symptoms, prevention of recurrence, and restoration of function. Depression rating scales can be useful for monitoring and treating depression. CONCLUSION: The proposed therapeutic model anticipates the chronic course of illness, defines treatment end points, encourages longer duration of treatment, and includes both pharmacologic and lifestyle therapies. The 7-item Hamilton Depression Rating Scale can assist clinicians in determining when full remission has occurred.

Khullar A; McIntyre RS

2004-01-01

86

A new approach to texture measurements: Orientation distribution function (ODF) determination by Rietveld refinement  

Energy Technology Data Exchange (ETDEWEB)

The preferred orientation of crystal grains within a manufactured part is described most fully by its orientation distribution function (ODF), which is a mapping of the probability of each of the possible grain orientations with respect to the exterior dimensions. Traditionally, an ODF is determined from pole figures for a relatively small number of reflections. These pole figures are measured with x-rays or neutrons using short detector scans over the center of an individual diffraction peak for a large number of different sample orientations. This is efficient if the selected diffraction peaks are reasonably strong (relative to background) and well separated, such as in pure fcc and bcc metals. It is also appropriate for constant wavelength sources where collection of individual diffraction peak intensities is a reasonably efficient use of the source. However, the traditional method is not very efficient for neutron diffraction at a spallation source such as LANSCE where the entire diffraction pattern is accessible for each sample setting. Moreover, a different approach is necessary for complicated diffraction patterns, such as from composite materials, intermetallic compounds, high {Tc} ceramics, polyphasic minerals and polymers where there is expected to be heavy overlap of adjacent diffraction peaks. In addition, the large number of settings normally collected for an individual pole figure may not be necessary, since the entire pattern is obtained at each setting. Thus, a new method of ODF analysis needs to be developed to handle the more complex diffraction patterns obtained from modern technological materials as well as take advantage of the particular characteristics of spallation neutron sources. This project sought to develop the experimental procedures and the mathematical treatment needed to produce an orientation distribution function (ODF) directly from full diffraction patterns from a sample in a limited number of orientations.

Vondreele, R.; Larson, A.; Lawson, A.; Sheldon, R.; Wright, S.

1996-09-01

87

A new approach to texture measurements: Orientation distribution function (ODF) determination by Rietveld refinement  

International Nuclear Information System (INIS)

The preferred orientation of crystal grains within a manufactured part is described most fully by its orientation distribution function (ODF), which is a mapping of the probability of each of the possible grain orientations with respect to the exterior dimensions. Traditionally, an ODF is determined from pole figures for a relatively small number of reflections. These pole figures are measured with x-rays or neutrons using short detector scans over the center of an individual diffraction peak for a large number of different sample orientations. This is efficient if the selected diffraction peaks are reasonably strong (relative to background) and well separated, such as in pure fcc and bcc metals. It is also appropriate for constant wavelength sources where collection of individual diffraction peak intensities is a reasonably efficient use of the source. However, the traditional method is not very efficient for neutron diffraction at a spallation source such as LANSCE where the entire diffraction pattern is accessible for each sample setting. Moreover, a different approach is necessary for complicated diffraction patterns, such as from composite materials, intermetallic compounds, high Tc ceramics, polyphasic minerals and polymers where there is expected to be heavy overlap of adjacent diffraction peaks. In addition, the large number of settings normally collected for an individual pole figure may not be necessary, since the entire pattern is obtained at each setting. Thus, a new method of ODF analysis needs to be developed to handle the more complex diffraction patterns obtained from modern technological materials as well as take advantage of the particular characteristics of spallation neutron sources. This project sought to develop the experimental procedures and the mathematical treatment needed to produce an orientation distribution function (ODF) directly from full diffraction patterns from a sample in a limited number of orientations

1996-01-01

88

Agent-Oriented Approach for Detecting and Managing Risks in Emergency Situations  

CERN Multimedia

This paper presents an agent-oriented approach to build a decision support system aimed at helping emergency managers to detect and to manage risks. We stress the flexibility and the adaptivity characteristics that are crucial to build a robust and efficient system, able to resolve complex problems. The system should be independent as much as possible from the subject of study. Thereby, an original approach based on a mechanism of perception, representation, characterisation and assessment is proposed. The work described here is applied on the RoboCupRescue application. Experimentations and results are provided.

Kebair, Fahem

2009-01-01

89

Experimental assessment of an automatic approach for stereo models generation using directly measured orientation parameters  

Directory of Open Access Journals (Sweden)

Full Text Available With the evolution of digital image acquisition devices, satellite positioning systems (GPS) and space orientation by the inertial navigation systems (INS), new applications of fast cartography, became feasible, as disaster management and environment monitoring. Such applications require periodic georeferenced information with characteristics of speed and reliability that can be obtained by digital photogrammetry, using additional data from sensors of direct orientation. However, the exterior orientation parameters (EO) provided by these sensors are under the required accuracy to remove the vertical parallax in the model. This paper presents an experimental evaluation of an approach for removing the vertical parallax of the model. This appoach is based on the reprocessing of the EO parameters provided by the sensors, using a modified coplanarity model. Some experiments with simulated and real data are presented. The experiments with simulated data were performed in order to assess the acceptable errors in the exterior orientation parameters. The experiments with real data were carried out to evaluate the vertical parallax effect, before and after the reprocessing of the EO parameters, and to access the accuracy of check points calculated by photogrammetric intersection.

Antonio M. G. Tommaselli; Roberto da S. Ruy

2004-01-01

90

A Comparison of Two Coaching Approaches to Enhance Implementation of a Recovery-Oriented Service Model.  

UK PubMed Central (United Kingdom)

Moving to recovery-oriented service provision in mental health may entail retraining existing staff, as well as training new staff. This represents a substantial burden on organisations, particularly since transfer of training into practice is often poor. Follow-up supervision and/or coaching have been found to improve the implementation and sustainment of new approaches. We compared the effect of two coaching conditions, skills-based and transformational coaching, on the implementation of a recovery-oriented model following training. Training followed by coaching led to significant sustained improvements in the quality of care planning in accordance with the new model over the 12-month study period. No interaction effect was observed between the two conditions. However, post hoc analyses suggest that transformational coaching warrants further exploration. The results support the provision of supervision in the form of coaching in the implementation of a recovery-oriented service model, and suggest the need to better elucidate the mechanisms within different coaching approaches that might contribute to improved care.

Deane FP; Andresen R; Crowe TP; Oades LG; Ciarrochi J; Williams V

2013-08-01

91

An Aspect-Oriented Approach for Use Case Based Modeling of Software Product Lines  

Directory of Open Access Journals (Sweden)

Full Text Available Software Product Line Development advocates software reuse by modeling common and variable artefacts separately across members of a family of products. Aspect-Oriented Software Development aims at separation of concerns with “aspects” to increase modularity, reusability, maintainability and ease of evolution. In this paper, we apply an as-pect-oriented use case modeling approach to product line system modeling. A use case specification captures stake-holders concerns as interactions between a system and its actors. We adapt our previous work with the introduction of a “variability” relationship for the expression of variabilities. This relationship is used to model variable and common behaviours across a family of products as use cases. A variability composition mechanism enables building of executa-ble behaviour models for each member of a product line family by integrating common elements with the applicable variable elements.

Stéphane S. SOMé; Pauline ANTHONYSAMY

2009-01-01

92

Media-Oriented Service Composition with Service Overlay Networks: Challenges, Approaches and Future Trends (Invited Paper)  

Directory of Open Access Journals (Sweden)

Full Text Available The massive and timely delivery of media is gradually integrating itself with the dynamic composition of media-oriented services so that new types of customized media services can be created according to the diverse de- mand of end users. The resulting effective and differentiated networking support will become one of the most important requirements of the network infrastructure in the future. In this survey paper, we first present the emerging trend on the interaction of media-oriented service composition and overlay-based networks by introducing related technical issues. Then, we describe the top-down and the bottom- up approaches that coordinate service mapping using the service overlay networks (SONs) and provisioning resources for them, respectively. Finally, we examine latest research on futuristic overlay networks for service realization.

JongWon Kim; Sang Woo Han; Dong-Hoon Yi; Namgon Kim; C.-C Jay Kuo

2010-01-01

93

A goal-oriented adaptive finite-element approach for plane wave 3-D electromagnetic modelling  

Science.gov (United States)

We have developed a novel goal-oriented adaptive mesh refinement approach for finite-element methods to model plane wave electromagnetic (EM) fields in 3-D earth models based on the electric field differential equation. To handle complicated models of arbitrary conductivity, magnetic permeability and dielectric permittivity involving curved boundaries and surface topography, we employ an unstructured grid approach. The electric field is approximated by linear curl-conforming shape functions which guarantee the divergence-free condition of the electric field within each tetrahedron and continuity of the tangential component of the electric field across the interior boundaries. Based on the non-zero residuals of the approximated electric field and the yet to be satisfied boundary conditions of continuity of both the normal component of the total current density and the tangential component of the magnetic field strength across the interior interfaces, three a-posterior error estimators are proposed as a means to drive the goal-oriented adaptive refinement procedure. The first a-posterior error estimator relies on a combination of the residual of the electric field, the discontinuity of the normal component of the total current density and the discontinuity of the tangential component of the magnetic field strength across the interior faces shared by tetrahedra. The second a-posterior error estimator is expressed in terms of the discontinuity of the normal component of the total current density (conduction plus displacement current). The discontinuity of the tangential component of the magnetic field forms the third a-posterior error estimator. Analytical solutions for magnetotelluric (MT) and radiomagnetotelluric (RMT) fields impinging on a homogeneous half-space model are used to test the performances of the newly developed goal-oriented algorithms using the above three a-posterior error estimators. A trapezoidal topographical model, using normally incident EM waves at both MT and RMT frequencies, is adopted to further test the convergence of the newly developed algorithms against a surface integral approach. Next, the 3D-1 benchmark model from the COMMEMI project is used to show the efficiency of the goal-oriented adaptive algorithm and to compare our solutions against volume integral solutions and other finite-element solutions. For all three test cases, we found that the error estimator using face jumps of normal components of current density embedded in the goal-oriented adaptive refinement procedure shows the most robust performance.

Ren, Zhengyong; Kalscheuer, Thomas; Greenhalgh, Stewart; Maurer, Hansruedi

2013-08-01

94

Fundamentals of object-oriented information systems specification and design: the OBLOG/TROLL approach  

Science.gov (United States)

A survey of concepts for an information system specification is given, based on the viewpoint that an information system is a community of interacting objects. Objects are self-contained units of structure and behavior capable of operating independently and cooperating concurrently. The approach integrates concepts from semantic data modeling and concurrent processes, adopting structuring principles partly developed in the framework of object-orientation and partly in that of abstract data types. The languages OBLOG and TROLL are based on these concepts and their use is illustrated by examples. Corresponding author.

Ehrich, Hans-Dieter

1994-12-01

95

A ring-oriented approach for block matrix factorizations on shared and distributed memory architectures  

Energy Technology Data Exchange (ETDEWEB)

A block (column) wrap-mapping approach for design of parallel block matrix factorization algorithms that are (trans)portable over and between shared memory multiprocessors (SMM) and distributed memory multicomputers (DMM) is presented. By reorganizing the matrix on the SMM architecture, the same ring-oriented algorithms can be used on both SMM and DMM systems with all machine dependencies comprised to a small set of communication routines. The algorithms are described on high level with focus on portability and scalability aspects. Implementation aspects of the LU, Cholesky, and QR factorizations and machine specific communication routines for some SMM and DMM systems are discussed.

Dackland, K.; Elmroth, E.; Kagstroem, B. [Univ. of Umea (Sweden)

1993-12-31

96

Query Data with Fuzzy Information in Object-Oriented Databases an Approach Interval Values  

Directory of Open Access Journals (Sweden)

Full Text Available In this paper, we propose methods of handling attributive values of object classes in object oriented database with fuzzy information and uncertainty based on quantitatively semantics based hedge algebraic. In this approach we consider to attributive values (as well as methods) object class is interval values and the interval values are converted into sub interval in [0, 1] respectively. That its the fuzziness of the elements in the hedge algebra is also sub interval in [0,1]. So, we present an algorithm allows the comparison of two sub interval [0,1] helping the requirements of the query data.

Doan Van Thang; Doan Van Ban

2011-01-01

97

The Complex Approach for Improvement of Personnel Management System in Export-Oriented Enterprise of Ukraine ??????????? ?????? ? ????????????????? ??????? ?????????? ?????????? ?? ???????????????????????? ???????????? ???????  

Directory of Open Access Journals (Sweden)

Full Text Available Personnel management system for export-oriented enterprises of Ukraine was studied and the complex comprehensive approach for improving the system was proposed as the solution for the problem of complex combining of foreign personnel management systems with existing systems on the enterprises of Ukraine. The world experience of human resource management in transnational corporations, international organizations and enterprises was considered in the analysis of peculiarities of the domestic economy, social environment, Ukrainian mentality and process of external and internal information influence. The comparison of some elements of management systems in industrial and information economics was conducted.??????????? ??????? ?????????? ?????????? ?? ????????? ????????????? ???????????? ??????? ? ????????? ??????????? ?????? ? ?????????????????? ???? ??????? ? ???? ??????? ???????? ???????????? ????????? ?????????? ?????? ??????????? ? ????????????? ????????? ?? ???????????? ???????. ????? ??????? ???? ?????????? ????????????? ????????? ? ????????????????? ???????????, ????????????? ???????????? ? ???????????? ??? ??????? ???????????? ????????????? ?????????, ?????????? ?????, ?????????? ???????????? ? ???????? ???????? ? ??????????? ??????????????? ???????????. ???????????? ????????? ????????? ????????? ?????? ?????????? ? ?????????????? ? ?????????????? ?????????.

Kuznetsova Tatyana V.

2013-01-01

98

An Evaluation of Maintainability of Aspect-Oriented Systems: a Practical Approach  

Directory of Open Access Journals (Sweden)

Full Text Available Maintenance of software systems is becoming major concern for software developers and users. In software projects/products, where software changes/updates are frequently required to improve software quality, maintainability is an important characteristic of ISO 9126 quality standard to evaluate. Analyzability, changeability, stability, and testability are sub attributes/characteristics of maintainability in ISO 9126. In this paper, changeability is measured by making changes at code level of an Aspect- Oriented (AO) system. The approach taken to evaluate the changeability of an AO system is to compute the impact of changes made to modules of the system. Some projects1 in aspect-oriented programming (AOP) language, AspectJ, have been taken for testing. The results suggest that the AO system can easily absorb changes and AO design metrics can be used as indicators of changeability as well as of maintainability. The results also suggest that a code level change in AO systems not always cause less change impact to other modules than a code level change in Object-Oriented (OO) systems.

Avadhesh Kumar; Rajesh Kumar; P.S. Grover

2007-01-01

99

Design, testing, and results of an outcomes-managed approach to patients requiring prolonged mechanical ventilation.  

UK PubMed Central (United Kingdom)

BACKGROUND: Outcomes management that uses critical pathways may decrease costs while improving outcomes for patients who require prolonged mechanical ventilation. OBJECTIVE: To study the efficacy of an outcomes-managed approach to weaning patients from prolonged (more than 3 days) mechanical ventilation. METHODS: A method of multidisciplinary care delivery was designed that included an outcomes manager, a care pathway for patients receiving mechanical ventilation, and weaning protocols. Data collection consisted of three parts: a retrospective review of 124 patients who required prolonged ventilation during a 1-year period before implementation of the care model, a 6-month prospective study in which 91 patients were alternately assigned by month to an outcomes-managed approach or a non-outcomes-managed approach, and a 6-month prospective study of 90 patients in which an outcomes-managed approach without alternate-month assignment was used. RESULTS: Outcomes management had no significant effect on total duration of mechanical ventilation or length of stay in the hospital, days of mechanical ventilation without tracheostomy, days of mechanical ventilation with tracheostomy, or outcome (weaned, withdrawal from mechanical ventilation, death, or transfer without weaning). However, duration of mechanical ventilation was 1.3 days shorter, length of stay in the hospital was 2.1 days shorter, and the cost per case was $ 3341 less for patients in the outcomes-managed group than for patients in the non-outcomes-managed group. CONCLUSION: Outcomes-managed care did not have a significant effect on duration of ventilation, length of stay in the hospital, or outcome in patients receiving long-term mechanical ventilation.

Burns SM; Marshall M; Burns JE; Ryan B; Wilmoth D; Carpenter R; Aloi A; Wood M; Truwit JD

1998-01-01

100

A Process-Oriented Guided Inquiry Approach to Teaching Medicinal Chemistry  

Science.gov (United States)

Objective To integrate process-oriented guided-inquiry learning (POGIL) team-based activities into a 1-semester medicinal chemistry course for doctor of pharmacy (PharmD) students and determine the outcomes. Design Students in the fall 2007 section of the Medicinal Chemistry course were taught in a traditional teacher-centered manner, with the majority of class time spent on lectures and a few practice question sets. Students in the fall 2008 and fall 2009 sections of Medicinal Chemistry spent approximately 40% of class time in structured self-selected teams where they worked through guided-inquiry exercises to supplement the lecture material. Assessment The mean examination score of students in the guided-inquiry sections (fall 2008 and fall 2009) was almost 3 percentage points higher than that of students in the fall 2007 class (P < 0.05). Furthermore, the grade distribution shifted from a B-C centered distribution (fall 2007 class) to an A-B centered distribution (fall 2008 and fall 2009 classes). Conclusions The inclusion of the POGIL style team-based learning exercises improved grade outcomes for the students, encouraged active engagement with the material during class time, provided immediate feedback to the instructor regarding student-knowledge deficiencies, and created a classroom environment that was well received by students.

2010-01-01

 
 
 
 
101

From an Object-Oriented Approach to the Financial Reporting: An Open Architecture  

Directory of Open Access Journals (Sweden)

Full Text Available This paper developed an Object-Oriented (O-O) approach as an open architecture forfinancial reporting that is based on the notation Unified Modelling Language (UML) and theRational Rose® tool. The O-O approach integrated into the financial reporting has interoperablebuilding financial statements that must be available to be included in any economic and financialanalysis of a corporation. The implementation of an open architecture for developing financialreporting is supported by the systems analyst work that observes and understands the generaldomain of financial reporting, as well as, input from the specialists, directors and stakeholders of the corporation. Then, with reference to the Portuguese experience, the research scope is towardsa basic structure of financial reporting whose results are applicable to any corporation. Thefurther implication of the architecture for the financial reporting is to built a prototype to answerthe market needs.

Clara Silveira; Rute Abreu; Fátima David

2007-01-01

102

Concept of Financial Planning in a Company on the Basis of Process Oriented Approach ????????? ??????????? ???????????? ?? ??????????? ?? ?????? ?????????-???????????????? ???????  

Directory of Open Access Journals (Sweden)

Full Text Available The article uses the study of evolution and specific features of the process management for substantiation of a necessity of development of theoretical provisions and practical tools of financial planning on the basis of process approach as a prerequisite of harmonisation of finance management with its other subsystems under conditions of development and introduction into practical activity of modern concepts of management (strategic management, quality management, theory of constraints, value oriented management) and a factor of increase of the value of a company and provision of its balanced development in the long-term prospective. It provides conceptual provisions of construction of a system of financial planning on the basis of a process approach: original theoretical prerequisites of its formation; formulates its essence and components, specific features of realisation and advantages of implementation in a company.? ?????? ?? ?????? ???????????? ???????? ? ???????????? ??????????? ?????????? ?????????????? ????????????? ???????? ????????????? ????????? ? ????????????? ?????????????? ??????????? ???????????? ?? ?????? ??????????? ??????? ??? ??????????? ???????????? ?????????? ????????? ? ??? ??????? ???????????? ? ???????? ???????? ? ????????? ? ???????????? ???????????? ??????????? ????????? ?????????? (??????????????? ???????????, ??????????? ????????, ?????? ???????????, ?????????-???????????????? ??????????) ? ??????? ????????? ???????? ???????????, ??????????? ??? ????????????????? ???????? ? ???????????? ???????????. ???????? ?????????????? ????????? ?????????? ??????? ??????????? ???????????? ?? ?????? ??????????? ???????: ???????? ????????????? ??????????? ?? ????????????, ?????????????? ???????? ? ?? ???????????? ????????, ??????????? ?????????? ? ???????????? ?? ????????? ?? ???????????.

Sytnik Anna V.

2013-01-01

103

An Object-Oriented Modeling Approach for Collaboration Management in Virtual Enterprises  

Directory of Open Access Journals (Sweden)

Full Text Available For the rapid progress of Internet technologies in recent years, Electronic Commerce (EC) has gained attention as a major theme for enterprises to keep their competitiveness. From the perspective of effective resources utilization, it becomes now an important group for an enterprise to promote its performance and competitiveness through integrating itself and relevant suppliers and consumer as a virtual goal to achieve the so-called Business-to- Business EC. In this paper, we propose an object-oriented modeling approach that addresses the management of collaboration on the Internet between enterprises. The approach divides those required mechanisms for collaboration management into three layers: commitment, role, and activity ones. With this architecture, two enterprises may collaborate via the establishment and maintenance of commitment, the collaboration and coordination between roles and the interaction and coordination between activities. For specification, an object-oriented model is presented for each layer that describes the working details of that layer. To illustrate, these models are applied in a simplified supply chain management among various enterprises.

Jyhjong Lin

2002-01-01

104

SESAME: An event driven approach for modeling object-oriented communication software systems  

Energy Technology Data Exchange (ETDEWEB)

The Object-Oriented (OO) paradigm represents a significant shift in approach to the development of complex software systems. The OO approach provides a very natural solution, where entities in the system have close association with the problem domain. However the application of the approach suffers from a major draw back - the lack of well defined methods for visualizing objects which map well to the problem domain. The very first activity of object identification itself has for a long time been more of an art than science. Object identification in the case of some problem domains (like communication network protocols etc.) is even more difficult as they are more abstract and cannot be easily related to the real world objects. The proposed method SESAME (Scenario Event State Action MEthod) builds a solution to the problems based on events that occur in the system. whether they are generated by people. machines or components of the software. It approaches the problem domains by looking at scenarios which are characterized by events, states, and actions. This approach helps in adopting an organized way of visualizing the entities that need to participate in the system. Abstraction of these entities into objects will then be relatively simple. The SESAME method features a comprehensive Analysis and Specification activity which comprises of building an Object Behavioral Model (OBM) and a Class Specification Model (CSM). The analysis is taken through by tracing the events and their responses in every visualizable scenario.

Ashok, S.; Murthy, K.R.S. [Information Communication Institute, Singapore (Singapore)

1995-12-31

105

Goal-oriented failure analysis - a systems analysis approach to hazard identification  

International Nuclear Information System (INIS)

Goal-Oriented Failure Analysis, GOFA, is a methodology which is being developed to identify and analyse the potential failure modes of a hazardous plant or process. The technique will adopt a structured top-down approach, with a particular failure goal being systematically analysed. A systems analysis approach is used, with the analysis being organised around a systems diagram of the plant or process under study. GOFA will also use checklists to supplement the analysis -these checklists will be prepared in advance of a group session and will help to guide the analysis and avoid unnecessary time being spent on identifying obvious failure modes or failing to identify certain hazards or failures. GOFA is being developed with the aim of providing a hazard identification methodology which is more efficient and stimulating than the conventional approach to HAZOP. The top-down approach should ensure that the analysis is more focused and the use of a systems diagram will help to pull the analysis together at an early stage whilst also helping to structure the sessions in a more stimulating way than the conventional techniques. GOFA will be, essentially, an extension of the HAZOP methodology. GOFA is currently being computerised using a knowledge-based systems approach for implementation. The Goldworks II expert systems development tool is being used. (author)

1990-01-01

106

[An object-oriented intelligent engineering design approach for lake pollution control].  

UK PubMed Central (United Kingdom)

Regarding the shortage and deficiency of traditional lake pollution control engineering techniques, a new lake pollution control engineering approach was proposed in this study, based on object-oriented intelligent design (OOID) from the perspective of intelligence. It can provide a new methodology and framework for effectively controlling lake pollution and improving water quality. The differences between the traditional engineering techniques and the OOID approach were compared. The key points for OOID were described as object perspective, cause and effect foundation, set points into surface, and temporal and spatial optimization. The blue algae control in lake was taken as an example in this study. The effect of algae control and water quality improvement were analyzed in details from the perspective of object-oriented intelligent design based on two engineering techniques (vertical hydrodynamic mixer and pumping algaecide recharge). The modeling results showed that the traditional engineering design paradigm cannot provide scientific and effective guidance for engineering design and decision-making regarding lake pollution. Intelligent design approach is based on the object perspective and quantitative causal analysis in this case. This approach identified that the efficiency of mixers was much higher than pumps in achieving the goal of low to moderate water quality improvement. However, when the objective of water quality exceeded a certain value (such as the control objective of peak Chla concentration exceeded 100 microg x L(-1) in this experimental water), the mixer cannot achieve this goal. The pump technique can achieve the goal but with higher cost. The efficiency of combining the two techniques was higher than using one of the two techniques alone. Moreover, the quantitative scale control of the two engineering techniques has a significant impact on the actual project benefits and costs.

Zou R; Zhou J; Liu Y; Zhu X; Zhao L; Yang PJ; Guo HC

2013-03-01

107

[An object-oriented intelligent engineering design approach for lake pollution control].  

Science.gov (United States)

Regarding the shortage and deficiency of traditional lake pollution control engineering techniques, a new lake pollution control engineering approach was proposed in this study, based on object-oriented intelligent design (OOID) from the perspective of intelligence. It can provide a new methodology and framework for effectively controlling lake pollution and improving water quality. The differences between the traditional engineering techniques and the OOID approach were compared. The key points for OOID were described as object perspective, cause and effect foundation, set points into surface, and temporal and spatial optimization. The blue algae control in lake was taken as an example in this study. The effect of algae control and water quality improvement were analyzed in details from the perspective of object-oriented intelligent design based on two engineering techniques (vertical hydrodynamic mixer and pumping algaecide recharge). The modeling results showed that the traditional engineering design paradigm cannot provide scientific and effective guidance for engineering design and decision-making regarding lake pollution. Intelligent design approach is based on the object perspective and quantitative causal analysis in this case. This approach identified that the efficiency of mixers was much higher than pumps in achieving the goal of low to moderate water quality improvement. However, when the objective of water quality exceeded a certain value (such as the control objective of peak Chla concentration exceeded 100 microg x L(-1) in this experimental water), the mixer cannot achieve this goal. The pump technique can achieve the goal but with higher cost. The efficiency of combining the two techniques was higher than using one of the two techniques alone. Moreover, the quantitative scale control of the two engineering techniques has a significant impact on the actual project benefits and costs. PMID:23745391

Zou, Rui; Zhou, Jing; Liu, Yong; Zhu, Xiang; Zhao, Lei; Yang, Ping-Jian; Guo, Huai-Cheng

2013-03-01

108

Innovative data mining approaches for outcome prediction of trauma patients  

Directory of Open Access Journals (Sweden)

Full Text Available Trauma is the most common cause of death to young people and many of these deaths are preventable [1]. The prediction of trauma patients outcome was a difficult problem to investigate till present times. In this study, prediction models are built and their capabilities to accurately predict the mortality are assessed. The analysis includes a comparison of data mining techniques using classification, clustering and association algorithms. Data were collected by Hellenic Trauma and Emergency Surgery Society from 30 Greek hospitals. Dataset contains records of 8544 patients suffering from severe injuries collected from the year 2005 to 2006. Factors include patients' demographic elements and several other variables registered from the time and place of accident until the hospital treatment and final outcome. Using this analysis the obtained results are compared in terms of sensitivity, specificity, positive predictive value and negative predictive value and the ROC curve depicts these methods performance.

Eleni-Maria Theodoraki; Stylianos Katsaragakis; Christos Koukouvinos; Christina Parpoula

2010-01-01

109

Angiofibroma: an outcome review of conventional surgical approaches.  

UK PubMed Central (United Kingdom)

Juvenile nasopharyngeal angiofibroma (JNA) is a benign tumor of the nasopharynx, and for its treatment, many surgical approaches have been recommended. However, selecting the appropriate one for the tumor in an advanced stage is still controversial. In this study, we evaluate the rate of recurrence of JNA and its relationship to the preoperative stage as well as various surgical approaches. Thirty-seven patients with pathologically proven JNA were retrospectively analyzed. For each patient, data were obtained regarding the primary extension, various surgical approaches and rate of recurrence. Seven patients were in stage III with intracranial extensions. Two of these patients had symptomatic recurrence that needed surgery. Three of them were disease free, and in two cases residues were demonstrated that were asymptomatic and were chosen only to be observed. Among different surgical approaches used, the transpalatal resulted in 1 recurrence out of 14 patients treated with this approach when the lesion was limited to the nasal cavity, nasopharynx and paranasal sinuses (stage I). No recurrence was observed with the use of this approach with lesions with minimal extension to the pterygopalatine fossa (stage IIA). But among three patients with intracranial extension who were treated with this approach, two resulted in symptomatic recurrence; however, using the Lefort I surgical technique, no evidence of recurrence was observed in the two patients in stage III who were treated with this approach. Involvement of the orbit, middle cranial fossa and base of the pterygoid by the primary JNA results in a higher incident of recurrent tumor. Among different surgical techniques, the lowest recurrence rate is seen either in the transpalatal approach when the tumor is limited to the nasopharynx with extension to the nasal cavity or paranasal sinuses or with the Lefort I approach when skull base invasion is present.

Hosseini SM; Borghei P; Borghei SH; Ashtiani MT; Shirkhoda A

2005-10-01

110

Angiofibroma: an outcome review of conventional surgical approaches.  

Science.gov (United States)

Juvenile nasopharyngeal angiofibroma (JNA) is a benign tumor of the nasopharynx, and for its treatment, many surgical approaches have been recommended. However, selecting the appropriate one for the tumor in an advanced stage is still controversial. In this study, we evaluate the rate of recurrence of JNA and its relationship to the preoperative stage as well as various surgical approaches. Thirty-seven patients with pathologically proven JNA were retrospectively analyzed. For each patient, data were obtained regarding the primary extension, various surgical approaches and rate of recurrence. Seven patients were in stage III with intracranial extensions. Two of these patients had symptomatic recurrence that needed surgery. Three of them were disease free, and in two cases residues were demonstrated that were asymptomatic and were chosen only to be observed. Among different surgical approaches used, the transpalatal resulted in 1 recurrence out of 14 patients treated with this approach when the lesion was limited to the nasal cavity, nasopharynx and paranasal sinuses (stage I). No recurrence was observed with the use of this approach with lesions with minimal extension to the pterygopalatine fossa (stage IIA). But among three patients with intracranial extension who were treated with this approach, two resulted in symptomatic recurrence; however, using the Lefort I surgical technique, no evidence of recurrence was observed in the two patients in stage III who were treated with this approach. Involvement of the orbit, middle cranial fossa and base of the pterygoid by the primary JNA results in a higher incident of recurrent tumor. Among different surgical techniques, the lowest recurrence rate is seen either in the transpalatal approach when the tumor is limited to the nasopharynx with extension to the nasal cavity or paranasal sinuses or with the Lefort I approach when skull base invasion is present. PMID:15739087

Hosseini, Seyed Mousa Sadr; Borghei, Peyman; Borghei, Seyed Hebatodin; Ashtiani, Mohammad Taghi Khorsandi; Shirkhoda, Ali

2005-03-01

111

Influence of study approaches on academic outcomes during pre-clinical medical education.  

UK PubMed Central (United Kingdom)

BACKGROUND: Different approaches to study lead to differing academic outcomes. Deep and strategic approaches have been linked to academic success while surface approaches lead to poorer understandings. AIMS: This study sought to characterize how the approaches to study used by medical students impacted their academic success as measured by three outcomes: cumulative grades at the end of the first year, cumulative grades at the end of the second year, and performance on a medical licensing examination. METHODS: The approaches and study skills inventory for students was administered to medical students to determine their predominant study approach (deep, strategic, superficial) at the beginning of their first year, end of first year, and end of second year. Each group's mean performance on each outcome measure was compared by ANOVA to find significant differences. RESULTS: For all three outcome measures, strategic approaches to study were associated with high performance while surface approaches with a poor one. Deep approaches were most popular at all times and were largely associated with adequate performance. CONCLUSIONS: Deep approaches to study are sufficient for success in the current paradigm of medical education but strategic ones may offer a selective advantage to those who use them. Surface approaches to study must be discouraged by instructors through deliberate course design.

Ward PJ

2011-01-01

112

Segment-oriented liver resections based on posterior intrahepatic glissonian approach  

Directory of Open Access Journals (Sweden)

Full Text Available Background: Segment-oriented liver resections can be performed effective by posterior intrahepatic approach. A significance of such resection is that they are oncologically radical as well as parenchyma- sparing. Methodology: Segmental liver resections were performed in 102 patients with liver tumors. Suprahilar control of the appropriate glissonean pedicle was achieved by the posterior intrahepatic approach. Liver parenchyma was transsected by ultrasonic dissector, under intermittent vascular occlusion (IVO). Pedicle was divided at the end of resection using "endo-GIA" vascular stapler. Results: The overall transection time was 30,14+12,56 min. The amount of blood loss was 285,59+129,92 ml. The postoperative complication rate was 25,49%. R0 resection had 94 (92,16%) patients. There was no liver failure or perioperative death. Conclusions: Posterior intrahepatic approach for segmental resection is safe, can expedite the liver transection and reduce intraoperative hemorrhage. This approach provides adequate tumor clearance with preservation of normal parenchyma, as well as the vasculature or the biliary drainage of the contralateral liver.

Doklesti? Krstina; ?uki? Vladimir; Bumbaširevi? Vesna; Jovanovi? Bojan; Karamarkovi? Aleksandar

2012-01-01

113

Persistence of Adult Undergraduates on a Traditionally-Oriented University Campus: Does Donaldson and Graham's Model of College Outcomes for Adult Students Still Apply?  

Science.gov (United States)

The purpose of this study was to explore the social and academic experiences of non-traditional students pursuing a bachelor's degree at a traditionally-oriented residential university and how these experiences promote or impede their persistence to graduation. The study explored components of Donaldson and Graham's Model of College Outcomes for…

Samuels, Wendy; Beach, Andrea L.; Palmer, Louann Bierlein

2012-01-01

114

Community participation as a predictor of recovery-oriented outcomes among emerging and mature adults with mental illnesses.  

UK PubMed Central (United Kingdom)

OBJECTIVE: The promotion of recovery and quality of life is a major focus of national and local mental health system transformation efforts. There has been simultaneous interest in enhancing community participation as a facilitator of recovery. This study examines the community participation experiences of emerging adults and mature adults with serious mental illnesses and the relationship between various types of participation and recovery, quality of life, and meaning of life. METHODS: Baseline data from the Consumer-Operated Service Program multisite study were utilized. The sample was recruited from traditional mental health services and consisted of 233 emerging adults and 1,594 mature adults. Ten areas of participation were examined: parenting, employment, volunteering, college student, group membership, civic engagement, peer support, friendships, intimate relationships, and engagement in religious/spiritual activities. RESULTS: Emerging and mature adults differed in developmentally appropriate ways. Emerging adults and those who participated more had higher scores on the recovery, quality of life and meaning of life measures. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: The higher scores on the dependent variables may be explained by younger adults having greater hope and higher expectations that are typical for those at that stage of life and that living longer with a serious mental illness and being exposed longer to the mental health system may dampen hope. Participation in general, and specific areas of participation, were predictive of recovery-oriented outcomes. These results should inspire future developmentally-oriented research examining factors that facilitate recovery and provide direction to providers about participation areas that may be most beneficial in facilitating recovery.

Kaplan K; Salzer MS; Brusilovskiy E

2012-01-01

115

Decomposed Approach of Market Orientation and Marketing Mix Capability: Research on Their Relationships with Firm Performance in the Korean Context  

Directory of Open Access Journals (Sweden)

Full Text Available The notion that market orientation provides firms a source of competitive advantage seems to be widely accepted since the effects of market orientation on business performance have been extensively researched and many studies have confirmed their affirmative relationships. However, aggregated approach of market orientation as one single construct has left the detailed investigations yet unexplored despite its tremendous contribution in marketing strategy arena. Thus, decomposed properties of market orientation and their relationships with various components of firm success were explored to precisely examine the paths in this study. Furthermore, to resolve conflicting arguments on whether market orientation has a direct influence on firm level consequences, marketing mix capability was suggested as a critical mediator to complete a resource deployment system rather than a resource possession approach, which is equivalent to resource-based view. From an analysis of a survey data of 285 Korean organizations, three dimensions of market orientation, namely customer orientation, competitor orientation, and interfunctional coordination, and four sub-constructs of marketing mix capability, such as product, communication, channel and pricing capability, along with their impacts on business performance were investigated in detail. This study revealed that customer orientation and interfunctional coordination had a direct impact on only customer satisfaction while all three dimensions of market orientation failed to directly link to other firm performance variables like market effectiveness, adaptability, and profitability. To bridge these relationships product and communication capabilities were proven to be a necessary condition while channel capability and pricing capability showed interesting relationships. Findings and implications were discussed and limitations and further research directions were also suggested.

Sohyoun Shin

2011-01-01

116

Frame-of-reference training effectiveness: effects of goal orientation and self-efficacy on affective, cognitive, skill-based, and transfer outcomes.  

UK PubMed Central (United Kingdom)

Empirical evidence supporting frame-of-reference (FOR) training as an effective intervention for calibrating raters is convincing. Yet very little is known about who does better or worse in FOR training. We conducted a field study of how motivational factors influence affective, cognitive, and behavioral learning outcomes, as well as near transfer indexed by achieving professional certification. Relying on goal orientation theory, we hypothesized effects for 3 goal orientations: learning, prove performance, and avoid performance. Results were generally supportive across learning outcomes and transfer. Findings further supported a hypothesized interaction between learning self-efficacy and avoid performance goal orientation, such that higher levels of learning self-efficacy mitigated the negative effects of higher performance avoid tendencies.

Dierdorff EC; Surface EA; Brown KG

2010-11-01

117

Analytical Learning Based on a Meta-programming Approach for the Detection of Object-oriented Design Defects  

Directory of Open Access Journals (Sweden)

Full Text Available This study proposed a new defect-detection approach using a declarative meta-programming technique to analytical learning for object-oriented software. The extrapolating patterns are generated using analytical learning in which certain design defect characteristics can be understood through deductive learning. This study uses declarative meta-programming to represent the specific object-oriented components as logic rules with which design defects can finally be described. Using the two complementary techniques, the object-oriented software is transformed into the narrow related problem domain, in which design defect problems can be managed and simplified. The approach is validated by detecting design defects in certain open-source systems. The results obtained exhibit a superior precision to the conventional method. In application, the proposed strategy can be recognised as a flexible and automated system for detecting software design defects which many object-oriented software systems are able to use.

Sakorn Mekruksavanich; Preecha P. Yupapin; Pornsiri Muenchaisri

2012-01-01

118

A Fuzzy Approach for Integrated Measure of Object-Oriented Software Testability  

Directory of Open Access Journals (Sweden)

Full Text Available For large software systems, testing phase seems to have profound effect on the overall acceptability and quality of the final product. The success of this activity can be judged by measuring the testability of the software. A good measure for testability can better manage the testing effort and time. Different Object Oriented Metrics are used in measurement of object-oriented testability but none of them is alone sufficient to give an overall reflection of software testability. Thus an integrated measure considering the effect of all these measures is required to well define the testability. The paper combines OO software metric values into a single overall value (called Testability Index) that can be used to calculate the testability of a class. The approach uses fuzzy techniques and concepts (fuzzification of crisp metric values, inference and aggregation, defuzzification of fuzzy output). We include empirical data of testing time of 25 different Java classes, which proves that individual metric values are not sufficient to arrive at the testability of a class and validates the testability index as a good integrated measure for arriving at the testability of the class.

Vandana Gupta; K. K. Aggarwal; Yogesh Singh

2005-01-01

119

Postresuscitation myocardial stunning and its outcome: new approaches.  

Science.gov (United States)

What is the successful cardiopulmonary resuscitation? It is the few minutes postcardiopulmonary arrest that can answer. Twenty to 40 percent of patients who sustained cardiac arrest are initially resuscitated, but only 10% survive to hospital discharge, and more than 60% of victims succumb within 24 hours. This high fatality rate in the early hours and days after successful resuscitation is mainly related to the acute, intense, and reversible form of postresuscitation myocardial dysfunction (stunning) together with the ventricular tachyarrhythmia. It is a reversible process, provided that we are aware of the pertinent pathophysiology and then intervene accordingly. Herein I reviewed most of the published relevant articles concerning the causes, underlying mechanism, and the updated trials for management of postresuscitation myocardial stunning. I do agree that not only the restoration of the circulation but also long-term outcome should be the aim of resuscitation, and I readdress the role of epinephrine, dobutamine, biphasic defibrillator, with the new promising agent (ie, potassium channel opener), Delta-opioid receptor agonist, unloading intracellular calcium, antioxidants, and therapeutic hypothermia to halt this period of stunning. This will improve the outcome of the resuscitation efforts. PMID:18340174

El-Menyar, Ayman A; Elmenyar, Ayman A

2004-12-01

120

The design of neonatal incubators: a systems-oriented, human-centered approach.  

UK PubMed Central (United Kingdom)

OBJECTIVE: This report describes a multidisciplinary design project conducted in an academic setting reflecting a systems-oriented, human-centered philosophy in the design of neonatal incubator technologies. STUDY DESIGN: Graduate students in Architectural Design and Human Factors Engineering courses collaborated in a design effort that focused on supporting the needs of three user groups of incubator technologies: infant patients, family members and medical personnel. Design teams followed established human-centered design methods that included interacting with representatives from the user groups, analyzing sets of critical tasks and conducting usability studies with existing technologies. RESULT: An iterative design and evaluation process produced four conceptual designs of incubators and supporting equipment that better address specific needs of the user groups. CONCLUSION: This report introduces the human-centered design approach, highlights some of the analysis findings and design solutions, and offers a set of design recommendations for future incubation technologies.

Ferris TK; Shepley MM

2013-04-01

 
 
 
 
121

AUDITING THE LEADERSHIP APPROACHES AND THEIR RELATIONSHIPS TO ORGANIZATIONAL OUTCOMES  

Directory of Open Access Journals (Sweden)

Full Text Available This is a content analysis paper that audits the leadership literature, synthesizes and reports developments regarding organization leadership approaches. The paper is important because it gives updated development in the organization leadership literature for better understanding of different leadership approaches in contemporary organizations. The paper also will help readers to better understand the organizationalleadership dynamics. From this development, therefore, this paper opens up opportunities for leadership research to expand within and into many fields of endeavors. In short this paper can further help the development of management practice and theory as leadership is central in the survival of all organizations.

ABDU JA’AFARU BAMBALE

2011-01-01

122

Change Prediction in Object-Oriented Software Systems: A Probabilistic Approach  

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Full Text Available An estimation of change-proneness of parts of a software system is an active topic in the area of software engineering. Such estimates can be used to predict changes to different classes of a system from one release to the next. They can also be used to estimate and possibly reduce the effort required during the development and maintenance phase by balancing the amount of developers’ time assigned to each part of a software system. This research work proposes a novel approach to predict changes in an object-oriented software system. The rationale behind this approach is that in a well-designed software system, feature enhancement or corrective maintenance should affect a limited amount of existing code. Our goal is to quantify this aspect of quality by assessing the probability that each class will change in a future generation. Our proposed probabilistic approach uses the dependencies obtained from the UML diagrams, as well as other code metrics extracted from source code of several releases of a software system using reverse engineering techniques. These measures, combined with the change log of the software system and the expected time of next release, are used in an automated manner to predict whether a class will change in the next release of the software system. The proposed systematic approach has been evaluated on a multiversion medium sized open source project namely JFlex, the Fast Scanner Generator for Java. The obtained results indicate the simplicity and accuracy of our approach in the comparison with existing methods referred in the literature.

Ali R. Sharafat; Ladan Tahvildari

2008-01-01

123

Treatment approaches and outcomes in childhood supracondylar humerus fractures.  

