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Sample records for case study evidence

  1. Cost decreases in environmental technology. Evidence from four case studies

    Energy Technology Data Exchange (ETDEWEB)

    Oosterhuis, F. [Instituut for Environmental Studies, Vrije Universiteit VU, Amsterdam (Netherlands)

    2007-07-15

    The cost of a new technology tends to decrease as its uptake grows, and environmental technology is no exception to this general rule. Factors that can bring about such cost reductions include economies of scale, 'learning-by-doing', incremental technological improvements, and growing competition. In preparing environmental policies, the potential for future cost reductions is often disregarded. The present study aims to provide some additional empirical evidence on the cost decreases in environmental technology and the factors that lie behind them. To this end, four exemplary case studies have been selected. The first case (NOx emission abatement by Selective Catalytic Reduction (SCR)), shows a wide variety in cost estimates, without a clear trend. This is even true for the costs of a fairly homogeneous type of investment (SCR in coal fired power plants). Nevertheless, it is clear that an important cost decrease has been achieved by prolonging the lifetime of the catalyst, which is one of the main cost components in SCR. In the second case (NH3 emission abatement by chemical air scrubbers in pig farming) there is not yet sufficient experience with the technology to draw conclusions on the development of costs. However, it is already clear that economizing on the capacity of the system can contribute to important cost savings. Three-way catalytic converters in cars have shown significant price decreases following their large scale introduction on the European market in the early 1990s. Probably economies of scale have played an important role in this case, as the size of the market made mass production possible. To some extent, cost reductions may also be attributed to improvements such as the need for less materials (e.g. platinum). Furthermore, the performance of catalytic converters has improved, implying that the cost per unit of emission reduction has decreased even more than the cost of the device itself. Market prices of Compact Fluorescent Lamps

  2. Clinicians adopting evidence based guidelines: a case study with thromboprophylaxis

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    Fry Margaret

    2011-09-01

    Full Text Available Abstract Background Venous Thromboembolism (VTE is a cause of hospital mortality and managing its morbidity is associated with significant expenditure. Uptake of evidenced based guideline recommendations intended to prevent VTE in hospital settings is sub-optimal. This study was conducted to explore clinicians' attitudes and the clinical environment in which they work to understand their reluctance to adopt VTE prophylaxis guidelines. Methods Between February and November 2009, 40 hospital employed doctors from 2 Australian metropolitan hospitals were interviewed in depth. Qualitative data were analysed according to thematic methodology. Results Analysis of interviews revealed that barriers to evidence based practice include i the fragmented system of care delivery where multiple members of teams and multiple teams are responsible for each patient's care, and in the case of VTE, where everyone shares responsibility and no-one in particular is responsible; ii the culture of practice where team practice is tailored to that of the team head, and where medicine is considered an 'art' in which guidelines should be adapted to each patient rather than applied universally. Interviewees recommend clear allocation of responsibility and reminders to counteract VTE risk assessment being overlooked. Conclusions Senior clinicians are the key enablers for practice change. They will need to be convinced that guideline compliance adds value to their patient care. Then with the support of systems in the organisation designed to minimize the effects of care fragmentation, they will drive practice changes in their teams. We believe that evidence based practice is only possible with a coordinated program that addresses individual, cultural and organisational constraints.

  3. SFA Adoption: Empirical Evidences from a Case Study

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    Silvio Cardinali

    2014-06-01

    Full Text Available Understanding how technology investments create business value is a research priority in today's technology-intensive world. Drawing on a literature review as well as a qualitative study, this research suggests that sales technology can support both: externally focused tasks towards managing customer relationships and internal administrative tasks. To unleash its real potential, sales technology should be designed to enable customer relationships rather than being perceived as a cost cutting tool. Today organisations are forced to constantly invent new ways of interacting with the customer to increase customer loyalty and to decrease the possibility of commoditization. This paper will focus on Sales Force Automation (SFA and its increasing importance. It will explore the purpose of SFA, its advantages and disadvantages, and its future impact on organisations through a qualitative research study: the authors investigated a small company operating in the business-to-business services sector to obtain practical feedback on the organisational and individual implications, the potential benefits and the problems related to adoption of an SFA system.

  4. Evidence-based medicine - an appropriate tool for evidence-based health policy? A case study from Norway.

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    Malterud, Kirsti; Bjelland, Anne Karen; Elvbakken, Kari Tove

    2016-03-05

    Evidence-based policy (EBP), a concept modelled on the principles of evidence-based medicine (EBM), is widely used in different areas of policymaking. Systematic reviews (SRs) with meta-analyses gradually became the methods of choice for synthesizing research evidence about interventions and judgements about quality of evidence and strength of recommendations. Critics have argued that the relation between research evidence and service policies is weak, and that the notion of EBP rests on a misunderstanding of policy processes. Having explored EBM standards and knowledge requirements for health policy decision-making, we present an empirical point of departure for discussing the relationship between EBM and EBP. In a case study exploring the Norwegian Knowledge Centre for the Health Services (NOKC), an independent government unit, we first searched for information about the background and development of the NOKC to establish a research context. We then identified, selected and organized official NOKC publications as an empirical sample of typical top-of-the-line knowledge delivery adhering to EBM standards. Finally, we explored conclusions in this type of publication, specifically addressing their potential as policy decision tools. From a total sample of 151 SRs published by the NOKC in the period 2004-2013, a purposive subsample from 2012 (14 publications) advised major caution about their conclusions because of the quality or relevance of the underlying documentation. Although the case study did not include a systematic investigation of uptake and policy consequences, SRs were found to be inappropriate as universal tools for health policy decision-making. The case study demonstrates that EBM is not necessarily suited to knowledge provision for every kind of policy decision-making. Our analysis raises the question of whether the evidence-based movement, represented here by an independent government organization, undertakes too broad a range of commissions using

  5. Case histories as evidence.

    Science.gov (United States)

    Herxheimer, Andrew; Healy, David; Menkes, David B

    2012-01-01

    In courts case histories play a central part when a crime may have resulted from an effect of a prescribed drug; in civil cases where a person may have suffered damage from a drug; and in coroners' enquiries into the cause of unexplained deaths. The court must decide two important questions: 1. Can the suspected medication(s) cause this kind of effect? 2. Did it (or they) do so in this particular case? Many judges and coroners have not addressed these questions clearly and have not used expert witnesses consistently, on occasion disregarding scientific evidence. Courts need to appoint experts to explain and interpret the scientific evidence. Few judges are equipped to resolve contradictions between different experts. Brief accounts of five cases from four countries illustrate these points. The reluctance of legal processes to implicate drugs as a possible cause of violent behaviour leads to injustice. Courts must be required to obtain appropriate expert evidence, and be given independent data on which drugs can cause such behaviour.

  6. Initiatives supporting evidence informed health system policymaking in Cameroon and Uganda: a comparative historical case study.

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    Ongolo-Zogo, Pierre; Lavis, John N; Tomson, Goran; Sewankambo, Nelson K

    2014-11-29

    There is a scarcity of empirical data on institutions devoted to knowledge brokerage and their influence in Africa. Our objective was to describe two pioneering Knowledge Translation Platforms (KTPs) supporting evidence informed health system policymaking (EIHSP) in Cameroon and Uganda since 2006. This comparative historical case study of Evidence Informed Policy Network (EVIPNet) Cameroon and Regional East African Community Health Policy Initiative (REACH-PI) Uganda using multiple methods comprised (i) a descriptive documentary analysis for a narrative historical account, (ii) an interpretive documentary analysis of the context, profiles, activities and outputs inventories and (iii) an evaluative survey of stakeholders exposed to evidence briefs produced and policy dialogues organized by the KTPs. Both initiatives benefited from the technical and scientific support from the global EVIPNet resource group. EVIPNet Cameroon secretariat operates with a multidisciplinary group of part-time researchers in a teaching hospital closely linked to the ministry of health. REACH-PI Uganda secretariat operates with a smaller team of full time staff in a public university. Financial resources were mobilized from external donors to scale up capacity building, knowledge management, and linkage and exchange activities. Between 2008 and 2012, twelve evidence briefs were produced in Cameroon and three in Uganda. In 2012, six rapid evidence syntheses in response to stakeholders' urgent needs were produced in Cameroon against 73 in Uganda between 2010 and 2012. Ten policy dialogues (seven in Cameroon and three in Uganda) informed by pre-circulated evidence briefs were well received. Both KTPs contributed to developing and testing new resources and tools for EIHSP. A network of local and global experts has created new spaces for evidence informed deliberations on priority health policy issues related to MDGs. This descriptive historical account of two KTPs housed in government

  7. Sustainability Strategy and Management Control Systems in Family Firms. Evidence from a Case Study

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    Fabio Caputo

    2017-06-01

    Full Text Available The aim of this paper is to investigate how the integration of new forms of sustainable control systems (SCSs and traditional management control systems (MCSs, and the use of these control systems affect the integration of sustainability within organizational strategy. A qualitative case study based on a longitudinal investigation of an Italian family firm operating in an environment-sensitive context, the intermodal transport industry, has been used to trace the company’s pathway to sustainability integration based on the Gond et al. framework. The paper enriches the Gond et al. conceptualization providing evidence of the external and internal factors relevant in affecting the organization’s pathway towards sustainability integration. To the best of the authors’ knowledge, the present study is the first analysis that investigates the integration of sustainability into organizational strategy in the context of family firms, from the point of view of performance management systems (PMSs.

  8. Maternal complication prevention: evidence from a case-control study in southwest Nigeria

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    Kayode O. Osungbade

    2014-12-01

    Full Text Available Background: The importance of strengthening maternal health services as a preventive intervention for morbidities and complications during pregnancy and delivery in developing countries cannot be over-emphasised, since use of prenatal health services improves maternal health outcomes. Aim: This study investigated differences in risk factors for maternal complications in booked and unbooked pregnant women in Nigeria, and provided evidence for their prevention. Setting: The study was carried out in a postnatal ward in a secondary health facility. Methods: This was a case-control study involving booked and unbooked pregnant women who had delivered. Consecutive enrolment of all unbooked pregnant women (cases was done, and one booked pregnant woman (control was enrolled and matched for age with each of these. Both groups were interviewed using a questionnaire, whilst records of delivery were extracted from the hospital files. Findings were subjected to logistical regression at a significance level of p < 0.05. Results: Booked women had a lower median length of labour (10 hours compared to unbooked women (13 hours. More women in the booked control group (139; 35.1% than in the unbooked case group (96; 23.6% reported at least one type of morbidity during the index pregnancy (p = 0.0004. Booking status was associated with a likelihood of spontaneous vaginal delivery. Young maternal age, low education, rural residence and low socio-economic status were associated with less likelihood of using prenatal services. Young maternal age, low education and intervention in the delivery were associated with a likelihood of experiencing a complication of delivery. Conclusion: Strengthening antenatal and secondary healthcare services as short- and mediumterm measures might be cost-effective as a preventive strategy in complications of pregnancy,whilst socio-economic dimensions of health are accorded priority in the long term.

  9. Building capacity for evidence informed decision making in public health: a case study of organizational change

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    Peirson Leslea

    2012-02-01

    Full Text Available Abstract Background Core competencies for public health in Canada require proficiency in evidence informed decision making (EIDM. However, decision makers often lack access to information, many workers lack knowledge and skills to conduct systematic literature reviews, and public health settings typically lack infrastructure to support EIDM activities. This research was conducted to explore and describe critical factors and dynamics in the early implementation of one public health unit's strategic initiative to develop capacity to make EIDM standard practice. Methods This qualitative case study was conducted in one public health unit in Ontario, Canada between 2008 and 2010. In-depth information was gathered from two sets of semi-structured interviews and focus groups (n = 27 with 70 members of the health unit, and through a review of 137 documents. Thematic analysis was used to code the key informant and document data. Results The critical factors and dynamics for building EIDM capacity at an organizational level included: clear vision and strong leadership, workforce and skills development, ability to access research (library services, fiscal investments, acquisition and development of technological resources, a knowledge management strategy, effective communication, a receptive organizational culture, and a focus on change management. Conclusion With leadership, planning, commitment and substantial investments, a public health department has made significant progress, within the first two years of a 10-year initiative, towards achieving its goal of becoming an evidence informed decision making organization.

  10. Building capacity for evidence informed decision making in public health: a case study of organizational change.

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    Peirson, Leslea; Ciliska, Donna; Dobbins, Maureen; Mowat, David

    2012-02-20

    Core competencies for public health in Canada require proficiency in evidence informed decision making (EIDM). However, decision makers often lack access to information, many workers lack knowledge and skills to conduct systematic literature reviews, and public health settings typically lack infrastructure to support EIDM activities. This research was conducted to explore and describe critical factors and dynamics in the early implementation of one public health unit's strategic initiative to develop capacity to make EIDM standard practice. This qualitative case study was conducted in one public health unit in Ontario, Canada between 2008 and 2010. In-depth information was gathered from two sets of semi-structured interviews and focus groups (n = 27) with 70 members of the health unit, and through a review of 137 documents. Thematic analysis was used to code the key informant and document data. The critical factors and dynamics for building EIDM capacity at an organizational level included: clear vision and strong leadership, workforce and skills development, ability to access research (library services), fiscal investments, acquisition and development of technological resources, a knowledge management strategy, effective communication, a receptive organizational culture, and a focus on change management. With leadership, planning, commitment and substantial investments, a public health department has made significant progress, within the first two years of a 10-year initiative, towards achieving its goal of becoming an evidence informed decision making organization.

  11. A genetic basis for infectious mononucleosis: evidence from a family study of hospitalized cases in Denmark.

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    Rostgaard, Klaus; Wohlfahrt, Jan; Hjalgrim, Henrik

    2014-06-01

    Circumstantial evidence from genome-wide association and family studies of various Epstein-Barr virus-associated diseases suggests a substantial genetic component in infectious mononucleosis (IM) etiology. However, familial aggregation of IM has scarcely been studied. We used data from the Danish Civil Registration System and the Danish National Hospital Discharge Register to study rate ratios of IM in a cohort of 2 823 583 Danish children born between 1971 and 2011. Specifically, we investigated the risk of IM in twins and in first-, second-, and third-degree relatives of patients with IM. In the analyses, IM was defined as a diagnosis of IM in a hospital contact. Effects of contagion between family members were dealt with by excluding follow-up time the first year after the occurrence of IM in a relative. A total of 16 870 cases of IM were observed during 40.4 million person-years of follow-up from 1977 to 2011. The rate ratios and the associated 95% confidence intervals were 9.3 (3.0-29) in same-sex twins, 3.0 (2.6-3.5) in siblings, 1.9 (1.6-2.2) in children, 1.4 (1.3-1.6) in second-degree relatives, and 1.0 (0.9-1.2) in third-degree relatives of IM patients. The rate ratios were very similar for IM in children (aged 0-6 years) and older children/adolescents (aged 7-19 years). We found evidence of familial aggregation of IM that warrants genome-wide association studies on IM disease etiology, especially to examine commonalities with causal pathways in other Epstein-Barr virus-related diseases. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  12. Making the case for evidence-based design in healthcare: a descriptive case study of organizational decision making.