UK PubMed Central (United Kingdom)

BACKGROUND: Being one of the most frequent elbow fractures during childhood, supracondylar humerus fractures require rapid diagnosis and treatment, as they may be associated with significant neurovascular and functional problems. QUESTIONS AND PURPOSES: To evaluate demographic and clinical features, and treatment outcomes of the patients with supracondylar humerus fractures who underwent open reduction+minimal osteosynthesis or closed reduction+percutaneous wiring. PATIENTS AND METHODS: Forty patients (30 boys + 10 girls) between 2 and 13 years of age who were operated on with the diagnosis of supracondylar humerus fracture, between August 2003 and December 2006, were included. Open reduction+minimal osteosynthesis (n=34) and closed reduction+percutaneous wiring (n=6) were performed. The fractures were classified according to the Gartland classification and outcomes were assessed according to Flynn's criteria. RESULTS: All patients (mean age, 7.35 years; range, 2-13 years) had closed fractures (28 left and 12 right). Seven (17.5%) and 33 (82.5%) patients had Gartland type II and III fractures respectively. Three patients had flexion-type and 37 patients had extension-type fractures. Based on Flynn's criteria, cosmetic results were excellent in 37 (92.5%) patients and good in 3 (7.5%) patients, and functional results were excellent in 36 (90%) patients, good in 3 (7.5%) patients, and poor in 1 (2.5%) patient. A surgical success rate of 97.5% was noted. No significant difference was found between wire configurations (p > 0.05). CONCLUSIONS: Treatment of supracondylar humerus fractures in children should be patient-specific based on factors such as patient's age, soft tissue conditions and deformity status.

Uçar BY; Demirta? A; Uçar DE

2012-07-01

124

Generalized modeling approaches to risk adjustment of skewed outcomes data.  

UK PubMed Central (United Kingdom)

There are two broad classes of models used to address the econometric problems caused by skewness in data commonly encountered in health care applications: (1) transformation to deal with skewness (e.g., ordinary least square (OLS) on ln(y)); and (2) alternative weighting approaches based on exponential conditional models (ECM) and generalized linear model (GLM) approaches. In this paper, we encompass these two classes of models using the three parameter generalized Gamma (GGM) distribution, which includes several of the standard alternatives as special cases-OLS with a normal error, OLS for the log-normal, the standard Gamma and exponential with a log link, and the Weibull. Using simulation methods, we find the tests of identifying distributions to be robust. The GGM also provides a potentially more robust alternative estimator to the standard alternatives. An example using inpatient expenditures is also analyzed.

Manning WG; Basu A; Mullahy J

2005-05-01

125

Generalized modeling approaches to risk adjustment of skewed outcomes data.  

Science.gov (United States)

There are two broad classes of models used to address the econometric problems caused by skewness in data commonly encountered in health care applications: (1) transformation to deal with skewness (e.g., ordinary least square (OLS) on ln(y)); and (2) alternative weighting approaches based on exponential conditional models (ECM) and generalized linear model (GLM) approaches. In this paper, we encompass these two classes of models using the three parameter generalized Gamma (GGM) distribution, which includes several of the standard alternatives as special cases-OLS with a normal error, OLS for the log-normal, the standard Gamma and exponential with a log link, and the Weibull. Using simulation methods, we find the tests of identifying distributions to be robust. The GGM also provides a potentially more robust alternative estimator to the standard alternatives. An example using inpatient expenditures is also analyzed. PMID:15811539

Manning, Willard G; Basu, Anirban; Mullahy, John

2005-05-01

126

Task-oriented biofeedback to improve gait in individuals with chronic stroke: motor learning approach.  

UK PubMed Central (United Kingdom)

BACKGROUND: Electromyographic biofeedback (EMG-BFB) has shown equivocal benefits on gait retraining after stroke. OBJECTIVE: The authors evaluated the efficacy of EMG-BFB applied in a task-oriented approach based on principles of motor learning to increase peak ankle power of the affected leg and gait velocity in patients with chronic mild to moderate hemiparesis. METHODS: They assigned 20 participants randomly to the EMG-BFB group or a control group that received conventional therapy for the same duration. Quantitative gait analysis was performed before and after treatment. The EMG-BFB involved the triceps surae during functional gait activities. Treatment was administered with a fading frequency of BFB application and an increasing variability in gait activities. Both groups had 20 treatment sessions of 45 minutes each, including at least 15 minutes of walking-related therapy for the control group. Follow-up (FU) gait analysis was obtained 6 weeks after training. RESULTS: BFB treatment led to significant increases (P < .01) in peak ankle power at push-off (from 0.63 W/kg to 1.04 W/kg) in conjunction with significant increases in velocity (from 28.3 %h/s--normalized to percentage height per second--to 39.6 %h/s) and stride length (from 44.5 %h--normalized to percentage height--to 57.6 %h). Increases remained significant at FU. There were no changes in any gait variable in the control group. CONCLUSION: A task-oriented BFB treatment was effective in increasing peak ankle power, gait velocity, and stride length in a population with hemiparesis. Further studies should compare the combination intervention with either of its components in more impaired patients.

Jonsdottir J; Cattaneo D; Recalcati M; Regola A; Rabuffetti M; Ferrarin M; Casiraghi A

2010-06-01

127

Outcome Measurement in Economic Evaluations of Public Health Interventions: a Role for the Capability Approach?  

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Full Text Available Public health interventions have received increased attention from policy makers, and there has been a corresponding increase in the number of economic evaluations within the domain of public health. However, methods to evaluate public health interventions are less well established than those for medical interventions. Focusing on health as an outcome measure is likely to underestimate the impact of many public health interventions. This paper provides a review of outcome measures in public health; and describes the benefits of using the capability approach as a means to developing an all encompassing outcome measure.

Paula K. Lorgelly; Kenny D. Lawson; Elisabeth A.L. Fenwick; Andrew H. Briggs

2010-01-01

128

A problem-oriented approach to understanding adaptation: lessons learnt from Alpine Shire, Victoria Australia.  

Science.gov (United States)

Climate change is gaining attention as a significant strategic issue for localities that rely on their business sectors for economic viability. For businesses in the tourism sector, considerable research effort has sought to characterise the vulnerability to the likely impacts of future climate change through scenarios or ‘end-point' approaches (Kelly & Adger, 2000). Whilst useful, there are few demonstrable case studies that complement such work with a ‘start-point' approach that seeks to explore contextual vulnerability (O'Brien et al., 2007). This broader approach is inclusive of climate change as a process operating within a biophysical system and allows recognition of the complex interactions that occur in the coupled human-environmental system. A problem-oriented and interdisciplinary approach was employed at Alpine Shire, in northeast Victoria Australia, to explore the concept of contextual vulnerability and adaptability to stressors that include, but are not limited to climatic change. Using a policy sciences approach, the objective was to identify factors that influence existing vulnerabilities and that might consequently act as barriers to effective adaptation for the Shire's business community involved in the tourism sector. Analyses of results suggest that many threats, including the effects climate change, compete for the resources, strategy and direction of local tourism management bodies. Further analysis of conditioning factors revealed that many complex and interacting factors define the vulnerability and adaptive capacity of the Shire's tourism sector to the challenges of global change, which collectively have more immediate implications for policy and planning than long-term future climate change scenarios. An approximation of the common interest, i.e. enhancing capacity in business acumen amongst tourism operators, would facilitate adaptability and sustainability through the enhancement of social capital in this business community. Kelly, P. M., & Adger, W. N. (2000). Theory and practice in assessing vulnerability to climatic change and facilitating adaptation. Climatic Change, 47, 325-352. O'Brien, K., Eriksen, S., Nygaard, L. P., & Schjolden, A. (2007). Why different interpretations of vulnerability matter in climate change discourses. Climate Policy, 7, 73-88.

Roman, Carolina

2010-05-01

129

The Role of Parenting for the Adjustment of Children with and without Learning Disabilities: A Person-Oriented Approach  

Science.gov (United States)

A person-oriented approach was used to examine the role of parenting in the associations between single learning disabilities and multiple learning disabilities and the adjustment difficulties in 8-11-year-olds. The results revealed that multiple, but not single, learning disabilities were associated with greater difficulties in emotional and…

Barkauskiene, Rasa

2009-01-01

130

A pragmatic dose-finding approach using short-term surrogate efficacy outcomes to evaluate binary efficacy and toxicity outcomes in phase I cancer clinical trials.  

UK PubMed Central (United Kingdom)

There is a growing need for study designs that can evaluate efficacy and toxicity outcomes simultaneously in phase I or phase I/II cancer clinical trials. Many dose-finding approaches have been proposed; however, most of these approaches assume binary efficacy and toxicity outcomes, such as dose-limiting toxicity (DLT), and objective responses. DLTs are often defined for short time periods. In contrast, objective responses are often defined for longer periods because of practical limitations on confirmation and the criteria used to define 'confirmation'. This means that studies have to be carried out for unacceptably long periods of time. Previous studies have not proposed a satisfactory solution to this specific problem. Furthermore, this problem may be a barrier for practitioners who want to implement notable previous dose-finding approaches. To cope with this problem, we propose an approach using unconfirmed early responses as the surrogate efficacy outcome for the confirmed outcome. Because it is reasonable to expect moderate positive correlation between the two outcomes and the method replaces the surrogate outcome with the confirmed outcome once it becomes available, the proposed approach can reduce irrelevant dose selection and accumulation of bias. Moreover, it is also expected that it can significantly shorten study duration. Using simulation studies, we demonstrate the positive utility of the proposed approach and provide three variations of it, all of which can be easily implemented with modified likelihood functions and outcome variable definitions. Copyright © 2013 John Wiley & Sons, Ltd.

Asakawa T; Hamada C

2013-09-01

131

Targeting Oncogenic Protein-Protein Interactions by Diversity Oriented Synthesis and Combinatorial Chemistry Approaches  

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Full Text Available We are currently witnessing a decline in the development of efficient new anticancer drugs, despite the salient efforts made on all fronts of cancer drug discovery. This trend presumably relates to the substantial heterogeneity and the inherent biological complexity of cancer, which hinder drug development success. Protein-protein interactions (PPIs) are key players in numerous cellular processes and aberrant interruption of this complex network provides a basis for various disease states, including cancer. Thus, it is now believed that cancer drug discovery, in addition to the design of single-targeted bioactive compounds, should also incorporate diversity-oriented synthesis (DOS) and other combinatorial strategies in order to exploit the ability of multi-functional scaffolds to modulate multiple protein-protein interactions (biological hubs). Throughout the review, we highlight the chemistry driven approaches to access diversity space for the discovery of small molecules that disrupt oncogenic PPIs, namely the p53-Mdm2, Bcl-2/Bcl-xL-BH3, Myc-Max, and p53-Mdmx/Mdm2 interactions.

Andreas G. Tzakos; Demosthenes Fokas; Charlie Johannes; Vassilios Moussis; Eleftheria Hatzimichael; Evangelos Briasoulis

2011-01-01

132

Ontological Engineering Approach towards Trust Oriented Security Framework for Adhoc Networks  

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Full Text Available Conventionally, user authentication and access control mechanisms would be almost enough, to handle security for stand-alone computers and small networks. Ad hoc networks are illustrated by multi-hop wireless connectivity and recurrently changing network topology which have made them infrastructure less. Adding trust to the existing security infrastructures would improvise the security of these environments. Describing trust relations and their sub-components using ontologies, creates a methodology and mechanism in order to efficiently design and engineer trust networks. This is going tobe used as a service for providing trust for ad hoc network at any level i.e. routing, authentication or access control. A trust oriented security framework for adhoc network using ontological engineering approach is proposed by modeling ad hoc network, the OLSR (Optimized Link State Routing) protocol and trust model as OWL (Ontology Web language) ontologies, which are integrated using Jena. In this model, a trustor can calculate its trust about trustee and use the calculated trust values to make decisions depending on the context of the application or interaction about granting or rejecting it. A number ofexperiments with a possible implementation of suggested framework are performed to make out the characteristics of the trust model and its effect on the ad hoc network operations.

Amandeep Verma; Manpreet Singh Gujral

2012-01-01

133

Targeting oncogenic protein-protein interactions by diversity oriented synthesis and combinatorial chemistry approaches.  

UK PubMed Central (United Kingdom)

We are currently witnessing a decline in the development of efficient new anticancer drugs, despite the salient efforts made on all fronts of cancer drug discovery. This trend presumably relates to the substantial heterogeneity and the inherent biological complexity of cancer, which hinder drug development success. Protein-protein interactions (PPIs) are key players in numerous cellular processes and aberrant interruption of this complex network provides a basis for various disease states, including cancer. Thus, it is now believed that cancer drug discovery, in addition to the design of single-targeted bioactive compounds, should also incorporate diversity-oriented synthesis (DOS) and other combinatorial strategies in order to exploit the ability of multi-functional scaffolds to modulate multiple protein-protein interactions (biological hubs). Throughout the review, we highlight the chemistry driven approaches to access diversity space for the discovery of small molecules that disrupt oncogenic PPIs, namely the p53-Mdm2, Bcl-2/Bcl-xL-BH3, Myc-Max, and p53-Mdmx/Mdm2 interactions.

Tzakos AG; Fokas D; Johannes C; Moussis V; Hatzimichael E; Briasoulis E

2011-01-01

134

Hybrid Approach for Automatic Evaluation of Emotion Elicitation Oriented to People with Intellectual Disabilities  

Science.gov (United States)

People with intellectual disabilities and elderly need physical and intellectual support to ensuring independent living. This is one of the main issues in applying Information and Communication Technology (ICT) into Assistive Technology field. In this sense the development of appropriated Intelligent Systems (ISs) offers new perspectives to this community. In our project a new IS system (LAGUNTXO) which adds user affective information oriented to people with intellectual disabilities has been developed. The system integrates a Human Emotion Analysis System (HEAS) which attempts to solve critical situations for this community as block stages. In the development of the HEAS one of the critical issues was to create appropriated databases to train the system due to the difficulty to simulate pre-block stages in laboratory. Finally a films and real sequences based emotion elicitation database was created. The elicitation material was categorized with more actual features based on discrete emotions and dimensional terms (pleasant, unpleasant). Classically the evaluation is carried out by a specialist (psychologist). In this work we present a hybrid approach for Automatic Evaluation of Emotion Elicitation databases based on Machine Learning classifiers and K-means clustering. The new categorization and the automatic evaluation show a high level of accuracy with respect to others methodologies presented in the literature.

Martínez, R.; de Ipiña, K. López; Irigoyen, E.; Asla, N.

135

An ecological approach to examine lung cancer disparities due to sexual orientation.  

UK PubMed Central (United Kingdom)

OBJECTIVES: To determine whether there is an association between geographical areas with greater sexual minority density, defined as gay and lesbian individuals, and incidence and mortality rates for lung cancer. STUDY DESIGN: As individual surveillance data on sexual orientation are not available, this study used an ecological approach to examine the link between sexual minorities and lung cancer. METHODS: Population-based surveillance data on the incidence of and mortality due to lung cancer from 1996 to 2004 were used from 12 Surveillance, Epidemiology and End Results (SEER) registries and 2000 Census data on same-sex-partnered households for the geographical area covered by SEER 12. Using multiple regression models, the county-level association of sexual minority density with incidence or mortality rates for lung cancer was examined. RESULTS: A significant positive association was found between both incidence and mortality rates for lung cancer and areas with a higher density of sexual minority men, and a significant negative association was found between both incidence and mortality rates for lung cancer and areas with a higher density of sexual minority women. CONCLUSIONS: In the absence of surveillance data, this novel methodological strategy approximates population-level lung cancer disparities for sexual minority populations at the aggregate level.

Boehmer U; Ozonoff A; Miao X

2012-07-01

136

Recovering Use Case Diagrams from Object Oriented Code: an MDA-based Approach  

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Full Text Available Modernization of legacy systems requires the existence of technicalframeworks for information integration and tool interoperability that allow managing new platform technologies, design techniques and processes. MDA (Model Driven Architecture), adopted by the OMG (Object Management Group), is aligned with this requirement. Reverse engineering techniques play a crucial role in system modernization. In light of these issues, this article describes a framework to reverse engineering MDA models from object oriented code. This framework distinguishes three different abstraction levelslinked to models, metamodels and formal specifications. At model level,transformations are based on static and dynamic analysis. At metamodel level, transformations are specified as OCL (Object Constraint Language)contracts between MOF (Meta Object Facility) metamodels which control the consistency of these transformations. The level of formal specification includes algebraic specifications of MOF metamodels and metamodel-based transformations. This article shows how to reverse engineering use case diagrams from Java code in the MDA context focusing on transformations at model and metamodel levels. We validate our approach by using Eclipse Modeling Framework, Ecore metamodels and ATL (Atlas Transformation Language).

Claudia T. Pereira; Liliana I. Martinez; Liliana M. Favre

2012-01-01

137

Targeting oncogenic protein-protein interactions by diversity oriented synthesis and combinatorial chemistry approaches.  

Science.gov (United States)

We are currently witnessing a decline in the development of efficient new anticancer drugs, despite the salient efforts made on all fronts of cancer drug discovery. This trend presumably relates to the substantial heterogeneity and the inherent biological complexity of cancer, which hinder drug development success. Protein-protein interactions (PPIs) are key players in numerous cellular processes and aberrant interruption of this complex network provides a basis for various disease states, including cancer. Thus, it is now believed that cancer drug discovery, in addition to the design of single-targeted bioactive compounds, should also incorporate diversity-oriented synthesis (DOS) and other combinatorial strategies in order to exploit the ability of multi-functional scaffolds to modulate multiple protein-protein interactions (biological hubs). Throughout the review, we highlight the chemistry driven approaches to access diversity space for the discovery of small molecules that disrupt oncogenic PPIs, namely the p53-Mdm2, Bcl-2/Bcl-xL-BH3, Myc-Max, and p53-Mdmx/Mdm2 interactions. PMID:21623312

Tzakos, Andreas G; Fokas, Demosthenes; Johannes, Charlie; Moussis, Vassilios; Hatzimichael, Eleftheria; Briasoulis, Evangelos

2011-05-27

138

Comparison of postoperative facial nerve outcomes between translabyrinthine and retrosigmoid approaches in matched-pair patients.  

UK PubMed Central (United Kingdom)

OBJECTIVES/HYPOTHESIS: The objective was to assess whether the translabyrinthine approach for acoustic tumor removal offers better postoperative facial nerve function compared with the retrosigmoid approach. STUDY DESIGN: Retrospective case review from a tertiary otology referral center. METHODS: Patients who had undergone either retrosigmoid or translabyrinthine approach for removal of acoustic neuroma from January 1, 1980, to December 31, 1999, were included in the study. Two groups of patients were created, one containing retrosigmoid cases and the other, translabyrinthine. Attempts were made to match each retrosigmoid case to a translabyrinthine case with regard to tumor size, patient age, and date of operation. This matching served to eliminate these variables from influencing postoperative facial nerve outcomes. From an initial pool of 450 patients, 35 pairs of patients were matched for the study. Facial nerve functions were reported at immediate, 3-month, and 1-year postoperative periods. RESULTS: Patient demographics demonstrated that matched patients had almost identical tumor size, patient age, and date of operation. Comparisons of postoperative facial nerve functions between the matched groups revealed that retrosigmoid approach carried 2.86 times higher risk of facial nerve dysfunction during the immediate postoperative period. However, by 1 year, the facial nerve outcomes were similar between the two groups. CONCLUSION: Compared with the translabyrinthine approach, retrosigmoid approach carries a higher risk of postoperative facial nerve dysfunction during the immediate postoperative period. However, long-term facial nerve outcomes are identical between the two approaches.

Ho SY; Hudgens S; Wiet RJ

2003-11-01

139

The long and bumpy road to outcome-oriented management of long-term care in Germany: implementation of the Resident Assessment Instrument in home-care services.  

UK PubMed Central (United Kingdom)

OBJECTIVE: Although the quality of long-term care has improved, many problems still remain, and better processes seem to be necessary. Hence, outcome-oriented management is of particular importance. The Resident Assessment Instrument (RAI) is a tool that has been used successfully in many countries to improve quality of care. However, there are problems of implementation and it lacks information on the conditions of successful or failing information of the RAI. The aim of this article is to find out to what extent technical/qualification requirements help to introduce or lead to failure of the implementation of an assessment instrument like RAI. METHODS: Therefore, a cluster randomized controlled trial showed services using RAI intensively tend to have better outcomes after 12?months. But the effects depend on the success of the implementation. Using a factor analysis, an index was built to divide the care providers into "optimal" and "suboptimal" RAI users. RESULTS: Some factors that seem to lead to a rather successful implementation could be detected: A higher proportion of qualified staff, a lower perceived quantitative workload, a small size of care providers, the type of ownership (for-profit) and a late entry in study [Correction made here after initial online publication.]. CONCLUSION: The success or failure of the implementation of an outcome-oriented control instrument is determined by professional, organizational restrictions. The results show that a better implementation leads to better outcomes for clients. Copyright © 2013 John Wiley & Sons, Ltd.

Roth G; Wolter A; Stolle C; Rothgang H

2013-05-01

140

A Case-Based Approach Increases Student Learning Outcomes and Comprehension of Cellular Respiration Concepts  

Science.gov (United States)

This study investigated student learning outcomes using a case-based approach focused on cellular respiration. Students who used the case study, relative to students who did not use the case study, exhibited a significantly greater learning gain, and demonstrated use of higher-order thinking skills. Preliminary data indicate that after engaging…

Rybarczyk, Brian J.; Baines, Antonio T.; McVey, Mitch; Thompson, Joseph T.; Wilkins, Heather

2007-01-01

 
 
 
 
141

Valuing the contribution of knowledge-oriented workers to projects: a merit based approach in the construction industry  

Directory of Open Access Journals (Sweden)

Full Text Available Evidence points to the fact that frequent resignation of project engineers from construction companies is primarily the result of dissatisfaction with the factors that shape the salary scale. This research aims to identify the major influencing factors in merit based salary calculation systems for knowledge-oriented engineers so as to more accurately reflect their contribution to construction projects. Results from a questionnaire sent to managers, engineers and HR professionals throughout the Iranian construction industry revealed that while there was overall agreement on principles to a merit-based approach, engineers in particular identified ‘professional skills’, ‘experience’ and ‘creativity’. Management-oriented parties should take into account engineer perspectives in order to more accurately value the knowledge-oriented contribution of these workers to construction projects. This research provides a basis for understanding the key factors in the merit based salary scale formulation through the construction industry.

Mehrdad Arashpour; Majeed Shabanikia; Mohammadreza Arashpour

2012-01-01

142

A Comprehensive Assessment of Object-Oriented Software Systems Using Metrics Approach  

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Full Text Available Demand for efficient software is increasing day by day and object-oriented design technique became able to fulfill this demand because it is the most powerful mechanism to develop efficient software systems. It can not only help in reducing the cost but also helps in the development of high quality software systems. Software developers need appropriate metrics to develop efficient software system. Object-oriented metrics can play important role in this aspect due to their importance in the development of successful software applications. This paper assesses the object-oriented software system using metricsapproach to precisely define the qualitative characteristics of thesoftware system

Sanjay Kumar Dubey; Prof. (Dr.) Ajay Rana

2010-01-01

143

Microwave enhanced palladium catalysed coupling reactions: a diversity-oriented synthesis approach to functionalised flavones.  

Science.gov (United States)

Microwave enhanced diversity-oriented synthesis (MEDOS) using palladium catalysed protocols is introduced as a powerful new strategy for the synthesis of systematically modified small molecules and is highlighted by application to functionalised flavones. PMID:17345738

Fitzmaurice, Richard J; Etheridge, Zac C; Jumel, Emelie; Woolfson, Derek N; Caddick, Stephen

2006-12-14

144

A New Focus on Distance Learning for Physically Impaired Students: A Multi-agent Oriented Approach  

Directory of Open Access Journals (Sweden)

Full Text Available Physically impaired students cannot continue their studies in the existing education system due to some major problems. A multi-agent oriented distance learning system can be a better solution for disabled students to continue their studies. In this paper, a scheme of a multi-agent oriented distance learning system has been proposed. Agents within the system work on the basis of centralized as well as distributed multi-agent planning for inter-agent communication, collaboration and negotiation.

Shiladitya Pujari; Subrata Mondal

2012-01-01

145

Software Quality Analysis by Object Oriented Approach in Design Phase Using UML  

Directory of Open Access Journals (Sweden)

Full Text Available Software Quality is the degree to which a finished product conforms to its specifications. The earlier a fault is detected and is removed the easier it is to fix. Object oriented metrics focus on the combination of functions and data as an integrated object. Object oriented paradigm substantially improves productivity due to the effect of reuse. Requirement specifications, designs and test plans are all artifacts that could potentially be fully or partially be reused in different projects.Object O

Anand Handa

2011-01-01

146

Orientation and mobility training for adults with low vision: a new standardized approach.  

UK PubMed Central (United Kingdom)

BACKGROUND: Orientation and mobility training aims to facilitate independent functioning and participation in the community of people with low vision. OBJECTIVE: (1) To gain insight into current practice regarding orientation and mobility training, and (2) to develop a theory-driven standardized version of this training to teach people with low vision how to orientate and be safe in terms of mobility. STUDY OF CURRENT PRACTICE: Insight into current practice and its strengths and weaknesses was obtained via reviewing the literature, observing orientation and mobility training sessions (n = 5) and interviewing Dutch mobility trainers (n = 18). Current practice was mainly characterized by an individual, face-to-face orientation and mobility training session concerning three components: crystallizing client's needs, providing information and training skills. A weakness was the lack of a (structured) protocol based on evidence or theory. NEW THEORY-DRIVEN TRAINING: A new training protocol comprising two face-to-face sessions and one telephone follow-up was developed. Its content is partly based on the components of current practice, yet techniques from theoretical frameworks (e.g. social-cognitive theory and self-management) are incorporated. DISCUSSION: A standardized, tailor-made orientation and mobility training for using the identification cane is available. The new theory-driven standardized training is generally applicable for teaching the use of every low-vision device. Its acceptability and effectiveness are currently being evaluated in a randomized controlled trial.

Zijlstra GA; Ballemans J; Kempen GI

2013-01-01

147

Learning approaches of undergraduate medical students to physiology in a non-PBL- and partially PBL-oriented curriculum  

Science.gov (United States)

Melaka Manipal Medical College (Manipal Campus; Manipal, Karnataka, India) conducts the Bachelor of Medicine and Bachelor of Surgery program, for which the admission intakes are during the months of March and September. The present study was undertaken to study the differences in learning approaches to physiology of undergraduate medical students in a partially problem-based learning (PBL)- and non-PBL-oriented curriculum. PBL was introduced as a curricular reform for the September 2006 batch of students (partially PBL group), whereas it was not incorporated for the March 2006 batch of students (non-PBL group). Learning approaches to physiology of both groups of students were compared using the short inventory of approaches to learning. Mean scores for deep and strategic approaches were found to be significantly higher for the partially PBL group compared with the non-PBL group. The results of the present study support the earlier observation that PBL promotes a deep approach to learning.

Reem Rachel Abraham (Melaka Manipal Medical College (Manipal Campus) Dept. of Physiology); P Vinod (Melaka Manipal Medical College Microbiology); M G Kamath (Melaka Manipal Medical College Physiology); K Asha (Kasturba Medical College Community Medicine); K. Ramnarayan (Melaka Manipal Medical College (Manipal Campus) Dept. of Physiology)

2007-07-27

148

Magnetic orientation of the Common Toad: establishing an arena approach for adult anurans.  

UK PubMed Central (United Kingdom)

BACKGROUND: Magnetic orientation is a taxonomically widespread phenomenon in the animal kingdom, but has been little studied in anuran amphibians. We collected Common Toads (Bufo bufo) during their migration towards their spawning pond and tested them shortly after displacement for possible magnetic orientation in arena experiments. Animals were tested in two different set-ups, in the geomagnetic field and in a reversed magnetic field. To the best of our knowledge, this is the first study testing orientation of adult anurans with a controlled magnetic field of a known strength and alignment. RESULTS: After displacement, toads oriented themselves unimodally under the geomagnetic field, following their former migration direction (d-axis). When the magnetic field was reversed, the distribution of bearings changed from a unimodal to a bimodal pattern, but still along the d-axis. The clustering of bearings was only significant after the toads reached the outer circle, 60.5 cm from their starting point. At a virtual inner circle (diameter 39 cm) and at the start of the experiment, orientation of toads did not show any significant pattern. CONCLUSIONS: The experimental set-up used in our study is suitable to test orientation behaviour of the Common Toad. We speculate that toads had not enough time to relocate their position on an internal map. Hence, they followed their former migration direction. Bimodality in orientation when exposed to the reversed magnetic field could be the result of a cue conflict, between magnetic and possibly celestial cues. For maintaining their migration direction toads use, at least partly, the geomagnetic field as a reference system.

Landler L; Gollmann G

2011-01-01

149

FAO/IAEA consultants' meeting on integrated approach for improving small scale market oriented dairy systems. Report  

International Nuclear Information System (INIS)

[en] A Consultants' Meeting was held at IAEA, Vienna from 21-24 August 2000 to discuss the need for, and to develop an FAO/IAEA Co-ordinated Research Project (CRP) to demonstrate increases in the productivity of small scale market oriented dairy systems using an integrated approach to improving nutrition, reproductive management and disease control. The meeting was attended by five consultants with expertise in specific aspects of research and development in dairy production, three external resource persons who were funded from their own institutes, a staff member of FAO's Animal Production Service, a representative of the IAEA's Department of Technical Co-operation and staff members of the Joint FAO/IAEA Division's Subprogramme on Animal Production and Health. The list of participants is given. The specific objectives of the meeting were to: Review the current research thrusts that are relevant to the objectives of the project, recommend areas that should be included and determine the most appropriate modalities for supporting these activities; Define the scientific scope of the project and recommend appropriate technologies and methods that should be applied in field and laboratory studies for obtaining the necessary information; Review the background document which has been prepared and make appropriate improvements and modifications; and Develop work plans, time scales, schedule of Research Co-ordination Meetings (RCMs) and the project framework matrix. The meeting was formally opened by Dr Martyn Jeggo, Head of the Animal Production and Health Section, who outlined the Sub-programme's mandate, medium-term strategy and how the planned CRP fits into this strategy. Dr Oswin Perera, the Scientific Secretary of the meeting, outlined the previous activities of the Sub-programme in animal nutrition and reproduction, discussed the background to the proposed project, and presented the objectives and expected outcomes of the meeting. The consultants and resource persons presented reviews on aspects of relevance to the proposed CRP. Subsequently, discussions were held in plenary sessions and in small groups to develop, modify and/or improve specific aspects of the draft project document. Finally, conclusions and recommendations were drafted, discussed and adopted

2002-01-01

150

Physical-activity coaching and health status in rheumatoid arthritis: a person-oriented approach.  

UK PubMed Central (United Kingdom)

PURPOSE: No interventions to promote physical activity can succeed for all participants. Insights into the specific characteristics of those who do succeed are needed. One aim was to investigate whether a selection of correlates of general health perception creates cluster typologies in individuals with rheumatoid arthritis (RA). Another was to evaluate whether magnitude of change in health status differs between clusters after a 1-year coaching intervention targeting health-enhancing physical activity. METHOD: Two hundred and twenty-eight patients (74% women, mean age 56 years, disease duration 1 year) with RA, from 10 rheumatology clinics in Sweden, participated. The patients were assigned at random to intervention or control. The intervention group underwent 1 year of coaching to adopt health-enhancing physical activity (moderately intensive, 30 min/day, > 4 days/week). The cluster analysis included five correlates of general health perception: disease activity; pain; timed standing; activity limitation; and self-reported physical activity. The primary outcome of the coaching intervention was self-reported health status. RESULTS: One-hundred and forty-six patients were eligible for inclusion in the cluster analysis. The eight clusters identified both at baseline and post interventions were operationalized according to the number of cluster variables affected: less (LE) affected or more (MO) affected, respectively. Clusters with LE affected variables had significantly better general health perception at baseline than those with MO affected variables. Further, coached individuals in MO affected clusters significantly improved self-reported health status compared both to those coached in LE affected clusters and to those in MO affected clusters in the control group. CONCLUSION: This person-based approach contributed more than did the results in a previous randomized controlled trial to the understanding of which patients benefit most from the present physical-activity coaching intervention. The intervention may thus be most beneficial for individuals more severely affected by their disease at baseline.

Sjöquist ES; Almqvist L; Asenlöf P; Lampa J; Opava CH

2010-01-01

151

The effects of temperature on service employees' customer orientation: an experimental approach.  

UK PubMed Central (United Kingdom)

Numerous studies have demonstrated how temperature can affect perceptual, cognitive and psychomotor performance (e.g. Hancock, P.A., Ross, J., and Szalma, J., 2007. A meta-analysis of performance response under thermal stressors. Human Factors: The Journal of the Human Factors and Ergonomics Society, 49 (5), 851-877). We extend this research to interpersonal aspects of performance, namely service employees' and salespeople's customer orientation. We combine ergonomics with recent research on social cognition linking physical with interpersonal warmth/coldness. In Experiment 1, a scenario study in the lab, we demonstrate that student participants in rooms with a low temperature showed more customer-oriented behaviour and gave higher customer discounts than participants in rooms with a high temperature - even in zones of thermal comfort. In Experiment 2, we show the existence of alternative possibilities to evoke positive temperature effects on customer orientation in a sample of 126 service and sales employees using a semantic priming procedure. Overall, our results confirm the existence of temperature effects on customer orientation. Furthermore, important implications for services, retail and other settings of interpersonal interactions are discussed. Practitioner Summary: Temperature effects on performance have emerged as a vital research topic. Owing to services' increasing economic importance, we transferred this research to the construct of customer orientation, focusing on performance in service and retail settings. The demonstrated temperature effects are transferable to services, retail and other settings of interpersonal interactions.

Kolb P; Gockel C; Werth L

2012-01-01

152

Outcomes.  

Science.gov (United States)

Outcomes encompass multiple factors, not just success and failure. They include other considerations such as being workable and profitable to the dentist and safe and acceptable to the patient. The more biological outcomes are most frequently measured. These measurements are on a scale from least to most predictable outcomes of treatment by the dentist, as shown on the evidence pyramid. Impact trauma is an example of a general scarcity of high-level evidence with treatment because of the nature and individuality of the injuries and the difficulty (or impossibility) of designing controlled clinical trials in humans. Much of the evidence is cohort (retrospective or observational studies), case reports, animal studies, and "expert" opinion. Thus, guidelines are largely based on lower levels of evidence. Nonetheless, the current guidelines provide the clinician with the best evidence that is available. The best opportunity for randomized controlled trials is in prevention. Specifically, mouthguard design and usage can be subjected to higher levels of controlled research. Revitalization and regeneration are relatively new procedures. To date, there is a lack of high levels of evidence to be able to substantiate whether these are clinically feasible to become a routine in practice. PMID:23439047

Walton, Richard E

2013-03-01

153

Query Data With Fuzzy Information In Object-Oriented Databases An Approach The Semantic Neighborhood Of Hedge Algebras  

Directory of Open Access Journals (Sweden)

Full Text Available In this paper, we present an approach for handling attribute values of object classes with fuzzy information and uncertainty in object-oriented database based on theory hedge algebraic. In this approach, semantics be quantified by quantitative semantic mapping of hedge algebraic that still preserving in order semantics may allow manipulation data on the real domain of attribute in relation with the semantics of linguistic. And then, evaluating semantics, searching information uncertainty, fuzziness and classical data entirely consistent based on the ensuring homogeneity of data types. Hence, we present algorithm that allow the data matching helping the requirements of the query data.

Doan Van Thang; Doan Van Ban

2011-01-01

154

An Aspect-Oriented Programming-based approach to software development for fault detection in measurement systems  

CERN Multimedia

An Aspect-Oriented Programming-based approach to the development of software components for fault detection in automatic measurement systems is proposed. Faults are handled by means of specific software units, the ``aspects{''}, in order to better modularize issues transversal to several components. As a case study, this approach was applied to the design of the fault detection software inside a flexible framework for magnetic measurements, developed at the European Organization for Nuclear Research (CERN). Experimental results of software modularity and performance measurements for comparing aspect- and objectoriented solutions in rotating coils tests on superconducting magnets are reported. (C) 2009 Elsevier B.V. All rights reserved.

Arpaia, P; Inglese, Vitaliano; Bernardi, Mario Luca; Di Lucca, Giuseppe; Spiezia, Giovanni

2010-01-01

155

Promulgate: an approach to Optimize the data transfer in Service Oriented Architecture  

Directory of Open Access Journals (Sweden)

Full Text Available The main potential benefit of Service-oriented architecture (SOA) is applying across multiple solution environments based on the request and reply paradigm. Service-oriented architecture integrates both enterprise and application architectures. When the services and size of the workflow increases, the SOA orchestration reaches the scalability limits and same effected on the data transmission between services, a standard orchestration desires to transport all the data through a workflow engine when communicate on the web service without any third party data transfer, which results redundant data transfer and engine to become a bottleneck to execution of a workflow. As a solution, we present Promulgate, an alternative service-oriented architecture. Promulgate proposed an orchestration model as central control in grouping with a choreography model of optimized distributed data transport. We are using Data caching techniques by using dynamic proxy deployment and SOAP compression techniques by using zipped SOAP for this hybrid architecture to optimize the data transfer in SOA.

B. Chandra Mouli , Prof. C. Rajendra

2012-01-01

156

The International Outcome Inventory for Hearing Aids (IOI-HA) and its relationship to the Client-oriented Scale of Improvement (COSI).  

UK PubMed Central (United Kingdom)

The International Outcome Inventory-Hearing Aids (IOI-HA) was administered to 161 consecutive patients who had been fitted with hearing aids just prior to their being discharged from the clinic. Most also completed the Client-oriented Scale of Improvement (COSI). Very few questions (<2%) were not completed. Analyses indicated two subscales of IOI-HA, one of which could be defined as a 'benefit' subscale and the other a 'residual problems' subscale. Both elements of COSI correlated with the 'benefit' subscale, but only the 'residual' measure of COSI related to the 'residual problems' subscale. There were no consistent relationships between the IOI-HA and a range of demographic factors.

Stephens D

2002-01-01

157

Diversity of approaches to classic galactosemia around the world: a comparison of diagnosis, intervention, and outcomes.  

UK PubMed Central (United Kingdom)

Without intervention, classic galactosemia is a potentially fatal disorder in infancy. With the benefit of early diagnosis and dietary restriction of galactose, the acute sequelae of classic galactosemia can be prevented or reversed. However, despite early and lifelong dietary treatment, many galactosemic patients go on to experience serious long-term complications including cognitive disability, speech problems, neurological and/or movement disorders and, in girls and women, ovarian dysfunction. Further, there remains uncertainty surrounding what constitutes a 'best practice' for treating this disorder. To explore the extent and implications of this uncertainty, we conducted a small but global survey of healthcare providers who follow patients with classic galactosemia, seeking to compare established protocols for diagnosis, intervention, and follow-up, as well as the outcomes and outcome frequencies seen in the patient populations cared for by these providers. We received 13 survey responses representing five continents and 11 countries. Respondents underscored disparities in approaches to diagnosis, management and follow-up care. Notably, we saw no clear relationship between differing approaches to care and long-term outcomes in the populations studied. Negative outcomes occurred in the majority of cases regardless of when treatment was initiated, how tightly galactose intake was restricted, or how closely patients were monitored. We document here what is, to our knowledge, the first global comparison of healthcare approaches to classic galactosemia. These data reinforce the idea that there is currently no one best practice for treating patients with classic galactosemia, and underscore the need for more extensive and statistically powerful comparative studies to reveal potential positive or negative impacts of differing approaches.

Jumbo-Lucioni PP; Garber K; Kiel J; Baric I; Berry GT; Bosch A; Burlina A; Chiesa A; Pico ML; Estrada SC; Henderson H; Leslie N; Longo N; Morris AA; Ramirez-Farias C; Schweitzer-Krantz S; Scheweitzer-Krantz S; Silao CL; Vela-Amieva M; Waisbren S; Fridovich-Keil JL

2012-11-01

158

Diversity of approaches to classic galactosemia around the world: a comparison of diagnosis, intervention, and outcomes.  

Science.gov (United States)

Without intervention, classic galactosemia is a potentially fatal disorder in infancy. With the benefit of early diagnosis and dietary restriction of galactose, the acute sequelae of classic galactosemia can be prevented or reversed. However, despite early and lifelong dietary treatment, many galactosemic patients go on to experience serious long-term complications including cognitive disability, speech problems, neurological and/or movement disorders and, in girls and women, ovarian dysfunction. Further, there remains uncertainty surrounding what constitutes a 'best practice' for treating this disorder. To explore the extent and implications of this uncertainty, we conducted a small but global survey of healthcare providers who follow patients with classic galactosemia, seeking to compare established protocols for diagnosis, intervention, and follow-up, as well as the outcomes and outcome frequencies seen in the patient populations cared for by these providers. We received 13 survey responses representing five continents and 11 countries. Respondents underscored disparities in approaches to diagnosis, management and follow-up care. Notably, we saw no clear relationship between differing approaches to care and long-term outcomes in the populations studied. Negative outcomes occurred in the majority of cases regardless of when treatment was initiated, how tightly galactose intake was restricted, or how closely patients were monitored. We document here what is, to our knowledge, the first global comparison of healthcare approaches to classic galactosemia. These data reinforce the idea that there is currently no one best practice for treating patients with classic galactosemia, and underscore the need for more extensive and statistically powerful comparative studies to reveal potential positive or negative impacts of differing approaches. PMID:22450714

Jumbo-Lucioni, Patricia P; Garber, Kathryn; Kiel, John; Baric, Ivo; Berry, Gerard T; Bosch, Annet; Burlina, Alberto; Chiesa, Ana; Pico, Maria Luz Couce; Estrada, Sylvia C; Henderson, Howard; Leslie, Nancy; Longo, Nicola; Morris, Andrew A M; Ramirez-Farias, Carlett; Schweitzer-Krantz, Susanne; Scheweitzer-Krantz, Susanne; Silao, Catherine Lynn T; Vela-Amieva, Marcela; Waisbren, Susan; Fridovich-Keil, Judith L

2012-03-27

159

Collaborating With Clients and Improving Outcomes: The Relational Re-enactment Systems Approach to Treatment Model.  

UK PubMed Central (United Kingdom)

The Relational Re-enactment Systems Approach to Treatment model is a coherent and comprehensive approach to residential treatment that increases family involvement through system-wide clinical consultation. The therapeutic alliance with youth and their families is emphasized as the key to creating client-centered goals for discharge to a less restrictive environment. The current study examined outcomes from four years of the model's implementation. Results indicated a significant increase in the proportion of youth discharged to a family home. Additionally, the proportion of discharges that were the result of youth running away from treatment was reduced by half.

McConnell C; Taglione P

2012-04-01

160

Collaborating With Clients and Improving Outcomes: The Relational Re-enactment Systems Approach to Treatment Model  

Science.gov (United States)

The Relational Re-enactment Systems Approach to Treatment model is a coherent and comprehensive approach to residential treatment that increases family involvement through system-wide clinical consultation. The therapeutic alliance with youth and their families is emphasized as the key to creating client-centered goals for discharge to a less restrictive environment. The current study examined outcomes from four years of the model's implementation. Results indicated a significant increase in the proportion of youth discharged to a family home. Additionally, the proportion of discharges that were the result of youth running away from treatment was reduced by half.

McConnell, Catherine; Taglione, Patricia

2012-01-01

 
 
 
 
161

Input-Based Approaches to Teaching Grammar: A Review of Classroom-Oriented Research.  

Science.gov (United States)

Examines the theoretical rationales (universal grammar, information-processing theories, skill-learning theories) for input-based grammar teaching and reviews classroom-oriented research (i.e., enriched-input studies, input-processing studies) that has integrated this option. (Author/VWL)

Ellis, Rod

1999-01-01

162

El Oriente Medio en la política mundial: un enfoque sistémico/ The Middle East in Global Politics: A Systemic Approach  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish El Oriente Medio ha sido siempre centro de atención debido a sus problemas e importancia económica para el mundo. Es además fuente de una considerable cantidad de petróleo y gas para el mundo, así como el lugar donde puede ser obtenido más barato. Este artículo asume un enfoque sistémico para entender el Oriente Medio y ubicarlo dentro de la política mundial. En el Oriente Medio hay varias instituciones que conectan la región al mundo y que, por tanto, tienen un (more) cierto grado de influencia en la conformación de la política regional. Esta estructura institucional es importante en la localización del Oriente Medio en la política mundial, porque cada una de ellas tiene una agenda, una inclinación, y unas prioridades diferentes. Al entender la diversidad de las organizaciones regionales también se evidencia que el Oriente Medio no es una unidad, sino que tiene varios centros de poder. Abstract in english The Middle East has always been center of attention for its problems and economic importance to the world. The Middle East is the source of a considerable amount of the world?s oil and gas and is the place where it can be most cheaply obtained. This article takes a systemic approach to understand the Middle East and locate it within the global politics. In the Middle East there are various institutions that connect the region to the world. These institutions have a certa (more) in degree of influence in shaping regional politics. This institutional structure is important in locating the Middle East in global politics because each of them has different agenda, inclination and priories. Understanding the diversity of regional organizations will also show that the Middle East is not a single unity, rather it has various power centers.