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    Shoemaker, Lorie K; Kazley, Abby Swanson; White, Andrea

    2010-01-01

    The aim of this study was to describe the organizational decision-making process used in the selection of evidence-based design (EBD) concepts, the criteria used to make these decisions, and the extent to which leadership style may have influenced the decision-making process. Five research questions were formulated to frame the direction of this study, including: (1) How did healthcare leaders learn of innovations in design? (2) How did healthcare leaders make decisions in the selection of healthcare design concepts? (3) What criteria did healthcare leaders use in the decision-making process? (4) How did healthcare leaders consider input from the staff in design decisions? and (5) To what extent did the leadership style of administrators affect the outcomes of the decision-making process? Current issues affecting healthcare in the community led the principal investigator's organization to undertake an ambitious facilities expansion project. As part of its planning process, the organization learned of EBD principles that seemingly had a positive impact on patient care and safety and staff working conditions. Although promising, a paucity of empirical research addressed the cost/benefit of incorporating many EBD concepts into one hospital setting, and there was no research that articulated the organizational decision-making process used by healthcare administrators when considering the use of EBD in expansion projects. A mixed-method, descriptive, qualitative, single-case study and quantitative design were used to address the five research questions. The Systems Research Organizing Model provided the theoretical framework. A variety of data collection methods was used, including interviews of key respondents, the review of documentary evidence, and the Multifactor Leadership Questionnaire. A participatory process was used throughout the design decision phases, involving staff at all levels of the organization. The Internet and architects facilitated learning about

  13. Building a Culture of Evidence: A Case Study of a California Community College

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    Baker, Jill H.; Sax, Caren L.

    2012-01-01

    The purpose of this study was to better understand the practices associated with building a culture of evidence and to identify the factors influencing the success of such an endeavor. By definition, a culture of evidence is based upon practices employing data and research to inform decision making at all levels of the institution, with the…

  14. When evidence is not enough: a case study on alcohol marketing legislation in Brazil.

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    Vendrame, Alan

    2017-01-01

    This case study identifies the influence and mechanisms that the alcohol industry in Brazil has been able to bring to bear to maintain self-regulation in the marketing of beer and many wines set against a trend of increasing alcohol consumption in Brazil, particularly among young people and women. It identifies the forms of power and strategies used by the alcohol industry in Brazil that may be useful for other countries to consider in seeking to move from self-regulation to state regulation of alcohol marketing. A review was conducted of recent legal documents and court cases, as well as the activities of alcoholic beverage industries. Because of an exemption, Brazilian law had established that both beer and many wines are not alcoholic beverages for marketing purposes. These beverages are subjected to industry self-regulation codes. Research shows that beer and wine marketing often violates industry codes, with little or no enforcement of penalties for non-compliance. Attempts to include beer and wine in the legal definition of alcohol have been opposed by the alcohol industry, and the courts have delegated responsibility to the legislature. The recent legal activities surrounding alcohol sales during the 2014 World Cup games in Brazil provide evidence of the alcohol industry's influence on the legislative process. The alcohol industry in Brazil plays a significant role in the formulation of public policies on alcohol, especially regarding the regulation of marketing. This power is exercised by strong lobbying of government officials responsible for public policies. © 2016 Society for the Study of Addiction.

  15. Secondary school physics teachers' conceptions of scientific evidence: A collective case study

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    Taylor, Joseph A.

    Engaging secondary school students in inquiry-oriented tasks that more closely simulate the scholarly activities of scientists has been recommended as a way to improve scientific literacy. Two tasks that are frequently recommended include students' design of original experiments, and students' evaluation of scientific evidence and conclusions. Yet, little is known about teachers' conceptions of experimentation. The principal aim of this study, therefore, was to describe the nature of prospective and practicing physics teachers' conceptions of scientific evidence. More specifically, the following research questions guided this study: (1) What types of issues related to the measurement reliability and experimental validity of scientific evidence do practicing and prospective physics teachers think about when designing experiments? (2) When presented with hypothetical scenarios that describe unsound experimental procedures or poorly supported conclusions (or both), what concerns will prospective and practicing physics teachers raise? And (3) When the participants' responses to parallel research prompts are compared across protocols, what similarities and differences exist? The nature of the teacher-participants' conceptions was described from an analysis of data collected from research prompts such as interviews and hand written artifacts. In these research prompts, the teachers "thought aloud" while designing experiments and critically evaluated student-collected evidence presented in hypothetical classroom scenarios. The data from this study suggested that the three teachers, while contemplating the reliability and validity of scientific evidence, frequently used their conceptions of evidence in conjunction with specific subject matter conceptions. The data also indicated that the relationship between subject matter knowledge and conceptions of evidence was more pronounced for some conceptions of evidence than for others. Suggestions for future research included

  16. Homocyst(e)ine and cardiovascular disease: a systematic review of the evidence with special emphasis on case-control studies and nested case-control studies.

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    Ford, Earl S; Smith, S Jay; Stroup, Donna F; Steinberg, Karen K; Mueller, Patricia W; Thacker, Stephen B

    2002-02-01

    Elevated concentrations of homocyst(e)ine are thought to increase the risk of vascular diseases including coronary heart disease and cerebrovascular disease. We searched MEDLINE (1966-1999), EMBASE (1974-1999), SciSearch (1974- 1999), and Dissertation Abstracts (1999) for articles and theses about homocyst(e)ine concentration and coronary heart disease and cerebrovascular disease. We included 57 publications (3 cohort studies, 12 nested case-control studies, 42 case-control studies) that reported results on 5518 people with coronary heart disease (11,068 control subjects) and 1817 people with cerebrovascular disease (4787 control subjects) in our analysis. For coronary heart disease, the summary odds ratios (OR) for a 5-micromol/l increase in homocyst(e)ine concentration were 1.06 (95% CI : 0.99-1.13) for 2 publications of cohort studies, 1.23 (95% CI : 1.07-1.41) for 10 publications of nested case-control studies, and 1.70 (95% CI : 1.50-1.93) for 26 publications of case-control studies. For cerebrovascular disease, the summary OR for a 5-micromol/l increase in homocyst(e)ine concentration were 1.10 (95% CI : 0.94-1.28) for 2 publications of cohort studies, 1.58 (95% CI : 1.35-1.85) for 5 publications of nested case-control studies, and 2.16 (95% CI : 1.65-2.82) for 17 publications of case-control studies. Prospective studies offer weaker support than case-control studies for an association between homocyst(e)ine concentration and cardiovascular disease. Although other lines of evidence support a role for homocyst(e)ine in the pathogenesis of cardiovascular disease, more information from prospective epidemiological studies or clinical trials is needed to clarify this role.

  17. The Role of Context in Online Gaming Excess and Addiction: Some Case Study Evidence

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    Griffiths, Mark D.

    2010-01-01

    Research into online gaming addiction is a relatively new area of psychological study. Furthermore, there are studies that have claimed that online gaming addiction may be addictive because of self-report accounts of very excessive use of up to 80 h a week. This study uses data from two case studies to highlight the role of context in…

  18. Contemporary internal auditing practices : (new) roles and influencing variables. Evidence from extended case studies

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    G. SARENS; I. DE BEELDE

    2004-01-01

    Following the recommendation made by Rittenberg (1999), this study encompasses the broader nature of internal auditing that is evolving in practice and confirmed by the revised definition of internal auditing and the new Professional Practices Framework, both issued by the IIA in 1999. This study, based on six extended case studies, attempts to contribute to the literature by studying contemporary internal auditing practices in Belgium (assurance and / or consulting oriented), refining the in...