Ozkan, Mehmet

2011-06-01

163

System-active approach in working with gifted children on the program author's circle of ecological and biological orientation  

Directory of Open Access Journals (Sweden)

Full Text Available The article presents the author's program of environmental and biological circle orientation. It is shown that the basis of the federal state educational standards is a system-activity approach. The result of its application is the development of the child on the basis of Universal Instructional activities. The main advantage of the course by choice "school environmental monitoring 'is his experimental and practice-oriented direction. As a result of the development of the educational program students will learn: about current research in biology, chemistry, ecology, and their practical and moral-ethical significance, the actions of human beings in critical environmental situations, the impact of the natural environment on human health (eg, geochemical characteristics of terrain, the quality of drinking water, dust atmosphere, etc.), health-enhancing effects of natural elements (plants, recreational resources, etc.).

Plonish Julia

2013-01-01

164

Multi-board concept - a scenario based approach for supporting product quality and life cycle oriented design  

DEFF Research Database (Denmark)

This paper will describe the multi-board concept, which is a working approach for supporting life cycle oriented design and product quality. Aspects of this concept include construction of a common working environment where multiple display boards depict scenarios of the product life cycle, creating a shared quality mindset amongst design-ers, and developing creativity and synthesis in product design. The appropriateness of scenarios for supporting life cycle oriented design will be ar-gued and preliminary results from early experi-mentation will be presented.Initial results lead us to believe that the multi-board concept promises to be a useful means of communication amongst the design team. We be-lieve that it fosters a thorough understanding of life cycle events, which, in turn, inspires the design of innovative products of the highest quality.

Robotham, Antony John; Hertzum, Morten

2000-01-01

165

Structuring requirements as necessary premise for customer-oriented development of complex products: A generic approach  

Directory of Open Access Journals (Sweden)

Full Text Available Purpose: Complex products like for example intra-logistical facilities make high demands on developers and producers and involve high investment and operating costs. When planning and developing and also making buying decisions the facility utilization and the thus ensuing requirements on the facility and its components are inadequately considered to date. Nevertheless, with regard to customer-directed product design, these requirements must all be taken into account – especially as they can contribute to possible savings. In this context, it is necessary to survey and systematically regard requirements from a large number of areas like for example the operator, the facility producer and also requirements of external parties such as the law and to implement into adequate product characteristics to produce customer-oriented products. This is, however, a difficult task because of the diversity of stakeholders involved and their numerous and often divergent requirements. Therefore, it is essential to structure the requirements, so that planners and developers are able to manage the large amount of information. Structure models can be used in this context to cluster requirements. Within the German Collaborative Research Centre 696 a 10-dimensional model has been developed. This model allows structuring of all requirements on intra-logistical facilities or respectively complex products in general. In the context of dealing with hundreds of data records, structuring requirements is mandatory to achieve accuracy, clarity and consequently satisfactory results when transforming requirements into product characteristics which fit customer needs. In the paper an excerpt of this model is presented. Design/methodology/approach: In literature a multitude of methods which deal with the topic of structuring exist. The methods have been analysed regarding their purpose and their level of specification, i.e. the number of differentiated categories, to check if they could be applied in the regarded area of intra-logistics. Also potential stakeholders have been identified to ensure that the surveying of requirements is not incomplete. Based on these analyses an own model has been developed which combines, adepts and enlarges the existing methods. Findings: A 10-dimensional model has been developed for structuring requirements on intra-logistical facilities. This model is holistic, because additionally it allows capturing the stakeholders’ feedback to the requirements’ fulfilment. The dimensions of the model can be divided into four groups. The first one serves to structure the requirements regarding their content. These are the dimensions obligations, surroundings, information, qualification, technical-functional requirements and qualification. The second group serves to structure the reference object to which the requirements refer and includes the dimension product. Weighted level of performance and customer satisfaction are part of the third group, which encompasses the evaluation of the requirements’ fulfilment. The fourth group is for the temporal structuring of requirements and includes the dimension time. For applying the model it has been implemented for data processing as component of a large data processing system. The developed model is presented in this paper. Research limitations/implications: A 10-idimensional model for structuring requirements is presented in this paper. Thereby, a sub-division of the dimensions into categories and sub-categories has been made to ensure a topical classification of the requirements and additionally a structuring according to their level of specification. Considering individual dimensions and/or selected categories of dimensions allow a thematic focus to be placed on certain groups of requirements. This is particularly important, not only for the implementation of requirements into solutions but also for focusing on the needs of individual stakeholders, if e.g. requirements on maintenance have to be observed. Using the model, working with lots of requ

Sandra Klute; Robert Refflinghaus

2011-01-01

166

Performance Measurement of Service Oriented Enterprise: An EVA-Based Approach  

Directory of Open Access Journals (Sweden)

Full Text Available Service Oriented Enterprise (SOE) has brought up requirement for performance measurement of the novel business model in its dynamic and flexible business environment. To solve the problem, conception of SOE is discussed from business perspective firstly, and an operation architecture of SOE is proposed and analyzed. The Service Oriented Economic Value Added (SO-EVA) performance measurement model is then presented. The model structure of SO-EVA, construction and calculation of indicators, as well as application are given and discussed in this paper. The SO-EVA model is based on the Economic Value Added (EVA) method, extends EVA into multiple levels and introduces Independent Performance Factors (IPF), to focus on value creation and attain comprehensive performance measurement of SOE, with agility and flexibility. A case study is also given, indicating that the presented model not only better reflects the performance of business operation compared to traditional models, but also supports the business model of SOE more effectively.

Weiran Wang; Yushun Fan

2011-01-01

167

Object-oriented approach to preequilibrium and equilibrium decays in Geant4  

International Nuclear Information System (INIS)

The Geant4 simulation toolkit provides a set of parameterized models that allow to model hadronic showers. However, in order to allow extrapolation beyond the experimental data and to offer an alternative set of models at conventional energies, Geant4 also provides a set of theory based hadronic shower models. We present the Object Oriented Design of a semiclassical exciton model for preequilibrium decays and a set of statistical models for deexcitation of compound nuclei. Our design follows the philosophy of hadronic models in Geant4, allowing for maximum of extendibility and customizability of the underlying physics by means of the use of abstract interfaces. We exploit advanced Software Engineering techniques and Object Oriented technology to achieve those goals. We present also a series of comparisons against experimental data being made in order to test the model. (orig.)

2001-01-01

168

Object-oriented approach to preequilibrium and equilibrium decays in Geant4  

Energy Technology Data Exchange (ETDEWEB)

The Geant4 simulation toolkit provides a set of parameterized models that allow to model hadronic showers. However, in order to allow extrapolation beyond the experimental data and to offer an alternative set of models at conventional energies, Geant4 also provides a set of theory based hadronic shower models. We present the Object Oriented Design of a semiclassical exciton model for preequilibrium decays and a set of statistical models for deexcitation of compound nuclei. Our design follows the philosophy of hadronic models in Geant4, allowing for maximum of extendibility and customizability of the underlying physics by means of the use of abstract interfaces. We exploit advanced Software Engineering techniques and Object Oriented technology to achieve those goals. We present also a series of comparisons against experimental data being made in order to test the model. (orig.)

Lara, V. [CERN, Geneva (Switzerland)

2001-07-01

169

A new approach to modeling of loss separation in grain-oriented Fe-Si laminations  

International Nuclear Information System (INIS)

A model of magnetic loss separation based on the distribution of relaxation times is suggested. If the magnetic flux excitation is sinusoidal and the magnetization process by planar 180 deg. domain wall movement is dominant, then it is possible to separate the hysteretic and dynamic part of total losses analytically. The experimental verification of proposed model is performed on a set of grain-oriented laminations cut at various angles with respect to the rolling direction.

2003-01-01

170

[Process orientation as a tool of strategic approaches to corporate governance and integrated management systems].  

Science.gov (United States)

The concept of general process orientation as an instrument of organisation development is the core principle of quality management philosophy, i.e. the learning organisation. Accordingly, prestigious quality awards and certification systems focus on process configuration and continual improvement. In German health care organisations, particularly in hospitals, this general process orientation has not been widely implemented yet - despite enormous change dynamics and the requirements of both quality and economic efficiency of health care processes. But based on a consistent process architecture that considers key processes as well as management and support processes, the strategy of excellent health service provision including quality, safety and transparency can be realised in daily operative work. The core elements of quality (e.g., evidence-based medicine), patient safety and risk management, environmental management, health and safety at work can be embedded in daily health care processes as an integrated management system (the "all in one system" principle). Sustainable advantages and benefits for patients, staff, and the organisation will result: stable, high-quality, efficient, and indicator-based health care processes. Hospitals with their broad variety of complex health care procedures should now exploit the full potential of total process orientation. PMID:20951952

Sens, Brigitte

2010-08-21

171

Designing Logical Topology for Wireless Sensor Networks: A Multi-Chain Oriented Approach  

Directory of Open Access Journals (Sweden)

Full Text Available An optimal logical topology of a wireless sensor network (WSN) facilitates the deployed sensor nodes tocommunicate with each other with little overheads,lowers energy consumption, lengthens lifetime of thenetwork, provides scalability, increases reliability, and reduces latency. Designing an optimal logicaltopology for a WSN thus needs to consider numerousfactors. Chain oriented topologies have been foundto offer a number of improvements in energy consumptions, lifetime, and load balancing than othertopologies of WSNs. However, they usually suffer from latency, scalability, reliability and interferenceproblems. In this paper, we present a chain oriented logical topology, which offers solutions to thoseproblems. The proposed topology is designed such that it retains the advantages of the chain orientedtopologies, and at the same time, overcomes the problems of the chain oriented topology such as latency,scalability, and data reliability. The proposed topology provides a communication abstraction, which canbe easily used to devise a range of application protocols. Moreover, the logical topology offers nodemanagement, resource management, and other services. The performance of the proposed topology iscompared with other topologies in respect to totalenergy consumption and lifetime of the network.

Quazi Mamun

2013-01-01

172

Service Oriented Architecture for Business Dynamics: An Agent Based Business Modeling Approach  

Directory of Open Access Journals (Sweden)

Full Text Available In today's rapidly changing environment the industries areinterested in executing business functions that has scope inmultiple applications. Business dynamics and technologicalinnovations have felt organizations to comply with adisparate mix of operating systems, applications anddatabases. This makes it difficult, time-consuming and costlyfor IT departments to deliver new applications that integrateheterogeneous technologies. It demands high interoperabilityand more flexible and adaptive business processmanagement. The inclination is to have systems assembled,from a loosely coupled collection of Web services, which areuniversal and integrated. This technical area appears tohave scope where the Agent Technology can be exploitedwith significant advantages. With Service OrientedArchitecture a decomposable architecture, and associatedset of development and IT management disciplines,composed of loosely coupled services communicating viapre-established protocols, these services can be assembledad-hoc to form customized applications that address a widevariety of business requirements.In the present paper, we propose a conceptual frameworkfor agent-based Service Oriented Architecture (SOA). Inwhich we try to integrate Service Oriented Architecture withthe agent technology & other tactical technologies like webservices, business workflow services, Business meta-rules,search optimization of services and semantic Webtechnology for business service mappings.

O. P. Rishi

2009-01-01

173

From an Ontology-Oriented Approach Conception to User Interface Development  

Digital Repository Infrastructure Vision for European Research (DRIVER)

* The presented work has discussed on the KDS-2003. It has corrected in compliance with remarks and requests of participants. , The paper describes a new approach to user interface development which is an evolution of the model-based approach. The aim of the new, ontology-based approach is to elimina...

Kleshchev, Alexander; Gribova, Valeriya

174

Machine learning approach for the outcome prediction of temporal lobe epilepsy surgery.  

UK PubMed Central (United Kingdom)

Epilepsy surgery is effective in reducing both the number and frequency of seizures, particularly in temporal lobe epilepsy (TLE). Nevertheless, a significant proportion of these patients continue suffering seizures after surgery. Here we used a machine learning approach to predict the outcome of epilepsy surgery based on supervised classification data mining taking into account not only the common clinical variables, but also pathological and neuropsychological evaluations. We have generated models capable of predicting whether a patient with TLE secondary to hippocampal sclerosis will fully recover from epilepsy or not. The machine learning analysis revealed that outcome could be predicted with an estimated accuracy of almost 90% using some clinical and neuropsychological features. Importantly, not all the features were needed to perform the prediction; some of them proved to be irrelevant to the prognosis. Personality style was found to be one of the key features to predict the outcome. Although we examined relatively few cases, findings were verified across all data, showing that the machine learning approach described in the present study may be a powerful method. Since neuropsychological assessment of epileptic patients is a standard protocol in the pre-surgical evaluation, we propose to include these specific psychological tests and machine learning tools to improve the selection of candidates for epilepsy surgery.

Armañanzas R; Alonso-Nanclares L; Defelipe-Oroquieta J; Kastanauskaite A; de Sola RG; Defelipe J; Bielza C; Larrañaga P

2013-01-01

175

Goal Oriented Activity Towards Life Skill Training: Preliminary Indications of a Task-intensive Approach to Manage Cerebral Palsy  

Directory of Open Access Journals (Sweden)

Full Text Available Purpose: To devise a viable programme of intervention for older people with Cerebral Palsy (CP). Methods: Using focus group interviews, a ‘top down’ model of intervention was devised among older children and adolescents with CP. Ten participants volunteered and a custom tailored approach was employed, in keeping with the participants’ goals. Results: The outcomes are described qualitatively. Conclusions: There are preliminary indications that the programme is versatile and feasible. Further trials must be conducted before conclusive comments can be made.

Kavitha Raja; Saumen Gupta

2013-01-01

176

Olfactory groove meningiomas from neurosurgical and ear, nose, and throat perspectives: approaches, techniques, and outcomes.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To review the surgical approaches, techniques, outcomes, and recurrence rates in a series of 80 olfactory groove meningioma (OGM) patients operated on between 1990 and 2003. METHODS: Eighty patients underwent 81 OGM surgeries. Tumor diameter varied from 2 to 9 cm (average, 4.6 cm). In 35 surgeries (43.2%), the tumor was removed through bifrontal craniotomy; nine operations (11.1%) were performed through a unilateral subfrontal approach; 18 surgeries (22.2%) were performed through a pterional approach; seven surgeries (8.6%) were carried out using a fronto-orbital craniotomy; and 12 procedures (14.8%) were accomplished via a subcranial approach. Nine patients (11.3%) had undergone surgery previously and had recurrent tumor. RESULTS: Total removal was obtained in 72 patients (90.0%); subtotal removal was achieved in 8 patients (10.0%). Two patients, one with total and one with subtotal removal, had atypical (World Health Organization Grade II) meningiomas, whereas 78 patients had World Health Organization Grade I tumors. There was no operative mortality and no new permanent focal neurological deficit besides anosmia. Twenty-five patients (31.3%) experienced surgery-related complications. There were no recurrences in 75 patients (93.8%) 6 to 164 months (mean, 70.8 mo) after surgery. Three patients (3.8%) were lost to follow-up. In two patients (2.5%) with subtotal removal, the residual evidenced growth on computed tomography and/or magnetic resonance imaging 1 year after surgery. One of them had an atypical meningioma. The second, a multiple meningiomata patient, was operated on twice in this series. CONCLUSION: A variety of surgical approaches are used for OGM resection. An approach tailored to the tumor's size, location, and extension, combined with modern microsurgical cranial base techniques, allows full OGM removal with minimal permanent morbidity, excellent neurological outcome, and very low recurrence rates.

Spektor S; Valarezo J; Fliss DM; Gil Z; Cohen J; Goldman J; Umansky F

2005-10-01

177

A policy-oriented review of strategies for improving the outcomes of services for substance use disorder patients.  

UK PubMed Central (United Kingdom)

AIMS: To inform policy makers on available options for improving the effectiveness of treatments for substance use disorders and to stimulate debate about treatment improvement strategies among public officials, clinical providers, care managers, service users, families and researchers. METHODS: ? We draw on the scientific literature and our public policy experiences in two countries (the United Kingdom and the United States) to give an overview of policies which may improve care for individuals with substance use disorders. We divide such policies into 'process-focused quality improvement strategies' that attempt to change some aspect of treatment (e.g. increased retention, greater use of evidence-based practices) and 'patient-focused strategies' that attempt to reward outcomes directly (e.g. contingency management for patients, payment by results for providers). FINDINGS: ? Many policies of both types are poorly developed, have shown poor results, or both. The evidence is clear that process-focused quality improvement strategies can change what providers do and how treatment programs work, but such changes have thus far demonstrated only minimal impact on patient outcomes. Patient-focused strategies face challenges including treatment providers avoiding hard-to-treat patients or spending inordinate time relocating patients after treatment to assess outcome. However, policies that reward in-treatment outcomes and policies that allow the patient to purchase desired recovery support services show more promise. As policy makers go forward in this endeavor, they can do an enormous service to their countries and the field by embedding careful evaluation studies alongside new treatment outcome improvement initiatives.

Humphreys K; McLellan AT

2011-12-01

178

An object-oriented graphical approach for teaching electric machinery analysis  

Energy Technology Data Exchange (ETDEWEB)

This paper presents a teaching method used at the Naval Postgraduate School for electric machinery analysis. An objected-oriented, graphical tool for real-time simulation of electric machines is described. An undergraduate exercise is detailed to show how the use of the new analysis techniques significantly enhances the learning process. Rapid modeling of electric machines and subsequent simulation results encourage the student to explore machine behavior under a variety of transient and steady state operating conditions, thus significantly broadening the students knowledge of electric machinery.

Williams, S.M.; Kline, D.B. (Naval Postgraduate School, Monterey, CA (United States))

1994-05-01

179

Work Process Oriented Learning via Mobile Devices – Theoretical Basics and Examples for a (New) Didactical Approach  

Directory of Open Access Journals (Sweden)

Full Text Available Two problems can be identified which counteract the need for further training: On the one hand the clientele of skilled workers is not necessarily keen on further training. On the other hand the time and cost pressure within the sector does not offer any room for time-consuming further training measures far away from the workplace. This is why the project “Virtual Learning on the building site – (Vila-b)” was realized in cooperation with the project partners of the University of Bremen (Working group »Digital Media« of the Centre for Information Technology) as well as from the economy (Arbeitskreis ökologischer Holzbau e. V. and Claus Holm, pm|c). The project team has tested a concept which facilitated learning adapted to the occupational reality and supported by the advantages of digital media. The central didactical elements for the development of this further training course are the contextual and methodological orientation to real work processes as well as the use of digital mobile media which facilitate learning directly at the workplace. The present article starts with a description of the theoretical basics for learning within the work process and discusses the didactical elements which are necessary for work process oriented learning with digital and mobile media.

Georg Spöttl; Sven Schulte

2012-01-01

180

The importance of training strategy adaptation: A learner-oriented approach for improving older adults' memory and transfer.  

UK PubMed Central (United Kingdom)

We investigated the benefits of strategy-adaptation training for promoting transfer effects. This learner-oriented approach-which directly encourages the learner to generalize strategic behavior to new tasks-helps older adults appraise new tasks and adapt trained strategies to them. In Experiment 1, older adults in a strategy-adaptation training group used 2 strategies (imagery and sentence generation) while practicing 2 tasks (list and associative learning); they were then instructed on how to do a simple task analysis to help them adapt the trained strategies for 2 different unpracticed tasks (place learning and text learning) that were discussed during training. Two additional criterion tasks (name-face associative learning and grocery-list learning) were never mentioned during training. Two other groups were included: A strategy training group (who received strategy training and transfer instructions but not strategy-adaptation training) and a waiting-list control group. Both training procedures enhanced older adults' performance on the trained tasks and those tasks that were discussed during training, but transfer was greatest after strategy-adaptation training. Experiment 2 found that strategy-adaptation training conducted via a manual that older adults used at home also promoted transfer. These findings demonstrate the importance of adopting a learner-oriented approach to promote transfer of strategy training. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

Bottiroli S; Cavallini E; Dunlosky J; Vecchi T; Hertzog C

2013-09-01

 
 
 
 
181

A Model Transformation Approach to Derive Architectural Models from Goal-Oriented Requirements Models  

Science.gov (United States)

Requirements engineering and architectural design are key activities for successful development of software systems. Both activities are strongly intertwined and interrelated, but many steps toward generating architecture models from requirements models are driven by intuition and architectural knowledge. Thus, systematic approaches that integrate requirements engineering and architectural design activities are needed. This paper presents an approach based on model transformations to generate architectural models from requirements models. The source and target languages are respectively the i* modeling language and Acme architectural description language (ADL). A real web-based recommendation system is used as case study to illustrate our approach.

Lucena, Marcia; Castro, Jaelson; Silva, Carla; Alencar, Fernanda; Santos, Emanuel; Pimentel, João

182

Statistical approaches to assessing single and multiple outcome measures in dry eye therapy and diagnosis.  

Science.gov (United States)

Dry eye is a multifactorial disease which would require a broad spectrum of test measures in the monitoring of its treatment and diagnosis. However, studies have typically reported improvements in individual measures with treatment. Alternative approaches involve multiple, combined outcomes being assessed by different statistical analyses. In order to assess the effect of various statistical approaches to the use of single and combined test measures in dry eye, this review reanalyzed measures from two previous studies (osmolarity, evaporation, tear turnover rate, and lipid film quality). These analyses assessed the measures as single variables within groups, pre- and post-intervention with a lubricant supplement, by creating combinations of these variables and by validating these combinations with the combined sample of data from all groups of dry eye subjects. The effectiveness of single measures and combinations in diagnosis of dry eye was also considered. PMID:24112230

Tomlinson, Alan; Hair, Mario; McFadyen, Angus

2013-07-09

183

Statistical Approaches to Assessing Single and Multiple Outcome Measures in Dry Eye Therapy and Diagnosis.  

UK PubMed Central (United Kingdom)

Dry eye is a multifactorial disease which would require a broad spectrum of test measures in the monitoring of its treatment and diagnosis. However, studies have typically reported improvements in individual measures with treatment. Alternative approaches involve multiple, combined outcomes being assessed by different statistical analyses. In order to assess the effect of various statistical approaches to the use of single and combined test measures in dry eye, this review reanalyzed measures from two previous studies (osmolarity, evaporation, tear turnover rate, and lipid film quality). These analyses assessed the measures as single variables within groups, pre- and post-intervention with a lubricant supplement, by creating combinations of these variables and by validating these combinations with the combined sample of data from all groups of dry eye subjects. The effectiveness of single measures and combinations in diagnosis of dry eye was also considered.

Tomlinson A; Hair M; McFadyen A

2013-10-01

184

Computational protein design approaches with significant biological outcomes: progress and challenges  

Directory of Open Access Journals (Sweden)

Full Text Available Enzymes are powerful biocatalysts, however, so far there is still a large gap between the number of enzyme-based practical applications and that of naturally occurring enzymes. Multiple experimental approaches have been applied to generate nearly all possible mutations of target enzymes, allowing the identification of desirable variants with improved properties to meet the practical needs. Meanwhile, an increasing number of computational methods have been developed to assist in the modification of enzymes during the past few decades. With the development of bioinformatic algorithms, computational approaches are now able to provide more precise guidance for enzyme engineering and make it more efficient and less laborious. In this review, we summarize the recent advances of method development with significant biological outcomes to provide important insights into successful computational protein designs. We also discuss the limitations and challenges of existing methods and the future directions that should improve them.

Xiaoman Li; Ziding Zhang; Jiangning Song

2012-01-01

185

The EU-Project PROMOTE: A Process-oriented Approach for Knowledge Management  

UK PubMed Central (United Kingdom)

PROMOTE is a EU project dealing withknowledge management and running in the ISTprogramme, Nr. IST-1999-11658 [IST00]. Theoverall goal of the project is to develop anintegrated framework for process-orientedknowledge management based on the existingbusiness process management toolkit ADONISfi,to validate it by developing a product namedPROMOTEfiand to test it with end usercompanies from the financial and insurancesector. Information about the project can also befound under the website http://www.boceu.com/promote.1 Process-oriented Knowledge ManagementIn this paper we propose knowledge management to bebased on processes. A process-based point of viewenables - similar to business process management - thedevelopment of an integrated framework fordocumenting, analyzing and improving knowledgeactivities. As opposed to a purely document-centricperspective for knowledge management we examine whatprocesses create knowledge objects like documents,huma...

D. Karagiannis; Boc Gmbh; R. Telesko

186

An object-oriented approach to risk and reliability analysis : methodology and aviation safety applications.  

Energy Technology Data Exchange (ETDEWEB)

This article describes how features of event tree analysis and Monte Carlo-based discrete event simulation can be combined with concepts from object-oriented analysis to develop a new risk assessment methodology, with some of the best features of each. The resultant object-based event scenario tree (OBEST) methodology enables an analyst to rapidly construct realistic models for scenarios for which an a priori discovery of event ordering is either cumbersome or impossible. Each scenario produced by OBEST is automatically associated with a likelihood estimate because probabilistic branching is integral to the object model definition. The OBEST methodology is then applied to an aviation safety problem that considers mechanisms by which an aircraft might become involved in a runway incursion incident. The resulting OBEST model demonstrates how a close link between human reliability analysis and probabilistic risk assessment methods can provide important insights into aviation safety phenomenology.

Dandini, Vincent John; Duran, Felicia Angelica; Wyss, Gregory Dane

2003-09-01

187

Collections Digitization Framework: A Service-oriented Approach to Digitization in Academic Libraries  

Directory of Open Access Journals (Sweden)

Full Text Available With advances in information technologies, academic libraries are now in a position to offer collections digitization services beyond campus communities. By mobilizing digitization to off-campus communities, academic libraries can reposition themselves as responsive and relevant in the face of a changing digital services landscape. This will also help academic libraries create unique opportunities to access and share hidden knowledge embedded within local and remote communities with rich intellectual traditions. This article proposes a service-oriented framework for academic libraries to reimagine and mobilize collections digitization as part of broader library services. The proposed Collections Digitization Framework is based on the Service Framework for Digital Libraries developed by the Digital Library Federation, whereby digitization activities have been formalized into discrete processes and functions. The issues and challenges that academic libraries may face in mobilizing digitization services are also discussed in the context of a collaborative community digitization initiative undertaken by two Canadian academic libraries.

Karim Tharani

2012-01-01

188

Interrelations among University Students' Approaches to Learning, Regulation of Learning, and Cognitive and Attributional Strategies: A Person Oriented Approach  

Science.gov (United States)

This study investigated the relationships among approaches to learning, regulation of learning, cognitive and attributional strategies, stress, exhaustion, and study success. University students (N = 437) from three faculties filled in a questionnaire concerning their self-reported study behaviour, cognitive strategies, and well-being. Their…

Heikkila, Annamari; Niemivirta, Markku; Nieminen, Juha; Lonka, Kirsti

2011-01-01

189

A Role-Oriented Content-based Filtering Approach: Personalized Enterprise Architecture Management Perspective  

Directory of Open Access Journals (Sweden)

Full Text Available In the content filtering-based personalized recommender systems, most of the existing approaches concentrate on finding out similarities between users’ profiles and product items under the situations where a user usually plays a single role and his/her interests persist identical on long term basis. The existing approaches argue to resolve the issues of cold-start significantly while achieving an adequate level of personalized recommendation accuracy by measuring precision and recall. However, we investigated that the existing approaches have not been significantly applied in the context where a user may play multiple roles in a system simultaneously or may change his/her role overtime in order to navigate the resources in distinct authorized domains. The example of such systems is enterprise architecture management systems, or e-Commerce applications. In the scenario of existing approaches, the users need to create very different profiles (preferences and interests) based on their multiple /changing roles; if not, then their previous information is either lost or not utilized. Consequently, the problem of cold-start appears once again as well as the precision and recall accuracy is affected negatively. In order to resolve this issue, we propose an ontology-driven Domain-based Filtering (DBF) approach focusing on the way users’ profiles are obtained and maintained over time. We performed a number of experiments by considering enterprise architecture management aspect and observed that our approach performs better compared with existing content filtering-based techniques.

Imran GHANI; Choon Yeul LEE; Seung Ryul JEONG; Sung Hyun JUHN; Mohammad Shafie Bin Abd Latiff

2010-01-01

190

German Orientalism  

Directory of Open Access Journals (Sweden)

Full Text Available Review of: Suzanne L. Marchand, German Orientalism in the Age of Empire: Religion, Race and Scholarship, Cambridge and Washington, D.C.: Cambridge University Press, 2009. This analysis of Suzanne L. Marchand’s German Orientalism in the Age of Empire: Religion, Race and Scholarship reads her contribution in part against the background of Edward Said’s path breaking book Orientalism. Differences lie in her more expansive understanding of the term ‘Oriental’ to include the Far East and her concentration on German scholarship. Approaches to Orientalist scholarship are often judgmental. Marchand complicates the discourse by speaking to the individual and institutional circumstances, and not overestimating the effect that scholars have when they talk truth, or even merely ideas, to power. Her treatment of scholarship of visual art and of Jewish learning are the areas that could benefit from more nuanced thought and more research.

Margaret Olin

2011-01-01

191

Visual and refractive outcome of one-site phacotrabeculectomy compared with temporal approach phacoemulsification  

Directory of Open Access Journals (Sweden)

Full Text Available Daniela Vaideanu, Kaveri Mandal, Anthony Hildreth, Scott G Fraser, Peter S PhelanGlaucoma Unit, Sunderland Eye Infirmary, Sunderland, UKBackground: We aimed to compare visual and refractive outcome following phacoemulsification and intraocular lens implant (IOL) and combined one-site phacotrabeculectomy.Method: We performed a retrospective study of case records of patients who had temporal incision phacoemulsification with IOL or one-site phacotrabeculectomy, between June 1997 and June 2001. The patients were matched for age group, operating list and IOL type. All patients were operated on under local anesthesia by the same surgeon. Each arm of the study had 90 patients, age range 60 to 75 years. We collected pre- and postoperative visual acuity, pre- and postoperative refraction within six months after surgery, and intended refraction. The intraocular pressure control was not recorded, as it was not the aim of our study.Results: In the phacotrabeculectomy group, 76.6% of patients achieved aimed spherical equivalent, 15.5% of patients had against-the-rule (ATR) astigmatism induced by the surgery, and 90% of the patients had best corrected visual acuity (BCVA) more than 6/12. In the temporal incision phacoemulsification group, 81.1% of patients achieved aimed spherical equivalent, 10% of the patients had induced ATR by the surgery and 95.55% of patients achieved BCVA more than 6/12.Conclusion: In this study the visual outcome of the phacotrabeculectomy group did not differ significantly from the visual outcome of temporal approach phacoemulsification.Keywords: refractive outcome, phacoemulsifi cation, phacotrabeculectomy, astigmatism

Daniela Vaideanu; Kaveri Mandal; Anthony Hildreth; Scott G Fraser; Peter S Phelan

2008-01-01

192

Component-oriented approach to the development and use of numerical models in high energy physics  

International Nuclear Information System (INIS)

We discuss the main concepts of a component approach to the development and use of numerical models in high energy physics. This approach is realized as the NiMax software system. The discussed concepts are illustrated by numerous examples of the system user session. In appendix chapter we describe physics and numerical algorithms of the model components to perform simulation of hadronic and nuclear collisions at high energies. These components are members of hadronic application modules that have been developed with the help of the NiMax system. Given report is served as an early release of the NiMax manual mainly for model component users

2002-01-01

193

Making the Black Box of Collaborative Learning Transparent: Combining Process-Oriented and Cognitive Load Approaches  

Science.gov (United States)

Traditional research on collaborative learning employs a "black box" approach that makes it difficult to gain a deeper understanding of the differential effects of collaborative learning. To make the black box transparent, researchers have studied the process of collaboration, in order to establish which interaction features are likely to make…

Janssen, Jeroen; Kirschner, Femke; Erkens, Gijsbert; Kirschner, Paul A.; Paas, Fred

2010-01-01

194

Flood mitigation designs with respect to river ecosystem functions. A problem oriented conceptual approach  

Digital Repository Infrastructure Vision for European Research (DRIVER)

We formulated five proposals to improve specifications of flood hazard reduction projects and five proposals to preserve the river ecosystem functions, based on literature and authors' experience. Starting from these, we established a conceptual approach using the notion of riverscape, with related ...

Poulard, C.; Lafont, M.; Lenar Matyas, A.; Lapuszek, M.

195

Creating a performance-oriented e-learning environment: A design science approach  

Digital Repository Infrastructure Vision for European Research (DRIVER)

E-learning is now being used by many organizations as an approach for enhancing the skills of knowledge workers. However, most applications have performed poorly in motivating employee learning, being perceived as less effective due to a lack of alignment of learning with work performance. To help s...

Wang, M; Vogel, D; Ran, W

196

A new approach for goal-oriented analysis of healthcare processes.  

UK PubMed Central (United Kingdom)

The development of efficient e-services for patient-centered healthcare requires insight into concrete problems in administrative and clinical work processes as well as an understanding of the strategic goals that should guide these healthcare processes. However, considering both concrete process related problems and high-level strategic goals during process analysis and solution design can be problematic. To address this, we propose a structured approach for analyzing both high- and low-level goals in a healthcare process and relating these to identified problems. Thereby proposed solutions for each problem in form of, e.g. e-services can be connected to strategic goals. The approach consists of five steps; process modeling; process-based problem identification and classification; process goal identification; mapping to strategic goals; and solution proposal. The approach is illustrated by examples from a case study of Swedish stroke care. In conclusion, the approach enables analysis of high- and low-level goals in a healthcare process by relating these to identified problems. The results thereof form a basis for redefinition of current care processes, as well as for design of supporting e-health solutions.

Hägglund M; Henkel M; Zdravkovic J; Johannesson P; Rising I; Krakau I; Koch S

2010-01-01

197

A new approach for goal-oriented analysis of healthcare processes.  

Science.gov (United States)

The development of efficient e-services for patient-centered healthcare requires insight into concrete problems in administrative and clinical work processes as well as an understanding of the strategic goals that should guide these healthcare processes. However, considering both concrete process related problems and high-level strategic goals during process analysis and solution design can be problematic. To address this, we propose a structured approach for analyzing both high- and low-level goals in a healthcare process and relating these to identified problems. Thereby proposed solutions for each problem in form of, e.g. e-services can be connected to strategic goals. The approach consists of five steps; process modeling; process-based problem identification and classification; process goal identification; mapping to strategic goals; and solution proposal. The approach is illustrated by examples from a case study of Swedish stroke care. In conclusion, the approach enables analysis of high- and low-level goals in a healthcare process by relating these to identified problems. The results thereof form a basis for redefinition of current care processes, as well as for design of supporting e-health solutions. PMID:20841884

Hägglund, Maria; Henkel, Martin; Zdravkovic, Jelena; Johannesson, Paul; Rising, Inger; Krakau, Ingvar; Koch, Sabine

2010-01-01

198

Object-Oriented Approach for Integration of Heterogeneous Databases in a Multidatabase System and Local Schemas Modifications Propagation  

Directory of Open Access Journals (Sweden)

Full Text Available One of the challenging problems in the multidatabase systems is to find the most viable solution to the problem of interoperability of distributed heterogeneous autonomous local component databases. This has resulted in the creation of a global schema over set of these local component database schemas to provide a uniform representation of local schemas. The aim of this paper is to use object-oriented approach to integrate schemas of distributed heterogeneous autonomous local component database schemas into a global schema. The resulting global schema provides a uniform interface and high level of location transparency for retrieval of data from the local component databases. A set of integration operators are defined to integrate local schemas based on the semantic relevance of their classes and to provide a model independent representation of virtual classes of the global schema. The schematic representation and heterogeneity is also taken into account in the integration process. Justifications about Object-Oriented Modal are also discussed. Bottom up local schema modifications propagation in Global schema is also considered to maintain Global schema as local schemas are autonomous and evolve over time. An example illustrates the applicability of the integration operator defined.

Mohammad Ghulam Ali

2009-01-01

199

Target-Oriented Approach to Identification of Business Processes of a Company ??????????????????? ?????? ? ????????????? ??????-????????? ???????????  

Directory of Open Access Journals (Sweden)

Full Text Available The article identifies essence of the procedure of identification of business processes and its place in creation of a process model of a company. It shapes a set of properties of the business process, which should be determined at its identification. It considers approaches to construction of a process model of a company and identifies its advantages and shortcomings. It considers procedures of structurisation and identification of business processes of a company, which are alternative ones by direction of movement along levels of its hierarchy. It demonstrates that the goal (task), at achievement of which a business process is directed, directly identifies its boundaries at exit and indirectly (through production and management technology of a company and in accordance with the accepted level of detailing business processes) – boundaries at entry. The offered approach to identification of business processes on the basis of its goals is illustrated by an example of sales activity of a company.? ?????? ?????????? ???????? ????????? ????????????? ??????-????????? ? ?? ????? ??? ???????? ?????????? ?????? ???????????. ??????? ???? ??????? ??????-????????, ??????? ?????? ???? ?????????? ??? ??? ?????????????. ??????????? ??????? ? ?????????? ?????????? ?????? ???????????, ?????????? ?? ???????????? ? ??????????. ??????????? ????????? ?????????????? ? ????????????? ??????-????????? ???????????, ?????????????? ?? ??????????? ??????????? ?? ??????? ??? ????????. ??????????????????, ??? ???? (??????), ?? ?????????? ??????? ????????? ??????-???????, ??????????????? ?????????? ??? ??????? ?? ?????? ? ????????????? (????? ???????????????? ? ?????????????? ?????????? ??????????? ? ???????? ????????? ?????? ??????????? ??????-?????????) – ??????? ?? ?????. ???????????? ?????? ? ????????????? ??????-????????? ?? ?????? ?? ????? ???????????????? ?? ??????? ???????? ???????????? ???????????.

Kotlik Andrey V.

2013-01-01

200

An Embedded Software Modeling and Process by Using Aspect-Oriented Approach  

Directory of Open Access Journals (Sweden)

Full Text Available In recent years, mobile devices have become widespread and refined, and they have offered increased convenience in human life. For these reasons, a variety of embedded systems have been designed. Therefore, improving methods for developing of embedded software systematically has become an important issue. Platform-based design is one example of an embedded-system design method that can reduce the design cost via improving a design’s abstraction level. However, platform-based design lacks precise definitions for platforms and design processes. This paper provides an approach that combines the aspects and platform-based design methods for developing embedded software. The approach is built on platform-based design methodology and uses the separating of concerns (SoC) concept to define the aspects and to reduce the crosscutting concerns in embedded system modeling. For aspect issues, we use the extended UML notation with aspects to describe both the static structure and the dynamic structure of the embedded system. We used an example of a digital photo frame system to demonstrate our approach.

Yong-Yi FanJiang; Jong-Yih Kuo; Shang-Pin Ma

2011-01-01

 
 
 
 
201

A data-gathering broker as a future-orientated approach to supporting EPR users.  

UK PubMed Central (United Kingdom)

With the continued expansion of electronic patient record systems ahead of comprehensive evidence, metrics, or future-proofing, health informatics in Europe and beyond is embarking on a faith-driven adventure that also risks data swamping of end-users. An alternative approach is an information broker system, drawing from departmental data sources. A 3-year study in health and social care has produced a first demonstrator which can search for specified information in heterogeneous distributed data stores, with source-specific permission can copy it, and then merge the search results into one integrated picture in a real-time process which is also captured in an audit system. The research project has addressed a number of issues during the study, including updating the concepts of role-based access, semantic interoperability, and harnessing web-based services bound at the time of need. A demonstrator now exists, and provides a platform for further application and development research. This paper summarises how this opens up a viable alternative approach for the next generation of health record systems, enabling record searching and integration as and when it is needed for specific patient-related purposes, whilst being independent of organisations, diagnostic approaches, or service delivery structures, and reducing the risks of data swamping.

Rigby M; Budgen D; Turner M; Kotsiopoulos I; Brereton P; Keane J; Bennett K; Russell M; Layzell P; Zhu F

2007-02-01

202

Foramen magnum meningiomas: clinical outcome after microsurgical resection via a posterolateral suboccipital retrocondylar approach.  

UK PubMed Central (United Kingdom)

OBJECTIVE: We analyzed a consecutive series of patients operated for a foramen magnum (FM) meningioma located on the ventral aspect of the medulla oblongata via a posterolateral suboccipital retrocondylar approach with regard to long-term surgical outcome. METHODS: Clinical data in a consecutive series of 25 patients experiencing a meningioma attached to dura of the anterior or anterolateral FM rim were retrospectively reviewed. RESULTS: The most common symptoms of the 19 women and six men (mean age, 59.2 yr) was cervico-occipital pain (72%) and gait disturbance (32%). Clinical examination revealed gait ataxia in 48% of the patients. As depicted from preoperative magnetic resonance imaging (MRI), dural attachment of the meningioma at the FM rim was anterior in 36% and anterolateral in 64% of cases. Tumor removal was accomplished via a posterolateral suboccipital retrocondylar approach in all patients. A Simpson Grade 2 resection was achieved in 96% of the patients. Permanent surgical morbidity and mortality rates were 8 and 4%, respectively. No tumor recurrence was observed after a mean follow-up period of 6.1 years (range, 1-14 yr) with clinical and MRI examination, and 80% of the patients have regained full daily activity. CONCLUSION: Anterior and anterolateral FM meningiomas that displace the medulla/spinal cord can be safely and completely resected via a posterolateral suboccipital retrocondylar approach. A tumor remnant should be left on critical neurovascular structures in cases with poor arachnoid dissection planes.

Bassiouni H; Ntoukas V; Asgari S; Sandalcioglu EI; Stolke D; Seifert V

2006-12-01

203

Product Service Systems and Non-Market Oriented Approach – Methodological and Ethical Considerations from a Design Perspective  

DEFF Research Database (Denmark)

Macroscopic social and economic changes in the last few years are forcing business companies and public institutions to redefine their approach to social intervention, focusing on local and highly individualised solutions. This change is also calling for a new design approach. The challenge for designers is not only to be able to provide local and highly individualised solutions, but also to propose strategies to transfer and reproduce the solutions, or part of them, into different local contexts, thus creating economy of scope. This would be possible by using forms of codification and modularisation of the most relevant components in local solutions. The code refers to the organisational knowledge included in local components and the way each component interacts with the others. Like software systems, local product-service systems can be built upon a source code. This paper will illustrate how this process was developed in a concrete case. Through this case the authors analyse the possibility to build something similar to a source code for initiatives based on social interaction and investigate the process of construction of such a code Furthermore, the author discuss differences and analogies between design intervention in a social context and in the normal business context. The question of codification suggests a methodological approach for supporting transferability both in the problem space (dealing with complexity) and in the solution space (dealing with contingency). The analysis of differences and similarities between business- and socially-oriented processes suggests a new role for designers and new opportunities for innovation.

Morelli, Nicola; Jonas, Wolfgang

2008-01-01

204

Risk factors and pregnancy outcomes in women with syphilis diagnosed using a molecular approach.  

UK PubMed Central (United Kingdom)

OBJECTIVES: To investigate the risk factors for infection and the outcome of pregnancy in women diagnosed with syphilis using a molecular approach. METHODS: Case-control study of pregnant women admitted to a maternity ward, with the cases classified as early or latent maternal syphilis, based on clinical-serological diagnoses. The DNA of total peripheral blood was used to detect the polA gene using nested PCR (nPCR). The case and control groups were divided into subgroups based on whether the birth was successful (infant survived) or had a lethal outcome (miscarriage, stillbirth or neonatal death). RESULTS: The frequency of maternal syphilis was 1% (237/25 600), considering both those that had live births (71.3%, 169/237) and those with a lethal outcome (28.7%, 68/237), with a higher detection rate being provided by the nPCR in women with early syphilis. The cases of nPCR(+) congenital syphilis were more frequent in the women with early syphilis, nPCR(+) mothers and those who did not have treatment during the prenatal. The risk of maternal syphilis was greater in women who had not received preventive counselling, initiated sexual activity at 16 years of age or younger, had multiple partners, used drugs, were from households with a low income and poor sanitation, and had a history of miscarriage. CONCLUSIONS: The risk factors for congenital syphilis are closely related to the health of the mother, reflecting the lack of adequate prenatal care. The high frequency of maternal syphilis was associated in particular to the socio-economic conditions of the mother and her sexual and reproductive health.

Casal C; Araújo Eda C; Corvelo TC

2013-05-01

205

A NTCP approach for estimating the outcome in radioiodine treatment of hyperthyroidism.  

Science.gov (United States)

Radioiodine has been in use for over 60 years as a treatment for hyperthyroidism. Major changes in clinical practice have led to accurate dosimetry capable of avoiding the risks of adverse effects and the optimization of the treatment. The aim of this study was to test the capability of a radiobiological model, based on normal tissue complication probability (NTCP), to predict the outcome after oral therapeutic 131I administration. Following dosimetric study, 79 patients underwent treatment for hyperthyroidism using radioiodine and then 67 had at least a one-year follow up. The delivered dose was calculated using the MIRD formula, taking into account the measured maximum uptake of administered iodine transferred to the thyroid, U0, and the effective clearance rate, Teff and target mass. The dose was converted to normalized total dose delivered at 2 Gy per fraction (NTD2). Furthermore, the method to take into account the reduction of the mass of the gland during radioiodine therapy was also applied. The clinical outcome and dosimetric parameters were analyzed in order to study the dose-response relationship for hypothyroidism. The TD50 and m parameters of the NTCP model approach were then estimated using the likelihood method. The TD50, expressed as NTD2, resulted in 60 Gy (95% C.I.: 45-75 Gy) and 96 Gy (95% C.I.: 86-109 Gy) for patients affected by Graves or autonomous/multinodular disease, respectively. This supports the clinical evidence that Graves' disease should be characterized by more radiosensitive cells compared to autonomous nodules. The m parameter for all patients was 0.27 (95% C.I.: 0.22-0.36). These parameters were compared with those reported in the literature for hypothyroidism induced after external beam radiotherapy. The NTCP model correctly predicted the clinical outcome after the therapeutic administration of radioiodine in our series. PMID:18841841

Strigari, L; Sciuto, R; Benassi, M; Bergomi, S; Nocentini, S; Maini, C L

2008-09-01

206

The percutaneous surgical approach for repairing acute Achilles tendon rupture: a comprehensive outcome assessment.  

UK PubMed Central (United Kingdom)

BACKGROUND: Treatment modalities for acute Achilles tendon rupture can be divided into operative and nonoperative. The main concern with nonoperative treatment is the high incidence of repeated ruptures; operative treatment is associated with risk of infection, sural nerve injury, and wound-healing sequelae. We assessed our experience with a percutaneous operative approach for treating acute Achilles tendon rupture. METHODS: The outcomes of percutaneous surgery in 29 patients (25 men; age range, 24-58 years) who underwent percutaneous surgery for Achilles tendon rupture between 1997 and 2004 were retrospectively evaluated. Their demographic data, subjective and objective evaluation findings, and isokinetic evaluation results were retrieved, and they were assessed with the modified Boyden score and the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale. RESULTS: All 29 patients demonstrated good functional outcome, with no- to mild-limitations in recreational activities and high patient satisfaction. Mean follow-up was 31.8 months. Changes in ankle range of motion in the operated leg were minimal. Strength and power testing revealed a significant difference at 90 degrees /sec for plantarflexion power between the injured and healthy legs but no difference at 30 degrees and 240 degrees /sec or in dorsiflexion. The mean modified Boyden score was 74.3, and the mean Ankle-Hindfoot Scale score was 94.5. CONCLUSIONS: Percutaneous surgery for Achilles tendon rupture is easily executed and has excellent functional results and low complication rates. It is an appealing alternative to either nonoperative or open surgery treatments.

Tenenbaum S; Dreiangel N; Segal A; Herman A; Israeli A; Chechik A

2010-07-01

207

Improving health outcomes in young people - a holistic, team based approach.  

UK PubMed Central (United Kingdom)

BACKGROUND: Young people aged 12-25 years are poorly serviced by current models of healthcare; they are under represented in Medicare data and are poor seekers of healthcare. However, the majority of mental health problems commence during this age span, significant sexual health issues arise, and there is poor compliance with treatment for chronic disease. OBJECTIVE: This article describes a holistic, multisector primary healthcare delivery model which may provide a way forward to improve both access and outcomes for young people. DISCUSSION: The 'headspace Gold Coast' model incorporates the relationship the young person has with both the organisation and the individuals within it; a focus on social and vocational rehabilitation; and a team based approach. The model provided at headspace serves an unmet need for young people in urban settings. However, more and ongoing support is crucial, including options for integration into existing primary care.

Radford S; Van Driel ML; Swanton K

2011-03-01

208

A reliable approach to diabetic neuroischemic foot wounds: below-the-knee angiosome-oriented angioplasty.  

UK PubMed Central (United Kingdom)

PURPOSE: To evaluate the clinical benefit in wound healing and limb preservation after primary below-the-knee angioplasty guided by an angiosome model of perfusion in diabetic patients with neuroischemic foot ulcers. METHODS: From September 2001 to April 2010, 232 limb-threatening neuroischemic wounds in 208 diabetic patients (147 men; mean age 74.3 years, range 42-97) were treated by below-the-knee endoluminal and/or subintimal angioplasty. There were 19 (8%) TASC II type B, 80 (34%) type C, and 133 (57%) type D infrapopliteal lesions. Patients treated prior to 2005 when the angiosome-targeted revascularization protocol was introduced (89 limbs, group 1) were compared to 134 limbs treated subsequently according to the angiosome model (group 2). The angiosome-oriented group 2 included 25% procedures focusing on the anterior tibial and dorsalis pedis arteries, 68% on the posterior tibial and plantar vessels, and 7% on the peroneal arteries. RESULTS: The global technical success was 80% (187/232): 82% in group 1 and 79% in group 2. The cumulative patient survival rates were 90%, 78%, and 65% in group 1 and 93%, 82%, and 71% in group 2 at 12, 24, and 36 months, respectively (p = 0.545). At the same time points, the freedom from amputation rates were 84%, 79%, and 79% in group 1 versus 90%, 89%, and 89% in group 2 (p = 0.035). Clinical success rates were 76%, 68%, 68% in the group 1 and 85%, 79%, and 79% in group 2 (p = 0.025). Primary and secondary patency rates did not differ between groups (p = 0.813 and p = 0.511). Patients in group 2 treated with angiosome-targeted revascularization had significantly better wound healing (p<0.018) and limb preservation (p<0.030). CONCLUSION: Below-the-knee first-line angioplasty guided by an angiosome model may prove beneficial in terms of better wound healing of diabetic foot ulcers and subsequent limb salvage. Further technical improvements and large comparative studies are necessary to support these observations.

Alexandrescu V; Vincent G; Azdad K; Hubermont G; Ledent G; Ngongang C; Filimon AM

2011-06-01

209

Coronary revascularization of the circumflex system: different approaches and long-term outcome.  

UK PubMed Central (United Kingdom)

BACKGROUND: Minimally invasive direct coronary artery bypass, without cardiopulmonary bypass, through a left lateral thoracotomy approach (lateral MIDCAB), is a safe alternative to coronary artery bypass surgery using cardiopulmonary bypass (on-pump CABG) of the circumflex system via median sternotomy. However, it is unknown whether lateral MIDCAB may yield an improved long-term outcome over the conventional on-pump median sternotomy approach. METHODS: We compared the perioperative outcomes of patients undergoing lateral MIDCAB (n = 34) versus conventional on-pump CABG of the circumflex system (n = 16) from June 1996 to July 1999. The two groups were similar with respect to baseline characteristics and risk stratification. Patients who required only one or two grafts for complete revascularization were included. RESULTS: Lateral MIDCAB patients had a lower need than on-pump CABG patients for intraoperative (12% MIDCAB vs 43% on-pump CABG, p = 0.03) and postoperative transfusions (29% vs 69%, p = 0.01), had fewer neuropsychologic changes (0% vs 19%, p = 0.03), and had a lower rate of postoperative atrial fibrillation (12% vs 44%, p = 0.02). Lateral MIDCAB was also associated with a significantly lower postoperative length of stay (5 +/- 2 vs 7 +/- 3 days, p = 0.02). Actuarial survival at a mean period of follow-up of 19 +/- 11 months was 97% for the lateral MIDCAB versus 88% for the on-pump CABG group (p = 0.6). Event-free survival was 88% for lateral MIDCAB versus 81% for on-pump CABG (p = 0.1). CONCLUSIONS: Lateral MIDCAB may safely be performed in patients with isolated coronary artery disease of the circumflex system with improved early morbidity and an abbreviated hospital stay compared with conventional median sternotomy on-pump CABG.

Stamou SC; Bafi AS; Boyce SW; Pfister AJ; Dullum MK; Hill PC; Zaki S; Garcia JM; Corso PJ

2000-10-01

210

Hilar cholangiocarcinoma: preoperative liver optimization with multidisciplinary approach. Toward a better outcome.  

UK PubMed Central (United Kingdom)

INTRODUCTION: The diagnosis and treatment of hilar tumors requires a multidisciplinary approach based on the synergy of radiologists, surgeons, oncologists, and gastroenterologists. Klatskin tumor is a relatively rare disease with a poor prognosis. Currently, the only possible treatment is represented by the removal of the tumor associated with radical surgery, even though its results are still jeopardized by significant morbidity and mortality. A proper preoperative optimization of the patient, including staging laparoscopy, biliary drainage, and portal vein embolization, may improve short-term outcome. The purpose of this study was to evaluate the short- and long-term impact of preoperative optimization in patients affected by hilar cholangiocarcinoma. METHODS: From January 2004 to May 2012, 94 patients with preoperative diagnosis of Klastkin tumors were candidates for surgery at the Hepatobiliary Surgery Unit of the Hospital San Raffaele in Milan. The data of all patients were prospectively collected and retrospectively reviewed. The outcome was evaluated in terms of perioperative morbidity and mortality and overall and disease-free survival. Short-term outcome of patients undergoing preoperative optimization was compared with outcome of patients who did not undergo it in terms of intraoperative data, morbidity and mortality. RESULTS: Of 94 patients undergoing surgery, 80 underwent hepatic and biliary confluence resection. Fourteen patients were considered unresectable due to the presence of peritoneal carcinomatosis or advanced disease seen during staging laparoscopy or at laparotomy and therefore were excluded from the analysis. Seventy-five (93.7 %) patients underwent major liver resections: in 14 of these, surgery was performed at a distance of 30-40 days from PVE. In 55 patients, biliary drainage was preoperatively placed for palliation of obstructive jaundice. The postoperative morbidity rate was 51.2 % and mortality 6.2 %. The most frequent cause of death was postoperative liver failure. Five-year survival rate was 29 %. Patients undergoing preoperative optimization experienced a significant reduction of postoperative morbidity, especially in terms of infectious related events. CONCLUSIONS: Klatskin tumor remains a disease associated with poor prognosis, but a correct preoperative diagnostic and therapeutic management provides tools to perform this type of surgery with acceptable morbidity and mortality, thus improving long-term results.

Ratti F; Cipriani F; Ferla F; Catena M; Paganelli M; Aldrighetti LA

2013-06-01

211

Olfactory groove meningioma: discussion of clinical presentation and surgical outcomes following excision via the subcranial approach.  

UK PubMed Central (United Kingdom)

OBJECTIVES/HYPOTHESIS: To describe surgical outcomes and radiographic features of olfactory groove meningiomas treated by excision through the subcranial approach. Special emphasis is placed on paranasal sinus and orbit involvement. STUDY DESIGN: Retrospective review of a series of patients. METHODS: Nineteen patients underwent excision of olfactory groove meningioma (OGM) via the transglabellar/subcranial approach between December 1995 and November 2009. Nine patients had previously undergone prior resection at outside institutions, and four had prior radiotherapy in addition to a prior excision. Transglabellar/subcranial surgical approach to the anterior skull base was performed. RESULTS: Tumor histology included three World Health Organization (WHO) grade III lesions, one WHO grade II lesion, and 15 WHO grade I lesions. Fourteen patients had evidence of extension into the paranasal sinuses, with the ethmoid sinus being most commonly involved. Kaplan-Meier estimates of mean overall and disease-free survival were 121.45 months and 93.03 months, respectively. The mean follow-up interval was 41.0 months, and at the time of data analysis three patients had recurrent tumors. Seven (36.8%) patients experienced a major complication in the perioperative period; there were no perioperative mortalities. Orbit invasion was observed in four patients, with optic nerve impingement in 11 patients. Of these, three patients had long-term diplopia. No patients experienced worsening of preoperative visual acuity. CONCLUSIONS: Olfactory groove meningiomas demonstrate a propensity to spread into the paranasal sinuses, particularly in recurrent cases. Given a tendency for infiltrative recurrence along the skull base, this disease represents an important area of collaboration between neurosurgery and otolaryngology. The subcranial approach offers excellent surgical access for excision, particularly for recurrences that involve the paranasal sinuses and optic apparatus.

Pepper JP; Hecht SL; Gebarski SS; Lin EM; Sullivan SE; Marentette LJ

2011-11-01

212

Biologically oriented preparation technique (BOPT): a new approach for prosthetic restoration of periodontically healthy teeth.  

UK PubMed Central (United Kingdom)

Tooth preparations for fixed prosthetic restorations can be done in different ways, basically of two kinds: preparation with a defined margin and the so-called vertical preparation or feather edge. The latter was originally used for prosthetics on teeth treated with resective surgery for periodontal disease. In this article, the author presents a prosthetic technique for periodontally healthy teeth using feather edge preparation in a flapless approach in both esthetic and posterior areas with ceramometal and zirconia restorations, achieving high quality clinical and esthetic results in terms of soft tissue stability at the prosthetic/tissue interface, both in the short and in the long term (clinical follow-up up to fifteen years). Moreover, the BOPT technique, if compared to other preparation techniques (chamfer, shoulder, etc), is simpler and faster when in preparation impression taking, temporary crowns' relining and creating the crowns' profiles up to the final prosthetic restoration.

Loi I; Di Felice A

2013-01-01

213

(Dis)orientation of international medical graduates: an approach to foster teaching, learning, and collaboration (TLC).  

UK PubMed Central (United Kingdom)

OBJECTIVE: The Teaching for Learning and Collaboration (TLC) Program is a teaching-skills program focusing on methods to improve student learning. This program was adopted to address the professional and personal challenges faced by International Medical Graduates (IMGs) completing a fellowship in psychosomatic medicine. METHOD: The authors conducted a literature review on the educational challenges encountered by IMGs. Based on this review, an adapted TLC Program was piloted on four IMG fellows who completed a psychosomatic medicine fellowship between 2008 and 2011. RESULTS: Teachers using the adapted TLC Program reported the following as being significant in the IMG training process: a safe educational environment; having an extended period of time for assessment and fellow adjustment; and more direct, rather than "diplomatic," feedback. CONCLUSIONS: Although piloted in a psychosomatic medicine fellowship, the TLC program is intended to be generalizable to other medical training settings. Further evaluation of the effectiveness of this approach for IMGs is required.

Tan A; Hawa R; Sockalingam S; Abbey SE

2013-03-01

214

Design of the DISCovery project: tailored work-oriented interventions to improve employee health, well-being, and performance-related outcomes in hospital care  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background It is well-known that health care workers in today’s general hospitals have to deal with high levels of job demands, which could have negative effects on their health, well-being, and job performance. A way to reduce job-related stress reactions and to optimize positive work-related outcomes is to raise the level of specific job resources and opportunities to recover from work. However, the question remains how to translate the optimization of the balance between job demands, job resources, and recovery opportunities into effective workplace interventions. The aim of the DISCovery project is to develop and implement tailored work-oriented interventions to improve health, well-being, and performance of health care personnel. Methods/Design A quasi-experimental field study with a non-equivalent control group pretest-posttest design will be conducted in a top general hospital. Four existing organizational departments will provide both an intervention and a comparison group. Two types of research methods are used: (1) a longitudinal web-based survey study, and (2) a longitudinal daily diary study. After base-line measures of both methods, existing and yet to be developed interventions will be implemented within the experimental groups. Follow-up measurements will be taken one and two years after the base-line measures to analyze short-term and long-term effects of the interventions. Additionally, a process evaluation and a cost-effectiveness analysis will be carried out. Discussion The DISCovery project fulfills a strong need for theory-driven and scientifically well-performed research on job stress and performance interventions. It will provide insight into (1) how a balance between job demands, job resources, and recovery from work can be optimized, (2) the short-term and long-term effects of tailored work-oriented effects, and (3) indicators for successful or unsuccessful implementation of interventions.

Niks Irene MW; de Jonge Jan; Gevers Josette MP; Houtman Irene LD

2013-01-01

215

Design of the DISCovery project: tailored work-oriented interventions to improve employee health, well-being, and performance-related outcomes in hospital care.  

UK PubMed Central (United Kingdom)

BACKGROUND: It is well-known that health care workers in today's general hospitals have to deal with high levels of job demands, which could have negative effects on their health, well-being, and job performance. A way to reduce job-related stress reactions and to optimize positive work-related outcomes is to raise the level of specific job resources and opportunities to recover from work. However, the question remains how to translate the optimization of the balance between job demands, job resources, and recovery opportunities into effective workplace interventions. The aim of the DISCovery project is to develop and implement tailored work-oriented interventions to improve health, well-being, and performance of health care personnel. METHODS/DESIGN: A quasi-experimental field study with a non-equivalent control group pretest-posttest design will be conducted in a top general hospital. Four existing organizational departments will provide both an intervention and a comparison group. Two types of research methods are used: (1) a longitudinal web-based survey study, and (2) a longitudinal daily diary study. After base-line measures of both methods, existing and yet to be developed interventions will be implemented within the experimental groups. Follow-up measurements will be taken one and two years after the base-line measures to analyze short-term and long-term effects of the interventions. Additionally, a process evaluation and a cost-effectiveness analysis will be carried out. DISCUSSION: The DISCovery project fulfills a strong need for theory-driven and scientifically well-performed research on job stress and performance interventions. It will provide insight into (1) how a balance between job demands, job resources, and recovery from work can be optimized, (2) the short-term and long-term effects of tailored work-oriented effects, and (3) indicators for successful or unsuccessful implementation of interventions.

Niks IM; de Jonge J; Gevers JM; Houtman IL

2013-01-01

216

Binasal endoscopic approach to the sellar region: experience and outcome analysis of 80 cases.  

Science.gov (United States)

A prospective study was performed on 80 cases of different types of sellar lesions during the period between January 2007 and December 2010. The binasal approach was used in all patients. Functioning lesions were diagnosed in 59 patients. The most common secretory tumors were prolactinomas (37 patients) followed by adrenocorticotropic hormone producing tumors (11 patients) and growth hormone producing tumors (11 patients). Nonfunctioning lesions included: 14 pituitary adenomas, 2 chordomas, 2 metastatic lesions (ovarian carcinoma and thyroid carcinoma), and 1 case of sarcoidosis, Rathke's cleft cyst, and craniopharyngioma. Seven nonfunctioning cases developed apoplexy. Among the 59 patients with functioning pituitary lesions, postoperative endocrinological control was achieved in 51 of them (86.5%) 3 months postoperatively with normalization of pituitary functions and complete tumor resection as proved by postoperative magnetic resonance imaging. Postoperative visual field defect improvement was achieved in 15 out of 23 patients (65.2%), including the cases with apoplexy, with complete tumor resection. Postoperative discomfort such as headache, vomiting, or dizziness was minimal and hospitalization period was 2 to 3 days. Postoperative leak continued in one patient in whom revision surgical repair was performed 7 days later. The merits, outcome, and limitations of the approach were discussed. PMID:23905006

El-Fiki, Mohamed E; Aly, Ahmed; Elwany, Samy

2012-08-01

217

Binasal endoscopic approach to the sellar region: experience and outcome analysis of 80 cases.  

UK PubMed Central (United Kingdom)

A prospective study was performed on 80 cases of different types of sellar lesions during the period between January 2007 and December 2010. The binasal approach was used in all patients. Functioning lesions were diagnosed in 59 patients. The most common secretory tumors were prolactinomas (37 patients) followed by adrenocorticotropic hormone producing tumors (11 patients) and growth hormone producing tumors (11 patients). Nonfunctioning lesions included: 14 pituitary adenomas, 2 chordomas, 2 metastatic lesions (ovarian carcinoma and thyroid carcinoma), and 1 case of sarcoidosis, Rathke's cleft cyst, and craniopharyngioma. Seven nonfunctioning cases developed apoplexy. Among the 59 patients with functioning pituitary lesions, postoperative endocrinological control was achieved in 51 of them (86.5%) 3 months postoperatively with normalization of pituitary functions and complete tumor resection as proved by postoperative magnetic resonance imaging. Postoperative visual field defect improvement was achieved in 15 out of 23 patients (65.2%), including the cases with apoplexy, with complete tumor resection. Postoperative discomfort such as headache, vomiting, or dizziness was minimal and hospitalization period was 2 to 3 days. Postoperative leak continued in one patient in whom revision surgical repair was performed 7 days later. The merits, outcome, and limitations of the approach were discussed.

El-Fiki ME; Aly A; Elwany S

2012-08-01

218

A set cover approach to fast beam orientation optimization in intensity modulated radiation therapy for total marrow irradiation.  

Science.gov (United States)

The beam orientation optimization (BOO) problem in intensity modulated radiation therapy (IMRT) treatment planning is a nonlinear problem, and existing methods to obtain solutions to the BOO problem are time consuming due to the complex nature of the objective function and size of the solution space. These issues become even more difficult in total marrow irradiation (TMI), where many more beams must be used to cover a vastly larger treatment area than typical site-specific treatments (e.g., head-and-neck, prostate, etc). These complications result in excessively long computation times to develop IMRT treatment plans for TMI, so we attempt to develop methods that drastically reduce treatment planning time. We transform the BOO problem into the classical set cover problem (SCP) and use existing methods to solve SCP to obtain beam solutions. Although SCP is NP-Hard, our methods obtain beam solutions that result in quality treatments in minutes. We compare our approach to an integer programming solver for the SCP to illustrate the speed advantage of our approach. PMID:21828910

Lee, Chieh-Hsiu Jason; Aleman, Dionne M; Sharpe, Michael B

2011-08-10

219

Examination of the role of magnetic resonance imaging in multiple sclerosis: A problem-orientated approach  

Directory of Open Access Journals (Sweden)

Full Text Available Magnetic Resonance Imaging (MRI) has brought in several benefits to the study of Multiple Sclerosis (MS). It provides accurate measurement of disease activity, facilitates precise diagnosis, and aid in the assessment of newer therapies. The imaging guidelines for MS are broadly divided in to approaches for imaging patients with suspected MS or clinically isolated syndromes (CIS) or for monitoring patients with established MS. In this review, the technical aspects of MR imaging for MS are briefly discussed. The imaging process need to capture the twin aspects of acute MS viz. the autoimmune acute inflammatory process and the neurodegenerative process. Gadolinium enhanced MRI can identify acute inflammatory lesions precisely. The commonly applied MRI marker of disease progression is brain atrophy. Whole brain magnetization Transfer Ratio (MTR) and Magnetic Resonance Spectroscopy (MRS) are two other techniques use to monitor disease progression. A variety of imaging techniques such as Double Inversion Recovery (DIR), Spoiled Gradient Recalled (SPGR) acquisition, and Fluid Attenuated Inversion Recovery (FLAIR) have been utilized to study the cortical changes in MS. MRI is now extensively used in the Phase I, II and III clinical trials of new therapies. As the technical aspects of MRI advance rapidly, and higher field strengths become available, it is hoped that the impact of MRI on our understanding of MS will be even more profound in the next decade.

McFarland Henry

2009-01-01

220

What do resource-oriented approaches mean to general practitioners and how can they be facilitated in primary care? A qualitative study.  

UK PubMed Central (United Kingdom)

Although resource orientation, as a part of health promotion, should play a major role in general practice, the anchoring and realization of resource-oriented approaches remain small in Germany. The aim of this study was to analyze what resource orientation means to general practitioners (GPs) and develop strategies as to how this can be facilitated in GP practice. Within a qualitative research approach, 19 semi-structured telephone interviews were recorded, transcribed, and analyzed using qualitative content analysis. Within the interviews, the inclusion of the patients' individual resources is described as core competence of GPs. Supporting the patients' disease coping strategies and self-help were seen as important by GPs. However, perceptions as to which resources are considered to be fundamental ranged widely across the participant group. The results confirm the important role of resource-oriented approaches in general practice. However, a general definition of resource orientation is needed. In addition, working conditions for GPs need to be taken into account to ensure that these contribute to a healthy work-life balance. The need for GP training was identified to improve communication skills. Further integration of GPs in health promotion and communal structures would be beneficial.

Prüfer F; Joos S; Miksch A

2013-01-01

 
 
 
 
221

BBM Approach to Outdoor Recreation Programming.  

Science.gov (United States)

|The benefits based management (BBM) approach to outdoor recreation programming is a technique focused on outcomes and benefits derived from participating in outdoor recreation activities. This approach can be used to establish the significance of college outdoor programs on campus. The four premises of BBM are the articulation of outcome-oriented

Harwell, Rick; Brookover, Bob

222

Innovative community-based approaches doubled tuberculosis case notification and improve treatment outcome in Southern Ethiopia.  

UK PubMed Central (United Kingdom)

BACKGROUND: TB Control Programmes rely on passive case-finding to detect cases. TB notification remains low in Ethiopia despite major expansion of health services. Poor rural communities face many barriers to service access. METHODS AND FINDINGS: A community-based intervention package was implemented in Sidama zone, Ethiopia. The package included advocacy, training, engaging stakeholders and communities and active case-finding by female Health Extension Workers (HEWs) at village level. HEWs conducted house-to-house visits, identified individuals with a cough for two or more weeks, with or without other symptoms, collected sputum, prepared smears and supervised treatment. Supervisors transported smears for microscopy, started treatment, screened contacts and initiated Isoniazid preventive therapy (IPT) for children. Outcomes were compared with the pre-implementation period and a control zone. Qualitative research was conducted to understand community and provider perceptions and experiences. HEWs screened 49,857 symptomatic individuals (60% women) from October 2010 to December 2011. 2,262 (4·5%) had smear-positive TB (53% women). Case notification increased from 64 to 127/100,000 population/year resulting in 5,090 PTB+ and 7,071 cases of all forms of TB. Of 8,005 contacts visited, 1,949 were symptomatic, 1,290 symptomatic were tested and 69 diagnosed with TB. 1,080 children received IPT. Treatment success for smear-positive TB increased from 77% to 93% and treatment default decreased from 11% to 3%. Service users and providers found the intervention package highly acceptable. CONCLUSIONS: Community-based interventions made TB diagnostic and treatment services more accessible to the poor, women, elderly and children, doubling the notification rate and improving treatment outcome. This approach could improve TB diagnosis and treatment in other high burden settings.

Yassin MA; Datiko DG; Tulloch O; Markos P; Aschalew M; Shargie EB; Dangisso MH; Komatsu R; Sahu S; Blok L; Cuevas LE; Theobald S

2013-01-01

223

The 0-1 Outcomes Feature Selection Problem : a Chi-2 Approach  

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This paper addresses the 0-1 outcome feature selection problem. In such a problem, a set of features leads to an outcome that is 0 or 1, depending upon the values of the features. The goal is to extract subsets of features that characterize at best outcome 1. This kind of problem arises in medical a...

Duron, Cyril; Proth, Jean-Marie

224

Pharmacological versus microvascular decompression approaches for the treatment of trigeminal neuralgia: clinical outcomes and direct costs  

Directory of Open Access Journals (Sweden)

Full Text Available Laurinda Lemos1,2, Carlos Alegria3, Joana Oliveira3, Ana Machado2, Pedro Oliveira4, Armando Almeida11Life and Health Sciences Research Institute (ICVS), School of Health Sciences, Campus de Gualtar, University of Minho, Braga, Portugal; 2Hospital Center of Alto Ave, Unit of Fafe, Fafe, Portugal; 3Department of Neurosurgery, Hospital São Marcos; 4Products and Systems Engineering, Campus de Azurém, University of Minho, Guimarães, PortugalAbstract: In idiopathic trigeminal neuralgia (TN) the neuroimaging evaluation is usually normal, but in some cases a vascular compression of trigeminal nerve root is present. Although the latter condition may be referred to surgery, drug therapy is usually the first approach to control pain. This study compared the clinical outcome and direct costs of (1) a traditional treatment (carbamazepine [CBZ] in monotherapy [CBZ protocol]), (2) the association of gabapentin (GBP) and analgesic block of trigger-points with ropivacaine (ROP) (GBP+ROP protocol), and (3) a common TN surgery, microvascular decompression of the trigeminal nerve (MVD protocol). Sixty-two TN patients were randomly treated during 4 weeks (CBZ [n = 23] and GBP+ROP [n = 17] protocols) from cases of idiopathic TN, or selected for MVD surgery (n = 22) due to intractable pain. Direct medical cost estimates were determined by the price of drugs in 2008 and the hospital costs. Pain was evaluated using the Numerical Rating Scale (NRS) and number of pain crises; the Hospital Anxiety and Depression Scale, Sickness Impact Profile, and satisfaction with treatment and hospital team were evaluated. Assessments were performed at day 0 and 6 months after the beginning of treatment. All protocols showed a clinical improvement of pain control at month 6. The GBP+ROP protocol was the least expensive treatment, whereas surgery was the most expensive. With time, however, GBP+ROP tended to be the most and MVD the least expensive. No sequelae resulted in any patient after drug therapies, while after MDV surgery several patients showed important side effects. Data reinforce that, (1) TN patients should be carefully evaluated before choosing therapy for pain control, (2) different pharmacological approaches are available to initiate pain control at low costs, and (3) criteria for surgical interventions should be clearly defined due to important side effects, with the initial higher costs being strongly reduced with time.Keywords: trigeminal neuralgia, carbamazepine, gabapentin associated with ropivacaine, microvascular decompression, clinical outcomes, direct costs 

Lemos L; Alegria C; Oliveira J; Machado A; Oliveira P; Almeida A

2011-01-01

225

Profiling provider outcome quality for pay-for-performance in the presence of missing data: a simulation approach.  

UK PubMed Central (United Kingdom)

OBJECTIVE: Provider profiling of outcome performance has become increasingly common in pay-for-performance programs. For chronic conditions, a substantial proportion of patients eligible for outcome measures may be lost to follow-up, potentially compromising outcome profiling. In the context of primary care depression treatment, we assess the implications of missing data for the accuracy of alternative approaches to provider outcome profiling. DATA: We used data from the Improving Mood-Promoting Access to Collaborative Treatment trial and the Depression Improvement across Minnesota, Offering a New Direction initiative to generate parameters for a Monte Carlo simulation experiment. STUDY DESIGN: The patient outcome of interest is the rate of remission of depressive symptoms at 6 months among a panel of patients with major depression at baseline. We considered two alternative approaches to profiling this outcome: (1) a relative, or tournament style threshold, set at the 80th percentile of remission rate among all providers, and (2) an absolute threshold, evaluating whether providers exceed a specified remission rate (30 percent). We performed a Monte Carlo simulation experiment to evaluate the total error rate (proportion of providers who were incorrectly classified) under each profiling approach. The total error rate was partitioned into error from random sampling variability and error resulting from missing data. We then evaluated the accuracy of alternative profiling approaches under different assumptions about the relationship between missing data and depression remission. PRINCIPAL FINDINGS: Over a range of scenarios, relative profiling approaches had total error rates that were approximately 20 percent lower than absolute profiling approaches, and error due to missing data was approximately 50 percent lower for relative profiling. Most of the profiling error in the simulations was a result of random sampling variability, not missing data: between 11 and 21 percent of total error was attributable to missing data for relative profiling, while between 16 and 33 percent of total error was attributable to missing data for absolute profiling. Finally, compared with relative profiling, absolute profiling was much more sensitive to missing data that was correlated with the remission outcome. CONCLUSIONS: Relative profiling approaches for pay-for-performance were more accurate and more robust to missing data than absolute profiling approaches.

Ryan AM; Bao Y

2013-04-01

226

A HOLISTIC APPROACH TO DEVELOP ENGINEERING PROGRAMME OUTCOMES: A CASE STUDY OF TAYLOR'S UNIVERSITY  

Directory of Open Access Journals (Sweden)

Full Text Available Part fulfilment of providing an engineering programme which implements outcome based education includes various outcomes that are tied to what the graduate should achieve after, during and before graduation. The programme outcomes are specifically crafted to encapsulate attributes that must be attained by a student upon graduation. The following paper details the principles used to craft the programme outcomes of an engineering undergraduate degree programme. The principles used were chosen based its importance and innovative content as well as being aligned to the purpose of the university which is running the degree programme. Upon crafting the prescribed outcomes, the paper will also detail how stakeholders were engaged and how their opinion was accounted for in the final crafting of the new set of programme outcomes. The paper also highlights how a gap analysis was performed to capture areas which were not covered by the previous programme outcomes.

MUSHTAK AL-ATABI; SATESH NAMASIVAYAM; CHIEN HWA CHONG; FLORENCE CHOONG; MOHAMMAD HOSSEINI

2013-01-01

227

Clinical outcomes measures for assessment of longevity in the dental implant literature: ORONet approach.  

UK PubMed Central (United Kingdom)

The Oral Rehabilitation Outcomes Network (ORONet) Longevity Working Group undertook a search of the literature from 1995 to 2009 on randomized controlled trials related to longevity of osseointegrated implants. Outcomes measures used in these studies were identified and subjected to the OMERACT component criteria of truth, validity, and feasibility. Through this process, it was a challenge to identify clinical outcomes measures that fully met the criteria. An attenuated version of the component criteria was applied, and clinical measures were identified for implant outcomes, prosthetic outcomes, and indices. A recommendation on standardized reporting periods was also presented for future consideration. The endpoint of the evaluation process is to develop consensus on clinical outcomes measures that can be applied across broad populations for osseointegrated implant care. The present ORONet initiative represents a beginning toward continual improvement and consensus development for clinical outcomes measures for osseointegrated implants.

Bassi F; Carr AB; Chang TL; Estafanous E; Garrett NR; Happonen RP; Koka S; Laine J; Osswald M; Reintsema H; Rieger J; Roumanas E; Estafanous E; Salinas TJ; Stanford CM; Wolfaardt J

2013-07-01

228

Midterm outcome after a microsurgical unilateral approach for bilateral decompression of lumbar degenerative spondylolisthesis.  

UK PubMed Central (United Kingdom)

OBJECT: The aim of this study was to evaluate the results and effectiveness of bilateral decompression via a unilateral approach in the treatment of lumbar degenerative spondylolisthesis (DS). METHODS: Operations were performed in 84 selected patients (mean age 62.1 ± 10 years) with lumbar DS between the years 2001 and 2008. The selection criteria included lower back pain with or without sciatica, neurogenic claudication that had not improved after at least 6 months of conservative treatment, and a radiological diagnosis of Grade I DS and lumbar stenosis. Decompression was performed at 3 levels in 15.5%, 2 levels in 54.8%, and 1 level in 29.7% of the patients with 1 level of spondylolisthesis. All patients were followed up for at least 24 months. For clinical evaluations, a visual analog scale, Oswestry Disability Index (ODI), and Neurogenic Claudication Outcome Score (NCOS) were used. Spinal canal size and (neutral and dynamic) slip percentages were measured both pre- and postoperatively. RESULTS: Neutral and dynamic slip percentages did not significantly change after surgery (p = 0.67 and p = 0.63, respectively). Spinal canal size increased from 50.6 ± 5.9 to 102.8 ± 9.5 mm(2) (p < 0.001). The ODI decreased significantly in both the early and late follow-up evaluations, and good or excellent results were obtained in 64 cases (80%). The NCOS demonstrated significant improvement in the late follow-up results (p < 0.001). One patient (1.2%) required secondary fusion during the follow-up period. CONCLUSIONS: Postoperative clinical improvement and radiological findings clearly demonstrated that the unilateral approach for treating 1-level and multilevel lumbar spinal stenosis with DS is a safe, effective, and minimally invasive method in terms of reducing the need for stabilization.

Müslüman AM; Cansever T; Y?lmaz A; Çavu?o?lu H; Yüce ?; Ayd?n Y

2012-01-01

229

Surgical approach to and reproductive outcome after surgical correction of a T-shaped uterus.  

UK PubMed Central (United Kingdom)

BACKGROUND: The aim of this study was to describe the surgical approach to, and evaluate the reproductive outcome of, a T-shaped uterus. METHODS: The study included 97 women who were eligible for hysteroscopic surgery, by either monopolar or bipolar electrosurgical instruments. All had diagnostic hysteroscopy 2 months afterwards to assess the success of the procedure and determine whether any synechiae were present. RESULTS: Forty-eight women (49.5%) became pregnant after metroplasty. The overall live birth rate per pregnancy before surgery was 0%; for these patients, it increased to 73%, and their miscarriage rate fell from 78 to 27% (P < 0.05). For all 57 pregnancies in 48 women, the ectopic pregnancy rate was 9% (n = 5), the miscarriage rate 28% (n = 16), the preterm delivery rate 14% (n = 8), the term delivery rate 49% (n = 28) and the live birth rate was 63% (n = 36). CONCLUSIONS: Hysteroscopic metroplasty improves the live birth rate for women with a T-shaped uterus and a history of primary infertility, recurrent abortion or preterm delivery, although it is not a treatment of infertility.

Fernandez H; Garbin O; Castaigne V; Gervaise A; Levaillant JM

2011-07-01

230

Can a multi-disciplinary assessment approach improve outcomes for children with attention deficit hyperactivity disorder?  

UK PubMed Central (United Kingdom)

OBJECTIVE: Public, consumer and professional views about attention deficit hyperactivity disorder, its assessment and treatment - especially with medication - remain a highly contested domain. Parents in particular express disquiet with services. One response to this tension is a multidisciplinary evaluation. Parental and education perceptions of this process have not been evaluated previously. A community multidisciplinary approach was assessed in terms of diagnostic outcomes and client satisfaction. METHOD: A comprehensive multidisciplinary structured assessment of the first 50 referred children with severe attentional problems was documented. Demographic and symptom/behavioural profiles, developmental history and indicated multi-disciplinary evaluation were recorded. A team consensus process arrived at diagnostic classification. Post-assessment satisfaction of parents and school staff was surveyed. RESULTS: Thirteen children (26%) were diagnosed with attention deficit hyperactivity disorder and three commenced stimulants. The majority of parents and educators were satisfied with the service. CONCLUSIONS: A multidisciplinary assessment clinic for children presenting with attention problems resulted in minimal prescribing. Overall, education staff and parents were satisfied with the service. The model may be a suitable response to the multiple concerns in the community.

Bor W; Heath F; Heussler H; Reuter R; Perrett C; Lee E

2013-07-01

231

Subungual glomus tumors: surgical approach and outcome based on tumor location.  

UK PubMed Central (United Kingdom)

BACKGROUND: Subungual glomus tumors are uncommon tumors that present with a classic triad of temperature sensitivity, pain, and localized tenderness. Different surgical approaches can be performed according to the anatomic location of the tumor. OBJECTIVE: To investigate the outcome of surgical excision of subungual glomus tumors according to anatomic location. METHODS: The records of 22 Korean patients diagnosed with subungual glomus tumor by histopathologic examination who underwent surgical excision over a 7-year period (2005-2011) were retrospectively reviewed. Local complications including persistence of symptoms, surgical methods, and tumor recurrence were evaluated through long-term follow-up. RESULTS: In the 22 patients, 13 tumors were located in the nail matrix and nine in the nail bed. No recurrence was observed after a mean follow-up of 36.6 months. Eight of the 13 patients with nail matrix involvement had complications such as nail deformity, decreased sensation, and prolonged pain sensation, whereas only one of the nine patients with nail bed lesion had prolonged pain sensation. CONCLUSIONS: Careful dissection and complete removal of the tumor offered cure without recurrence; anatomic location of the subungual glomus tumor at initial presentation may predict postoperative complications.

Lee SH; Roh MR; Chung KY

2013-07-01

232

Aspect-Oriented Approach for the Improvement of the Reliability and Time Performance of a Fault-Tolerant System  

Directory of Open Access Journals (Sweden)

Full Text Available The principle of separation of concerns is a basis element in the software engineering and allows for the division of properties, becoming smaller each time, so as to master their complexity, from the design phase to achievement phase. This paper proposes the probabilistic assessment of critical fault-tolerant programmed systems to improve reliability and availability of an embedded system. In addition, to improve their response time, we use separation of concerns approach, functional (behavior) and non-functional (control). This phase will be achieved by developing a simulator based on aspect-oriented programming (AspectJ). The main objective is to show the impact of this separation on the response time when a hardware architecture of a processor executes instructions and routines of a software application correctly. The probabilistic assessment is based on the failure rate of software instructions executed on hardware architecture of a stack processor whose choice will be justified. The failures considered in this work are the basis of a study of decomposition and refinement carried out by the NFR Framework. As a result, this work has treated the issue of hardware / software interaction in programmed critical systems and the improvement of execution time.

Khalid Bouragba; Hicham Belhadaoui; Mohammed Ouzzif; Mounir Rifi

2011-01-01

233

Decision support system for transport demand management: Object oriented approach using kappa pc 2.4 expert system shell  

Directory of Open Access Journals (Sweden)

Full Text Available In view of the fact that supply strategies alone could not solve urban congestion, many cities around the globe have adopted Transport Demand Management (TDM) strategies as part and partial of their congestion mitigation plan. TDM comprises several strategies and policies that aim to modifying travelers’ behaviour. TDM comprises strategies and policies that are different in nature which can be divided into several categories according to how they affect travelers’ behavior. Selecting and determining suitable TDM strategies for a particular congestion mitigation goal can be a complex task; thus requires expertise. In this regards, the effectiveness of a TDM strategy is primarily depending on whether its selection was appropriately examined prior to its field implementation. This paper presents the development of an expert system shell for TDM. The process of organizing the available knowledge of TDM strategies, as well as the process leading to the selection of one or more strategy advice, is encoded in the knowledge based expert system shell developed for the purpose by using shell expert system Kappa-PC version 2.4 which was adopted object oriented approach and high resolution graphical user interface. The advice given from the working system was evaluated and validated by comparing the output of the system against the recommendations made by transportation professionals. The evaluations indicate favourable results for the system. The expert advisory system can be used as a decision support system as well as a teaching tool for junior transportation engineers, planners, private developers, and government officials.

Resdiansyah Mansyur; Riza Atiq O. K. Rahmat; Amiruddin Ismail; Mohamad Raduan Kabit

2011-01-01

234

Sink-oriented Dynamic Location Service Protocol for Mobile Sinks with an Energy Efficient Grid-Based Approach.  

UK PubMed Central (United Kingdom)

Sensor nodes transmit the sensed information to the sink through wireless sensor networks (WSNs). They have limited power, computational capacities and memory. Portable wireless devices are increasing in popularity. Mechanisms that allow information to be efficiently obtained through mobile WSNs are of significant interest. However, a mobile sink introduces many challenges to data dissemination in large WSNs. For example, it is important to efficiently identify the locations of mobile sinks and disseminate information from multi-source nodes to the multi-mobile sinks. In particular, a stationary dissemination path may no longer be effective in mobile sink applications, due to sink mobility. In this paper, we propose a Sink-oriented Dynamic Location Service (SDLS) approach to handle sink mobility. In SDLS, we propose an Eight-Direction Anchor (EDA) system that acts as a location service server. EDA prevents intensive energy consumption at the border sensor nodes and thus provides energy balancing to all the sensor nodes. Then we propose a Location-based Shortest Relay (LSR) that efficiently forwards (or relays) data from a source node to a sink with minimal delay path. Our results demonstrate that SDLS not only provides an efficient and scalable location service, but also reduces the average data communication overhead in scenarios with multiple and moving sinks and sources.

Jeon H; Park K; Hwang DJ; Choo H

2009-01-01

235

Sink-oriented Dynamic Location Service Protocol for Mobile Sinks with an Energy Efficient Grid-Based Approach  

Directory of Open Access Journals (Sweden)

Full Text Available Sensor nodes transmit the sensed information to the sink through wireless sensor networks (WSNs). They have limited power, computational capacities and memory. Portable wireless devices are increasing in popularity. Mechanisms that allow information to be efficiently obtained through mobile WSNs are of significant interest. However, a mobile sink introduces many challenges to data dissemination in large WSNs. For example, it is important to efficiently identify the locations of mobile sinks and disseminate information from multi-source nodes to the multi-mobile sinks. In particular, a stationary dissemination path may no longer be effective in mobile sink applications, due to sink mobility. In this paper, we propose a Sink-oriented Dynamic Location Service (SDLS) approach to handle sink mobility. In SDLS, we propose an Eight-Direction Anchor (EDA) system that acts as a location service server. EDA prevents intensive energy consumption at the border sensor nodes and thus provides energy balancing to all the sensor nodes. Then we propose a Location-based Shortest Relay (LSR) that efficiently forwards (or relays) data from a source node to a sink with minimal delay path. Our results demonstrate that SDLS not only provides an efficient and scalable location service, but also reduces the average data communication overhead in scenarios with multiple and moving sinks and sources.