  19. Coherence of evidence from systematic reviews as a basis for evidence strength - a case study in support of an epistemological proposition

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    Mickenautsch Steffen

    2012-01-01

    Full Text Available Abstract Background This article aims to offer, on the basis of Coherence theory, the epistemological proposition that mutually supportive evidence from multiple systematic reviews may successfully refute radical, philosophical scepticism. Methods A case study including seven systematic reviews is presented with the objective of refuting radical philosophical scepticism towards the belief that glass-ionomer cements (GIC are beneficial in tooth caries therapy. The case study illustrates how principles of logical and empirical coherence may be applied as evidence in support of specific beliefs in healthcare. Results The results show that radical scepticism may epistemologically be refuted on the basis of logical and empirical coherence. For success, several systematic reviews covering interconnected beliefs are needed. In praxis, these systematic reviews would also need to be of high quality and its conclusions based on reviewed high quality trials. Conclusions A refutation of radical philosophical scepticism to clinical evidence may be achieved, if and only if such evidence is based on the logical and empirical coherence of multiple systematic review results. Practical application also requires focus on the quality of the systematic reviews and reviewed trials.

  20. Medicine Based Evidence for Individualized Decision Making: Case Study of Systemic Lupus Erythematosus.

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    Wivel, Ashley E; Lapane, Kate; Kleoudis, Christi; Singer, Burton H; Horwitz, Ralph I

    2017-11-01

    To guide management decisions for an index patient, evidence is required from comparisons between approximate matches to the profile of the index case, where some matches contain responses to treatment and others act as controls. We describe a method for constructing clinically relevant histories/profiles using data collected but unreported from 2 recent phase 3 randomized controlled trials assessing belimumab in subjects with clinically active and serologically positive systemic lupus erythematosus. Outcome was the Systemic lupus erythematosus Responder Index (SRI) measured at 52 weeks. Among 1175 subjects, we constructed an algorithm utilizing 11 trajectory variables including 4 biological, 2 clinical, and 5 social/behavioral. Across all biological and social/behavioral variables, the proportion of responders based on the SRI whose value indicated clinical worsening or no improvement ranged from 27.5% to 42.3%. Kappa values suggested poor agreement, indicating that each biological and patient-reported outcome provides different information than gleaned from the SRI. The richly detailed patient profiles needed to guide decision-making in clinical practice are sharply at odds with the limited information utilized in conventional randomized controlled trial analyses. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Brain damage associated with apraxia of speech: evidence from case studies.

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    Moser, Dana; Basilakos, Alexandra; Fillmore, Paul; Fridriksson, Julius

    2016-08-01

    The site of crucial damage that causes acquired apraxia of speech (AOS) has been debated in the literature. This study presents five in-depth cases that offer insight into the role of brain areas involved in AOS. Four of the examined participants had a primary impairment of AOS either with (n = 2) or without concomitant mild aphasia (n = 2). The fifth participant presented with a lesion relatively isolated to the left anterior insula (AIns-L), damage that is rarely reported in the literature, but without AOS. Taken together, these cases challenge the role of the AIns-L and implicate the left motor regions in AOS.

  2. Use of Evidence from Systematic Reviews to Inform Commissioning Decisions: A Case Study

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    Chambers, Duncan; Grant, Rod; Warren, Erica; Pearson, Sally-Anne; Wilson, Paul

    2012-01-01

    Systematic reviews provide high-level evidence but there are barriers to their use by policy makers. This paper reports the preparation and evaluation of an evidence briefing, using systematic reviews and other existing sources of synthesised evidence, to support a possible reorganisation of services for young people with eating disorders in an…

  3. Linking clinical quality indicators to research evidence - a case study in asthma management for children.

    Science.gov (United States)

    Choong, Miew Keen; Tsafnat, Guy; Hibbert, Peter; Runciman, William B; Coiera, Enrico

    2017-07-21

    Clinical quality indicators are used to monitor the performance of healthcare services and should wherever possible be based on research evidence. Little is known however about the extent to which indicators in common use are based on research. The objective of this study is to measure the extent to which clinical quality indicators used in asthma management in children with outcome measurements can be linked to results in randomised controlled clinical trial (RCT) reports. This work is part of a broader research program to trial methods that improve the efficiency and accuracy of indicator development. National-level indicators for asthma management in children were extracted from the National Quality Measures Clearinghouse database and the National Institute for Health and Care Excellence quality standards by two independent appraisers. Outcome measures were extracted from all published English language RCT reports for asthma management in children below the age of 12 published between 2005 and 2014. The two sets were then linked by manually mapping both to a common set of Unified Medical Language System (UMLS) concepts. The analysis identified 39 indicators and 562 full text RCTs dealing with asthma management in children. About 95% (37/39) of the indicators could be linked to RCT outcome measures. It is possible to identify relevant RCT reports for the majority of indicators used to assess the quality of asthma management in childhood. The methods reported here could be automated to more generally support assessment of candidate indicators against the research evidence.

  4. Case Study: Evidence-Based Interventions Enhancing Diabetic Foot Care Behaviors among Hospitalized DM Patients

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    Titis Kurniawan

    2011-01-01

    Full Text Available Background: Improving diabetic patients’ foot care behaviors is one of the most effective strategies in minimizing diabetic foot ulceration and its further negative impacts, either in diabetic hospitalized patients or outpatients.Purpose: To describe foot care knowledge and behaviors among hospitalized diabetic patients, to apply selected foot care knowledge and behaviors improvement evidence, and to evaluate its effectiveness.Method: Four diabetic patients who were under our care for at least three days and could communicate in Thai language were selected from a surgical ward in a university hospital. The authors applied educational program based on patients’ learning needs, provided diabetic foot care leaflet, and assisted patients to set their goal and action plans. In the third day of treatment, we evaluated patients’ foot care knowledge and their goal and action plan statements in improving foot care behaviors.Result: Based on the data collected among four hospitalized diabetic patients, it was shown that all patients needed foot care behaviors improvement and the educational program improved hospitalized patients’ foot care knowledge and their perceived foot care behaviors. The educational program that combined with goal setting and action plans method was easy, safe, and seemed feasibly applicable for diabetic hospitalized patients.Conclusion: The results of this study provide valuable information for improvement of hospitalized diabetic patients’ foot care knowledge and behaviors. The authors recommend nurses to use this evidence-based practice to contribute in improving the quality of diabetic care.Keywords: Intervention, diabetic foot care, hospitalized diabetic patients

  5. Vocabulary skills are well developed in university students with dyslexia: Evidence from multiple case studies.

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    Cavalli, Eddy; Casalis, Séverine; El Ahmadi, Abdessadek; Zira, Mélody; Poracchia-George, Florence; Colé, Pascale

    2016-01-01

    Most studies in adults with developmental dyslexia have focused on identifying the deficits responsible for their persistent reading difficulties, but little is known on how these readers manage the intensive exposure to written language required to obtain a university degree. The main objective of this study was to identify certain skills, and specifically vocabulary skills, that French university students with dyslexia have developed and that may contribute to their literacy skills. We tested 20 university students with dyslexia and 20 normal readers (matched on chronological age, gender, nonverbal IQ, and level of education) in reading, phonological, vocabulary breadth (number of known words), and vocabulary depth (accuracy and precision) tasks. In comparing vocabulary measures, we used both Rasch model and single case study methodologies. Results on reading and phonological tasks confirmed the persistence of deficits in written word recognition and phonological skills. However, using the Rasch model we found that the two groups performed at the same level in the vocabulary breadth task, whereas dyslexics systematically outperformed their chronological age controls in the vocabulary depth task. These results are supplemented by multiple case studies. The vocabulary skills of French university students with dyslexia are well developed. Possible interpretations of these results are discussed. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Risk of gastric cancer by water source: evidence from the Golestan case-control study.