Hyeonjae Jeon; Kwangjin Park; Dae-Joon Hwang; Hyunseung Choo

2009-01-01

236

Organizing information integration in agri-food—A method based on a service-oriented architecture and living lab approach  

UK PubMed Central (United Kingdom)

Agri-food enterprises operate in a complex and dynamic environment. To meet increasing demands of consumers, government and business partners, enterprises continuously have to work on innovations of products, processes and ways of cooperation in agri-food supply chain networks (AFSCN). Hence, a development towards a more knowledge-based economy is needed. The Lisbon strategy, launched by the European Union, to attain this knowledge-based economy, has failed so far. This paper argues that information sharing and organizing ICT are main critical areas to overcome this deadlock. However, ICT development in AFSCN involves an information integration task that has to deal with technical and organizational requirements and starts with an existing installed base. Traditional software engineering approaches are inadequate to address these issues. This paper provides an overall method for analysis, design and implementation of information integration, taking technical as well as organizational development into account. The method was derived from experiences in a research and development program in the Dutch arable farming sector. A generic integration framework forms the backbone of the method to ensure systematic and sustainable ICT development. Business process management (BPM), in combination with reference information models, plays an important role. The technical architecture and infrastructure are based on a service-oriented architecture (SOA). Attention is paid to the organizational infrastructure that is needed to embed the results in the right context, so that they will be broadly supported and used. The method is divided into three phases: analysis, basic design and iterative implementation. Analysis of the current situation in AFSCN is supported by an information integration framework. The basic design is a first version of the generic integration framework. In the iterative implementation phase, pilot projects are guided by this basic design, which results in incremental growth of the framework. The pilot projects follow a Living Lab (LL) approach. LLs represent a user-centric, open innovation approach for sensing, prototyping, validating and refining complex solutions in multiple and evolving real life contexts. The method is illustrated by an application to the Dutch arable farming sector. It can be concluded that the contribution of the presented method lies in combining different methodologies into a design approach for information integration, based on a sound architecture. The presented method leads to ICT that follows the business processes in real life and thus enhances appropriate information sharing to support a knowledge-based economy.

Wolfert J; Verdouw CN; Verloop CM; Beulens AJM

2010-03-01

237

Outcomes of transcatheter approach for initial treatment of pulmonary atresia with intact ventricular septum.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To review the short and medium term outcome of transcatheter pulmonary valve perforation (PVP) in patients with pulmonary atresia-intact ventricular septum and non-right ventricular dependant coronary circulation (PA/IVS non-RVDCC). BACKGROUND: PVP in patients with PA/IVS non-RVDCC has become more common in the past two decades. However, data on outcomes with this strategy are mixed. METHODS: Data were reviewed retrospectively for all patients with PA/IVS non-RVDCC treated from 1996- 2010 at our institution. Patients who had severe neonatal Ebstein malformation, or initial interventional management at another institution were excluded. RESULTS: PVP was attempted in 30 of 50 patients (60%); 26 (87%) of these had a successful procedure. Twenty-four patients (48%) had surgery without PVP. There were no deaths in the cohort. Complications of PVP included 5 (17%) myocardial perforations. Of those with successful PVP, 10 (38%) did not have surgery (PVP-NS) and 16 (62%) had surgery (PVP-S) prior to discharge. Tricuspid valve (TV) Z-score was larger in the PVP-NS than in PVP-S patients, with median TV diameter Z-scores of +0.7 (-0.9, 1.7) and -1.1 (-2.8, 2), respectively (P = 0.01). Time from PVP to either hospital discharge (PVP-NS group) or surgery (PVP-S group) was significantly different between groups: 15 (7, 22) and 8 days (0, 46), respectively (P = 0.01). There were no differences in the number of trials or lowest arterial PaO2 off prostaglandins between groups. All patients in the PVP-NS group had a biventricular circulation at a median follow-up of 4.3 years. CONCLUSIONS: The results of a collaborative approach to treating neonates with PA/IVS non-RVDCC are excellent. Smaller TV size is associated with greater likelihood of surgery prior to discharge, and may serve as a surrogate for early RV inadequacy.

Hasan BS; Bautista-Hernandez V; McElhinney DB; Salvin J; Laussen PC; Prakash A; Geggel RL; Pigula FA

2013-01-01

238

Decomposed Approach of Market Orientation and Marketing Mix Capability: Research on Their Relationships with Firm Performance in the Korean Context  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The notion that market orientation provides firms a source of competitive advantage seems to be widely accepted since the effects of market orientation on business performance have been extensively researched and many studies have confirmed their affirmative relationships. However, aggregat...

Sohyoun Shin

239

Extending the Peters-Belson approach for assessing disparities to right censored time-to-event outcomes.  

Science.gov (United States)

The Peters-Belson (PB) method was developed for quantifying and testing disparities between groups in an outcome by using linear regression to compute group-specific observed and expected outcomes. It has since been extended to generalized linear models for binary and other outcomes and to analyses with probability-based sample weighting. In this work, we extend the PB approach to right-censored survival analysis, including stratification if needed. The extension uses the theory and methods of expected survival on the basis of Cox regression in a reference population. Within the PB framework, among the groups to be compared, one group is chosen as the reference group, and outcomes in that group are modeled as a function of available predictors. By using this fitted model's estimated parameters, and the predictor values for a comparator group, the comparator group's expected outcomes are then calculated and compared, formally with testing and informally with graphics, with their observed outcomes. We derive the extension, show how we applied it in a study of incontinence in nursing home elderly, and discuss issues in implementing it. We used the 'survival' package in the R system to do computations. Copyright © 2013 John Wiley & Sons, Ltd. PMID:23703882

Eberly, Lynn E; Hodges, James S; Savik, Kay; Gurvich, Olga; Bliss, Donna Z; Mueller, Christine

2013-05-24

240

Categorical and dimensional approaches to negative symptoms of schizophrenia: focus on long-term stability and functional outcome.  

Science.gov (United States)

Negative symptoms of schizophrenia represent a heterogeneous psychopathological domain. Both categorical and dimensional approaches have been proposed to reduce negative symptoms heterogeneity. In the present 5-year follow-up study, long-term stability and impact on outcome of different aspects of negative symptoms were investigated. Following a categorical approach, long-term stability and outcome of deficit schizophrenia (DS), in comparison with nondeficit schizophrenia (NDS), were assessed. Following a dimensional approach, the factor structure and stability of broadly defined negative symptoms and the ability of the identified factors to predict functional outcome were investigated. DS and NDS subjects included in a previous study were invited to participate. Fifty-one out of 58 patients previously diagnosed as DS and 44 out of 54 NDS patients were included in the present study. The DS/NDS categorization was confirmed in 82.4% of DS and 79.6% of NDS subjects. At follow-up, DS patients showed more severe negative symptoms and greater social dysfunction than NDS ones. Schedule for the Deficit Syndrome (SDS) severity scores loaded on two factors: "Poor Emotional Expression" and "Avolition" and the factor structure was stable after 5 years. Avolition was associated to social outcome measures and Poor Emotional Expression to functioning in household activities. Psychosocial outcome was predicted by SDS factors reflecting the severity of broadly defined negative symptoms, but not by the DS/NDS categorization. This might lend support to the recent shift of research focus from the categorical approach focusing on the presence of primary and enduring negative symptoms to the investigation of key domains of broadly defined negative symptoms. PMID:23608244

Galderisi, Silvana; Bucci, Paola; Mucci, Armida; Kirkpatrick, Brian; Pini, Stefano; Rossi, Alessandro; Vita, Antonio; Maj, Mario

2013-04-19

 
 
 
 
241

Multidisciplinary approach to breast cancer diagnosed during pregnancy: maternal and neonatal outcomes.  

UK PubMed Central (United Kingdom)

AIM: We assessed maternal and neonatal outcome in women diagnosed with breast cancer during pregnancy. PATIENTS AND METHODS: Retrospective single-centre cohort study of 25 consecutive pregnant women (mean age 36 years) diagnosed and treated for breast cancer between 2000 and 2011. Management was individualized according to type of tumor and time of gestation at diagnosis. RESULTS: Twelve patients were diagnosed during the second trimester. BI-RADS category <3 mammographic lesions were diagnosed in 7 patients. A suspicious area was detected by ultrasound in 20 of 21 women who underwent ultrasound studies. Nineteen patients had positive hormone receptors and 7 sobreexpressed HER2. One patient was in stage 0, 8 in stage I, 8 in stage II, 3 in stage III and 5 in stage IV. Four patients decided voluntarily to legally terminate their pregnancies, one had a spontaneous miscarriage and in three patients, pregnancy was interrupted at the end of the third trimester before oncological treatment. Eleven patients were treated with chemotherapy during pregnancy after the second trimester using anthracycline-based regimens. In five patients the pregnancy was ended before 34 weeks of gestation. Nine patients had gestation-related complications, including preterm labor, pneumonia, increase in velocity of the middle cerebral artery, oligohydramnios, preeclampsia, extreme prematurity, intrauterine growth restriction, dyspnea, spontaneous miscarriage and chemotherapy-related granulocytopenia. Betamethasone to stimulate fetal lung maturation was used in 6 patients. CONCLUSION: Breast cancer women diagnosed during pregnancy presented a high number of complications unrelated to antineoplastic treatment. A multidisciplinary team approach is necessary for satisfactory neonatal results.

Córdoba O; Llurba E; Saura C; Rubio I; Ferrer Q; Cortés J; Xercavins J

2013-08-01

242

Improved asthma outcomes using a coordinated care approach in a large medical group.  

UK PubMed Central (United Kingdom)

The objective of this study was to review the development of a multidisciplinary asthma disease management program in a large medical group practice in an urban area, and evaluate the impact of the program on processes of care and health care utilization for adults and children with asthma. The disease management intervention included the development of a patient registry, a systematic approach to assessment of asthma control using the Asthma Therapy Assessment Questionnaire (ATAQ), case management, and physician education. An administrative database was used to examine hospital admissions and emergency department (ED) visits. A medical record audit was conducted to examine recorded compliance with asthma guidelines and documentation practices. The baseline study population included 3486 adults and children with asthma. The ATAQ suggested that, at baseline, control problems were frequent, with 34% of adult respondents missing work because of asthma. ATAQ also revealed several areas for care improvement. For example, only 20% of adult respondents reported having a written treatment plan. The chart review and administrative claims analyses showed that the program had beneficial results in several areas. Medical record documentation improved for asthma diagnosis (83.3% vs. 98.6%; p < 0.001) and patient education (15.7% vs. 26.1%; p < 0.001). No improvements were seen in documentation of peak flow ownership/use, smoking cessation advice, or influenza vaccination. ED visits related to asthma decreased from 148 per 1000 to 88 per 1000 (p < 0.001), and hospitalizations related to asthma decreased from 81 per 1000 to 37 per 1000 (p < 0.001). The outcomes suggest that this program was associated with a marked reduction in rates of hospitalization and ED usage for asthma, as well as significant improvement in several essential processes of care.

Patel PH; Welsh C; Foggs MB

2004-01-01

243

Birth Outcomes among Older Mothers in Rural versus Urban Areas: A Residence-Based Approach  

Science.gov (United States)

Purpose: We examined the association between rural residence and birth outcomes in older mothers, the effect of parity on this association, and the trend in adverse birth outcomes in relation to the distance to the nearest hospital with cesarean-section capacity. Methods: A population-based retrospective cohort study, including all singleton…

Lisonkova, Sarka; Sheps, Samuel B.; Janssen, Patricia A.; Lee, Shoo K.; Dahlgren, Leanne; MacNab, Ying C.

2011-01-01

244

Patient perception of nursing service quality; an applied model of Donabedian's structure-process-outcome approach theory.  

UK PubMed Central (United Kingdom)

BACKGROUND: Nursing is a labour-intensive field, and an extensive amount of latent information exists to aid in evaluating the quality of nursing service, with patients' experiences, the primary focus of such evaluations. To effect further improvement in nursing as well as medical care, Donabedian's structure-process-outcome approach has been applied. AIMS: To classify and confirm patients' specific experiences with regard to nursing service based on Donabedian's structure-process-outcomes model for improving the quality of nursing care. METHODS: Items were compiled from existing scales and assigned to structure, process or outcomes in Donabedian's model through discussion among expert nurses and pilot data collection. With regard to comfort, surroundings were classified as structure (e.g. accessibility to nurses, disturbance); with regard to patient-practitioner interaction, patient participation was classified as a process (e.g. expertise and skill, patient decision-making); and with regard to changes in patients, satisfaction was classified as an outcome (e.g. information support, overall satisfaction). Patient inquiry was carried out using the finalized questionnaire at general wards in Japanese hospitals in 2005-2006. Reliability and validity were tested using psychometric methods. RESULTS: Data from 1,810 patients (mean age: 59.7 years; mean length of stay: 23.7 days) were analysed. Internal consistency reliability was supported (? = 0.69-0.96), with factor analysis items of structure aggregated to one factor and overall satisfaction under outcome aggregated to one. The remaining items of outcome and process were distributed together in two factors. Inter-scale correlation (r = 0.442-0.807) supported the construct validity of each structure-process-outcome approach. All structure items were represented as negative-worded examples, as they dealt with basic conditions under Japanese universal health care system, and were regarded as representative related to concepts of dissatisfaction and no dissatisfaction. CONCLUSION: Patients' experiences with nursing service were confirmed using Donabedian's approach and can therefore be applied to improve quality of nursing practice by practitioners, managers and policy makers.

Kobayashi H; Takemura Y; Kanda K

2011-09-01

245

Approach to infants born at 22 to 24 weeks' gestation: relationship to outcomes of more-mature infants.  

UK PubMed Central (United Kingdom)

OBJECTIVE: We sought to determine if a center's approach to care of premature infants at the youngest gestational ages (22-24 weeks' gestation) is associated with clinical outcomes among infants of older gestational ages (25-27 weeks' gestation). METHODS: Inborn infants of 401 to 1000 g birth weight and 22 0/7 to 27 6/7 weeks' gestation at birth from 2002 to 2008 were enrolled into a prospectively collected database at 20 centers participating in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Markers of an aggressive approach to care for 22- to 24-week infants included use of antenatal corticosteroids, cesarean delivery, and resuscitation. The primary outcome was death before postnatal day 120 for infants of 25 to 27 weeks' gestation. Secondary outcomes were the combined outcomes of death or a number of morbidities associated with prematurity. RESULTS: Our study included 3631 infants 22 to 24 weeks' gestation and 5227 infants 25 to 27 weeks' gestation. Among the 22- to 24-week infants, use of antenatal corticosteroids ranged from 28% to 100%, cesarean delivery from 13% to 65%, and resuscitation from 30% to 100% by center. Centers with higher rates of antenatal corticosteroid use in 22- to 24-week infants had reduced rates of death, death or retinopathy of prematurity, death or late-onset sepsis, death or necrotizing enterocolitis, and death or neurodevelopmental impairment in 25- to 27-week infants. CONCLUSIONS: This study suggests that physicians' willingness to provide care to extremely low gestation infants as measured by frequency of use of antenatal corticosteroids is associated with improved outcomes for more-mature infants.

Smith PB; Ambalavanan N; Li L; Cotten CM; Laughon M; Walsh MC; Das A; Bell EF; Carlo WA; Stoll BJ; Shankaran S; Laptook AR; Higgins RD; Goldberg RN

2012-06-01

246

Prospective one-year treatment outcomes of tortured refugees: a psychiatric approach.  

UK PubMed Central (United Kingdom)

The treatment of torture survivors from diverse cultures has been a difficult task involving issues of loss, massive trauma, cultural style, and adjusting to a new country. Research on treatment outcomes has shown inconsistent results. This report presents a prospective one year treatment outcome of 22 severely tortured patients from Ethiopia, Somalia, Iran and Afghanistan. Treatment was provided by psychiatrists and counselors with interpreters from each culture involved. The specific treatment included psychiatric evaluation, medicine, education, supportive psychotherapy and assisting some social needs. All 22 were diagnosed with depression and 17 of these also had posttraumatic stress disorder (PTSD). Twenty of 22 patients showed marked significant improvement on all of the scales for depression, PTSD, disability, and quality of life. Medicine was particularly useful in treating depression and the symptoms of flashbacks, nightmares and irritability. Standard psychiatric treatment with evaluation, diagnosis, appropriate medicine, supportive psychotherapy and counseling by ethnic counselors provided good outcomes.

Kinzie JD; Kinzie JM; Sedighi B; Woticha A; Mohamed H; Riley C

2012-01-01

247

Prospective one-year treatment outcomes of tortured refugees: a psychiatric approach.  

Science.gov (United States)

The treatment of torture survivors from diverse cultures has been a difficult task involving issues of loss, massive trauma, cultural style, and adjusting to a new country. Research on treatment outcomes has shown inconsistent results. This report presents a prospective one year treatment outcome of 22 severely tortured patients from Ethiopia, Somalia, Iran and Afghanistan. Treatment was provided by psychiatrists and counselors with interpreters from each culture involved. The specific treatment included psychiatric evaluation, medicine, education, supportive psychotherapy and assisting some social needs. All 22 were diagnosed with depression and 17 of these also had posttraumatic stress disorder (PTSD). Twenty of 22 patients showed marked significant improvement on all of the scales for depression, PTSD, disability, and quality of life. Medicine was particularly useful in treating depression and the symptoms of flashbacks, nightmares and irritability. Standard psychiatric treatment with evaluation, diagnosis, appropriate medicine, supportive psychotherapy and counseling by ethnic counselors provided good outcomes. PMID:23086001

Kinzie, J David; Kinzie, J Mark; Sedighi, Behjat; Woticha, Abdella; Mohamed, Halima; Riley, Crystal

2012-01-01

248

Multiple Scattering Approach to Polarization Dependence of F K-Edge XANES Spectra for Highly Oriented Polytetrafluoroethylene (PTFE) Thin Film  

International Nuclear Information System (INIS)

The polarization dependence of F K-edge X-ray absorption near edge structure (XANES) spectra of highly-oriented thin-film of polytetrafluoroethylene (PTFE) has been analyzed by using multiple scattering theory. The spectra show clear polarization dependence due to the highly-oriented structure. The multiple scattering calculations reflects a local structure around an absorbing atom. The calculated results obtained by considering intermolecular-interactions are in good agreement with the observed polarization-dependence. We have also analyzed structural models of the radiation damaged PTFE films.

2007-02-02

249

Extracting epidemiologic exposure and outcome terms from literature using machine learning approaches.  

UK PubMed Central (United Kingdom)

Much epidemiologic information resides in literature, which is not in a computable format. To extract information and build knowledge bases of epidemiologic studies, we developed a system to extract noun phrases about epidemiologic exposures and outcomes. The system consists of two components: a natural language processing (NLP) engine; a machine learning (ML) based classifier. Four ML algorithms were applied and compared over different feature sets. To evaluate the performance of the system, we manually constructed an annotated dataset. The system achieved the highest F-measure of 82.0% for extracting exposure terms, and 70% for extracting outcome terms.

Lu Y; Xu H; Peterson NB; Dai Q; Jiang M; Denny JC; Liu M

2012-01-01

250

Quantity versus Quality: A New Approach to Examine the Relationship between Technology Use and Student Outcomes  

Science.gov (United States)

The author argues that to examine the relationship between technology use and student outcomes, the quality of technology use--how, and what, technology is used--is a more significant factor than the quantity of technology use--how much technology is used. This argument was exemplified by an empirical study that used both angles to examine the…

Lei, Jing

2010-01-01

251

Visual and refractive outcome of one-site phacotrabeculectomy compared with temporal approach phacoemulsification  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Daniela Vaideanu, Kaveri Mandal, Anthony Hildreth, Scott G Fraser, Peter S PhelanGlaucoma Unit, Sunderland Eye Infirmary, Sunderland, UKBackground: We aimed to compare visual and refractive outcome following phacoemulsification and intraocular lens implant (IOL) and combined one-site phacotrabecule...

Daniela Vaideanu; Kaveri Mandal; Anthony Hildreth; Scott G Fraser; Peter S Phelan

252

Assessing asthma control: An evidence-based approach to improve skills and outcomes.  

UK PubMed Central (United Kingdom)

The goal of asthma therapy is to achieve and maintain good asthma control. By utilizing evidence-based guidelines recommended by the National Asthma Education Prevention Program Expert Panel-3 Report, nurse practitioners can improve assessment of asthma control, and ultimately improve asthma outcomes.

Yates C

2013-06-01

253

EASIMAP: a coherent approach to the assessment of learning outcomes on engineering degree programmes  

Directory of Open Access Journals (Sweden)

Full Text Available Leaders of accredited engineering degreeprogrammes are expected to be able todemonstrate that students are offeredthe opportunity of achieving the learningoutcomes specified by the professionalinstitution accrediting the programme.These learning outcomes should in turnmap onto the UK Standard for ProfessionalEngineering Competence: The Accreditationof Higher Education Programmes (UK-SPEC)output standards. In addition, programmeleaders are also expected to provideevidence that students have attained theselearning outcomes.The Engineering Subject Centre’s EASIMAPProject seeks to assist programme leadersin these tasks by providing a coherentapproach to the mapping, recording, andassessment of learning outcomes. To thisend, the project has recently developed anelectronic tool that will enable programmeleaders to map and record studentattainment of learning outcomes. In addition,the tool provides assessment feedback tothe student and demonstrates the student’sprogression in meeting the learningoutcomes for the programme of study.This paper explores key issues regardingassessment practice, details the rationalefor and purpose of the project, identifiesstakeholder needs, and describes thedesign framework underpinning thedevelopment of an electronic tool to supportacademics in the assessment of learningoutcomes.

Alan Maddocks

2007-01-01

254

Statistical approaches to analyse patient-reported outcomes as response variables: an application to health-related quality of life.  

Science.gov (United States)

Patient-reported outcomes (PRO) are used as primary endpoints in medical research and their statistical analysis is an important methodological issue. Theoretical assumptions of the selected methodology and interpretation of its results are issues to take into account when selecting an appropriate statistical technique to analyse data. We present eight methods of analysis of a popular PRO tool under different assumptions that lead to different interpretations of the results. All methods were applied to responses obtained from two of the health dimensions of the SF-36 Health Survey. The proposed methods are: multiple linear regression (MLR), with least square and bootstrap estimations, tobit regression, ordinal logistic and probit regressions, beta-binomial regression (BBR), binomial-logit-normal regression (BLNR) and coarsening. Selection of an appropriate model depends not only on its distributional assumptions but also on the continuous or ordinal features of the response and the fact that they are constrained to a bounded interval. The BBR approach renders satisfactory results in a broad number of situations. MLR is not recommended, especially with skewed outcomes. Ordinal methods are only appropriate for outcomes with a few number of categories. Tobit regression is an acceptable option under normality assumptions and in the presence of moderate ceiling or floor effect. The BLNR and coarsening proposals are also acceptable, but only under certain distributional assumptions that are difficult to test a priori. Interpretation of the results is more convenient when using the BBR, BLNR and ordinal logistic regression approaches. PMID:20858689

Arostegui, Inmaculada; Núñez-Antón, Vicente; Quintana, José M

2010-09-21

255

Statistical approaches to analyse patient-reported outcomes as response variables: an application to health-related quality of life.  

UK PubMed Central (United Kingdom)

Patient-reported outcomes (PRO) are used as primary endpoints in medical research and their statistical analysis is an important methodological issue. Theoretical assumptions of the selected methodology and interpretation of its results are issues to take into account when selecting an appropriate statistical technique to analyse data. We present eight methods of analysis of a popular PRO tool under different assumptions that lead to different interpretations of the results. All methods were applied to responses obtained from two of the health dimensions of the SF-36 Health Survey. The proposed methods are: multiple linear regression (MLR), with least square and bootstrap estimations, tobit regression, ordinal logistic and probit regressions, beta-binomial regression (BBR), binomial-logit-normal regression (BLNR) and coarsening. Selection of an appropriate model depends not only on its distributional assumptions but also on the continuous or ordinal features of the response and the fact that they are constrained to a bounded interval. The BBR approach renders satisfactory results in a broad number of situations. MLR is not recommended, especially with skewed outcomes. Ordinal methods are only appropriate for outcomes with a few number of categories. Tobit regression is an acceptable option under normality assumptions and in the presence of moderate ceiling or floor effect. The BLNR and coarsening proposals are also acceptable, but only under certain distributional assumptions that are difficult to test a priori. Interpretation of the results is more convenient when using the BBR, BLNR and ordinal logistic regression approaches.

Arostegui I; Núñez-Antón V; Quintana JM

2012-04-01

256

In black and white: an integrated approach to class-level testing of object-oriented programs  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Because of the growing importance of object-oriented programming, a number of testing strategies have been proposed. They are based either on pure black-box or white-box techniques. We propose in this article a methodology to integrate the black- and white-box techniques. The black-box technique is ...

Tse, TH; Chen, HY; Chan, FT; Chen, TY

257

Learner differences and learning outcomes in an introductory biochemistry class: Attitude toward images, visual cognitive skills, and learning approach.  

UK PubMed Central (United Kingdom)

The practice of using images in teaching is widespread, and in science education images are used so extensively that some have argued they are now the "main vehicle of communication" (C. Ferreira, A. Arroio Problems Educ. 21st Century 2009, 16, 48-53). Although this phenomenon is especially notable in the field of biochemistry, we know little about the role and importance of images in communicating concepts to students in the classroom. This study reports the development of a scale to assess students' attitude toward biochemical images, particularly their willingness and ability to use the images to support their learning. In addition, because it is argued that images are central in the communication of biochemical concepts, we investigated three "learner differences" which might impact learning outcomes in this kind of classroom environment: attitude toward images, visual cognitive skills, and learning approach. Overall, the students reported a positive attitude toward the images, the majority agreeing that they liked images and considered them useful. However, the participants also reported that verbal explanations were more important than images in helping them to understand the concepts. In keeping with this we found that there was no relationship between learning outcomes and the students' self-reported attitude toward images or visual cognitive skills. In contrast, learning outcomes were significantly correlated with the students' self-reported approach to learning. These findings suggest that images are not necessarily the main vehicle of communication in a biochemistry classroom and that verbal explanations and encouragement of a deep learning approach are important considerations in improving our pedagogical approach. © 2013 by The International Union of Biochemistry and Molecular Biology, 2013.

Milner RE

2013-02-01

258

Outcome of a multimodality approach to the management of idiopathic subglottic stenosis.  

UK PubMed Central (United Kingdom)

OBJECTIVES/HYPOTHESIS: To assess the results of treating idiopathic subglottic stenosis (ISS), determine predictors of treatment success and outcome, and better define roles and limitations of endoscopic and open surgery. STUDY DESIGN: Prospective observational study. METHODS: Fifty-four consecutive patients were treated between 2004 and 2012. Patient, stenosis and treatment details, complications, open surgery rates, and outcomes were recorded. Regression analyses were used to identify predictors of endoscopic treatment success; treatment frequency; and functional outcomes in airway, dyspnea, voice, and swallowing domains. RESULTS: All patients were female and mean age at diagnosis was 48 ± 12 years. Symptoms-to-diagnosis latency was 21?±?20 months. There were 10 concomitant glottic and subglottic stenoses. Most lesions were Myer-Cotton grade 3 (48%). Overall, 78% of patients were managed endoscopically. Treatment included intralesional corticosteroids, laser surgery, balloon dilation, and temporary silastic stenting in selected cases. Annual intervention rate was 1.07 ± 0.79. Mean follow-up was 45 months. Factors associated with intervention frequency were stenosis location and severity. Twelve patients underwent anteroposterior laryngotracheal reconstruction with biological inhibition. This resulted in disease remission in all patients with subglottic stenosis, and in most patients with concomitant glottic and subglottic stenosis. Patients with total laryngotracheal stenosis required ongoing treatment for glottic disease. All patients maintained prosthesis-free airways, but in one patient this required a laryngectomy. Most patients achieved good functional outcomes. Stenosis location was the only independent predictor of dyspnea and voice outcomes. CONCLUSIONS: ISS can be effectively treated with endoscopic surgery or a bespoke open reconstructive procedure that does not compromise on female voice quality. LEVEL OF EVIDENCE: 4.Laryngoscope, 2012.

Nouraei SA; Sandhu GS

2013-08-01

259

A Power Electronic and Drives Curriculum with Project-oriented and Problem-based Learning: A Dynamic Teaching Approach for the Future  

DEFF Research Database (Denmark)

Power electronics is an emerging technology. New applications are added every year as well as the power handling capabilities are steadily increasing. The demands to the education of engineers in this field are also increasing. Basically the content of the curriculum should be more expanded without extra study time. This paper present a teaching approach which makes it possible very fast for the student to get in-depth skills in this important area which is the problem-oriented and project-based learning. The trend and application of power electronics are illustrated. The necessary skills for power electronic engineers are outlined followed up by a discussion on how problem-oriented and project-based learning are implemented. A complete curriculum at Aalborg University is presented where different power electronics related projects at different study levels are carried out.

Blaabjerg, Frede

2002-01-01

260

Orientation in operator algebras  

Digital Repository Infrastructure Vision for European Research (DRIVER)

A concept of orientation is relevant for the passage from Jordan structure to associative structure in operator algebras. The research reported in this paper bridges the approach of Connes for von Neumann algebras and ourselves for C*-algebras in a general theory of orientation that is of geometric ...

Alfsen, Erik M.; Shultz, Frederic W.

 
 
 
 
261

Orientation in operator algebras.  

Science.gov (United States)

A concept of orientation is relevant for the passage from Jordan structure to associative structure in operator algebras. The research reported in this paper bridges the approach of Connes for von Neumann algebras and ourselves for C*-algebras in a general theory of orientation that is of geometric nature and is related to dynamics. PMID:9618457

Alfsen, E M; Shultz, F W

1998-06-01

262

[Clinical presentation, therapeutic approach and outcomes in acute poisoning treated with activated charcoal. Are there differences between men and women?].  

UK PubMed Central (United Kingdom)

OBJECTIVE: To determine whether there are gender-based differences in the clinical presentation, therapeutic approaches and outcomes in acute poisoning treated with activated charcoal. METHOD: A descriptive study conducted in the Emergency Department of the Hospital Clínic de Barcelona over the 7 years between the years 2001 and 2008. The study included poisoned patients who had received activated charcoal. The variables included, epidemiological data, clinical and toxicological presentation, therapeutic approach, time in emergency department and outcomes. RESULTS: A total of 575 patients were included in the study. The mean age was 37.8 (SD 14.8) years and 65.7% were females. No differences were observed between males and females with respect to age, number of drugs involved in the poisoning or the number of tablets ingested, but a higher prevalence of benzodiazepine poisoning was observed in females compared to males (69.8 vs. 61.2%; P<0.05). Alcohol combined with drug poisoning was more common in males than in females (32.4 vs.18.8%; P<0.001). Administration of activated charcoal in non-drug poisoning was also more common in males than in females (7.9 vs. 3.2%; P<0.05). There were no differences between genders as regards clinical presentation of the poisonings, delays in care, hours of emergency department stay, treatment or outcome. CONCLUSIONS: Benzodiazepine poisoning was more prevalent in females than in males. Non-drug poisonings and alcohol combined with drug ingestion were more common in males. The clinical outcomes of the poisonings, delays in care, therapeutic requirements and admissions were similar between genders.

Amigó-Tadín M; Nogué-Xarau S; Miró-Andreu O

2010-09-01

263

Outcome Measures of a Family-Based Education Approach with Mexican Immigrants in the Yakima Valley  

Directory of Open Access Journals (Sweden)

Full Text Available With the continued incidence of obesity and health related issues in the United States and especially in the Hispanic population, it is important to provide useful healthy lifestyle education to this population. One of the barriers to providing this information is the lack of culture sensitivity in the content and presentation of current programs. In this pilot study, pre and post tests were used to measure the effectiveness of Salsa, Sabor, y Salud, a culturally sensitive program designed for Latinos. Outcome measures included dietary changes, weight, body mass index, waist circumference, blood pressure, heart rate, reported physical activity, and healthy lifestyle score. Diet was evaluated by 24-hour diet recall for both adults and children. Difference in outcome measures was assessed using a dependent t test. Significant decreases in weight, waist circumference, diastolic blood pressure, kilocalories, and grams of carbohydrates were observed. Adults reported an increase in total minutes of physical activity and the importance of living a healthy lifestyle. This culturally sensitive education program, Salsa, Sabor, y Salud, has a positive effect on health related outcome measures.

Virginia A. Bennett; Carissa Sundsmo-Switzer

2011-01-01

264

Semantic Oriented Agent based Approach towards Engineering Data Management, Web Information Retrieval and User System Communication Problems  

CERN Multimedia

The four intensive problems to the software rose by the software industry .i.e., User System Communication / Human Machine Interface, Meta Data extraction, Information processing & management and Data representation are discussed in this research paper. To contribute in the field we have proposed and described an intelligent semantic oriented agent based search engine including the concepts of intelligent graphical user interface, natural language based information processing, data management and data reconstruction for the final user end information representation.

Ahmed, Zeeshan

2010-01-01

265

Acoustic metafluid with anisotropic mass density and tunable sound speed: An approach based on suspensions of orientable anisotropic particles  

Science.gov (United States)

We investigate liquid suspensions of micron-scale, anisotropic particles as potential acoustic metafluids having anisotropic and actively controllable acoustic properties. The effective mass density (and hence the sound propagation speed) of these metafluids can vary because the added mass of an anisotropic particle suspended in the fluid changes with the particle's orientation relative to the direction of the wave propagation. A suspension with disc-like particles oriented broadside to the direction of wave propagation is thus expected to have higher effective inertia and lower sound speed than a suspension with particles with end-on alignment. To test these predictions, sound speed is measured with a time-of-flight method in suspensions of micron-size nickel flakes suspended in oil, with and without magnetic-field-induced alignment of the particles. The sound speed, relative to the unaligned case, is found to decrease for particles oriented broadside to the sound wave, and increase for edgewise alignment. We also investigate the frequency dependence of the effective sound speed, since the added mass effect is expected to diminish as the flow becomes steady at low frequencies. The experimental results are compared to the predictions of a model proposed by Ahuja & Hardee (J. Acoust. Soc. Am 1978) for the acoustic properties of aligned oblate-spheroid suspensions.

Seitel, Mark; Tse, Stephen; Shan, Jerry

2011-11-01

266

Aspect Oriented Requirements Engineering  

Directory of Open Access Journals (Sweden)

Full Text Available Requirements engineering techniques that explicitly recognize the importance of clearly identifying and treating crosscutting concerns are called Aspect-oriented Requirements Engineering Approaches (AORE approaches). The emergence of aspect-oriented programming languages has raised the explicit need to identify crosscutting concerns already during the analysis phase. Besides this observation, the modular representation of crosscutting requirements is a first step to ensure traceability of crosscutting concerns through all other artifacts of the software lifecycle (architecture, design and implementation).Aspect-oriented requirements engineering approaches improve existing requirements engineering approaches through an explicit representation (and modularization) of concerns that were otherwise spread throughout other requirements artifacts (such as use cases, goal models, viewpoints, etc.).AORE approaches adopt the principle of separation of concerns at the analysis phase (the early separation of concerns). In other words, AORE approaches provide a representation of crosscutting concerns in requirements artifacts.

Ahmed Yakout A. Mohamed; Abd El Fatah .A. Hegazy; Ahmed R. Dawood

2010-01-01

267

System-oriented approach for the modeling and thermodynamic analysis of new energy concepts; Systemtechnische Vorgehensweise zur Modellierung und thermodynamischen Analyse neuer Energiekonzepte  

Energy Technology Data Exchange (ETDEWEB)

New energetic technologies are built up more and more frequently. Their internal structure can be compared with the internal structure of process engineering systems. In comparison to the infinitely large number of comparison processes (cycles) in chemical process engineering, the number of thermodynamic comparison processes is very limited. Under this aspect, the authors of the contribution under consideration report on a system-oriented approach for modelling and for the thermodynamic analysis of new energy concepts. The modelling of complicated energy concepts must consider thermodynamic aspects. Apparatus capacities have to be included.

Kozaczka, Jaroslaw [AGH - Univ. of Science and Technology, Krakow (Poland). Dept. of Power Machinery and Installations; Kolat, Pavel [Technical Univ. of Ostrava, Ostrava-Poruba (Czech Republic). Dept. of Power Engineering

2008-07-01

268

How a diversity-oriented approach has inspired a new hypothesis for the gabosine biosynthetic pathway. A new synthesis of (+)-gabosine C.  

Science.gov (United States)

A new synthesis of (+)-gabosine C has been accomplished as part of a general diversity-oriented approach that also delivered the previously unknown (-)-4-epi-gabosine C. The identification of the unexpected intermediate (+)-8, together with the isolation of ketones 9 and 10 in previous investigations, prompted us to formulate a new hypothesis for the biosynthesis of gabosines, based on a keto-enol equilibrium cascade pathway starting from 2-epi-5-epi-valiolone, along which the necessary precursors for all the different types of gabosines are generated. PMID:23982632

Fresneda, Miguel Ángel; Alibés, Ramon; Font, Josep; Bayón, Pau; Figueredo, Marta

2013-08-28

269

How a diversity-oriented approach has inspired a new hypothesis for the gabosine biosynthetic pathway. A new synthesis of (+)-gabosine C.  

UK PubMed Central (United Kingdom)

A new synthesis of (+)-gabosine C has been accomplished as part of a general diversity-oriented approach that also delivered the previously unknown (-)-4-epi-gabosine C. The identification of the unexpected intermediate (+)-8, together with the isolation of ketones 9 and 10 in previous investigations, prompted us to formulate a new hypothesis for the biosynthesis of gabosines, based on a keto-enol equilibrium cascade pathway starting from 2-epi-5-epi-valiolone, along which the necessary precursors for all the different types of gabosines are generated.

Fresneda MÁ; Alibés R; Font J; Bayón P; Figueredo M

2013-10-01

270

Relação entre gênero e orientação sexual a partir da perspectiva evolucionista Relation between gender and sexual orientation from the evolutionary approach  

Directory of Open Access Journals (Sweden)

Full Text Available Este estudo trata da relação entre gênero e orientação sexual a partir da perspectiva interacionista da Psicologia Evolucionista e da análise de diferentes elementos da sexualidade humana. Procurou-se discutir a literatura existente sobre os conceitos de gênero e de orientação sexual, com base nos quatro porquês da Etologia. Propõe-se a existência de múltiplas origens para a orientação sexual, sendo uma delas relacionada aos padrões típicos de gênero e à identidade de gênero. Isso levaria à identificação com indivíduos do mesmo sexo ou do sexo oposto e, consequentemente, à atração pelo grupo diferente daquele com o qual se desenvolveu a identificação. Essa perspectiva integra pré-disposições biológicas à análise de influências culturais, compreendendo, como complementares, vertentes teóricas usualmente tidas como contraditórias.This study addresses the relationship between gender and sexual orientation from the interacionist perspective of Evolutionary Psychology and the analysis of various aspects of human sexuality. This article aimed to discuss existing literature about gender and sexual orientation, based on four questions of Ethology. It's proposed that sexual orientation has multiple origins, and that one of those is related to typical patterns of gender and gender identity. This would lead to identification with same-sex or opposite-sex individuals, and hence, to the attraction for the group different from the one to which identification was established. This approach integrates biological pre-dispositions to the analysis of cultural influences, understanding, as complementary, theoretical views that are usually stated as contradictory.

Aline Beckmann Menezes; Regina Célia Souza Brito; Alda Loureiro Henriques

2010-01-01

271

Clinical outcomes using aggressive approach to anatomic screening and endovascular revascularization in a veterans affairs population with critical limb ischemia.  

UK PubMed Central (United Kingdom)

BACKGROUND: This study sought to examine the impact of an aggressive approach to anatomic screening and endovascular revascularization in a veterans administration population with critical limb ischemia (CLI) on the primary treatments received and overall clinical outcomes. METHODS: The baseline clinical and angiographic characteristics and clinical outcomes of the first consecutive fifty veterans who were referred for the evaluation and treatment of CLI using the strategy outlined were assessed by retrospective review of the computerized medical record and angiographic data. RESULTS: Among the entire cohort, the primary treatments received were as follows--revascularization n = 44 (88%), primary amputation n = 1 (2%), medical treatment n = 3 (6%), and primary minor amputation n = 2 (4%). Endovascular revascularization was the dominant mode of revascularization (94%), with a procedural success rate of 91%. Repeat revascularization was required in 19% of patients who had an initially successful endovascular procedure. A total of eight deaths and four major amputations occurred in the entire cohort over a mean follow-up of 397 +/- 190 days. The 1-year Kaplan-Meier estimates for survival and amputation-free survival for the entire cohort were 90 and 81%, respectively. Resolution of rest pain or complete wound healing was achieved in 85% of patients at a mean of 157 +/-126 days. CONCLUSIONS: An aggressive approach to anatomic screening and contemporary endovascular treatment of CLI resulted in a higher rate of revascularization as the primary treatment for CLI than previously reported, and was associated with high rates of overall and amputation-free survival.

Shah AP; Klein AJ; Sterrett A; Messenger JC; Albert S; Nehler MR; Hiatt WR; Casserly IP

2009-07-01

272

Management of anterior segment penetrating injuries with traumatic cataract by pentagon approach in paediatric age group: Constraints and outcome  

Directory of Open Access Journals (Sweden)

Full Text Available Purpose: To evaluate the efficacy of multiple combined procedure (Pentagon approach) as single-step secondary repair in cases of extensive keratolenticular trauma in paediatric age group. Methods: Retrospective evaluation of 18 patients of penetrating injuries with sclero-keratolenticular trauma, who underwent multiple procedure as single-step secondary repair by a single team of two surgeons during a 4 year period. Surgical procedure included reconstruction of anterior segment, synechiolysis, excision of membrane, lensectomy, open sky vitrectomy, PC IOL implantation over frill and penetrating keratoplasty. Meticulous antiamblyopia measures were applied in all cases. Results: Extensive vasoproliferative membrane, complicated cataract and anterior vitreous condensation were significant intra-operative hurdles. Moderate uveitis, secondary glaucoma, persistent epithelial defects were problems noted. Eleven (61.22%) patients attained good visual outcome. Regrafting was required in remaining cases due to delayed graft failure. Conclusion: Despite being a highly complex technique, Pentagon approach provides effective management profile in terms of graft success and functional outcome, especially in keratolenticular trauma, in children.

Parihar Jitendra; Dash Radha; Vats Devender; Verma Satish; Sahoo Profulla; Rodrigues Francis

2000-01-01

273

A Direct Comparison of Early and Late Outcomes with Three Approaches to Carotid Revascularization and Open Heart Surgery.  

UK PubMed Central (United Kingdom)

OBJECTIVE: Comparison of risk-adjusted outcomes of three approaches to carotid revascularization in the open heart surgery (OHS) population. BACKGROUND: Without randomized clinical trials, the best approach to managing coexisting severe carotid and coronary disease remains uncertain. Staged carotid endarterectomy (CEA) followed by OHS or combined CEA and OHS are commonly used. A recent alternative is carotid artery stenting (CAS). METHODS: From 1997-2009, 350 patients underwent carotid revascularization within 90 days prior to OHS at a tertiary center - 45 staged CEA-OHS, 195 combined CEA-OHS and 110 staged CAS-OHS. The primary composite end point was all-cause death, stroke, and myocardial infarction (MI). Staged CAS-OHS patients had higher prevalence of prior stroke (p = 0.03) and underwent more complex OHS. Therefore, propensity score adjusted multiphase hazard function models with modulated renewal to account for staging, and competing risks were used. RESULTS: Using propensity analysis, staged CAS-OHS and combined CEA-OHS had similar early hazard phase composite outcomes while staged CEA-OHS incurred the highest risk driven by inter-stage MI. Subsequently, staged CAS-OHS experienced significantly fewer late hazard phase events in comparison to both staged CEA-OHS (adjusted hazard ratio [HR]: 0.33; 95% confidence interval [CI]: 0.15 to 0.77; p = 0.01) and combined CEA-OHS (adjusted HR: 0.35; 95% CI: 0.18 to 0.70; p = 0.003). CONCLUSIONS: Staged CAS-OHS and combined CEA-OHS are associated with similar risk of death, stroke or MI in the short term, with both being better than staged CEA-OHS. However, the outcomes are significantly in favor of staged CAS-OHS after the first year.

Shishehbor MH; Venkatachalam S; Sun Z; Rajeswaran J; Kapadia SR; Bajzer C; Gornik HL; Gray BH; Bartholomew JR; Clair DG; Sabik JF 3rd; Blackstone EH

2013-07-01

274

Complications following the extended lateral approach for calcaneal fractures do not influence mid- to long-term outcome.  

UK PubMed Central (United Kingdom)

BACKGROUND AND AIM: Open reduction and internal fixation (ORIF) of intra-articular calcaneal fractures through an extended lateral approach is frequently accompanied by a high complication rate. However, ORIF currently provides the best long-term clinical results. The aim of this study was twofold: (1) to evaluate both mid- to long-term clinical and radiological results of a consecutive series treated by ORIF and (2) to determine the influence of short-term complications on long-term clinical outcome. METHODS: Patients with a displaced intra-articular calcaneal fracture, treated with ORIF, through an extended lateral approach, in a level-2 trauma centre between 1995 and 2008 were evaluated for the study. The long-term functional outcome (American Orthopaedic Foot & Ankle Society (AOFAS), 36-Item Short-Form Health Survey (SF-36) and Visual Analogue Scale (VAS)) and radiographic results (e.g., Böhler and Gissane angle, height, width and joint reduction) were determined. Short- and long-term complications were documented. RESULTS: A total of 57 patients matched the inclusion criteria, from which 39 patients agreed to participate in this study (68%). The median follow-up was 6.5 years (range 2-16 years). Based on the AOFAS hindfoot score, 74% of the patients had a good-to-excellent long-term clinical result. Radiological results were satisfying with a median postoperative Böhler angle of 26° and 25° at follow-up. Complications occurred in 32% of all patients; mainly wound-healing problems were noted. Short-term complications did not influence mid- to long-term clinical results (p>0.05). Anatomic reconstruction of the calcaneus was associated with improved long-term clinical results (p<0.05). CONCLUSION: Despite the high complication rate following ORIF of a calcaneal fracture, complications do not affect mid- to long-term clinical outcome. Surgical treatment should focus on restoring the anatomy. Level of evidence: Therapeutic level IV.

De Groot R; Frima AJ; Schepers T; Roerdink WH

2013-07-01

275

Isolated complete caudate lobectomy for hepatic tumor of the anterior transhepatic approach: surgical approaches and perioperative outcomes.  

UK PubMed Central (United Kingdom)

BACKGROUND: How to resect the caudate lobe safely is a major challenge to current liver surgery which requires further study. METHODS: Nine cases (6 hepatic cell carcinoma, 2 cavernous hemangioma and 1 intrahepatic cholangiocacinoma) were performed using the anterior transhepatic approach in the isolated complete caudate lobe resection. During the operation, we used the following techniques: the intraoperative routine use of Peng's multifunction operative dissector (PMOD), inflow and outflow of hepatic blood control, low central venous pressure and selective use of liver hanging maneuver. RESULTS: There were no perioperative deaths observed after the operation. The median operating time was 230 +/- 43.6 minutes, the median intraoperative blood loss was 606.6 +/- 266.3 ml and the median length of postoperative hospital stay was 12.6 +/- 2.9 days. The incidence of complications was 22.22 % (2/9). CONCLUSION: PMOD and "curettage and aspiration" technique can be of great help of in the dissection of vessels and parenchyma, clearly making caudate lobe resection safer, easier and faster.

Yang JH; Gu J; Dong P; Chen L; Wu WG; Mu JS; Li ML; Wu XS; Zhao YL; Zhang L; Weng H; Ding Q; Ding QC; Liu YB

2013-08-01

276

Mental health consumers and providers dialogue in an institutional setting: a participatory approach to promoting recovery-oriented care.  

UK PubMed Central (United Kingdom)

OBJECTIVE: This brief report presents the preliminary findings of a participatory project, to answer a question raised by stakeholders in mental health services: How can providers and patients create a process for knowledge exchange to support recovery-oriented care? METHOD: Participatory action research (PAR) and narrative phenomenological methodology guided the selection of methods, which consisted of an iterative process between telling stories and dialoguing about personal values related to recovery. The sample consisted of three occupational therapists, a psychiatrist, an academic-clinician, and five consumers of mental health services who were involved in each stage of the research, including design, interpretation, dissemination, and implementation. RESULTS: Significant interpersonal and intrapersonal tensions were named, and conditions for a more sustainable process of knowledge exchange were explored. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: The project revealed both the challenges with situating research within an institution (hierarchy of knowledge, power, and vulnerability) and face-to-face dialogue, as well as positive changes in professional attitudes and consumer empowerment, as providers and patients came to understand what was at stake for each other. The project underscored the need for provider-consumer dialogue as a process to explore tensions and values in promoting recovery-oriented care.

Schwartz R; Estein O; Komaroff J; Lamb J; Myers M; Stewart J; Vacaflor L; Park M

2013-06-01

277

Low outcomes and the first-order approach to agency problems  

Directory of Open Access Journals (Sweden)

Full Text Available This paper claims that the first-order approach to agency problems can only hold if the likelihood ratio is bounded from below. None of the classic sets of sucient conditions to validate it (Mirrlees-Rogerson (1979-1985) and Jewitt (1988)) guarantees such a condition.

Óscar Gutiérrez

2007-01-01

278

Patient outcome following 2 different stress imaging approaches: a prospective randomized comparison.  

UK PubMed Central (United Kingdom)

OBJECTIVES: The study sought to prospectively compare patient outcome after stress real-time myocardial contrast echocardiography (RTMCE) versus conventional stress echo (CSE), where contrast is used to optimize wall motion (WM) analysis. BACKGROUND: Myocardial perfusion imaging with RTMCE may improve the detection of coronary artery disease (CAD), and predict patient outcome. METHODS: Patients with intermediate to high pre-test probability referred for dobutamine or exercise stress echocardiography were prospectively randomized to either RTMCE or CSE. Definity contrast was used for CSE only when endocardial border delineation was inadequate (63% of studies). Studies were interpreted by either an experienced contrast reviewer (R1; n = 1257), or 4 Level 3 echocardiographers (R2) with basic contrast training (n = 806). Death, nonfatal myocardial infarction (MI), and revascularizations were recorded at follow-up. RESULTS: Follow-up was available in 2,014 patients (median 2.6 years). Mean age was 59 ± 13 years (53% women). An abnormal RTMCE was more frequently observed than an abnormal CSE (p < 0.001), and more frequently resulted in revascularization (p = 0.004). Resting WM abnormalities were also more frequently seen with RTMCE (p < 0.01), and were an independent predictor of death/nonfatal MI (p = 0.005) for RTMCE, but not CSE. The predictive value of a positive study, whether with CSE or RTMCE, was significant for both R1 and R2 reviewers in predicting the combined endpoint, but R1 was better than R2 at predicting patients at risk for death or nonfatal MI. CONCLUSIONS: Perfusion imaging with RTMCE improves the detection of CAD during stress echocardiography, and identifies those more likely to undergo revascularization following an abnormal study.

Porter TR; Smith LM; Wu J; Thomas D; Haas JT; Mathers DH; Williams E; Olson J; Nalty K; Hess R; Therrien S; Xie F

2013-06-01

279

Matching the graphical display of data to avoidance versus approach motivation increases outcome expectancies.  

Science.gov (United States)

This study is the first demonstration of the effect of motivational focus (approach vs. avoidance) on the interpretation of graphical view of personal data, specifically, weight loss progress. In two experiments, participants were randomly assigned to see the bogus weight loss data charted against either a goal or a baseline reference line. In the first experiment, we accessed participants' chronic motivational focus. In the second study, we primed motivation by exposing the participants to either a gain- or loss-focused health message. The results demonstrate that participants with either chronic or manipulated approach motivation predicted higher future weight loss in the goal reference line condition than in the baseline reference line condition. The opposite pattern was observed for participants with either chronic or manipulated avoidance motivation. The potential of matching graphical data display to personality characteristics to promote effective health management is discussed. PMID:22468423

Braverman, Julia; Frost, Jeana H

280

Subungual glomus tumours of the hand: diagnosis and outcome of the transungual approach.  

UK PubMed Central (United Kingdom)

We report 17 patients with a subungual glomus tumour. All complained of pain and tenderness when touched, and nine patients experienced severe pain in the cold. A transungual approach with nail plate avulsion on one side was used in all cases. A surgical microscope was used to localise and dissect the tumour and to repair the nail bed and matrix. This method has produced good results, without local recurrence or postoperative nail plate deformity.

Lee IJ; Park DH; Park MC; Pae NS

2009-10-01

 
 
 
 
281

An agent-based and semantic service oriented approach for service discovery in Network Centric Warfare (NCW)  

Directory of Open Access Journals (Sweden)

Full Text Available In the new age one of the most challenging aspects of the information age is discovering the desired services with most accuracy and speed. In this paper a new semantic model is presented for the service discovering process in network centric warfare (NCW). The model is based on predefined ontology which is determined for the most important aspects of NCW in the application level. Services is based on a service oriented infrastructure and implemented as a grid which is developed as independent services. In the model, service discovery mechanism allows each of service agents to interact with its agent neighbors semantically and form a service chain for a specific task dynamically. The introduced model considered the semantic SOA which can overcome the undesirable time-delays and overhead corresponding to complexity of service discovery at heterogeneous environment such as NCW.

Masoud Barati; Mohammad Sajjad Khaksar Fasaei

2011-01-01

282

Dust off the policy and procedure manual to develop an orientation program.  

UK PubMed Central (United Kingdom)

With clear and accurate peritoneal dialysis departmental policies, procedures, and patient care standards, the creation of an orientation module with objective and measurable patient care and staff performance outcomes is easily produced. This article describes revision of policies, procedures, and patient care standards, and an approach for building linkages with the employee orientation program. No formal classroom time is required, and the level of orientee experience is accommodated. All peritoneal dialysis staff members are capable of equal preceptor participation.

Cox KR; Ribby KJ; Coil NL

1997-08-01

283

Does the extraperitoneal laparoscopic approach improve the outcome of radical prostatectomy?  

UK PubMed Central (United Kingdom)

Laparoscopic radical prostatectomy (LRPE) became the operative procedure of choice for patients with clinically localized prostate cancer in selected urologic centers around the world. Principal advantages are the minimal invasive nature of the procedure, a superior visualization of the operative field because of the magnification of the optical system, an exact and watertight anastomosis, the possibility of early catheter removal, and a potentially reduced amount of blood loss. Recent data show that oncologic outcome is not compromised by the minimal invasive nature of the procedure. However, a major drawback of LRPE is the transperitoneal route of access to the extraperitoneal organ of the prostate. Therefore, principal disadvantages of LRPE are potential intraperitoneal complications. Endoscopic extraperitoneal radical prostatectomy is a further advancement of minimal invasive surgery because it overcomes the limitations of LRPE by the strictly extraperitoneal route of access, combining the advantages of minimal invasive surgery with the advantages of an extraperitoneal procedure. This article reviews the literature on minimally invasive (laparoscopic and endoscopic-extraperitoneal) radical prostatectomy.

Stolzenburg JU; Truss MC; Bekos A; Do M; Rabenalt R; Stief CG; Hoznek A; Abbou CC; Neuhaus J; Dorschner W

2004-04-01

284

Bone marrow transplantation for thalassemia from alternative related donors: improved outcomes with a new approach.  

UK PubMed Central (United Kingdom)

Bone marrow transplantation performance can be limited by a lack of ideal donors, and the role of alternative donor hematopoietic cell transplantation in thalassemia is not well established. Here we used a new treatment protocol (Pc 26.1) in 16 thalassemia patients to perform BMT using phenotypically HLA-identical or one-antigen mismatched relatives (related donors-RDs). We compared these results with HLA matched sibling (matched sibling donors-MSDs) BMT in 66 patients. The entire RD group and 88% of MSD group had sustained engraftment. Rejection incidence was 0% in the RD and 12% (95% CI, 6-21%) in MSD groups (P = 0.15), with respective thalassemia-free survival (TFS) probabilities of 94% (95% CI, 63-99%) and 82% (95% CI, 70-89%) (P = 0.24). Transplant-related mortality was 6% (95% CI, 1-26%) in the RD group and 8% (95% CI, 3-16%) in the MSD group (P = 0.83). The intensified new protocol was not associated with increased nonhematological toxicity. The present data show that the Pc 26.1 preparative regimen allows thalassemia patients to safely undergo BMT from related donors who are not HLA-matched siblings, with transplant outcomes similar to patients of MSD grafts.

Gaziev J; Marziali M; Isgrò A; Sodani P; Paciaroni K; Gallucci C; Andreani M; Testi M; De Angelis G; Alfieri C; Cardarelli L; Ribersani M; Armiento D; Lucarelli G

2013-08-01

285

Outcomes and complications of extension of previous long fusion to the sacro-pelvis: is an anterior approach necessary?  

UK PubMed Central (United Kingdom)

BACKGROUND: Patients with previous multilevel spinal fusion may require extension of the fusion to the sacro-pelvis. Our objective was to evaluate the outcomes and complications of these patients, stratified based on whether the revision was performed using a posterior-only spinal fusion (PSF) or combined anterior-posterior spinal fusion (APSF). METHODS: A retrospective, multicenter evaluation of adults (>18 years old) with a history of prior spinal fusion for scoliosis (?4 levels) terminating in the distal lumbar spine requiring extension of fusion to the sacro-pelvis (including iliac fixation in all cases), with minimum 2-year follow-up, was performed. Patients were stratified based on approach (APSF vs. PSF) and inclusion of pedicle subtraction osteotomy (PSO). The PSF group included patients treated with an anterior interbody fusion done through a posterior approach, whereas patients in the APSF group all had both anterior and posterior surgical approaches. Clinical outcomes were based on the Scoliosis Research Society (SRS-22) questionnaire. RESULTS: Between 1995 and 2006, 45 patients (mean age = 49 years) met inclusion criteria, with a mean follow-up of 41.9 months (range 24 to 135 months). Demographic, preoperative, operative, and postoperative radiographic, SRS-22, and follow-up results were similar between APSF (n=30) and PSF (n=15) groups. The APSF group had more complications (13 of 30 vs. 3 of 15) and a greater number of pseudarthrosis (4 of 30 vs. 0 of 15) than the PSF group; however, these differences did not reach statistical significance. Patients treated with a PSO (n=13) had greater sagittal vertical axis correction (7.7 cm vs. 2.2 cm; P=.04) compared with patients not treated with a PSO (n=32). There were no differences in complication rates or follow-up SRS-22 scores based on whether a PSO was performed (P>.05). CONCLUSIONS: Among adults with previously treated scoliosis requiring extension to the sacro-pelvis, PSF produced radiographic fusion and clinical outcomes equivalent to APSF, whereas complication rates may be lower. PSO resulted in greater sagittal plane correction, without an increase in overall complication rates.

Fu KM; Smith JS; Burton DC; Shaffrey CI; Boachie-Adjei O; Carlson B; Schwab FJ; Lafage V; Hostin R; Bess S; Akbarnia BA; Mundis G; Klineberg E; Gupta M

2013-01-01

286

Outcomes of Interventions Via a Transradial Approach for Dysfunctional Brescia-Cimino Fistulas  

International Nuclear Information System (INIS)

The transradial artery approach to angioplasty has rarely been reported as a method for treating dysfunctional Brescia-Cimino fistulas. This study evaluated the feasibility, safety, and 1-year efficacy of this method for treating dysfunctional Brescia-Cimino fistulas. We retrospectively evaluated 154 consecutive procedures in 131 patients (age, 58.3 ± 11.6 years; male, 48.1%) who underwent the transradial approach in dysfunctional Brescia-Cimino fistulas in the 1-year period after the procedure. The operator determined the use of a regular or a cutting balloon (two cases) in combination with urokinase injection (one case) or catheter thromboaspiration. Radial artery puncture was successful in all cases. Fifty-two cases (33.8%) had totally occluded fibrotic lesions. The overall anatomic success rate and clinical success rate were 61% (94/154) and 81.1% (125/154), respectively. In cases with a totally occluded fibrotic lesion, the clinical success rate was 46%. Successful intervention was associated with a significant reduction in the radial arterial systolic and diastolic pressures. There were no complications of symptomatic arterial embolization or pulmonary embolism, and one complication of venous rupture was successfully treated by compression. The primary patency rates based on intention-to-treat were 75.3% at 30 days and 39.0% at 1 year after the procedure. Excluding the cases with a totally occluded lesion, the clinical success rate was 99% (101/102) and the primary patency rates were 84.3% (86/102) and 52.0% (53/102) at 3 months and 1 year after the procedure, respectively. In conclusion, the transradial approach is a feasible, safe, and effective alternative for catheter intervention for dysfunctional Brescia-Cimino fistulas. Its success rate in cases with a totally occluded fibrotic lesion is unsatisfactory.

2009-01-01

287

A biology-driven approach identifies the hypoxia gene signature as a predictor of the outcome of neuroblastoma patients  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Hypoxia is a condition of low oxygen tension occurring in the tumor microenvironment and it is related to poor prognosis in human cancer. To examine the relationship between hypoxia and neuroblastoma, we generated and tested an in vitro derived hypoxia gene signature for its ability to predict patients' outcome. Results We obtained the gene expression profile of 11 hypoxic neuroblastoma cell lines and we derived a robust 62 probesets signature (NB-hypo) taking advantage of the strong discriminating power of the l1-l2 feature selection technique combined with the analysis of differential gene expression. We profiled gene expression of the tumors of 88 neuroblastoma patients and divided them according to the NB-hypo expression values by K-means clustering. The NB-hypo successfully stratifies the neuroblastoma patients into good and poor prognosis groups. Multivariate Cox analysis revealed that the NB-hypo is a significant independent predictor after controlling for commonly used risk factors including the amplification of MYCN oncogene. NB-hypo increases the resolution of the MYCN stratification by dividing patients with MYCN not amplified tumors in good and poor outcome suggesting that hypoxia is associated with the aggressiveness of neuroblastoma tumor independently from MYCN amplification. Conclusions Our results demonstrate that the NB-hypo is a novel and independent prognostic factor for neuroblastoma and support the view that hypoxia is negatively correlated with tumors' outcome. We show the power of the biology-driven approach in defining hypoxia as a critical molecular program in neuroblastoma and the potential for improvement in the current criteria for risk stratification.

Fardin Paolo; Barla Annalisa; Mosci Sofia; Rosasco Lorenzo; Verri Alessandro; Versteeg Rogier; Caron Huib N; Molenaar Jan J; Øra Ingrid; Eva Alessandra; Puppo Maura; Varesio Luigi

2010-01-01

288

Minimally invasive intermuscular approach does not improve outcomes in bipolar hemiarthroplasty for femoral neck fracture.  

UK PubMed Central (United Kingdom)

BACKGROUND: Minimally invasive surgery (MIS) can lead to early recovery, but its postoperative effect is short after total hip arthroplasty for osteoarthritis. Because bipolar hemiarthroplasty (BHA) for femoral neck fractures is preferred for elderly patients, early functional recovery may prevent the rapid progression of disuse atrophy, and an MIS surgical approach may improve subsequent hip joint function. METHODS: MIS-BHA was performed using the direct anterior approach, without muscle or tendon detachment. A total of 83 patients who underwent BHA from April 2007 to February 2009 were assigned to MIS-BHA or conventional BHA. Selection of patients for MIS-BHA was not randomized. Hip joint function was evaluated with the Hospital for Special Surgery (HSS) system at 1 month and 1 year after surgery. RESULTS: There were no significant differences in age, sex, height, weight, body mass index, time from admission to surgery, or preinjury HSS scores between two groups. HSS scores were higher with MIS-BHA (24.2 vs. 20.2; P = 0.01) at 1 month but were similar 1 year after surgery (29.9 vs. 27.2; P = 0.10). CONCLUSIONS: The effectiveness of MIS-BHA for femoral neck fracture is limited to the early postoperative period. Therefore, MIS-BHA does not appear to be appropriate for treatment of femoral neck fractures.

Tsukada S; Wakui M

2010-11-01

289

Effect of Teaching of Algebra through Social Constructivist Approach on 7th Graders’ Learning Outcomes in Sindh (Pakistan)  

Directory of Open Access Journals (Sweden)

Full Text Available It is a bitter reality that the curricula and traditional pedagogy prevailing in public schools of Pakistan in general and Sindh in particular do not incorporate the algebraic concepts properly. Both the content and the presentation therein cannot be considered up to the mark, thereby making “Algebra” a tough and dry subject. This quasi-experimental study focused to find out the effect of teaching algebra through social constructivism on the students learning outcomes of 7th graders in public schools of District Jamshoro Sindh. For this purpose two existing in-tact sections of grade 7 (7th A, and 7th B) of a government high school of district Jamshoro were selected as quasi control and treatment groups. The pre and posttest analyses were carried out. The first pattern t-test analysis revealed that both groups were parallel, however, the latter posttest analysis revealed that treatment group that was taught through social constructivist approach excelled in achieving statistically significant learning outcomes than that of control group that was taught through traditional one-way teaching.

Bhutto Muhammad Ilyas; Khalid Jamil Rawat; Muhammad Tariq Bhatti; Najeeb Malik

2013-01-01

290

Binarisms, regressive outcomes and biases in the drug policy interventions: a theoretical approach.  

UK PubMed Central (United Kingdom)

The golden age of drug policy was characterized by the informal regulation of drug use. Formalization of the control over regulation and its increasingly strict, aggressive character led to the emergence of a binary attitude. The main binarisms: pharmaceutical or drug; ban or tolerance; punishment or treatment; psychopathological or pathopsychological approach; subjective or objective knowledge; traditional or alternative. On the basis of Kuhn's paradigm theory, these binarisms can be integrated. Drug policy interventions based on the binary attitude have had regressive effects. Using the work of Sam Sieber, the author distinguishes nine regressive influences: functional imbalance, perverse diagnosis, ricochet, overload, goal displacement, exploitation, provocation, classification, and placation. The regressive influences have caused the escalation of "the drug problem," which in turn has led to further regressive interventions. This vicious circle could be broken by eliminating the four biases--the paternalistic, elitist, rationalist, and activist biases--underlying the regressive interventions.

Gerevich J

2005-01-01

291

Surgical approach and outcomes in patients with lithium-associated hyperparathyroidism.  

UK PubMed Central (United Kingdom)

BACKGROUND: Patients receiving lithium therapy are at elevated risk of developing hyperparathyroidism. In lithium-associated hyperparathyroidism (LAH), the incidence of multiglandular disease (MGD) is unclear, and the need for routine bilateral cervical exploration remains controversial. Therefore, in LAH patients, surgical approaches, pathologic findings, cure rates, and factors associated with persistent or recurrent disease were investigated. METHODS: Retrospective analysis of 27 patients with LAH undergoing parathyroidectomy with the intraoperative parathyroid hormone (PTH) assay. RESULTS: The median postoperative follow-up was 7 months; 17 patients had >6 months follow-up. Cervical exploration was unilateral in 9, bilateral in 18 (3 were converted from unilateral). Sixteen patients (62%) had MGD, 12 with four-gland hyperplasia and 4 with double adenomas. Ten patients (38%) had a single adenoma. Twenty-five (93%) of 27 patients had initially successful surgery. Of the 17 patients with >6 months follow-up, two had persistent disease and two experienced recurrent disease. All patients with a single adenoma remain free of disease. Three (75%) of four patients with persistent/recurrent disease had MGD and were receiving lithium at the time of surgery. Patients with persistent/recurrent disease were older (p = 0.01) and had experienced a longer duration of hypercalcemia (p = 0.04). CONCLUSIONS: LAH patients have a high incidence of MGD, and bilateral exploration is frequently necessary. With access to the intraoperative PTH assay, it is reasonable to initiate a unilateral approach because many patients will harbor single adenomas and can be reliably rendered normocalcemic. Patients with MGD remain at higher risk of persistent/recurrent disease.

Marti JL; Yang CS; Carling T; Roman SA; Sosa JA; Donovan P; Guoth MS; Heller KS; Udelsman R

2012-10-01

292

Recurrent upper cervical chordomas after radiotherapy: surgical outcomes and surgical approach selection based on complications.  

UK PubMed Central (United Kingdom)

STUDY DESIGN: Retrospective review of a case series. OBJECTIVE: To present and analyze our surgical results of recurrent chordomas in the upper cervical spine after radiotherapy and compare 2 surgical strategies. SUMMARY OF BACKGROUND DATA: Surgical treatment of recurrent chordomas in the upper cervical spine after radiotherapy is clinically rare but extremely challenging. No reports are found in the literatures focusing on the surgical results and strategies of such recurrent chordomas. METHODS: Clinical data of 8 patients with recurrent chordomas in the upper cervical spine after radiotherapy were retrospectively reviewed. RESULTS: Preoperative symptoms were relieved after our surgical procedures in 7 of the 8 patients. Total tumor removal was achieved in 6 of the 8 patients. Surgical complications mainly including cerebrospinal fluid leak and incision disunion were observed in 6 of the 8, and all the 3 patients after transoral operation had those complicated surgical complications, whereas the other 3 of the 5 patients after anterior retropharyngeal operation had relatively slighter complications. The disease free survival rates 1 year and 2 years after the surgery in this series were 50% and 12.5%, respectively, comparing with the general survival rates 1 year and 2 years after the surgery 87.5% and 37.5%. CONCLUSION: Revised surgery is effective for improving quality of life of patients with recurrent upper cervical chordomas after radiotherapy before further tumor recurrence. However, the prognosis of those patients is usually poor and surgical complications mainly including incision disunion and cerebrospinal fluid leak are common. To reduce the risk of surgical complications, anterior retropharyngeal approach may be superior to the transoral approach.Level of Evidence: N/A.

Wang Y; Xu W; Yang X; Jiao J; Zhang D; Han S; Xiao J

2013-08-01

293

Short-term outcomes of a motivation-enhancing approach to DUI intervention.  

UK PubMed Central (United Kingdom)

OBJECTIVE: We compared a group-delivered, theory-based, motivation-enhancing program (PRIME For Life(®) - PFL, n=450) to an intervention as usual (IAU, n=72). METHOD: Individuals convicted of a substance related offense in North Carolina, typically first offense alcohol and drug-impaired driving, participated in a PFL or IAU group. We compare the interventions on program satisfaction and changes made from preintervention to postintervention, and examined the moderating effects of demographics and alcohol dependence level. RESULTS: When significant, findings varied in magnitude from small to medium effects. Participants in both interventions showed intentions to use statistically significantly less alcohol and drugs in the future compared to their previous use, and differences between the groups were not statistically significant. Otherwise, findings favored PFL. PFL exhibited greater benefit than IAU on understanding tolerance, perceived risk for addiction, problem recognition, and program satisfaction. Additionally, IAU perceived less risk for negative consequences postintervention than they had at preintervention. Moderation analyses showed that the between-condition findings occurred regardless of gender, age, education, and number of alcohol dependence indicators. Additionally, younger people and those with more dependence indicators - groups of particular concern - showed the greatest change. CONCLUSIONS: Findings suggest that a motivation-enhancing approach can be effective in producing short-term change in factors that can help facilitate and sustain behavioral change. This is consistent with previous research on the use of motivational approaches, and extends such findings to suggest promise in group-based settings and with people across demographic categories and dependence levels. Future research should focus on larger studies looking at long-term behavioral change, including recidivism.

Beadnell B; Nason M; Stafford PA; Rosengren DB; Daugherty R

2012-03-01

294

Relação entre gênero e orientação sexual a partir da perspectiva evolucionista/ Relation between gender and sexual orientation from the evolutionary approach  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese Este estudo trata da relação entre gênero e orientação sexual a partir da perspectiva interacionista da Psicologia Evolucionista e da análise de diferentes elementos da sexualidade humana. Procurou-se discutir a literatura existente sobre os conceitos de gênero e de orientação sexual, com base nos quatro porquês da Etologia. Propõe-se a existência de múltiplas origens para a orientação sexual, sendo uma delas relacionada aos padrões típicos de gênero e ? (more) ? identidade de gênero. Isso levaria à identificação com indivíduos do mesmo sexo ou do sexo oposto e, consequentemente, à atração pelo grupo diferente daquele com o qual se desenvolveu a identificação. Essa perspectiva integra pré-disposições biológicas à análise de influências culturais, compreendendo, como complementares, vertentes teóricas usualmente tidas como contraditórias. Abstract in english This study addresses the relationship between gender and sexual orientation from the interacionist perspective of Evolutionary Psychology and the analysis of various aspects of human sexuality. This article aimed to discuss existing literature about gender and sexual orientation, based on four questions of Ethology. It's proposed that sexual orientation has multiple origins, and that one of those is related to typical patterns of gender and gender identity. This would lea (more) d to identification with same-sex or opposite-sex individuals, and hence, to the attraction for the group different from the one to which identification was established. This approach integrates biological pre-dispositions to the analysis of cultural influences, understanding, as complementary, theoretical views that are usually stated as contradictory.

Menezes, Aline Beckmann; Brito, Regina Célia Souza; Henriques, Alda Loureiro

2010-06-01

295

A business-oriented approach to data warehouse development Enfoque orientado al negocio para el desarrollo del almacén de datos  

Directory of Open Access Journals (Sweden)

Full Text Available Several surveys have indicated that many data warehouses fail to meet business objectives or are outright failures. One reason for this is that requirement engineering is typically overlooked in real projects. This paper addresses data warehouse design from a business perspective by highlighting business strategy analysis, alignment between data warehouse objectives and a firm’s strategy, goal-orientated information requirements’ modelling and how an underlying multidimensional data warehouse model may be derived. A set of guidelines is provided allowing developers to design a data warehouse aligned with a prevailing business strategy. A classic case study is presented.Varios trabajos indican que un porcentaje significativo de los almacenes de datos no cumplen con los objetivos del negocio o que son fracasos rotundos. Una de las razones consiste en que la ingeniería de requerimientos es pasada por alto en proyectos reales.En este trabajo el diseño del almacén de datos es abordado desde un punto de vista empresarial, en el que se da relevancia al análisis de la estrategia del negocio, la alineación entre los objetivos del almacén de datos y la estrategia de la empresa, un modelo de objetivos que permite obtener los requisitos de información y la derivación del modelo multidimensional del almacén. Proveemos un conjunto de directrices que permite a los desarrolladores diseñar un almacén de datos alineado a la estrategia del negocio. Se presenta un caso de estudio clásico.

Cravero Leal Ania; Mazón Jose Norberto; Trujillo Juan

2013-01-01

296

Introducing a novel approach of network oriented analysis of ERPs, demonstrated on adult attention deficit hyperactivity disorder.  

UK PubMed Central (United Kingdom)

OBJECTIVE: Introducing a network-oriented analysis method (brain network activation [BNA]) of event related potential (ERP) activities and evaluating its value in the identification and severity-grading of adult ADHD patients. METHODS: Spatio-temporal interrelations and synchronicity of multi-sited ERP activity peaks were extracted in a group of 13 ADHD patients and 13 control subjects for the No-go stimulus in a Go/No-go task. Participants were scored by cross-validation against the most discriminative ensuing group patterns and scores were correlated to neuropsychological evaluation scores. RESULTS: A distinct frontal-central-parietal pattern in the delta frequency range, dominant at the P3 latency, was unraveled in controls, while central activity in the theta and alpha frequency ranges predominated in the ADHD pattern, involving early ERP components (P1-N1-P2-N2). Cross-validation based on this analysis yielded 92% specificity and 84% sensitivity and individual scores correlated well with behavioral assessments. CONCLUSIONS: These results suggest that the ADHD group was more characterized by the process of exerting attention in the early monitoring stages of the No-go signal while the controls were more characterized by the process of inhibiting the response to that signal. SIGNIFICANCE: The BNA method may provide both diagnostic and drug development tools for use in diverse neurological disorders.

Shahaf G; Reches A; Pinchuk N; Fisher T; Ben Bashat G; Kanter A; Tauber I; Kerem D; Laufer I; Aharon-Peretz J; Pratt H; Geva AB

2012-08-01

297

A business-oriented approach to data warehouse development/ Enfoque orientado al negocio para el desarrollo del almacén de datos  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish Varios trabajos indican que un porcentaje significativo de los almacenes de datos no cumplen con los objetivos del negocio o que son fracasos rotundos. Una de las razones consiste en que la ingeniería de requerimientos es pasada por alto en proyectos reales. En este trabajo el diseño del almacén de datos es abordado desde un punto de vista empresarial, en el que se da relevancia al análisis de la estrategia del negocio, la alineación entre los objetivos del almacén (more) de datos y la estrategia de la empresa, un modelo de objetivos que permite obtener los requisitos de información y la derivación del modelo multidimensional del almacén. Proveemos un conjunto de directrices que permite a los desarrolladores diseñar un almacén de datos alineado a la estrategia del negocio. Se presenta un caso de estudio clásico. Abstract in english Several surveys have indicated that many data warehouses fail to meet business objectives or are outright failures. One reason for this is that requirement engineering is typically overlooked in real projects. This paper addresses data warehouse design from a business perspective by highlighting business strategy analysis, alignment between data warehouse objectives and a firm's strategy, goal-oriented information requirements' modelling and how an underlying multidimensi (more) onal data warehouse model may be derived. A set of guidelines is provided allowing developers to design a data warehouse aligned with a prevailing business strategy. A classic case study is presented

Cravero Leal, A; Mazón, J. N; Trujillo, J

2013-04-01

298

Patients' expectations of deep brain stimulation, and subjective perceived outcome related to clinical measures in Parkinson's disease: a mixed-method approach.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To study patients' expectations of subthalamic deep brain stimulation (STN-DBS) and their subjective perceived outcome, by using qualitative and quantitative methods in Parkinson's disease (PD). METHODS: PD patients were prospectively examined before and 3 months after surgery. Semistructured interviews regarding preoperative expectations and postsurgical subjective perceived outcome were conducted. These were analysed using content analysis. For statistical analyses, patients were classified according to their subjective perceived outcome, resulting in three different subjective outcome groups (negative, mixed, positive outcome). The groups were used for multiple comparisons between and within each group regarding motor impairment, quality of life (QoL), neuropsychiatric status and cognitive functioning, using standard instruments. A logistic regression analysis was conducted to find predictors of subjective negative outcome. Receiver operating characteristic curves were used to analyse cut-off scores for predictive tests. RESULTS: Of the 30 PD patients participating, 8 had a subjective negative outcome, 8 a mixed and 14 a positive outcome. All groups significantly improved in motor functioning. Patients with subjective negative outcome were characterised by preoperative unrealistic expectations, no postsurgical improvement in QoL, and significantly higher presurgical and postsurgical apathy and depression scores. Higher preoperative apathy and depression scores were significant predictors of negative subjective outcome. Cut-off scores for apathy and depression were identified. CONCLUSIONS: The mixed-method approach proved useful in examining a patient's subjective perception of STN-DBS outcome. Our results show that significant motor improvement does not necessarily lead to a positive subjective outcome. Moreover, PD patients should be screened carefully before surgery regarding apathy and depression. (DRKS-ID: DRKS00003221).

Maier F; Lewis CJ; Horstkoetter N; Eggers C; Kalbe E; Maarouf M; Kuhn J; Zurowski M; Moro E; Woopen C; Timmermann L

2013-05-01

299

Rescuing mutant CFTR: a multi-task approach to a better outcome in treating cystic fibrosis.  

UK PubMed Central (United Kingdom)

Correcting multiple defects of mutant CFTR with small molecule compounds has been the goal of an increasing number of recent Cystic Fibrosis (CF) drug discovery programmes. However, the mechanism of action (MoA) by which these molecules restore mutant CFTR is still poorly understood, in particular of CFTR correctors, i.e., compounds rescuing to the cells surface the most prevalent mutant in CF patients--F508del-CFTR. However, there is increasing evidence that to fully restore the multiple defects associated with F508del-CFTR, different small molecules with distinct corrective properties may be required. Towards this goal, a better insight into MoA of correctors is needed and several constraints should be addressed. The methodological approaches to achieve this include: 1) testing the combined effect of compounds with that of other (non-pharmacological) rescuing strategies (e.g., revertants or low temperature); 2) assessing effects in multiple cellular models (non-epithelial vs epithelial, non-human vs human, immortalized vs primary cultures, polarized vs non polarized, cells vs tissues); 3) assessing compound effects on isolated CFTR domains (e.g., compound binding by surface plasmon resonance, assessing effects on domain folding and aggregation); and finally 4) assessing compounds specificity in rescuing different CFTR mutants and other mutant proteins. These topics are reviewed and discussed here so as to provide a state-of-the art review on how to combine multiple ways of rescuing mutant CFTR to the ultimate benefit of CF patients.

Amaral MD; Farinha CM

2013-01-01

300

Imputation Approach for Missing Binary Outcomes in Buprenorphine/Naloxone Treatment for Opioid Dependent  

Directory of Open Access Journals (Sweden)

Full Text Available The opioids is useful to treat the chronic pain. Recently, the opioid mistreatment increased dramatically. The kidney damage may occur due opioid abuse treatment. The creatinine level can be measured to detect the level of kidney damage. The goal of this study is to know the effective drug to control the creatinine among opioid dependent patients. The dependent prior with Bayesian approach is applied to compare the treatment effect. The secondary data on Buprenorphine (BUP) was considered to compare the two drug treatments, viz. (1) BUP+ Standard Medical Management (SMM) and (2) BUP+Extended Medical Mangament (EMM), in opioid dependent patients. In both drug groups the mean creatinine level was found controlled over the duration of the treatment. No rapid changes of creainine level among the patients are observed. At the end of study it is found that the means of creatinine level are higher in BUP+EMM group. The Bayesian dependent prior is found to offer effective tool for drug treatment effect comparison. The drug treatment effect BUP+EMM is found to be more effective to control the creatinine among the patients.

Atanu Bhattacharjee; Dilip C. Nath

2013-01-01

 
 
 
 
301

Thematic approach: an analysis of the issues that oriented the choice of themes in the study situation  

Directory of Open Access Journals (Sweden)

Full Text Available This study focuses on the Study Situation (SE), curricular modality organized from the approach of themes and demarcated by the cultural historic approach. It is aimed to present and discuss the main aspects considered to choose the themes for the elaboration of SE that are developed at a high school, pointing the criteria adopted for the selection of the thematics. This is a qualitative research, is configured as a Case Study, and it were used as research instruments a questionnaire and semi structured interviews. The analysis of the information was based on the assumptions of the Discursive Textual Analysis, from four analytical categories defined a priori, which are: contextualization, interdisciplinarity, conceptual signification and problematization. It is pointed out that the main criterion to choose the themes for the elaboration of the SE is the conceptual issue, this is, some concepts have guided the choice of the thematics.

Karine Raquiel Halmenschlager; Carlos Alberto Souza

2012-01-01

302

A complementary mobile phase approach based on the peak count concept oriented to the full resolution of complex mixtures.  

UK PubMed Central (United Kingdom)

Situations of minimal resolution are often found in liquid chromatography, when samples that contain a large number of compounds, or highly similar in terms of structure and/or polarity, are analysed. This makes full resolution with a single separation condition (e.g., mobile phase, gradient or column) unfeasible. In this work, the optimisation of the resolution of such samples in reversed-phase liquid chromatography is approached using two or more isocratic mobile phases with a complementary resolution behaviour (complementary mobile phases, CMPs). Each mobile phase is dedicated to the separation of a group of compounds. The CMPs are selected in such a way that, when the separation is considered globally, all the compounds in the sample are satisfactorily resolved. The search of optimal CMPs can be carried out through a comprehensive examination of the mobile phases in a selected domain. The computation time of this search has been reported to be substantially reduced by application of a genetic algorithm with local search (LOGA). A much simpler approach is here described, which is accessible to non-experts in programming, and offers solutions of the same quality as LOGA, with a similar computation time. The approach makes a sequential search of CMPs based on the peak count concept, which is the number of peaks exceeding a pre-established resolution threshold. The new approach is described using as test sample a mixture of 30 probe compounds, 23 of them with an ionisable character, and the pH and organic solvent contents as experimental factors.

Ortín A; Torres-Lapasió JR; García-Álvarez-Coque MC

2011-08-01

303

A complementary mobile phase approach based on the peak count concept oriented to the full resolution of complex mixtures.  

Science.gov (United States)

Situations of minimal resolution are often found in liquid chromatography, when samples that contain a large number of compounds, or highly similar in terms of structure and/or polarity, are analysed. This makes full resolution with a single separation condition (e.g., mobile phase, gradient or column) unfeasible. In this work, the optimisation of the resolution of such samples in reversed-phase liquid chromatography is approached using two or more isocratic mobile phases with a complementary resolution behaviour (complementary mobile phases, CMPs). Each mobile phase is dedicated to the separation of a group of compounds. The CMPs are selected in such a way that, when the separation is considered globally, all the compounds in the sample are satisfactorily resolved. The search of optimal CMPs can be carried out through a comprehensive examination of the mobile phases in a selected domain. The computation time of this search has been reported to be substantially reduced by application of a genetic algorithm with local search (LOGA). A much simpler approach is here described, which is accessible to non-experts in programming, and offers solutions of the same quality as LOGA, with a similar computation time. The approach makes a sequential search of CMPs based on the peak count concept, which is the number of peaks exceeding a pre-established resolution threshold. The new approach is described using as test sample a mixture of 30 probe compounds, 23 of them with an ionisable character, and the pH and organic solvent contents as experimental factors. PMID:21782192

Ortín, A; Torres-Lapasió, J R; García-Álvarez-Coque, M C

2011-06-30

304

Determining the interviewer effect on CQ Index outcomes: a multilevel approach  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background The CQ Index for the elderly, a quality-of-care questionnaire administered by conducting interviews, is used to assess clients' experiences in Dutch nursing homes and homes for the elderly. This article describes whether inter-interviewer differences influence the perceived quality of healthcare services reported by residents, the size of this interviewer effect and the influence of the interviewer characteristics on CQ Index dimensions for public reporting. Methods Data from 4345 questionnaires was used. Correlations were calculated, reliability analyses were performed, and a multilevel analysis was used to calculate the degree of correlation between two interviewers within one health care institution. Five models were constructed and the Intra Class Correlation (ICC) was calculated. Healthcare institutions were given 1-5 stars on every quality dimensions (1 = worst and 5 = best), adjusted for resident and interviewer characteristics. The effect of these characteristics on the assignment of the stars was investigated. Results In a multilevel approach, the ICC showed a significant amount of variance on five quality dimensions. Of the interviewer characteristics, only previous interviewing experience, the reason of interviewing and general knowledge of health care had a significant effect on the quality dimensions. Adjusting for interviewer characteristics did not affect the overall star assignment to the institutions regarding 7 of 12 quality dimensions. For the other five dimensions (Shared decision-making, Meals, Professional competency, Autonomy, and Availability of personnel) a minor effect was found. Conclusions We have shown that training, the use of experienced interviewers, written instructions, supervision and educational meetings do not automatically prevent interviewer effects. While the results of this study can be used to improve the quality of services provided by these institutions, several CQ index dimensions should be interpreted with caution for external purposes (accountability and transparency).