    Directory of Open Access Journals (Sweden)

    Laura Eichelberger

    Full Text Available Gastric cancer (GC is the world's fifth most common cancer, and the third leading cause of cancer-related death. Over 70% of incident cases and deaths occur in developing countries. We explored whether disparities in access to improved drinking water sources were associated with GC risk in the Golestan Gastric Cancer Case Control Study.306 cases and 605 controls were matched on age, gender, and place of residence. We conducted unconditional logistic regression to calculate odds ratios (ORs and 95% confidence intervals (CI, adjusted for age, gender, ethnicity, marital status, education, head of household education, place of birth and residence, homeownership, home size, wealth score, vegetable consumption, and H. pylori seropositivity. Fully-adjusted ORs were 0.23 (95% CI: 0.05-1.04 for chlorinated well water, 4.58 (95% CI: 2.07-10.16 for unchlorinated well water, 4.26 (95% CI: 1.81-10.04 for surface water, 1.11 (95% CI: 0.61-2.03 for water from cisterns, and 1.79 (95% CI: 1.20-2.69 for all unpiped sources, compared to in-home piped water. Comparing unchlorinated water to chlorinated water, we found over a two-fold increased GC risk (OR 2.37, 95% CI: 1.56-3.61.Unpiped and unchlorinated drinking water sources, particularly wells and surface water, were significantly associated with the risk of GC.

  7. Sustainable Living and Co-Housing: Evidence from a Case Study of Eco-Villages

    DEFF Research Database (Denmark)

    Marckmann, Bella Margrethe Mørch; Gram-Hanssen, Kirsten; Christensen, Toke Haunstrup

    2012-01-01

    is whether co-housing offers better opportunities for choosing and using more sustainable technologies, which also relates to the question of whether co-housing offers better opportunities for building smaller and denser and thus more energy efficient buildings. The second and third questions are socially......, as the growing number of small households is an emerging sustainability problem. The empirical analyses are based on the results from a Danish study of eco-villages including a survey, interviews with representatives of the eco-village movement and a detailed case study of a group of people in the process...... of establishing a new cluster in an existing eco-village. The aim of the article is to contribute to the general discussions about co-housing and sustainability. The study adds nuances to this discussion and shows that the answer is not as straightforward as presented in much of the literature....

  8. Does autonomy for public hospitals in developing countries increase performance? Evidence-based case studies.

    Science.gov (United States)

    De Geyndt, Willy

    2017-04-01

    Governments in middle and low income countries have sought ways for the past decades to make their public hospitals more performing. The objectives of this assessment are to: (a) synthesize the experience of eleven countries at granting autonomy to their public hospitals and the obstacles encountered; (b) deduce which autonomy policies have or have not been effective documenting successes and failures; and (c) propose evidence-based recommendations to policy makers. Data for five countries are derived from the author's participation in the autonomy process augmented by current updates provided by national colleagues. Data for the other six countries are derived from publications available in the literature. Policies granting autonomy to public hospitals have had limited success. In all cases Boards of Directors have been created. Governance of autonomized hospitals by Boards however is obstructed by the resistance of central level entities to have their authority diminished. The Ministry of Finance tends to maintain control over revenues and expenditures. The Public Service Commission resists abdicating its role to hire, promote, transfer and dismiss government employees. The Ministry of Health attempts to keep its authority to appoint hospital staff, procure medical supplies and equipment; it may do so directly or indirectly by selecting and appointing Board members. Management information systems continue to collect activity measures to be aggregated at the national level for statistical purposes and do not provide financial and clinical data useful for decision making by the Boards and by senior management. Decentralizing decision making to the operational level has had limited success. Stakeholders at the central level devise strategies to maintain their power. Two main obstacles are delegating authority over human resources and finances that are sine qua non conditions for governing and increasing the performance of public hospitals. Copyright © 2017 Elsevier

  9. Leveraging Decentralization to Extend the Digital Evidence Acquisition Window: Case Study on Bittorrent Sync

    Directory of Open Access Journals (Sweden)

    Mark Scanlon

    2014-09-01

    Full Text Available File synchronization services such as Dropbox, Google Drive, Microsoft OneDrive, Apple iCloud, etc., are becoming increasingly popular in today's always-connected world. A popular alternative to the aforementioned services is BitTorrent Sync. This is a decentralized/cloudless file synchronization service and is gaining significant popularity among Internet users with privacy concerns over where their data is stored and who has the ability to access it. The focus of this paper is the remote recovery of digital evidence pertaining to files identified as being accessed or stored on a suspect's computer or mobile device. A methodology for the identification, investigation, recovery and verification of such remote digital evidence is outlined. Finally, a proof-of-concept remote evidence recovery from BitTorrent Sync shared folder highlighting a number of potential scenarios for the recovery and verification of such evidence.

  10. Integrative dynamic therapy for bulimia nervosa: An evidence-based case study.

    Science.gov (United States)

    Richards, Lauren K; Shingleton, Rebecca M; Goldman, Rachel; Siegel, Deborah; Thompson-Brenner, Heather

    2016-06-01

    Both cognitive-behavioral therapy (CBT) and psychodynamic psychotherapy are commonly used to treat eating disorders. To further investigate the effectiveness of integrative dynamic therapy (IDT) for bulimia nervosa (BN), our research group undertook a randomized, controlled pilot study comparing IDT with CBT for BN. The case described here was selected from a sample of N = 38 female patients with the symptoms of BN who enrolled in the study. IDT incorporated aspects of the first 4-week stage of CBT, including psychoeducation, self-monitoring, and regular eating. Subsequently, the treatment focused on emotional expression, emotion regulation (defenses), intrapsychic conflict, and interpersonal relationships. The objectives of the report are to demonstrate the effectiveness of an integrative approach to the treatment of eating disorders to address the symptoms of BN and personality issues using pre-, mid-, and posttreatment data, and to illustrate the patient and clinician reactions to each approach to treatment using excerpts from session transcripts and alliance data. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  11. A behavioural perspective on the effects of using performance measurement systems in the companies: Evidence from a case study

    Directory of Open Access Journals (Sweden)

    Lampreia, João

    2017-05-01

    Full Text Available The effects of Performance Measurement Systems (PMS on people’s behaviour are relevant for an organization performance and success. Yet motivational and behavioural consequences of PMS are far from being understood. This study aims to go further regarding the consequences on people’s behaviour of using PMS in organizations. In order to collect data researchers conducted a case study in a Portuguese multi-national company. Evidence shows that the way in which managers understand a PMS influences in a significant way how they behave. The data also lends support to the claim that PMS influence motivation, perceptions, participation and job-related stress of managers.

  12. Contrasting Medical and Legal Standards of Evidence: A Precision Medicine Case Study.

    Science.gov (United States)

    Marchant, Gary E; Scheckel, Kathryn; Campos-Outcalt, Doug

    2016-03-01

    As the health care system transitions to a precision medicine approach that tailors clinical care to the genetic profile of the individual patient, there is a potential tension between the clinical uptake of new technologies by providers and the legal system's expectation of the standard of care in applying such technologies. We examine this tension by comparing the type of evidence that physicians and courts are likely to rely on in determining a duty to recommend pharmacogenetic testing of patients prescribed the oral anti-coagulant drug warfarin. There is a large body of inconsistent evidence and factors for and against such testing, but physicians and courts are likely to weigh this evidence differently. The potential implications for medical malpractice risk are evaluated and discussed. © 2016 American Society of Law, Medicine & Ethics.

  13. Addressing refugee health through evidence-based policies: a case study.

    Science.gov (United States)

    Thiel de Bocanegra, Heike; Carter-Pokras, Olivia; Ingleby, J David; Pottie, Kevin; Tchangalova, Nedelina; Allen, Sophia I; Smith-Gagen, Julie; Hidalgo, Bertha

    2017-05-12

    The cumulative total of persons forced to leave their country for fear of persecution or organized violence reached an unprecedented 24.5 million by the end of 2015. Providing equitable access to appropriate health services for these highly diverse newcomers poses challenges for receiving countries. In this case study, we illustrate the importance of translating epidemiology into policy to address the health needs of refugees by highlighting examples of what works as well as identifying important policy-relevant gaps in knowledge. First, we formed an international working group of epidemiologists and health services researchers to identify available literature on the intersection of epidemiology, policy, and refugee health. Second, we created a synopsis of findings to inform a recommendation for integration of policy and epidemiology to support refugee health in the United States and other high-income receiving countries. Third, we identified eight key areas to guide the involvement of epidemiologists in addressing refugee health concerns. The complexity and uniqueness of refugee health issues, and the need to develop sustainable management information systems, require epidemiologists to expand their repertoire of skills to identify health patterns among arriving refugees, monitor access to appropriately designed health services, address inequities, and communicate with policy makers and multidisciplinary teams. Copyright © 2017. Published by Elsevier Inc.

  14. Further Evidence of Subphenotype Association with Systemic Lupus Erythematosus Susceptibility Loci: A European Cases Only Study

    Science.gov (United States)

    Alonso-Perez, Elisa; Suarez-Gestal, Marian; Calaza, Manuel; Ordi-Ros, Josep; Balada, Eva; Bijl, Marc; Papasteriades, Chryssa; Carreira, Patricia; Skopouli, Fotini N.; Witte, Torsten; Endreffy, Emöke; Marchini, Maurizio; Migliaresi, Sergio; Sebastiani, Gian Domenico; Santos, Maria Jose; Suarez, Ana; Blanco, Francisco J.; Barizzone, Nadia; Pullmann, Rudolf; Ruzickova, Sarka; Lauwerys, Bernard R.; Gomez-Reino, Juan J.; Gonzalez, Antonio

    2012-01-01

    Introduction Systemic Lupus Erythematosus (SLE) shows a spectrum of clinical manifestations that complicate its diagnosis, treatment and research. This variability is likely related with environmental exposures and genetic factors among which known SLE susceptibility loci are prime candidates. The first published analyses seem to indicate that this is the case for some of them, but results are still inconclusive and we aimed to further explore this question. Methods European SLE patients, 1444, recruited at 17 centres from 10 countries were analyzed. Genotypes for 26 SLE associated SNPs were compared between patients with and without each of 11 clinical features: ten of the American College of Rheumatology (ACR) classification criteria (except ANAs) and age of disease onset. These analyses were adjusted for centre of recruitment, top ancestry informative markers, gender and time of follow-up. Overlap of samples with previous studies was excluded for assessing replication. Results There were three new associations: the SNPs in XKR6 and in FAM167A-BLK were associated with lupus nephritis (OR = 0.76 and 1.30, Pcorr = 0.007 and 0.03, respectively) and the SNP of MECP2, which is in chromosome X, with earlier age of disease onset in men. The previously reported association of STAT4 with early age of disease onset was replicated. Some other results were suggestive of the presence of additional associations. Together, the association signals provided support to some previous findings and to the characterization of lupus nephritis, autoantibodies and age of disease onset as the clinical features more associated with SLE loci. Conclusion Some of the SLE loci shape the disease phenotype in addition to increase susceptibility to SLE. This influence is more prominent for some clinical features than for others. However, results are only partially consistent between studies and subphenotype specific GWAS are needed to unravel their genetic component. PMID:23049788

  15. Using supply side evidence to inform oral artemisinin monotherapy replacement in Myanmar: a case study.

    Science.gov (United States)

    Khin, Hnin Su Su; Aung, Tin; Aung, Moe; Thi, Aung; Boxshall, Matt; White, Chris

    2016-08-18

    In 2012, alarmingly high rates of oral artemisinin monotherapy availability and use were detected along Eastern Myanmar, threatening efforts to halt the spread of artemisinin resistance in the Greater Mekong Subregion (GMS), and globally. The aim of this paper is to exemplify how the use of supply side evidence generated through the ACTwatch project shaped the artemisinin monotherapy replacement malaria (AMTR) project's design and interventions to rapidly displace oral artemisinin monotherapy with subsidized, quality-assured ACT in the private sector. The AMTR project was implemented as part of the Myanmar artemisinin resistance containment (MARC) framework along Eastern Myanmar. Guided by outlet survey and supply chain evidence, the project implemented a high-level subsidy, including negotiations with a main anti-malarial distributor, with the aim of squeezing oral artemisinin monotherapy out of the market through price competition and increased availability of quality-assured artemisinin-based combinations. This was complemented with a plethora of demand-creation activities targeting anti-malarial providers and consumers. Priority outlet types responsible for the distribution of oral artemisinin monotherapy were identified by the outlet survey, and this evidence was used to target the AMTR project's supporting interventions. The widespread availability and use of oral artemisinin monotherapy in Myanmar has been a serious threat to malaria control and elimination in the country and across the region. Practical anti-malarial market evidence was rapidly generated and used to inform private sector approaches to address these threats. The program design approach outlined in this paper is illustrative of the type of evidence generation and use that will be required to ensure effective containment of artemisinin drug resistance and progress toward regional and global malaria elimination goals.

  16. Incubators as catalysts of academic spin-offs: evidence from the Israeli case-study

    OpenAIRE

    Pace Giuseppe

    2004-01-01

    There is already a respectable body of evidence that connect industrial innovation with knowledge spillovers from academic research, and many suggest that university research units can play a helpful role in small firm innovation, but very few take into account their role in the making of ‘innovation systems’, as promoters of innovative spin-offs. In addition, the theory does not distinguish sufficiently between different patterns that foster the spatial concentration of new activities. Deali...

  17. A case study: planning a statewide information resource for health professionals: an evidence-based approach

    Science.gov (United States)

    Chew, Katherine; Watson, Linda; Parker, Mary

    2009-01-01

    Question: What is the best approach for implementing a statewide electronic health library (eHL) to serve all health professionals in Minnesota? Setting: The research took place at the University of Minnesota Health Sciences Libraries. Methods: In January 2008, the authors began planning a statewide eHL for health professionals following the five-step process for evidence-based librarianship: formulating the question, finding the best evidence, appraising the evidence, assessing costs and benefits, and evaluating the effectiveness of resulting actions. Main Results: The authors identified best practices for developing a statewide eHL for health professionals relating to audience or population served, information resources, technology and access, funding model, and implementation and sustainability. They were compared to the mission of the eHL project to drive strategic directions by developing recommendations. Conclusion: EBL can guide the planning process for a statewide eHL, but findings must be tailored to the local environment to address information needs and ensure long-term sustainability. PMID:19851487

  18. Exploring evidence-policy linkages in health research plans: A case study from six countries

    Directory of Open Access Journals (Sweden)