Winters Sjenny; Strating Mathilde H; Klazinga Niek S; Kool Rudolf B; Huijsman Robbert

2010-01-01

305

A multi-institutional approach to implement fruit fly low prevalence and free areas in Central America: Outcomes and constraints  

International Nuclear Information System (INIS)

[en] Full text: For the purpose of boosting the fruit and vegetable exports of the Central American countries through fruit fly suppression/eradication actions, new approaches are used: - A multilateral alliance instead of isolated efforts. Thus, four international organisations, two donors Government institutions and the region's seven countries joined their efforts, coordinated by the IAEA; - A strategy of incremental enlargement of isolated low prevalence or free areas, instead of the old approach of attempting to eradicate the pest from the entire region; and - The use of pilot experimental areas, on which all elements that play a key role in a pest-free production-exports system are applied, instead of focusing only on some technologies in the field. Outcomes include the implementation of medfly-free areas in Honduras, Nicaragua and Costa Rica, and Panama is also in the process of doing so. Guatemala is presently negotiating with the Mexican Government the export of peach from its fruit fly-free zone in the Department of Quetzaltenango. Major constraints encountered are: - Weak alliances among the international organisations, - Troublesome coordination between Governments and the producers-exporters, - Insufficient trained civil servants in the Government and, - Insufficient funding to transfer the actions to bigger areas. (author)

2005-01-01

306

Transcriptome walking: a laboratory-oriented GUI-based approach to mRNA identification from deep-sequenced data  

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Full Text Available Abstract Background Deep sequencing technology provides efficient and economical production of large numbers of randomly positioned, relatively short, estimates of base identities in DNA molecules. Application of this technology to mRNA samples allows rapid examination of the molecular genetic environment in individual cells or tissues, the transcriptome. However, assembly of such short sequences into complete mRNA creates a challenge that limits the usefulness of the technology, particularly when no, or limited, genomic data is available. Several approaches to this problem have been developed, but there is still no general method to rapidly obtain an mRNA sequence from deep sequence data when a specific molecule, or family of molecules, are of interest. A frequent requirement is to identify specific mRNA molecules from tissues that are being investigated by methods such as electrophysiology, immunocytology and pharmacology. To be widely useful, any approach must be relatively simple to use in the laboratory by operators without extensive statistical or bioinformatics knowledge, and with readily available hardware. Findings An approach was developed that allows de novo assembly of individual mRNA sequences in two linked stages: sequence discovery and sequence completion. Both stages rely on computer assisted, Graphical User Interface (GUI)-guided, user interaction with the data, but proceed relatively efficiently once discovery is complete. The method grows a discovered sequence by repeated passes through the complete raw data in a series of steps, and is hence termed ‘transcriptome walking’. All of the operations required for transcriptome analysis are combined in one program that presents a relatively simple user interface and runs on a standard desktop, or laptop computer, but takes advantage of multi-core processors, when available. Complete mRNA sequence identifications usually require less than 24 hours. This approach has already identified previously unknown mRNA sequences in two animal species that currently lack any significant genome or transcriptome data. Conclusions As deep sequencing data becomes more widely available, accessible methods for extracting useful sequence information in the biological or medical laboratory will be of increasing importance. The approach described here does not rely on detailed knowledge of bioinformatic algorithms, and allows users with basic knowledge of molecular biology and standard laboratory computing equipment, but limited software or bioinformatics experience, to extract complete gene sequences from deep-sequencing data.

French Andrew S

2012-01-01

307

Transcriptome walking: a laboratory-oriented GUI-based approach to mRNA identification from deep-sequenced data.  

UK PubMed Central (United Kingdom)

BACKGROUND: Deep sequencing technology provides efficient and economical production of large numbers of randomly positioned, relatively short, estimates of base identities in DNA molecules. Application of this technology to mRNA samples allows rapid examination of the molecular genetic environment in individual cells or tissues, the transcriptome. However, assembly of such short sequences into complete mRNA creates a challenge that limits the usefulness of the technology, particularly when no, or limited, genomic data is available. Several approaches to this problem have been developed, but there is still no general method to rapidly obtain an mRNA sequence from deep sequence data when a specific molecule, or family of molecules, are of interest. A frequent requirement is to identify specific mRNA molecules from tissues that are being investigated by methods such as electrophysiology, immunocytology and pharmacology. To be widely useful, any approach must be relatively simple to use in the laboratory by operators without extensive statistical or bioinformatics knowledge, and with readily available hardware. FINDINGS: An approach was developed that allows de novo assembly of individual mRNA sequences in two linked stages: sequence discovery and sequence completion. Both stages rely on computer assisted, Graphical User Interface (GUI)-guided, user interaction with the data, but proceed relatively efficiently once discovery is complete. The method grows a discovered sequence by repeated passes through the complete raw data in a series of steps, and is hence termed 'transcriptome walking'. All of the operations required for transcriptome analysis are combined in one program that presents a relatively simple user interface and runs on a standard desktop, or laptop computer, but takes advantage of multi-core processors, when available. Complete mRNA sequence identifications usually require less than 24 hours. This approach has already identified previously unknown mRNA sequences in two animal species that currently lack any significant genome or transcriptome data. CONCLUSIONS: As deep sequencing data becomes more widely available, accessible methods for extracting useful sequence information in the biological or medical laboratory will be of increasing importance. The approach described here does not rely on detailed knowledge of bioinformatic algorithms, and allows users with basic knowledge of molecular biology and standard laboratory computing equipment, but limited software or bioinformatics experience, to extract complete gene sequences from deep-sequencing data.

French AS

2012-01-01

308

An exploratory study of spiritual orientation and adaptation to therapeutic community treatment.  

UK PubMed Central (United Kingdom)

The purpose of this study was to determine the extent to which spiritual orientation was associated with adaptation to therapeutic community treatment. Spiritual orientation was assessed by the Spirituality Self-Rating Scale, a measure consistent with the conceptualization of spirituality typically reflected in Alcoholics Anonymous members' views. Spiritual orientation was positively correlated with acceptance of therapeutic community principles and clinical progress. Further assessment of spirituality related characteristics and their relation to treatment outcomes is important in informing the design of interventions aimed at improving progress in the therapeutic community, particularly those aspects involving the relative value of integrating the 12-Step group approach in therapeutic community programs.

Dermatis H; James T; Galanter M; Bunt G

2010-07-01

309

An exploratory study of spiritual orientation and adaptation to therapeutic community treatment.  

Science.gov (United States)

The purpose of this study was to determine the extent to which spiritual orientation was associated with adaptation to therapeutic community treatment. Spiritual orientation was assessed by the Spirituality Self-Rating Scale, a measure consistent with the conceptualization of spirituality typically reflected in Alcoholics Anonymous members' views. Spiritual orientation was positively correlated with acceptance of therapeutic community principles and clinical progress. Further assessment of spirituality related characteristics and their relation to treatment outcomes is important in informing the design of interventions aimed at improving progress in the therapeutic community, particularly those aspects involving the relative value of integrating the 12-Step group approach in therapeutic community programs. PMID:20635280

Dermatis, Helen; James, Tina; Galanter, Marc; Bunt, Gregory

2010-07-01

310

[Sexual orientations].  

Science.gov (United States)

In this paper we study the concept of sexual orientation and its components by comparing the common orientations of hetero-, homo-, and bisexuality with alternative concepts suitable for describing persons with psychosexual and somatosexual divergencies (e.g., transgender or intersex developments). An assessment of these divergencies as well as their prevalence and societal influences are presented. Empirical findings on the relationship between sexual orientation and mental health are examined against the background of the sexual minority stress model, looking especially at the risks and the opportunities associated with belonging to a sexual minority. The paper also focuses on the normative power of a monosexual model. Finally, sexual orientation is conceptualized as an umbrella term encompassing both conscious and unconscious elements, including the aspects of sexual behavior, sexual identity, fantasies, and attraction. PMID:23361208

Schweizer, K; Brunner, F

2013-02-01

311

[Sexual orientations].  

UK PubMed Central (United Kingdom)

In this paper we study the concept of sexual orientation and its components by comparing the common orientations of hetero-, homo-, and bisexuality with alternative concepts suitable for describing persons with psychosexual and somatosexual divergencies (e.g., transgender or intersex developments). An assessment of these divergencies as well as their prevalence and societal influences are presented. Empirical findings on the relationship between sexual orientation and mental health are examined against the background of the sexual minority stress model, looking especially at the risks and the opportunities associated with belonging to a sexual minority. The paper also focuses on the normative power of a monosexual model. Finally, sexual orientation is conceptualized as an umbrella term encompassing both conscious and unconscious elements, including the aspects of sexual behavior, sexual identity, fantasies, and attraction.

Schweizer K; Brunner F

2013-02-01

312

Role of genetic heterogeneity and epistasis in bladder cancer susceptibility and outcome: a learning classifier system approach.  

UK PubMed Central (United Kingdom)

BACKGROUND AND OBJECTIVE: Detecting complex patterns of association between genetic or environmental risk factors and disease risk has become an important target for epidemiological research. In particular, strategies that provide multifactor interactions or heterogeneous patterns of association can offer new insights into association studies for which traditional analytic tools have had limited success. MATERIALS AND METHODS: To concurrently examine these phenomena, previous work has successfully considered the application of learning classifier systems (LCSs), a flexible class of evolutionary algorithms that distributes learned associations over a population of rules. Subsequent work dealt with the inherent problems of knowledge discovery and interpretation within these algorithms, allowing for the characterization of heterogeneous patterns of association. Whereas these previous advancements were evaluated using complex simulation studies, this study applied these collective works to a 'real-world' genetic epidemiology study of bladder cancer susceptibility. RESULTS AND DISCUSSION: We replicated the identification of previously characterized factors that modify bladder cancer risk--namely, single nucleotide polymorphisms from a DNA repair gene, and smoking. Furthermore, we identified potentially heterogeneous groups of subjects characterized by distinct patterns of association. Cox proportional hazard models comparing clinical outcome variables between the cases of the two largest groups yielded a significant, meaningful difference in survival time in years (survivorship). A marginally significant difference in recurrence time was also noted. These results support the hypothesis that an LCS approach can offer greater insight into complex patterns of association. CONCLUSIONS: This methodology appears to be well suited to the dissection of disease heterogeneity, a key component in the advancement of personalized medicine.

Urbanowicz RJ; Andrew AS; Karagas MR; Moore JH

2013-07-01

313

A joint-modeling approach to assess the impact of biomarker variability on the risk of developing clinical outcome.  

Science.gov (United States)

In some clinical trials and epidemiologic studies, investigators are interested in knowing whether the variability of a biomarker is independently predictive of clinical outcomes. This question is often addressed via a naïve approach where a sample-based estimate (e.g., standard deviation) is calculated as a surrogate for the "true" variability and then used in regression models as a covariate assumed to be free of measurement error. However, it is well known that the measurement error in covariates causes underestimation of the true association. The issue of underestimation can be substantial when the precision is low because of limited number of measures per subject. The joint analysis of survival data and longitudinal data enables one to account for the measurement error in longitudinal data and has received substantial attention in recent years. In this paper we propose a joint model to assess the predictive effect of biomarker variability. The joint model consists of two linked sub-models, a linear mixed model with patient-specific variance for longitudinal data and a full parametric Weibull distribution for survival data, and the association between two models is induced by a latent Gaussian process. Parameters in the joint model are estimated under Bayesian framework and implemented using Markov chain Monte Carlo (MCMC) methods with WinBUGS software. The method is illustrated in the Ocular Hypertension Treatment Study to assess whether the variability of intraocular pressure is an independent risk of primary open-angle glaucoma. The performance of the method is also assessed by simulation studies. PMID:21339862

Gao, Feng; Miller, J Philip; Xiong, Chengjie; Beiser, Julia A; Gordon, Mae

2011-03-01

314

A joint-modeling approach to assess the impact of biomarker variability on the risk of developing clinical outcome.  

UK PubMed Central (United Kingdom)

In some clinical trials and epidemiologic studies, investigators are interested in knowing whether the variability of a biomarker is independently predictive of clinical outcomes. This question is often addressed via a naïve approach where a sample-based estimate (e.g., standard deviation) is calculated as a surrogate for the "true" variability and then used in regression models as a covariate assumed to be free of measurement error. However, it is well known that the measurement error in covariates causes underestimation of the true association. The issue of underestimation can be substantial when the precision is low because of limited number of measures per subject. The joint analysis of survival data and longitudinal data enables one to account for the measurement error in longitudinal data and has received substantial attention in recent years. In this paper we propose a joint model to assess the predictive effect of biomarker variability. The joint model consists of two linked sub-models, a linear mixed model with patient-specific variance for longitudinal data and a full parametric Weibull distribution for survival data, and the association between two models is induced by a latent Gaussian process. Parameters in the joint model are estimated under Bayesian framework and implemented using Markov chain Monte Carlo (MCMC) methods with WinBUGS software. The method is illustrated in the Ocular Hypertension Treatment Study to assess whether the variability of intraocular pressure is an independent risk of primary open-angle glaucoma. The performance of the method is also assessed by simulation studies.

Gao F; Miller JP; Xiong C; Beiser JA; Gordon M

2011-03-01

315

Giant olfactory groove meningiomas: extent of frontal lobes damage and long-term outcome after the pterional approach.  

UK PubMed Central (United Kingdom)

OBJECTIVE: The treatment of giant olfactory groove meningiomas (OGMs; maximum diameter ? 6 cm) poses special problems and represents a surgical challenge. We discuss the long-term results in a series of 18 patients with giant OGMs and report our experience on a global strategy encompassing the pterional approach to manage the lesion and an extended transbasal approach to treat recurrences. METHODS: Between February 1991 and December 2007, 18 patients with giant OGMs were surgically managed via a pterional craniotomy. Postoperative follow-up imaging was obtained at one, six, and 12 months and then yearly. In preoperative images, data from tumor volume were assessed. The volume of the residual right frontal porencephalic cave (ipsilateral to the operative side) was compared with the volume of the porencephalic cave measured in the left frontal lobe (internal control) in each case. Comparison between porencephalic cave and the original tumor volume for each side was also performed. RESULTS: At the first operation in 17 of 18 patients (94.4%), the tumor resection was accomplished by a complete macroscopic lesion removal and coagulation of its dural attachment (Simpson grade II). In one patient, a Simpson grade V resection was obtained. The mean follow-up was 93.5 months, ranging from 12 to 214 months. Recurrences were observed in three patients (16.7%) at 103, 102, and 128 months, respectively, from the time of the first operation. These patients were operated on via an extended subfrontal transbasal approach accomplishing a complete (Simpson grade I) resection. No death occurred. The visual deficit improved in seven of 13 patients (53.8%), remained stable in five (38.5%), and worsened in one patient (7.7%). Overall, 17 of 18 patients (94.4%) had a good outcome and returned to their previous occupations. All the tumors presented with a symmetrical growth pattern. The mean meningioma volume was 23.51 ± 1.62 cm(3) for the right portion of the tumor and 23.04 ± 1.35 cm(3) for the left portion. The mean residual porencephalic volume was significantly smaller in the left frontal lobe (mean value 5.7 mL) than in the right frontal lobe (mean value 16.6 mL; P < 0.05). The mean residual porencephalic volume was significantly smaller than the tumor volume both in the left (P < 0.01) and in the right side (P < 0.05). CONCLUSION: The pterional-transsylvian approach provides two major advantages: first, it minimizes morbidity and mortality through an early neurovascular control and by limiting parenchymal damage as demonstrated by a quantitative analysis; second it is associated with low recurrence rate at a long-term follow-up.

Tomasello F; Angileri FF; Grasso G; Granata F; De Ponte FS; Alafaci C

2011-09-01

316

Orienteering Club  

CERN Document Server

Courses d’orientation ce printemps Le Club d’orientation du CERN vous invite à venir découvrir la course d’orientation et vous propose, en partenariat avec d’autres clubs de la région, une dizaine de courses populaires. Celles-ci ont lieu les samedis après-midi, elles sont ouvertes à tous, quel que soit le niveau, du débutant au sportif confirmé, en famille ou en individuel, en promenade ou en course. Si vous êtes débutant vous pouvez profiter d’une petite initiation offerte par l’organisateur avant de vous lancer sur un parcours. Divers types de parcours sont à votre choix lors de chaque épreuve : facile court (2-3 km), facile moyen (3-5 km), technique court (3-4 km), technique moyen (4-5 km) et technique long (5-7 km). Les dates à retenir sont les suivantes : Samedi 23 mars: Pully (Vd) Samedi 13 avril: Pougny...

Club d'orientation

2013-01-01

317

Treatment outcome and prognostic factor analysis in transplant-eligible Chinese myeloma patients receiving bortezomib-based induction regimens including the staged approach, PAD or VTD  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background We have reported promising outcomes using a staged approach, in which bortezomib/thalidomide/dexamethasone was used only in 14 patients with suboptimal response to VAD (vincristine/adriamycin/dexamethasone) before autologous stem cell transplantation (ASCT). Here we compared the outcomes of the staged approach with frontline PAD (bortezomib/doxorubicin/dexamethasone) or VTD (bortezomib/thalidomide/dexamethasone) induction, and analysed prognostic factors for outcome. Patients and methods Ninety-one transplant-eligible Chinese patients received three induction regimens prior to ASCT [staged approach (N?=?25), PAD (N?=?31), VTD (N?=?35)]. and received thalidomide maintenance for 2?years post-ASCT. Results 43 (47.3%) patients had International Staging System (ISS) III disease. By an intention-to-treat analysis, the overall CR/nCR rate were 37.4% post-induction, and 62.6% post-ASCT. Five-year overall (OS) and event-free (EFS) survivals were 66% and 45.1%. There was no difference of the post-induction CR/nCR rate, EFS or OS between patients induced by these three regimens. Moreover, ISS III disease did not affect CR/nCR rates. Multivariate analysis showed that ISS and post-ASCT CR/nCR impacted OS while ISS and post-induction CR/nCR impacted EFS. Conclusions These three induction regimens produced comparable and favorable outcomes in myeloma. The unfavorable outcome of ISS stage III persisted despite upfront/early use of bortezomib. CR/nCR predicted favorable survivals.

Chim Chor; Lie Albert Kwok; Chan Eric Yuk; Liu Herman Sung; Lau Ching; Yip Sze; Sim Joycelyn; Wan Thomas; Ma Edmond; Liang Raymond; Tse Eric; Kwong Yok-Lam

2012-01-01

318

OBJECT ORIENTED DESIGN HEURISTICS  

Directory of Open Access Journals (Sweden)

Full Text Available Object-oriented design is a process of identifying relevant objects, factoring them into classes, organizing hierarchically, and establishing dynamic collaborations among the objects. It is a difficult process especially for novice designers. In order to guide the novices, software engineers used some hints, guidelines and tips to communicate design experience from the expert. Design heuristic is common solution to design problems that developers encounter during software development. Heuristic is defined as the use of general knowledge gained by experience. Design heuristics are design experience from object-oriented developers. It is small and simpledesign expertise. This knowledge from the experienced designers is used to guide the novices. The purpose of this paper is to document design heuristics of object-oriented approach from literature study.

RAKESH KUMAR; DEEPALI GUPTA

2011-01-01

319

Behavioral and socioemotional outcomes through age 5 years of the legacy for children public health approach to improving developmental outcomes among children born into poverty.  

UK PubMed Central (United Kingdom)

OBJECTIVES: We evaluated Legacy for Children, a public health strategy to improve child health and development among low-income families. METHODS: Mothers were recruited prenatally or at the birth of a child to participate in Legacy parenting groups for 3 to 5 years. A set of 2 randomized trials in Miami, Florida, and Los Angeles, California, between 2001 and 2009 assessed 574 mother-child pairs when the children were 6, 12, 24, 36, 48, and 60 months old. Intent-to-treat analyses from 12 to 60 months compared groups on child behavioral and socioemotional outcomes. RESULTS: Children of mothers in the intervention group were at lower risk for behavioral concerns at 24 months and socioemotional problems at 48 months in Miami, and lower risk for hyperactive behavior at 60 months in Los Angeles. Longitudinal analyses indicated that children of intervention mothers in Miami were at lower risk for behavior problems from 24 to 60 months of age. CONCLUSIONS: Randomized controlled trials documented effectiveness of the Legacy model over time while allowing for implementation adaptations by 2 different sites. Broadly disseminable, parent-focused prevention models such as Legacy have potential for public health impact. These investments in prevention might reduce the need for later intervention strategies.

Kaminski JW; Perou R; Visser SN; Scott KG; Beckwith L; Howard J; Smith DC; Danielson ML

2013-06-01

320

Oriented divisions, fate decisions.  

UK PubMed Central (United Kingdom)

During development, the establishment of proper tissue architecture depends upon the coordinated control of cell divisions not only in space and time, but also direction. Execution of an oriented cell division requires establishment of an axis of polarity and alignment of the mitotic spindle along this axis. Frequently, the cleavage plane also segregates fate determinants, either unequally or equally between daughter cells, the outcome of which is either an asymmetric or symmetric division, respectively. The last few years have witnessed tremendous growth in understanding both the extrinsic and intrinsic cues that position the mitotic spindle, the varied mechanisms in which the spindle orientation machinery is controlled in diverse organisms and organ systems, and the manner in which the division axis influences the signaling pathways that direct cell fate choices.

Williams SE; Fuchs E

2013-09-01

 
 
 
 
321

Student performance and their perception of a patient-oriented problem-solving approach with audiovisual aids in teaching pathology: a comparison with traditional lectures  

Directory of Open Access Journals (Sweden)

Full Text Available Arjun SinghDepartment of Pathology, Sri Venkateshwara Medical College Hospital and Research Centre, Pondicherry, IndiaPurpose: We use different methods to train our undergraduates. The patient-oriented problem-solving (POPS) system is an innovative teaching–learning method that imparts knowledge, enhances intrinsic motivation, promotes self learning, encourages clinical reasoning, and develops long-lasting memory. The aim of this study was to develop POPS in teaching pathology, assess its effectiveness, and assess students’ preference for POPS over didactic lectures.Method: One hundred fifty second-year MBBS students were divided into two groups: A and B. Group A was taught by POPS while group B was taught by traditional lectures. Pre- and post-test numerical scores of both groups were evaluated and compared. Students then completed a self-structured feedback questionnaire for analysis.Results: The mean (SD) difference in pre- and post-test scores of groups A and B was 15.98 (3.18) and 7.79 (2.52), respectively. The significance of the difference between scores of group A and group B teaching methods was 16.62 (P < 0.0001), as determined by the z-test. Improvement in post-test performance of group A was significantly greater than of group B, demonstrating the effectiveness of POPS. Students responded that POPS facilitates self-learning, helps in understanding topics, creates interest, and is a scientific approach to teaching. Feedback response on POPS was strong in 57.52% of students, moderate in 35.67%, and negative in only 6.81%, showing that 93.19% students favored POPS over simple lectures.Conclusion: It is not feasible to enforce the PBL method of teaching throughout the entire curriculum; However, POPS can be incorporated along with audiovisual aids to break the monotony of dialectic lectures and as alternative to PBL.Keywords: medical education, problem-solving exercise, problem-based learning

Arjun Singh

2010-01-01

322

Student performance and their perception of a patient-oriented problem-solving approach with audiovisual aids in teaching pathology: a comparison with traditional lectures.  

UK PubMed Central (United Kingdom)

PURPOSE: We use different methods to train our undergraduates. The patient-oriented problem-solving (POPS) system is an innovative teaching-learning method that imparts knowledge, enhances intrinsic motivation, promotes self learning, encourages clinical reasoning, and develops long-lasting memory. The aim of this study was to develop POPS in teaching pathology, assess its effectiveness, and assess students' preference for POPS over didactic lectures. METHOD: One hundred fifty second-year MBBS students were divided into two groups: A and B. Group A was taught by POPS while group B was taught by traditional lectures. Pre- and posttest numerical scores of both groups were evaluated and compared. Students then completed a self-structured feedback questionnaire for analysis. RESULTS: The mean (SD) difference in pre- and post-test scores of groups A and B was 15.98 (3.18) and 7.79 (2.52), respectively. The significance of the difference between scores of group A and group B teaching methods was 16.62 (P < 0.0001), as determined by the z-test. Improvement in post-test performance of group A was significantly greater than of group B, demonstrating the effectiveness of POPS. Students responded that POPS facilitates self-learning, helps in understanding topics, creates interest, and is a scientific approach to teaching. Feedback response on POPS was strong in 57.52% of students, moderate in 35.67%, and negative in only 6.81%, showing that 93.19% students favored POPS over simple lectures. CONCLUSION: It is not feasible to enforce the PBL method of teaching throughout the entire curriculum; However, POPS can be incorporated along with audiovisual aids to break the monotony of dialectic lectures and as alternative to PBL.

Singh A

2011-01-01

323

CLOUD COMPUTING BASED ORIENTATION  

Directory of Open Access Journals (Sweden)

Full Text Available With the rapid increase in the technology internet plays a major role in the society with the existence of the cloud based scenario. Where it is very much useful in the technology based on information related to the software oriented approach. It is mainly concerned about the utilities of the system which is the primary goal. It play a key role in the transmission of the data with a high definition oriented security based analysis respectively. Therefore whenever the user in the form of the company based software got the requirement of the cloud oriented scenario then he demands the service provider regarding the particular requirement and buys for a rent or a leased scenario and meets the necessary requirement of the company. When ever in this real time environment an investor used to invest a lot of amount for the purpose of infrastructure with high storage and rapid speed. For this reason there is a cost effective phenomena takes place. But suddenly there is an great improvement in the system that itself provides the resources with high quality and storage with security oriented scenario that is on the basis of lease or rent. Therefore the total amount is got remained as it is whatever has to be invested on the resource allocation. Therefore user may start his work with less investment. Now a days it has become very popular and essential tool for the purpose of any advanced oriented research respectively.

K. Jithendar; K.Srujan Raju; K. Neeraja

2013-01-01

324

Dose prescription in carbon ion radiotherapy: a planning study to compare NIRS and LEM approaches with a clinically-oriented strategy  

Science.gov (United States)

In carbon ion radiotherapy there is an urgent clinical need to develop objective tools for the conversion of relative biological effectiveness (RBE)-weighted doses based on different models. In this work we introduce a clinically oriented method to compare NIRS-based and LEM-based GyE systems, minimizing differences in physical dose distributions between treatment plans. Carbon ion plans were optimized on target volumes of cubic and spherical shapes, for RBE-weighted dose prescription levels ranging from 3.6 to 4.4 GyE. Plans were calculated for target sizes from 4 to 12 cm defining three beam geometries: single beam, opposed beam and orthogonal beam configurations. The two treatment planning systems currently employed in clinical practice were used, providing the NIRS-based and LEM-based GyE calculations. Physical dose distributions of NIRS-based and LEM-based treatment plans were compared. LEM-based prescription doses that minimize differences in physical dose distributions between the two systems were found. These doses were compared with the mean RBE-weighted dose obtained with a Monte Carlo code (FLUKA) interfaced with LEM I. In the investigated dose range, LEM-based RBE-weighted prescription doses, that minimize differences with NIRS plans, should be higher than NIRS reported prescription doses. The optimal dose depends on target size, shape and position, number of beams and dose level. The opposed beam configuration resulted in the smallest average prescription dose difference (0.45 ± 0.09 GyE). The second approach of recalculating NIRS RBE-weighted dose with a Monte Carlo code interfaced with LEM resulted in no significant difference with the results obtained from the planning study. The delivery of a voxel by voxel iso-effective plan, if different RBE models are employed, is not feasible; it is however possible to minimize differences in a treatment plan with the simple approach presented here. Dose prescription ultimately represents a clinical task under the responsibility of the radiation oncologist, the presented analysis intends to be a quantitative and objective way to assist the clinical decision.

Fossati, Piero; Molinelli, Silvia; Matsufuji, Naruhiru; Ciocca, Mario; Mirandola, Alfredo; Mairani, Andrea; Mizoe, Junetsu; Hasegawa, Azusa; Imai, Reiko; Kamada, Tadashi; Orecchia, Roberto; Tsujii, Hirohiko

2012-11-01

325

Orienteering Club  

CERN Document Server

Course d’orientation Face aux Championnats de France des Clubs à Poitiers, et à une météo hivernale (vent glaciale et pluie), il ne restait qu’une cinquantaine d’orienteurs pour participer à l’épreuve organisée le samedi 25 mai à Grange-Malval. Les participants ont tout de même bien apprécié les 5 circuits proposés par le Satus Genève. Les résultats sont disponibles sur notre site http://cern.ch/club-orientation. En plus des résultats, vous pourrez noter des informations sur la nouvelle école de CO encadrée par B. Barge, Prof. EPS à Ferney-Voltaire pour les jeunes à partir de 6 ans. La prochaine étape de la coupe genevoise se déroulera samedi 1er juin à Morez (39). Epreuve organisée par le club O’Jura&nb...

Club d'Orientation

2013-01-01

326

Orienteering Club  

CERN Document Server

 Course d’orientation C’est sous un magnifique soleil que s’est tenue la 7e épreuve de la coupe genevoise organisée par le club d’orientation du CERN. Les organisateurs avaient concocté des parcours assez techniques sur le site de La Faucille. Sur le parcours technique long, beau podium avec la victoire de Domenico Lepori (double médaillés aux championnats du monde en 2010 en vétéran) du club Care Vevey en 1:00:23, juste devant Jürg Niggli du club O’Jura en 1:00:56 puis Beat Mueller du club Lausanne-Jorat en 1:04:28. Sur le parcours technique moyen, Franck Longchampt s’est octroyé la première place, sur le parcours technique court, le jeune Julien Vuitton, qui n’a pas tout à fait 11 ans, a remporté son circuit. Coté parcours facile moyen, Victor Kuznetsov a une fois de plus gagn&eacut...

Club d'Orientation

2012-01-01

327

Orienteering club  

CERN Multimedia

Courses d’orientation Le soleil enfin de retour a incité nombre de sportifs et promeneurs à nous rejoindre dans la belle forêt de Challex /Pougny pour la deuxième étape de notre coupe de printemps 2013. Certains sont revenus crottés et fourbus alors que d’autres avaient les joues bien roses après un grand bol d’air frais. Mais tous avaient passé un agréable moment dans la nature. Nous rappelons que nos activités sont ouvertes à tous, jeunes, moins jeunes, sportifs, familles, du CERN ou d’ailleurs, et que le seul inconvénient est que si vous goûtez à la course d’orientation, il vous sera difficile de ne pas y revenir ! Samedi 20 avril 2013, nous serons sur le Mont Mourex (entre Gex et Divonne) pour notre prochaine épreuve et vous y serez les bienvenus. Les inscriptions et les départ...

Club d'orientation

2013-01-01

328

Children’s Television as a Medium for Social Orientation? – An Approach in the Perspective of Children’s Use of Television  

Directory of Open Access Journals (Sweden)

Full Text Available The development of individualism, distinction and pluralism has not simply slipped by the every-day life of children and youth. Today they are moreover understood as humans, who take an active role in their social life. On the threshold from being a child to becoming an adolescent, children find themselves in a state of radical change, during this process they look out for possibilities of orientation. Accordingly questions of orientation are no longer mainly/principally asked within a personal environment, but increasingly outwards; for example towards the media. Television is still today the main form of media and presents an attractive source of orientation from which the youth today summon up their symbolic materials for their structuring of life. Adults to whom the children relate most closely and educationalists have their own opinion of what is important regarding the social orientation of the children. However which subjects of social orientation interest today’s youth? This question follows the existing work related to the background of the living situation. Which programmes are they viewing and which subjects of social orientation are in their favourites?

Claudia Raabe

2009-01-01

329

The use of health-related quality of life (HRQOL) in children and adolescents as an outcome criterion to evaluate family oriented support for young carers in Germany: an integrative review of the literature  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Young people below the age of 18, whose lives are affected by looking after a relative with a disability or long-term illness, are called young carers. Evidence based family oriented support for young carers and their families in Germany is currently being developed. To allow for scientific evaluation, an outcome criterion needs to be chosen. Until today, there are no assessment instruments available, which focus on young carer's specific demands and needs. As HRQOL seems to be an adequate alternative outcome criterion, an integrative review of the literature was carried out to verify this assumption. Methods The aim of the integrative review was to get information about a) the concept and the common definition of HRQOL in children, b) preferable HRQOL assessment techniques in children, and c) the relevance of HRQOL measures for the population of young carers. An additional aim of the review was to give advice on which instrument fits best to assess young carer's HRQOL in Germany. Searches were conducted in PubMed in order to obtain papers reporting about a) the development or psychometric assessment of instruments measuring HRQOL in children and adolescents up to the age of 18, and b) on the conceptual framework of HRQOL in children. Results HRQOL is a multidimensional construct covering physical, emotional, mental, social, and behavioural components of well-being and functioning as subjective perceived by a person depending on the cultural context and value system one is living in. Young carer's problems and needs are well covered by these common domains of HRQOL. Since no specific HRQOL-measures are available to address young carers, a generic one has to be chosen which a) has been created for use in children, b) allows self- and proxy-report, and c) has good psychometric testing results. Comparing four generic measures with currently best published psychometric testing results, items of the KIDSCREEN cover young carer's specific problems most accurate. Conclusion The KIDSCREEN questionnaires seems adequate to evaluate the intervention as their items cover young carer's needs and problems most accurate.

Schlarmann Jörg; Metzing-Blau Sabine; Schnepp Wilfried

2008-01-01

330

Description of a methodological approach to verify the outcome-optimization of tailored therapeutic choices and test application to PCI vs. CABG.  

Directory of Open Access Journals (Sweden)

Full Text Available Background. The decision process between Percutaneous Coronary Intervention (PCI) and Bypass Graft Surgery (CABG) is based on inconclusive evidence. Yet, it is generally regarded as capable of optimizing patient outcomes. Objectives. To verify this belief through a statistical approach investigating effect modification by propensity score (PS). Methods The probability of receiving PCI as the revascularisation strategy – PS - was calculated for all the 11750 patients with severe coronary disease who underwent coronary revascularization between 2002 and 2008 in Emilia-Romagna, Italy. Long-term risks of PCI vs. CABG for death, myocardial infarction, repeat revascularization and stroke were calculated by Cox regression in each decile of PS. The homogeneity of the Hazard Ratios (HR) across deciles was assessed with a likelihood ratio test and by visual inspection. Results. Repeat revascularization was the only outcome that significantly differed across deciles of PS (p=0.05) and whose trend supported a favorable effect of the decision process. Conclusions In agreement with the current scientific uncertainty, but contrary to common opinion, the medical decision process between PCI and CABG based on demographic and clinical factors is marginally capable of optimizing the post-procedural outcomes. The proposed methodology is limited by the assumption that clinicians considered only the variables that entered the PS calculation. Keywords Outcome And Process Assessment (Health Care), Coronary Disease, Coronary Artery Bypass, Angioplasty, Patient Selection, Propensity Score

Stefano Di Bartolomeo; Paolo Guastaroba; Daniela Fortuna; Rossana De Palma; Roberto Grilli

2012-01-01

331

A geometric morphometric approach to the analysis of lip shape during speech: development of a clinical outcome measure.  

UK PubMed Central (United Kingdom)

Objective assessments of lip movement can be beneficial in many disciplines including visual speech recognition, for surgical outcome assessment in patients with cleft lip and for the rehabilitation of patients with facial nerve impairments. The aim of this study was to develop an outcome measure for lip shape during speech using statistical shape analysis techniques. Lip movements during speech were captured from a sample of adult subjects considered as average using a three-dimensional motion capture system. Geometric Morphometrics was employed to extract three-dimensional coordinate data for lip shape during four spoken words decomposed into seven visemes (which included the resting lip shape). Canonical variate analysis was carried out in an attempt to statistically discriminate the seven visemes. The results showed that the second canonical variate discriminated the resting lip shape from articulation of the utterances and accounted for 17.2% of the total variance of the model. The first canonical variate was significant in discriminating between the utterances and accounted for 72.8% of the total variance of the model. The outcome measure was created using the 95% confidence intervals of the canonical variate scores for each subject plotted as ellipses for each viseme. The method and outcome model is proposed as reference to compare lip movement during speech in similar population groups.

Popat H; Richmond S; Zhurov AI; Rosin PL; Marshall D

2013-01-01

332

A robust approach for skewed and heavy-tailed outcomes in the analysis of health care expenditures  

Digital Repository Infrastructure Vision for European Research (DRIVER)

In this paper robust statistical procedures are presented for the analysis of skewed and heavy-tailed outcomes as they typically occur in health care data. The new estimators and test statistics are extensions of classical maximum likelihood techniques for generalized linear models. In contrast to t...

Cantoni, Eva; Ronchetti, Elvezio

333

Mother and Caregiver Sensitivity over Time: Predicting Language and Academic Outcomes with Variable- and Person-Centered Approaches  

Science.gov (United States)

Sensitive and responsive caregiving is associated with better cognitive and language outcomes. Using the longitudinal data set from the National Institute for Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development, this study asks how changes in the sensitivity of both mothers and caregivers from 6 months to 6…

Hirsh-Pasek, Kathy; Burchinal, Margaret

2006-01-01

334

Relation between brain lesion location and clinical outcome in patients with severe traumatic brain injury: a diffusion tensor imaging study using voxel-based approaches.  

Science.gov (United States)

The early prediction of consciousness recovery from traumatic brain injury (TBI) is crucial to make decisions about the appropriate use of prolonged intensive care. Diffusion tensor imaging (DTI) has been proposed as a biomarker of white matter injury that could be used in a classification purpose. Instead of region-of-interest-based approach, we applied voxel-based approaches (voxel-based DTI and tract-based spatial statistics) on 30 patients with TBI to identify, without any prior, the brain regions that were specifically damaged in unfavorable 1-year outcome group compared to the favorable one. DTI were acquired at mean 23 days (5-53 days) and two DTI-derived indices, fractional anisotropy (FA) and apparent diffusion coefficient (ADC), were tested. Our results showed that (1) ADC is not a relevant biomarker for early 1-year outcome prognosis; (2) FA measured in inferior longitudinal fasciculus, in cerebral peduncle, in posterior limb of the internal capsule, and in posterior corpus callosum is specifically decreased in unfavorable outcome group compare to the favorable one; (3) a linear discriminant analysis using the FA measured in these four regions showed good classification performance (sensitivity = 86% and specificity = 86%). These findings confirm the relevance of the use of DTI as biomarkers for consciousness recovery after TBI and support the possible use of these biomarkers for early classification of patients. PMID:19507154

Perlbarg, Vincent; Puybasset, Louis; Tollard, Eléonore; Lehéricy, Stéphane; Benali, Habib; Galanaud, Damien

2009-12-01

335

An adaptive approach to family-centered intervention in schools: linking intervention engagement to academic outcomes in middle and high school.  

UK PubMed Central (United Kingdom)

This study examined the impact of an adaptive approach to family intervention in public schools on academic outcomes from age 11 to 17. Students were randomly assigned to the three-session Family Check-Up (FCU), which is designed to motivate change in parenting practices by using an assessment-driven approach and strengths-based feedback. All services were voluntary, and approximately 25% of the families engaged in the FCU. Compared with matched controls, adolescents whose parents received the FCU maintained a satisfactory GPA into high school, and intervention engagement was associated with improved attendance. The highest-risk families were the most likely to engage in the family-centered intervention, suggesting the efficacy of integrating supportive services to families in the context of other schoolwide approaches to promote the success and achievement of vulnerable students.

Stormshak EA; Connell A; Dishion TJ

2009-09-01

336

An adaptive approach to family-centered intervention in schools: linking intervention engagement to academic outcomes in middle and high school.  

Science.gov (United States)

This study examined the impact of an adaptive approach to family intervention in public schools on academic outcomes from age 11 to 17. Students were randomly assigned to the three-session Family Check-Up (FCU), which is designed to motivate change in parenting practices by using an assessment-driven approach and strengths-based feedback. All services were voluntary, and approximately 25% of the families engaged in the FCU. Compared with matched controls, adolescents whose parents received the FCU maintained a satisfactory GPA into high school, and intervention engagement was associated with improved attendance. The highest-risk families were the most likely to engage in the family-centered intervention, suggesting the efficacy of integrating supportive services to families in the context of other schoolwide approaches to promote the success and achievement of vulnerable students. PMID:19390971

Stormshak, Elizabeth A; Connell, Arin; Dishion, Thomas J

2009-09-01

337

Nurse practice environment, workload, burnout, job outcomes, and quality of care in psychiatric hospitals: a structural equation model approach.  

UK PubMed Central (United Kingdom)

AIM: To study the relationships between nurse practice environment, workload, burnout, job outcomes and nurse-reported quality of care in psychiatric hospital staff. BACKGROUND: Nurses' practice environments in general hospitals have been extensively investigated. Potential variations across practice settings, for instance in psychiatric hospitals, have been much less studied. DESIGN: A cross-sectional design with a survey. METHOD: A structural equation model previously tested in acute hospitals was evaluated using survey data from a sample of 357 registered nurses, licensed practical nurses, and non-registered caregivers from two psychiatric hospitals in Belgium between December 2010-April 2011. The model included paths between practice environment dimensions and outcome variables, with burnout in a mediating position. A workload measure was also tested as a potential mediator between the practice environment and outcome variables. RESULTS: An improved model, slightly modified from the one validated earlier in samples of acute care nurses, was confirmed. This model explained 50% and 38% of the variance in job outcomes and nurse-reported quality of care respectively. In addition, workload was found to play a mediating role in accounting for job outcomes and significantly improved a model that ultimately explained 60% of the variance in these variables. CONCLUSION: In psychiatric hospitals as in general hospitals, nurse-physician relationship and other organizational dimensions such as nursing and hospital management were closely associated with perceptions of workload and with burnout and job satisfaction, turnover intentions, and nurse-reported quality of care. Mechanisms linking key variables and differences across settings in these relationships merit attention by managers and researchers.

Van Bogaert P; Clarke S; Willems R; Mondelaers M

2013-07-01

338

The impact of the work environment of nurses on patient safety outcomes: a multi-level modelling approach.  

UK PubMed Central (United Kingdom)

BACKGROUND: Patient safety is a priority for health services in all countries. The importance of the nurse's role in patient safety has been established. Effective nurse staffing levels, nurse education levels, and a positive work environment for nurses are factors which are known to impact on patient safety outcomes. OBJECTIVES: This study sought to explore the relationship between the ward environment in which nurses practice and specific patient safety outcomes, using ward level variables as well as nurse level variables. The outcomes were nurse-reported patient safety levels in the wards in which they work, and numbers of formal adverse events reports submitted by nurses in the last year. DESIGN: This cross-sectional quantitative study was carried out within a European FP7 project: Nurse Forecasting: Human Resources Planning in Nursing (RN4CAST) project. SETTINGS: 108 general medical and surgical wards in 30 hospitals throughout Ireland. PARTICIPANTS: All nurses in direct patient care in the study wards were invited to participate. Data from 1397 of these nurses were used in this analysis. METHODS: A nurse survey was carried out using a questionnaire incorporating the Practice Environment Scale of the Nursing Work Index (PES-NWI). Ethical approval was obtained from the authors' institution and all ethics committees representing the 30 study hospitals. Multilevel modelling was carried out to examine the impact of ward level factors on patient safety. These included proportions of nurses on the ward educated to degree level, and aggregated ward-level mean for PES-NWI scores. RESULTS: The study results support other research findings indicating that a positive practice environment enhances patient safety outcomes. Specifically at ward level, factors such as the ward practice environment and the proportion of nurses with degrees were found to significantly impact safety outcomes. The models developed for this study predicted 76% and 51% of the between-ward variance of these outcomes. The results can be used to enhance patient safety within hospitals by demonstrating factors at ward-level which enable nurses to effectively carry out this aspect of their role. CONCLUSIONS: The importance of ward-level nurse factors such as nurse education level and the work environment should be recognised and manipulated as important influences on patient safety.

Kirwan M; Matthews A; Scott PA

2013-02-01

339

The Outcomes of Gestational Diabetes Mellitus after a Telecare Approach Are Not Inferior to Traditional Outpatient Clinic Visits  

Directory of Open Access Journals (Sweden)

Full Text Available Objective. To evaluate the feasibility of a telemedicine system based on Internet and a short message service in pregnancy and its influence on delivery and neonatal outcomes of women with gestational diabetes mellitus (GDM). Methods. 100 women diagnosed of GDM were randomized into two parallel groups, a control group based on traditional face-to-face outpatient clinic visits and an intervention group, which was provided with a Telemedicine system for the transmission of capillary glucose data and short text messages with weekly professional feedback. 97 women completed the study (48/49, resp.). Main Outcomes Measured. The percentage of women achieving HbA1c values <5.8%, normal vaginal delivery and having a large for-gestational-age newborn were evaluated. Results. Despite a significant reduction in outpatient clinic visits in the experimental group, particularly in insulin-treated women (2.4 versus 4.6 hours per insulin-treated woman resp.; P<.001), no significant differences were found between the experimental and traditional groups regarding HbA1c levels (all women had HbA1c <5.8% during pregnancy), normal vaginal delivery (40.8% versus 54.2%, resp.; P>.05) and large-for-gestational-age newborns (6.1% versus 8.3%, resp.; P>.05). Conclusions. The system significantly reduces the need for outpatient clinic visits and achieves similar pregnancy, delivery, and newborn outcomes.

Natalia Pérez-Ferre; Mercedes Galindo; M. Dolores Fernández; Victoria Velasco; Isabelle Runkle; M. José de la Cruz; Patricia Martín Rojas-Marcos; Laura del Valle; Alfonso L. Calle-Pascual

2010-01-01

340

Production-oriented and reception-based approaches to teaching English grammar: An empirical study Rola produkcji i recepcji w nauczaniu gramatyki  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The main aim of the present work has been to explore the effectiveness of two pedagogical options, reception- and production-oriented, in the teaching of grammatical forms in the Polish educational context. The preliminary theoretical considerations included in Chapter One provided a relevant backgr...