    Oladepo Oladimeji

    2008-03-01

    Full Text Available Abstract The complex evidence-policy interface in low and middle income country settings is receiving increasing attention. Future Health Systems (FHS: Innovations for Equity, is a research consortium conducting health systems explorations in six Asian and African countries: Bangladesh, India, China, Afghanistan, Uganda, and Nigeria. The cross-country research consortium provides a unique opportunity to explore the research-policy interface. Three key activities were undertaken during the initial phase of this five-year project. First, key considerations in strengthening evidence-policy linkages in health system research were developed by FHS researchers through workshops and electronic communications. Four key considerations in strengthening evidence-policy linkages are postulated: development context; research characteristics; decision-making processes; and stakeholder engagement. Second, these four considerations were applied to research proposals in each of the six countries to highlight features in the research plans that potentially strengthen the research-policy interface and opportunities for improvement. Finally, the utility of the approach for setting research priorities in health policy and systems research was reflected upon. These three activities yielded interesting findings. First, developmental consideration with four dimensions – poverty, vulnerabilities, capabilities, and health shocks – provides an entry point in examining research-policy interfaces in the six settings. Second, research plans focused upon on the ground realities in specific countries strengthens the interface. Third, focusing on research prioritized by decision-makers, within a politicized health arena, enhances chances of research influencing action. Lastly, early and continued engagement of multiple stakeholders, from local to national levels, is conducive to enhanced communication at the interface. The approach described has four main utilities: first

  19. Visual art in hospitals: case studies and review of the evidence.

    Science.gov (United States)

    Lankston, Louise; Cusack, Pearce; Fremantle, Chris; Isles, Chris

    2010-12-01

    In 2006 a Department of Health Working Group on Arts and Health reported that the arts have 'a clear contribution to make and offer major opportunities in the delivery of better health, wellbeing and improved experience for patients, service users and staff alike'. In this review we examine the evidence underpinning this statement and evaluate the visual art of three of Scotland's newest hospitals: the Royal Infirmary of Edinburgh, the new Stobhill Hospital, and the new Victoria Infirmary in Glasgow. We conclude that art in hospitals is generally viewed positively by both patients and staff, but that the quality of the evidence is not uniformly high. Effects may be mediated by psychological responses to colour hue, brightness and saturation. Colours that elicit high levels of pleasure with low levels of arousal are most likely to induce a state of calm, while those causing displeasure and high levels of arousal may provoke anxiety. The fact that patients frequently express a preference for landscape and nature scenes is consistent with this observation and with evolutionary psychological theories which predict positive emotional responses to flourishing natural environments. Contrary to a view which may prevail among some contemporary artists, patients who are ill or stressed about their health may not always be comforted by abstract art, preferring the positive distraction and state of calm created by the blues and greens of landscape and nature scenes instead.

  20. Visual art in hospitals: case studies and review of the evidence

    Science.gov (United States)

    Lankston, Louise; Cusack, Pearce; Fremantle, Chris; Isles, Chris

    2010-01-01

    Summary In 2006 a Department of Health Working Group on Arts and Health reported that the arts have ‘a clear contribution to make and offer major opportunities in the delivery of better health, wellbeing and improved experience for patients, service users and staff alike’. In this review we examine the evidence underpinning this statement and evaluate the visual art of three of Scotland's newest hospitals: the Royal Infirmary of Edinburgh, the new Stobhill Hospital, and the new Victoria Infirmary in Glasgow. We conclude that art in hospitals is generally viewed positively by both patients and staff, but that the quality of the evidence is not uniformly high. Effects may be mediated by psychological responses to colour hue, brightness and saturation. Colours that elicit high levels of pleasure with low levels of arousal are most likely to induce a state of calm, while those causing displeasure and high levels of arousal may provoke anxiety. The fact that patients frequently express a preference for landscape and nature scenes is consistent with this observation and with evolutionary psychological theories which predict positive emotional responses to flourishing natural environments. Contrary to a view which may prevail among some contemporary artists, patients who are ill or stressed about their health may not always be comforted by abstract art, preferring the positive distraction and state of calm created by the blues and greens of landscape and nature scenes instead. PMID:21127332

  1. Single case design studies in music therapy: resurrecting experimental evidence in small group and individual music therapy clinical settings.

    Science.gov (United States)

    Geist, Kamile; Hitchcock, John H

    2014-01-01

    The profession would benefit from greater and routine generation of causal evidence pertaining to the impact of music therapy interventions on client outcomes. One way to meet this goal is to revisit the use of Single Case Designs (SCDs) in clinical practice and research endeavors in music therapy. Given the appropriate setting and goals, this design can be accomplished with small sample sizes and it is often appropriate for studying music therapy interventions. In this article, we promote and discuss implementation of SCD studies in music therapy settings, review the meaning of internal study validity and by extension the notion of causality, and describe two of the most commonly used SCDs to demonstrate how they can help generate causal evidence to inform the field. In closing, we describe the need for replication and future meta-analysis of SCD studies completed in music therapy settings. SCD studies are both feasible and appropriate for use in music therapy clinical practice settings, particularly for testing effectiveness of interventions for individuals or small groups. © the American Music Therapy Association 2014. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  2. Interracial Friendships across the College Years: Evidence from a Longitudinal Case Study

    Science.gov (United States)

    Martin, Nathan D.; Tobin, William; Spenner, Kenneth I.

    2014-01-01

    In this study the authors explored factors that influence the degree to which students' campus friends are of a different race or ethnicity. They focused on relationships that were more sustained and that involved greater trust than routine interactions on campus, but were less intimate than best or closest friends. Recent studies show that high…

  3. The Role of Philanthropic Funding in Building Research Evidence to Support an Aging Population: A Case Study from Ireland.

    Science.gov (United States)

    Cochrane, Andy; McGilloway, Sinéad

    2017-01-01

    This case study examines the role of philanthropic funding in building capacity for aging research in Ireland, and how this investment has addressed the lack of evidence to support planning for an aging population. The funding has supported a range of initiatives including the national longitudinal study on aging (TILDA), the creation of three professorships/chairs, and the establishment of four new research centers. Important potential outcomes are emerging across other domains including research-informed policy development and the generation of health benefits. The efforts of academic researchers to ensure that their findings are readily accessible to end users and to forge robust working relationships with all stakeholders have helped to enhance the use of research findings. Overall, philanthropy has played a pivotal role in building capacity, infrastructure, and expertise in academic settings in Ireland. Moreover, this work provides an excellent example of how such efforts can begin to inform effective planning and service provision.

  4. Blended Learning from Design to Evaluation: International Case Studies of Evidence-Based Practice

    Science.gov (United States)

    Vaughan, Norman; Reali, Aline; Stenbom, Stefan; Van Vuuren, Marieta Jansen; MacDonald, David

    2017-01-01

    This study compares and contrasts four international faculty development programs for blended learning in order to understand the benefits, challenges, lessons learned, and recommendations from such initiatives. The benefits identified for faculty members, who participated in these programs, were that they became more reflective of their teaching…

  5. Understanding the Relationship between Language Proficiency, Language Impairment and Rehabilitation: Evidence from a Case Study

    Science.gov (United States)

    Kiran, Swathi; Iakupova, Regina

    2011-01-01

    The goal of this study was to address the relationship between language proficiency, language impairment and rehabilitation in bilingual Russian-English individuals with aphasia. As a first step, we examined two Russian-English patients' pre-stroke language proficiency using a detailed and comprehensive language use and history questionnaire and…

  6. Constructing Departmental Culture to Support Student Development: Evidence from a Case Study in Rwanda

    Science.gov (United States)

    Schendel, Rebecca

    2016-01-01

    In recent years, there have been numerous attempts to improve the quality of higher education in Africa, but there is limited knowledge about the impact of these initiatives on student learning. The results of a study published in 2015 offered some initial data in this regard by identifying a lack of improvement in the critical thinking ability of…

  7. The Leadville Mine Drainage Tunnel Catastrophe: A Case Study of How Isotope Geochemistry Provided Forensic Evidence to Inform Policy Decisions

    Science.gov (United States)

    Williams, M. W.; Wireman, M.; Liu, F.; Gertson, J.