Mystkowska-Wiertelak, Anna

 
 
 
 
341

SERS and in situ SERS spectroscopy of riboflavin adsorbed on silver, gold and copper substrates. Elucidation of variability of surface orientation based on both experimental and theoretical approach  

Science.gov (United States)

Surface-enhanced Raman scattering and in situ surface-enhanced Raman scattering spectra have been collected to study influences of (i) used metal and (ii) applied electrode potential on orientation of adsorbed riboflavin molecules. Special in situ SERS spectroelectrochemical cell was used to obtain in situ SERS spectra of riboflavin adsorbed on silver, gold and copper nanostructured surfaces. Varying electrode potential was applied in discrete steps forming a cycle from positive values to negative and backward. Observed spectral features in in situ SERS spectra, measured at alternate potentials, have been changing very significantly and the spectra have been compared with SERS spectra of riboflavin measured ex situ. Raman spectra of single riboflavin molecule in the vicinity to metal (Ag, Au and Cu) clusters have been calculated for different mutual positions. The results demonstrate significant changes of bands intensities which can be correlated with experimental spectra measured at different potentials. Thus, the orientation of riboflavin molecules adsorbed on metal surfaces can be elucidated. It is influenced definitely by the value of applied potential. Furthermore, the riboflavin adsorption orientation on the surface depends on the used metal. Adsorption geometries on the copper substrates are more diverse in comparison with the orientations on silver and gold substrates.

Dendisová-Vyškovská, Marcela; Kokaislová, Alžb?ta; On?ák, Milan; Mat?jka, Pavel

2013-04-01

342

Orienteering Club  

CERN Multimedia

De jour comme de nuit Les amateurs de course d’orientation ont pu s’en donner à cœur joie ce week-end puisqu’ils avaient la possibilité de courir sur deux épreuves en moins de 24 heures. En effet, le club du CERN organisait une course de nuit aux Evaux et la 7e étape de la coupe genevoise se tenait samedi après-midi dans les bois du Grand Jorat à Savigny. Les vainqueurs pour chaque course sont : Technique long CO de nuit: Julien Charlemagne, SOS Sallanches CO samedi: Philipp Khlebnikov, ANCO   Technique moyen CO de nuit: Céline Zosso, CO CERN CO samedi: Pavel Khlebnikov, ANCO Technique court CO de nuit: Colas Ginztburger, SOS Sallanches CO samedi: Victor Kuznetsov, COLJ Lausannne Facile moyen CO de nuit: Gaëtan Rickenbacher, CO CERN CO samedi: Tamas Szoke   Facile court CO de nuit:Oriane Rickenbacher, CO CERN CO samedi: Katya Kuznetsov...

Club d'orientation

2013-01-01

343

Orienteering Club  

CERN Multimedia

Course d'orientation Avec la CO en nocturne organisée par le club du CERN vendredi 14 octobre au stade des Eveaux (Ge), et la CO à Savigny (Vd) proposée par le club de Lausanne-Jorat le lendemain, les étapes de la coupe genevoise d’automne s’enchainent rapidement. Il ne reste plus que 3 rendez-vous pour boucler la saison. Les premières places devraient certainement se jouer entre des membres du club du CERN, du O’Jura ou de Lausanne-Jorat. La prochaine course du club est programmée pour samedi 22 octobre à Pomier, près de Cruseilles. L’accueil se fera à partir de 12h30 et les départs s’échelonneront de 13h à 15h. * * * * * * * Nouvelle belle victoire samedi 8 octobre à Saint Cergue du jeune finlandais Ville Keskisaari (COLJ) en 50:56 devant Jürg Niggli (O’Jura) en 1:03:32, et Alexandre...

Club d'Orientation

2011-01-01

344

Orienteering Club  

CERN Multimedia

Course d'orientation Le coup d’envoi de la coupe genevoise a été donné samedi 31 août dans les bois de Combe Froide à Prémanon. Plus de 150 coureurs avaient fait le déplacement. Les parcours facile court, facile moyen et technique court ont été remportés par des coureurs du club O’Jura - Ulysse Dannecker, Léo Lonchampt, Franck Lonchampt, le technique moyen par Pekka Marti du club Ol Biel Seeland et le technique long par Térence Risse du CA Rosé – également membre de l’équipe nationale suisse des moins de 20 ans. Pour le club du CERN, les meilleures résultats ont été obtenus pas Emese Szunyog sur technique court et Marie Vuitton sur technique moyen avec une 4e place. La prochaine course aura lieu samedi 14 septembre à La Faucille. Le club propose aussi...

Club d'orientation

2013-01-01

345

Orienteering Club  

CERN Multimedia

Calendrier de la coupe d’automne Le Club d’orientation du CERN, en partenariat avec d’autres clubs de la région, vous propose, pour cette nouvelle coupe d’automne genevoise, une série de 10 courses. Le club du O’Jura donnera le coup d’envoi le samedi 31 août. Les courses s’enchaîneront selon le calendrier suivant : Samedi 31 août : Prémanon (39) - longue distance Samedi 14 septembre : La Faucille (01) - longue distance Samedi 21 septembre : Saint Cergue (VD) - longue distance Samedi 28 septembre : Ballens (VD) - relais Samedi 5 octobre : La Pile (VD) - longue distance Vendredi 11 octobre : Les Evaux (GE) - nocturne Samedi 12 octobre : Grand Jorat, Savigny (VD) - longue distance Samedi 19 octobre : Terrasses de Genève (74) - longue distance Samedi 26 octobre : Prémanon (39) - longue distance Samedi 2 novembre : Bois Tollot (GE) - score - Finale Les &a...

CLUB D'ORIENTATION

2013-01-01

346

Orienteering club  

CERN Multimedia

Reprise fin août Le Club d’orientation, en partenariat avec d’autres clubs de la région, vous propose une nouvelle série de courses pour cet automne. Le calendrier à retenir est le suivant : Samedi 27 août : Granges Malval (GE) – type classique Samedi 10 septembre : Lamoura (39) – type classique Samedi 17 septembre : La Dôle (F/VD) – type classique Samedi 24 septembre : Monteret (VD) – relais Samedi 8 octobre : Saint Cergue (VD) – type classique Vendredi 14 octobre : Les Evaux (GE) – nocturne Samedi 15 octobre : Grand Jorat (VD) – type classique Samedi 22 octobre : Pomier (74) – type classique Samedi 5 novembre : Echallens (VD) – type classique Samedi 12 novembre : CERN (GE) - sprint - Finale Généralement cinq circuits sont disponibles : ceci va du facile court (2 km) adapt&eacu...

Club d'orientation

2011-01-01

347

Orienteering Club  

CERN Document Server

Finale de la coupe d’automne   La coupe d’automne organisée par le club d’orientation du CERN s’est terminée ce samedi 10 novembre avec une course sprint à Prévessins. C’était la 12e épreuve de la saison. En stage dans la région, Tanya Ryabkina, championne d’Europe en titre et médaillée de bronze en moyenne distance lors des championnats du monde à La Givrine cet été, a fait l’honneur de sa présence et termine 2e à 8 secondes de Trygve Buanes, norvégien du club de Bergen. A l’issue de cette dernière épreuve, le classement général de la coupe d’automne, basé sur les 8 meilleurs résultats de la saison, est ainsi le suivant : Circuit technique long : 1er Jurg Niggli (O&rsqu...

Club d'orientation

2012-01-01

348

Orienteering Club  

CERN Multimedia

 Finale de la coupe de printemps   La dernière course d’orientation comptant pour la Coupe de printemps a eu lieu samedi dernier dans le village des Rousses et vers le Fort. Il s’agissait d’un sprint organisé par le club O’Jura. Les temps de course ont avoisiné les 20 minutes que ce soit pour le parcours technique moyen ou technique long. Tous les habitués étaient au rendez-vous pour venir consolider ou améliorer leur place au classement. A l’issue de cette course, le classement général de la Coupe de printemps prenant en compte les 6 meilleurs résultats des 9 courses était établi et les lauréats de chaque catégorie sont les suivants: Circuit technique long : 1er Berni Wehrle, 2e Bruno Barge, 3e Edvins Reisons. Circuit technique moyen : 1er Jean-Bernard Zosso, 2e Cédric Wehrl&...

Club d'Orientation

2012-01-01

349

Orienteering club  

CERN Multimedia

Course d'orientation Vers les dernières courses de printemps Une centaine de coureurs se sont déplacés sur le site de la Roche Fendue prés de Morez pour gouter à un des 5 parcours proposés par le club du O’Jura. Le terrain était gras mais que peut-on trouver d’autre avec cette météo! Les vainqueurs de chaque circuit sont : Alina Niggli (O’Jura) facile court, Natalja Niggli (O’Jura) facile moyen, Victor Kuznetsov (COLJ) technique court, Yves Rousselot (Balise 25) technique moyen et pour finir François Gonon (O’Jura) avec une victoire haut la main sur le technique long. Il ne reste plus que deux épreuves pour la coupe genevoise de printemps : à savoir samedi 8 juin, course de type longue distance organisée par le club de Lausanne Jorat (COLJ) dans le bois de Seyte sur Mutrux/Concise, inscription de 12h &...

Club d'orientation

2013-01-01

350

Orienteering club  

CERN Document Server

Course d'orientation Finale de la coupe genevoise Rapide et méthodique, voilà les qualités dont il fallait faire preuve pour remporter la dernière étape de la coupe organisée par le club du CERN dans les bois de Monteret. Il s’agissait d’une course au score où chaque concurrent disposait d’un temps imparti pour poinçonner le maximum de balises. Le parcours technique a été remporté par Tomas Shellman et le parcours facile par Victor Dannecker. Cette dernière étape était aussi décisive pour la désignation des lauréats de la coupe genevoise de printemps. Les résultats officiels étaient donnés par le président du club, L. Jirden : Circuit Technique Long : Berni Wehrle, Bruno Barge, Edvins Reisons Circuit Technique Moyen : J.-Bernard Zosso, ...

Club d'orientation

2013-01-01

351

Polycrystal orientation maps from TEM.  

UK PubMed Central (United Kingdom)

Determination of topography of crystallite orientations is an important technique of investigation of polycrystalline materials. A system for creating orientation maps using transmission electron microscope (TEM) Kikuchi patterns and Convergent beam electron diffraction patterns is presented. The orientation maps are obtained using a step-by-step beam scan on a computer-controlled TEM equipped with a CCD camera. At each step, acquired diffraction patterns are indexed and orientations are determined. Although, the approach used is similar to that applied in SEM/electron back scattered diffraction (EBSD) orientation imaging setups, the TEM-based system considerably differs from its SEM counterpart. The main differences appear due to specific features of TEM and SEM diffraction patterns. Also, the resulting maps are not equivalent. On these generated by TEM, the accuracy of orientation determination can be better than 0.1 degrees. The spatial resolution is estimated to be about 10nm. The latter feature makes the TEM orientation mapping system an important tool for studies at fine scale unreachable by SEM/EBSD systems. The automatic orientation mapping is expected to be a useful complement of the conventional TEM contrast images. The new technique will be essential for characterization of fine structure materials. To illustrate that, example maps of an aluminum sample produced by severe plastic deformation are included.

Fundenberger JJ; Morawiec A; Bouzy E; Lecomte JS

2003-08-01

352

Comparing the mid-vastus and medial parapatellar approaches in total knee arthroplasty: a meta-analysis of short term outcomes.  

UK PubMed Central (United Kingdom)

PURPOSE: Proponents of a mid-vastus (MV) approach for primary total knee arthroplasties (TKA) stress its importance in preserving function of the extensor mechanism with earlier rehabilitation and decreased prevalence of lateral release. We conducted a meta-analysis of randomised and quasi-randomised controlled trials to compare functional outcomes of the standard medial parapatellar (PP) and mid-vastus (MV) approaches in primary knee arthroplasties. METHODS: The study was conducted according to the guidelines described in the Cochrane Handbook for Systematic Reviews of Interventions. Methodological features were rated independently by two reviewers. RESULTS: We included 18 studies involving 1040 patients with mean age of 69 (SD ± 2.7) for the MV and 68.8 (SD ± 2.8) for the PP group. Using a MV approach led to significant improvement in flexion (mean difference (MD) 8.88, 95% confidence interval (CI) 4.50 to 13.25, P<0.01) and visual analogue scale score (MD -1.72 95% CI -2.08 to -1.36, P<0.01) in the first week postoperatively and reduced the number of required lateral releases (risk difference -0.16 95% CI -0.30 to -0.01, P=0.03) with no increase in complication rates. CONCLUSION: We conclude that the MV approach may provide an alternative to the standard PP approach with earlier rehabilitation and decreased lateral release rates in primary TKA and no increase in complication rates.

Alcelik I; Sukeik M; Pollock R; Misra A; Naguib A; Haddad FS

2012-08-01

353

Possible Associations of NTRK2 Polymorphisms with Antidepressant Treatment Outcome: Findings from an Extended Tag SNP Approach  

Science.gov (United States)

Background Data from clinical studies and results from animal models suggest an involvement of the neurotrophin system in the pathology of depression and antidepressant treatment response. Genetic variations within the genes coding for the brain-derived neurotrophic factor (BDNF) and its key receptor Trkb (NTRK2) may therefore influence the response to antidepressant treatment. Methods We performed a single and multi-marker association study with antidepressant treatment outcome in 398 depressed Caucasian inpatients participating in the Munich Antidepressant Response Signature (MARS) project. Two Caucasian replication samples (N?=?249 and N?=?247) were investigated, resulting in a total number of 894 patients. 18 tagging SNPs in the BDNF gene region and 64 tagging SNPs in the NTRK2 gene region were genotyped in the discovery sample; 16 nominally associated SNPs were tested in two replication samples. Results In the discovery analysis, 7 BDNF SNPs and 9 NTRK2 SNPs were nominally associated with treatment response. Three NTRK2 SNPs (rs10868223, rs1659412 and rs11140778) also showed associations in at least one replication sample and in the combined sample with the same direction of effects (Pcorr?=?.018, Pcorr?=?.015 and Pcorr?=?.004, respectively). We observed an across-gene BDNF-NTRK2 SNP interaction for rs4923468 and rs1387926. No robust interaction of associated SNPs was found in an analysis of BDNF serum protein levels as a predictor for treatment outcome in a subset of 93 patients. Conclusions/Limitations Although not all associations in the discovery analysis could be unambiguously replicated, the findings of the present study identified single nucleotide variations in the BDNF and NTRK2 genes that might be involved in antidepressant treatment outcome and that have not been previously reported in this context. These new variants need further validation in future association studies.

Hennings, Johannes M.; Kohli, Martin A.; Czamara, Darina; Giese, Maria; Eckert, Anne; Wolf, Christiane; Heck, Angela; Domschke, Katharina; Arolt, Volker; Baune, Bernhard T.; Horstmann, Sonja; Bruckl, Tanja; Klengel, Torsten; Menke, Andreas; Muller-Myhsok, Bertram; Ising, Marcus; Uhr, Manfred; Lucae, Susanne

2013-01-01

354

Possible associations of NTRK2 polymorphisms with antidepressant treatment outcome: findings from an extended tag SNP approach.  

UK PubMed Central (United Kingdom)

BACKGROUND: Data from clinical studies and results from animal models suggest an involvement of the neurotrophin system in the pathology of depression and antidepressant treatment response. Genetic variations within the genes coding for the brain-derived neurotrophic factor (BDNF) and its key receptor Trkb (NTRK2) may therefore influence the response to antidepressant treatment. METHODS: We performed a single and multi-marker association study with antidepressant treatment outcome in 398 depressed Caucasian inpatients participating in the Munich Antidepressant Response Signature (MARS) project. Two Caucasian replication samples (N?=?249 and N?=?247) were investigated, resulting in a total number of 894 patients. 18 tagging SNPs in the BDNF gene region and 64 tagging SNPs in the NTRK2 gene region were genotyped in the discovery sample; 16 nominally associated SNPs were tested in two replication samples. RESULTS: In the discovery analysis, 7 BDNF SNPs and 9 NTRK2 SNPs were nominally associated with treatment response. Three NTRK2 SNPs (rs10868223, rs1659412 and rs11140778) also showed associations in at least one replication sample and in the combined sample with the same direction of effects (Pcorr ?=?.018, Pcorr ?=?.015 and Pcorr ?=?.004, respectively). We observed an across-gene BDNF-NTRK2 SNP interaction for rs4923468 and rs1387926. No robust interaction of associated SNPs was found in an analysis of BDNF serum protein levels as a predictor for treatment outcome in a subset of 93 patients. CONCLUSIONS/LIMITATIONS: Although not all associations in the discovery analysis could be unambiguously replicated, the findings of the present study identified single nucleotide variations in the BDNF and NTRK2 genes that might be involved in antidepressant treatment outcome and that have not been previously reported in this context. These new variants need further validation in future association studies.

Hennings JM; Kohli MA; Czamara D; Giese M; Eckert A; Wolf C; Heck A; Domschke K; Arolt V; Baune BT; Horstmann S; Brückl T; Klengel T; Menke A; Müller-Myhsok B; Ising M; Uhr M; Lucae S

2013-01-01

355

How to minimize infection and thereby maximize patient outcomes in total joint arthroplasty: a multicenter approach: AAOS exhibit selection.  

UK PubMed Central (United Kingdom)

Total joint arthroplasty is one of the most common and most successful orthopaedic procedures. Infection after total joint arthroplasty is a devastating problem that expends patient, surgeon, and hospital resources, and it substantially decreases the chances of a successful patient outcome. Postoperative infection affects approximately 1% to 7% of all total joint arthroplasties, at a cost of approximately $50,000 per infection. Decreasing postoperative periprosthetic joint infection is of the utmost importance for the total joint arthroplasty surgeon. Preoperative, perioperative, intraoperative, and postoperative measures to minimize infection and optimize patient outcomes in total joint arthroplasty are discussed. Preoperative measures include management of patients colonized by Staphylococcus aureus, nutritional optimization, and management of medical comorbidities. Perioperative measures include skin preparation and prophylactic antibiotics. Intraoperative measures include body exhaust suits, laminar flow, ultraviolet light, operating-room traffic control, surgical suite enclosures, anesthesia-related considerations, and antibiotic-loaded bone cement. Postoperative measures include continued antibiotic prophylaxis, blood transfusions, hematoma formation and wound drainage, duration of hospital stay, and antibiotic prophylaxis for future invasive procedures.

Illingworth KD; Mihalko WM; Parvizi J; Sculco T; McArthur B; el Bitar Y; Saleh KJ

2013-04-01

356

Prediction of short-term and long-term outcomes after cardiac arrest: a prospective multivariate approach combining biochemical, clinical, electrophysiological, and neuropsychological investigations.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To determine the prognostic accuracy of biochemical, clinical, electrophysiological, and neuropsychological investigations in predicting outcomes after cardiac arrest. DESIGN: Prospective study. SETTING: Intensive care unit of the Hamburg-Eppendorf University Medical Center, Hamburg, Germany. PATIENTS: A total of 80 patients (mean age, 63.79 +/- 15.85 yrs) after cardiopulmonary resuscitation. INTERVENTIONS: Serial blood samples (days 2-4), clinical examinations (days 2 and 4), sensory-evoked potentials (day 4), and neuropsychological assessments (outcome; 4-5, unfavorable outcome) and a comprehensive neuropsychological test battery were applied. A multivariate logistic-regression analysis resulted in a model in which 85% of the variance in the dichotomized Glasgow-Pittsburgh Cerebral Performance Categories was explained by neuron-specific enolase at day 4, clinical examination score at day 4, and age. This predictor index had a sensitivity of 92% and a specificity of 93%. In addition, 26 patients (out of 33) underwent neuropsychological testing at 6 months. Significant correlations were found with selected cognitive variables and S-100B at day 3, long-latency sensory-evoked potential at day 4, and neuropsychological bedside screening. CONCLUSIONS: A multivariate assessment approach should be used to establish an early high-certainty prognosis after cardiac arrest. However, further prospective clinical studies are necessary to confirm this derived predictor index. In addition, an early recording of S-100B, long-latency sensory-evoked potential, and neuropsychological bedside screening reflect a cognitive long-term outcome.

Prohl J; Röther J; Kluge S; de Heer G; Liepert J; Bodenburg S; Pawlik K; Kreymann G

2007-05-01

357

Orienteering Club  

CERN Document Server

Course d'orientation Ces deux dernières semaines, le club a organisé la troisième puis la quatrième étape de la coupe de printemps, une dans la forêt de Collogny/Moissey près de Vulbens, l’autre vers le parcours vita de Trélex. Les résultats sont: Facile court Vulbens : 1er Léo Lonchampt, O’Jura (16:04), 2e Timothée Bazin (23:07), 3e Francesco Pieri (26:57) Trélex : 1er Noora Maurent (23:11), 2e Sarah Stuber, COLJ (26:51), 3e T. Bazin (28:17) Facile moyen Vulbens : 1er Victor Kuznetsov, CO CERN (25:36), 2e Didier Descourvières (28:03), 3e Konstantinos Haider, CO CERN (36:53) Trélex : 1er V. Kuznetsov, COLJ (38:01), 2e K. Haider, CO CERN (43:15), 3e ex aequo Olivia Nguyen et Sven Vietmeier (58:11) Technique court Vulbens : 1er Benoit Bazin (41:21), 2e Colas Gintzburger (55:12), 3e Nathan Freydoz (55:48) Trélex : 1...

Club d'Orientation

2012-01-01

358

Orienteering club  

CERN Document Server

Courses d’orientation Samedi 20 avril, les organisateurs du Club de CO du CERN ont accueilli au Mont Mourex 70 participants qui n’ont pas hésité à venir malgré la forte bise. Berni Wehrle du CO CERN s’est octroyé la première place en 1:04:49 sur le parcours technique long devant Pyry Kettunen du Saynso Juankoski en 1:06:52, la 3e place revenant à Bruno Barge, CO CERN, à 7 secondes. Les autres parcours ont été remportés par : Technique moyen : 1er Jacques Moisset, Chamonix (47:44), 2e Yves Rousselot, Balise 25 Besançon (57:16), 3e Jean-Bernard Zosso, CO CERN (59:28). Technique court : 1er Victor Kuznetsov, COLJ (51:53), 2e Pierrick Collet, CO CERN (1:12:52), 3e Dominique Balay, CO CERN (1:16:04). Pour les parcours facile moyen et facile court, Ralf Nardini et Léa Nicolas, tous deux du CO CERN, terminaient respectivement premier. Voi...

Club d'orientation

2013-01-01

359

A patient-centred approach to health service delivery: improving health outcomes for people with chronic illness.  

UK PubMed Central (United Kingdom)

BACKGROUND: The Wagner Model provides a framework that can help to facilitate health system transition towards a chronic care oriented model. Drawing on elements of this framework as well as health policy related to patient centred care, we describe the health needs of patients with chronic illness and compare these with services which should ideally be provided by a patient-centred health system. This paper aims to increase understanding of the challenges faced by chronically ill patients and family carers in relation to their experiences with the health care system and health service providers. METHOD: We interviewed patients, carers and health care professionals (HCPs) about the challenges faced by people living with complicated diabetes, chronic heart failure or chronic obstructive pulmonary disease. RESULTS: Patients indicated that they had a range of concerns related to the quality of health care encounters with health care professionals (HCPs), with these concerns being expressed as needs or wants. These included: 1) the need for improved communication and information delivery on the part of HCPs; 2) well organised health services and reduced waiting times to see HCPs; 3) help with self care; 4) greater recognition among professionals of the need for holistic and continuing care; and 5) inclusion of patients and carers in the decision making processes. CONCLUSIONS: In order to address the challenges faced by people with chronic illness, health policy must be more closely aligned with the identified needs and wants of people affected by chronic illness than is currently the case.

Mirzaei M; Aspin C; Essue B; Jeon YH; Dugdale P; Usherwood T; Leeder S

2013-01-01

360

Evaluating hospitals' provision of community benefit: an argument for an outcome-based approach to nonprofit hospital tax exemption.  

UK PubMed Central (United Kingdom)

Nonprofit hospitals are exempt from federal income taxation if they pass organizational and operational tests, including satisfying the community-benefit standard. Policymakers, however, have questioned the adequacy of the community benefits that nonprofit hospitals provide in exchange for these exemptions. The Internal Revenue Service recently responded to these concerns by redesigning its tax forms for nonprofit hospitals. The new Form 990 Schedule H requires nonprofit hospitals to provide additional information about their community-benefit activities. This new reporting requirement, however, places an undue focus on input-based community-benefit indicators, in particular expenditures. We argue that expanding the current input-based reporting requirement to include not only monetary inputs but also population health outcomes would achieve greater benefit for society.

Rubin DB; Singh SR; Jacobson PD

2013-04-01

 
 
 
 
361

Outcome of a Standardized Approach to Childhood Urinary Symptoms-Long-Term Follow-Up of 720 Patients  

DEFF Research Database (Denmark)

AIMS: To investigate the relevance of enuresis subtyping for selection of treatment modality and for long-term outcome in a large consecutive patient cohort. MATERIALS AND METHODS: We included all patients referred for urinary incontinence during a 5-year period but excluding recurrent urinary tract infections (UTI). Type and severity of incontinence, prior history, results of examinations performed, number of visits, and effect of all treatments provided, were included in a clinical database. RESULTS: Seven hundred twenty children aged 4-16 years (mean 8.5?±?2.2?years, 239 girls) were included in the analysis (42% with monosymptomatic (MNE), 55% with non-MNE, and 3% with isolated daytime incontinence). Initial evaluation revealed only few underlying causes (one neurological and eight anatomical). Investigations showed significant differences between MNE and non-MNE patients as both maximal voided volume and nocturnal urine volume was lower in non-MNE patients (P?

Rittig, Nikolaj; Hagstroem, SØren

2013-01-01

362

Input-Guarantee Versus Performance-Guarantee Approaches to School Accountability: Cross-State Comparisons of Policies, Resources, and Outcomes  

Science.gov (United States)

States' policy approaches to accountability tend to divide between a primary emphasis on input guarantees and a primary emphasis on performance guarantees. In the midst of keen controversies about the impact of high-stakes testing under the No Child Left Behind Act, this article examines separate and joint effects of input-guarantee versus…

Lee, Jaekyung

2006-01-01

363

Assessing the children's views on foods and consumption of selected food groups: outcome from focus group approach.  

UK PubMed Central (United Kingdom)

The food choices in childhood have high a probability of being carried through into their adulthood life, which then contributes to the risk of many non-communicable diseases. Therefore, there is a need to gather some information about children's views on foods which may influence their food choices for planning a related dietary intervention or programme. This paper aimed to explore the views of children on foods and the types of foods which are usually consumed by children under four food groups (snacks, fast foods, cereals and cereal products; and milk and dairy products) by using focus group discussions. A total of 33 school children aged 7-9 years old from Selangor and Kuala Lumpur participated in the focus groups. Focus groups were audio-taped, transcribed and analyzed according to the listed themes. The outcomes show that the children usually consumed snacks such as white bread with spread or as a sandwich, local cakes, fruits such as papaya, mango and watermelon, biscuits or cookies, tea, chocolate drink and instant noodles. Their choices of fast foods included pizza, burgers, French fries and fried chicken. For cereal products, they usually consumed rice, bread and ready-to-eat cereals. Finally, their choices of dairy products included milk, cheese and yogurt. The reasons for the food liking were taste, nutritional value and the characteristics of food. The outcome of this study may provide additional information on the food choices among Malaysian children, especially in urban areas with regard to the food groups which have shown to have a relationship with the risk of childhood obesity.

Sharif Ishak SI; Shohaimi S; Kandiah M

2013-04-01

364

Corneal approach to hyperopic presbyopia treatment: Six-month outcomes of a new multifocal excimer laser in situ keratomileusis procedure.  

UK PubMed Central (United Kingdom)

PURPOSE: To report the safety and efficacy of treatment of hyperopic presbyopia with a new multifocal corneal laser in situ keratomileusis (LASIK) procedure, Supracor. SETTING: Mater Private Hospital, Dublin, Ireland. DESIGN: Case series. METHODS: Bilateral LASIK using a multifocal corneal ablation profile was performed on consecutive hyperopic presbyopic patients with a manifest refraction spherical equivalent (MRSE) of +1.00 to +3.25 diopters (D) and a maximum 0.75 D difference between the MRSE and cycloplegic refraction. All patients were followed for a minimum of 6 months postoperatively. The main outcome measures were safety, efficacy in terms of uncorrected distance visual acuity (UDVA) and uncorrected reading ability (Vocational Reading Test), predictability, stability, patient satisfaction, and functioning at 6 months. RESULTS: Forty-six eyes (23 patients) were treated. The mean binocular UDVA was 0.07 logMAR ± 0.12 (SD) at 6 months, with 91% having a binocular UDVA of 0.2 logMAR or better. Ninety-one percent had an uncorrected reading ability of N8 or better, and 93% were fully independent of reading glasses. Six percent lost 2 or more lines of corrected distance visual acuity (CDVA), with 100% maintaining a CDVA of 0.2 logMAR or better. Five patients (22%) required a retreatment in the dominant eye to enhance UDVA. Ninety-six percent were happy they had the procedure. CONCLUSIONS: The procedure provided a high level of spectacle independence for near vision. The UDVA outcomes must be improved with nomogram adjustment to reduce the retreatment rate. Targeting emmetropia in the dominant eye and 0.50 D myopia in the nondominant eye may be an effective solution. FINANCIAL DISCLOSURE: Neither author has a financial or proprietary interest in any material or method mentioned.

Ryan A; O'Keefe M

2013-08-01

365

Assessing the children's views on foods and consumption of selected food groups: outcome from focus group approach.  

Science.gov (United States)

The food choices in childhood have high a probability of being carried through into their adulthood life, which then contributes to the risk of many non-communicable diseases. Therefore, there is a need to gather some information about children's views on foods which may influence their food choices for planning a related dietary intervention or programme. This paper aimed to explore the views of children on foods and the types of foods which are usually consumed by children under four food groups (snacks, fast foods, cereals and cereal products; and milk and dairy products) by using focus group discussions. A total of 33 school children aged 7-9 years old from Selangor and Kuala Lumpur participated in the focus groups. Focus groups were audio-taped, transcribed and analyzed according to the listed themes. The outcomes show that the children usually consumed snacks such as white bread with spread or as a sandwich, local cakes, fruits such as papaya, mango and watermelon, biscuits or cookies, tea, chocolate drink and instant noodles. Their choices of fast foods included pizza, burgers, French fries and fried chicken. For cereal products, they usually consumed rice, bread and ready-to-eat cereals. Finally, their choices of dairy products included milk, cheese and yogurt. The reasons for the food liking were taste, nutritional value and the characteristics of food. The outcome of this study may provide additional information on the food choices among Malaysian children, especially in urban areas with regard to the food groups which have shown to have a relationship with the risk of childhood obesity. PMID:23610606

Sharif Ishak, Sharifah Intan Zainun; Shohaimi, Shamarina; Kandiah, Mirnalini

2013-04-01

366

Clinical outcomes of using a conservative approach of late esophageal stent placement in palliation of malignant dysphagia.  

UK PubMed Central (United Kingdom)

BACKGROUND: Esophageal stents have been used as first-line treatment for palliation of malignant dysphagia, but this is associated with significant complications. The present study evaluated clinical outcomes and survival in patients with malignant dysphagia with esophageal stent placement who did not respond to prior chemoradiation or endoscopic modalities. PATIENTS AND METHODS: Patients with esophageal cancer, who had esophageal stents, were retrospectively reviewed from the electronic medical records. The patient demographics, type of stent placed, dysphagia scores, stent-related complications, and survival were recorded. RESULTS: Thirty-five patients with esophageal cancer received a total of 41 stents. There were 25 males and 10 females with mean age of 69.8 years. Twenty-two patients had esophageal adenocarcinoma, ten patients had squamous cell carcinoma, and three had poorly differentiated tumor. Esophageal malignancy was early stage (I, II) in 10 patients and advanced (III, IV) in 24 patients. Three patients had upper esophageal involvement, eight patients had mid-esophageal involvement; distal esophageal malignancy was present in 24 patients with 10 patients having gastroesophageal junction involvement. Six patients presented with tracheoesophageal fistula. Nine patients had prior esophagectomy. Thirty-three patients had chemoradiation, and 32 patients had other endoscopic therapies previously. Twelve of the 35 (33%) patients developed stent-related complications; nine patients had dysphagia due to various causes; one patient each developed aspiration, intractable hiccups, and intractable vomiting after stent placement, respectively. Nine patients underwent a repeat esophagogastroduodenoscopy. Development of stent-related complications was not significantly associated with poor survival. CONCLUSIONS: The clinical outcomes for patients with esophageal stent placement for malignant dysphagia after chemoradiation and other endoscopic treatments is not worse than that reported in patients where esophageal stent placement was used as first-line treatment.

Chadha KS; Schiff M; Sitrin MD; Wilding GE; Nava H

2010-09-01

367

Understanding social forces involved in diabetes outcomes: a systems science approach to quality-of-life research.  

UK PubMed Central (United Kingdom)

PURPOSE: The field of quality-of-life (QOL) research would benefit from learning about and integrating systems science approaches that model how social forces interact dynamically with health and affect the course of chronic illnesses. Our purpose is to describe the systems science mindset and to illustrate the utility of a system dynamics approach to promoting QOL research in chronic disease, using diabetes as an example. METHODS: We build a series of causal loop diagrams incrementally, introducing new variables and their dynamic relationships at each stage. RESULTS: These causal loop diagrams demonstrate how a common set of relationships among these variables can generate different disease and QOL trajectories for people with diabetes and also lead to a consideration of non-clinical (psychosocial and behavioral) factors that can have implications for program design and policy formulation. CONCLUSIONS: The policy implications of the causal loop diagrams are discussed, and empirical next steps to validate the diagrams and quantify the relationships are described.

Lounsbury DW; Hirsch GB; Vega C; Schwartz CE

2013-09-01

368

Arthroscopic Capsular Plication and Labral Preservation in Borderline Hip Dysplasia: Two-Year Clinical Outcomes of a Surgical Approach to a Challenging Problem.  

UK PubMed Central (United Kingdom)

BACKGROUND:The role of hip arthroscopy in the treatment of patients with dysplasia is unclear because of the spectrum of dysplasia that exists. Patients with borderline dysplasia are generally not candidates for periacetabular osteotomy because of the invasive nature of the procedure. However, arthroscopy in dysplasia has had mixed results and has the potential to exacerbate instability. HYPOTHESIS:Patients with borderline dysplasia will demonstrate postoperative improvement, high satisfaction rates, and low reoperation rates after a surgical approach that includes arthroscopic labral repair augmented by capsular plication with inferior shift. STUDY DESIGN:Case series; Level of evidence, 4. METHODS:Between April 2008 and November 2010, patients less than 40 years old who underwent hip arthroscopy for symptomatic intra-articular hip disorders, with a lateral center-edge (CE) angle ?18° and ?25°, were included in this study. Patients with Tönnis grade 2 or greater, severe hip dysplasia (CE ?17°), and Legg-Calve-Perthes disease were excluded. Patient-reported outcome scores, including the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score-Sport-Specific Subscale (HOS-SSS), Hip Outcome Score-Activity of Daily Living (HOS-ADL), and visual analog scale (VAS) for pain were obtained in all patients preoperatively and at 1, 2, and 3 years postoperatively. Revision surgery and complications were recorded for each group. RESULTS:A total of 26 patients met the criteria to be included in the study. Of these, 22 (85%) patients were available for follow-up. The mean (± standard deviation) length of follow-up for this cohort was 27.5 ± 5.5 months (range, 17-39 months) and the average age was 20 years (range, 14-39 years). The mean lateral CE angle was 22.2° (range, 18°-25°) and the mean Tönnis angle was 5.8° (range, 0°-17°). There was significant improvement in all patient-reported outcome scores (mHHS, NAHS, HOS-SSS, and HOS-ADL) (P < .0001). There was a significant improvement in VAS scores from 5.8 to 2.9 (P < .0001). Overall patient satisfaction was 8.4 out of 10. Seventeen patients had good/excellent results (77%). Two patients required revision arthroscopy. CONCLUSION:Patients with borderline dysplasia have often fallen into a gray area between arthroscopy and periacetabular osteotomy, and viable treatment options have remained scarce. The current study demonstrates favorable results at 2-year follow-up for an arthroscopic approach that includes labral repair augmented by capsular plication with inferior shift.

Domb BG; Stake CE; Lindner D; El-Bitar Y; Jackson TJ

2013-08-01

369

A welfare economic approach to measure outcomes in stuttering: comparing willingness to pay and quality adjusted life years.  

UK PubMed Central (United Kingdom)

PURPOSE: The purpose of this study was to compare two welfare outcome measures, willingness to pay (WTP) and quality adjusted life years (QALYs) gained, to measure outcomes in stuttering. METHOD: Seventy-eight adult participants (74 nonstuttering and 4 persons with stuttering) completed one face-to-face structured interview regarding how much they would be willing to pay to alleviate severe stuttering in three interventions of varying impact. These data were compared with QALYs gained as calculated from time trade off (TTO) and standard gamble (SG) data. RESULTS: Mean (median) WTP bids ranged from US $16,875 (8000), for an intervention resulting in improvement from severe stuttering to mild stuttering, to US $41,844 (10,000) for an intervention resulting in a cure of severe stuttering. These data were consistent with mean changes in QALYs for the same stuttering interventions ranging from 2.19 (using SG) to 18.42 (using TTO). CONCLUSIONS: This study presents the first published WTP and QALY data for stuttering. Results were consistent with previous cost-of-illness data for stuttering. Both WTP and QALY measures were able to quantify the reduction in quality of life that occurs in stuttering, and both can be used to compare the gains that might be achieved by different interventions. It is widely believed that stuttering can cause reduced quality of life for some speakers; the introduction into this field of standardized metrics for measuring quality of life is a necessary step for transparently weighing the costs and consequences of stuttering interventions in economic analyses. EDUCATIONAL OBJECTIVES: The reader will be able to (a) describe the underlying theoretical foundations for willingness to pay and quality adjusted life years, (b) describe the application of willingness to pay and quality adjusted life years for use in economic analyses, (c) compare and contrast the value of willingness to pay and quality adjusted life years in measuring the impact of stuttering treatment on quality of life, (d) interpret quality adjusted life years, and (e) interpret willingness to pay data.

Franic DM; Bothe AK; Bramlett RE

2012-12-01

370

Tetralogy of Fallot with atrioventricular septal defect: surgical strategies for repair and midterm outcome of pulmonary valve-sparing approach.  

Science.gov (United States)

Repair for tetralogy of Fallot (TOF) with complete atrioventricular septal defect (CAVSD) has been reported with good early and intermediate outcomes. Morbidity, however, remains significantly high. To date, repair of CAVSD/TOF using a pulmonary valve-sparing technique (PVS) and freedom from valve reoperation are not well defined. A study was undertaken to investigate outcomes. This study was conducted in as a retrospective investigation. Between January 1988 and December 2008, 13 consecutive patients with CAVSD/TOF were identified, and their records were reviewed retrospectively. Of these 13 patients, 9 had Rastelli type C CAVSD. Trisomy 21 was present in 9 cases (69 %; 7 with type C). Five patients had received a systemic-to-pulmonary shunt (SPS) before complete repair at a mean age 1.7 ± 0.6 months. All the patients survived until complete repair. At complete CAVSD/TOF repair, AVSD was corrected with a two-patch technique in all patients. For eight patients (61.5 %), PVS was used. The remaining five patients had transannular patch (TAP) repair. The mean age at complete repair was 6.3 ± 2.4 months. At complete repair, the mean cardiopulmonary bypass time was 173.5 ± 30.6 min, and the cross-clamp time was 134.7 ± 28.8 min. There was one hospitalization and no late deaths. The median follow-up period was 9.2 years [interquartile range (IQR), 4.7-13.3 years]. The actuarial survival was 90.0 ± 9.5 % at 1 year, 90 ± 9.5 % at 5 years, and 90 ± 9.5 % at 8 years. Of the 12 survivors, 6 had some reintervention during the follow-up period. Within the first 11 years after complete repair, two patients underwent left atrioventricular (AV) valve repair, and one patient had right AV valve repair. Two patients had residual VSD closure. Four patients underwent the first right ventricular outflow tract (RVOT) reintervention for critical insufficiency or stenosis at a mean interval of 6 ± 21) months. One patient had a second RVOT reoperation. Findings showed that CAVSD/TOF with PVS was related to significantly higher freedom from RVOT reintervention (100 % at 1, 5, and 8 years compared with 80 ± 17.9 % at 1 year, 60 ± 21.9 % at 5 years, and 40 ± 21.9 % at 8 years for CAVSD/TOF using TAP; P RVOT reintervention. PMID:23104595

Gupta, Umang; Polimenakos, Anastasios C; El-Zein, Chawki; Ilbawi, Michel N

2012-10-27

371

A configurational approach to the relationship between high-performance work practices and frontline health care worker outcomes.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To identify high-performance work practices (HPWP) associated with high frontline health care worker (FLW) job satisfaction and perceived quality of care. METHODS: Cross-sectional survey data from 661 FLWs in 13 large health care employers were collected between 2007 and 2008 and analyzed using both regression and fuzzy-set qualitative comparative analysis. PRINCIPAL FINDINGS: Supervisor support and team-based work practices were identified as necessary for high job satisfaction and high quality of care but not sufficient to achieve these outcomes unless implemented in tandem with other HPWP. Several configurations of HPWP were associated with either high job satisfaction or high quality of care. However, only one configuration of HPWP was sufficient for both: the combination of supervisor support, performance-based incentives, team-based work, and flexible work. These findings were consistent even after controlling for FLW demographics and employer type. Additional research is needed to clarify whether HPWP have differential effects on quality of care in direct care versus administrative workers. CONCLUSIONS: High-performance work practices that integrate FLWs in health care teams and provide FLWs with opportunities for participative decision making can positively influence job satisfaction and perceived quality of care, but only when implemented as bundles of complementary policies and practices.

Chuang E; Dill J; Morgan JC; Konrad TR

2012-08-01

372

Outcome of a Standardized Approach to Childhood Urinary Symptoms-Long-Term Follow-Up of 720 Patients.  

Science.gov (United States)

AIMS: To investigate the relevance of enuresis subtyping for selection of treatment modality and for long-term outcome in a large consecutive patient cohort. MATERIALS AND METHODS: We included all patients referred for urinary incontinence during a 5-year period but excluding recurrent urinary tract infections (UTI). Type and severity of incontinence, prior history, results of examinations performed, number of visits, and effect of all treatments provided, were included in a clinical database. RESULTS: Seven hundred twenty children aged 4-16 years (mean 8.5?±?2.2?years, 239 girls) were included in the analysis (42% with monosymptomatic (MNE), 55% with non-MNE, and 3% with isolated daytime incontinence). Initial evaluation revealed only few underlying causes (one neurological and eight anatomical). Investigations showed significant differences between MNE and non-MNE patients as both maximal voided volume and nocturnal urine volume was lower in non-MNE patients (P?desmopressin resistance 177 (33%) of these were dry on desmopressin monotherapy. CONCLUSIONS: The study indicated that MNE and non-MNE are two distinct disease entities with different optimal treatments and showed that the latter patients are more difficult and time-consuming to manage. Neurourol. Urodynam. 9999:1-7, 2013. © 2013 Wiley Periodicals, Inc. PMID:23765698

Rittig, Nikolaj; Hagstroem, Søren; Mahler, Birgitte; Kamperis, Konstantinos; Siggaard, Charlotte; Mikkelsen, Mette Marie; Bower, Wendy Fiona; Djurhuus, Jens C; Rittig, Søren

2013-06-14

373

Formación basada en competencias en educación sanitaria: aproximaciones a enfoques y modelos de competencia. [Outcome-based health education: Possible approaches and models of competence  

Directory of Open Access Journals (Sweden)

Full Text Available The great changes taking place in society today call into question traditional training, which is focused on the transmission of knowledge and training skills. Some experts suggest that the introduction of a competency-based approach to training has presented it with an avenue for modernization and cooperation with the needs of the organizational environment. The approach of Outcome Based Education is considered one of the most important changes in health education for the twenty-first century. This approach is predominant in higher education institutions around the world and is the method recommended by major governing bodies and evaluators of health education (or, in a narrower sense, medical education). Los grandes cambios que se están produciendo en la sociedad de hoy en día ponen en entredicho la formación tradicional, centrada en la transmisión de conocimientos y en el entrenamiento de ciertas habilidades. Algunos expertos apuntan que la introducción del enfoque de competencias ha significado para la formación una vía para la actualización y el acercamiento a necesidades del ambiente organizacional. El enfoque de Formación basada en Competencias (FBC, en adelante), más conocido en la literatura internacional como Out Come Based Education, es considerado uno de los cambios más importantes en la educación sanitaria para el siglo XXI. Este enfoque, e