    2008-12-01

    A state of emergency was declared in February 2008 because of fears that a blocked drainage tunnel in the Leadville mining district of Colorado could cause a catastrophic flood. An estimated 1 billion gallons of metals-laden water poses an eminent threat to the city of Leadville and the headwaters of the Arkansas river. Within days of the declaration of a state of emergency, Governor Ritter and Senator Salazer of Colorado, along with a host of other local and statewide politicians, visited the site and emphasized the need to develop a fast yet safe mitigation plan. Here we provide information from a case study that illustrates how a suite of isotopic and hydrologic tools enables identification of critical, site-specific variables essential in developing a science plan to guide targeted remediation of the Leadville drainage tunnel. The isotopic tools, including both stable and radiogenic isotopes, provided clear and compelling evidence of water sources and flowpaths in an area that has undergone extensive perturbations, including the drilling of more than 2,000 mine shafts. This forensic evidence was the key information in developing a plan to plug the drainage tunnel several hundred feet underground, divert a major source of polluted water from reaching the collapsed tunnel and piping it to an existing treatment plant, and guidance on where to place pumps in additional mine shafts, and the drilling of new wells to pump water in case the plugging of the tunnel caused water to pool up and raise the water table to dangerous heights. This particular case of forensic hydrology using isotopic tools not only provides the scientific basis for an operational plan to defuse a life- and property-threatening situation, it also provides the basis for decommissioning an existing water treatment plant, which will result in savings of over 1 million annually in operational costs. Decommissioning the existing water treatment plant will pay for the tunnel mitigation within several

  8. Real-World Evidence In Support Of Precision Medicine: Clinico-Genomic Cancer Data As A Case Study.

    Science.gov (United States)

    Agarwala, Vineeta; Khozin, Sean; Singal, Gaurav; O'Connell, Claire; Kuk, Deborah; Li, Gerald; Gossai, Anala; Miller, Vincent; Abernethy, Amy P

    2018-05-01

    The majority of US adult cancer patients today are diagnosed and treated outside the context of any clinical trial (that is, in the real world). Although these patients are not part of a research study, their clinical data are still recorded. Indeed, data captured in electronic health records form an ever-growing, rich digital repository of longitudinal patient experiences, treatments, and outcomes. Likewise, genomic data from tumor molecular profiling are increasingly guiding oncology care. Linking real-world clinical and genomic data, as well as information from other co-occurring data sets, could create study populations that provide generalizable evidence for precision medicine interventions. However, the infrastructure required to link, ensure quality, and rapidly learn from such composite data is complex. We outline the challenges and describe a novel approach to building a real-world clinico-genomic database of patients with cancer. This work represents a case study in how data collected during routine patient care can inform precision medicine efforts for the population at large. We suggest that health policies can promote innovation by defining appropriate uses of real-world evidence, establishing data standards, and incentivizing data sharing.

  9. Determinants of malaria program expenditures during elimination: case study evidence from select provinces in the Philippines.

    Directory of Open Access Journals (Sweden)

    Jenny X Liu

    Full Text Available ...Even though eliminating malaria from the endemic margins is a part of the Global Malaria Action Plan, little guidance exists on what resources are needed to transition from controlling malaria to eliminating it. Using Philippines as an example, this study aimed to (1 estimate the financial resources used by sub-national malaria programs in different phases during elimination and (2 understand how different environmental and organizational factors may influence expenditure levels and spending proportions. The Philippines provides an opportunity to study variations in sub-national programs because its epidemiological and ecological diversity, devolved health system, and progressive elimination strategy all allow greater flexibility for lower-level governments to direct activities, but also create challenges for coordination and resource mobilization. Through key informant interviews and archival record retrieval in four selected provinces chosen based on eco-epidemiological variation, expenditures associated with provincial malaria programs were collected for selected years (mid-1990s to 2010. Results show that expenditures per person at risk per year decrease as programs progress from a state of controlled low-endemic malaria to elimination to prevention of reintroduction regardless of whether elimination was deliberately planned. However, wide variation across provinces were found: expenditures were generally higher if mainly financed with donor grants, but were moderated by the level of economic development, the level of malaria transmission and receptivity, and the capacity of program staff. Across all provinces, strong leadership appears to be a necessary condition for maintaining progress and is vital in controlling outbreaks. While sampled provinces and years may not be representative of other sub-national malaria programs, these findings suggest that the marginal yearly cost declines with each phase during elimination.

  10. Determinants of malaria program expenditures during elimination: case study evidence from select provinces in the Philippines.

    Science.gov (United States)

    Liu, Jenny X; Newby, Gretchen; Brackery, Aprielle; Smith Gueye, Cara; Candari, Christine J; Escubil, Luz R; Vestergaard, Lasse S; Baquilod, Mario

    2013-01-01

    ...Even though eliminating malaria from the endemic margins is a part of the Global Malaria Action Plan, little guidance exists on what resources are needed to transition from controlling malaria to eliminating it. Using Philippines as an example, this study aimed to (1) estimate the financial resources used by sub-national malaria programs in different phases during elimination and (2) understand how different environmental and organizational factors may influence expenditure levels and spending proportions. The Philippines provides an opportunity to study variations in sub-national programs because its epidemiological and ecological diversity, devolved health system, and progressive elimination strategy all allow greater flexibility for lower-level governments to direct activities, but also create challenges for coordination and resource mobilization. Through key informant interviews and archival record retrieval in four selected provinces chosen based on eco-epidemiological variation, expenditures associated with provincial malaria programs were collected for selected years (mid-1990s to 2010). Results show that expenditures per person at risk per year decrease as programs progress from a state of controlled low-endemic malaria to elimination to prevention of reintroduction regardless of whether elimination was deliberately planned. However, wide variation across provinces were found: expenditures were generally higher if mainly financed with donor grants, but were moderated by the level of economic development, the level of malaria transmission and receptivity, and the capacity of program staff. Across all provinces, strong leadership appears to be a necessary condition for maintaining progress and is vital in controlling outbreaks. While sampled provinces and years may not be representative of other sub-national malaria programs, these findings suggest that the marginal yearly cost declines with each phase during elimination.

  11. Isotopic Evidence for Microbial Activity in Crystalline Bedrock Fractures - a Case Study from Olkiluoto, SW Finland

    Science.gov (United States)

    Sahlstedt, E. K.; Karhu, J.; Pitkänen, P.

    2015-12-01

    Changes in the geochemical environment in crystalline bedrock fractures were investigated using the stable isotopes of C, O and S in fracture filling minerals as tracers. Of special interest were the possible changes which may occur in the subsurface at low temperatures. Especially, the influence of microbial activity was recognized as a catalyst for inducing changes in the geochemical environment. The study site is the Olkiluoto island located on the western coast of Finland, planned to host a geological repository for nuclear waste. Fracture surfaces were investigated to recognize the latest mineralizations at the site. These fillings were comprised of thin plates or small euhedral crystals of calcite and pyrite. The carbon and sulfur isotope compositions of calcite and pyrite were measured from bulk material by conventional IRMS, and in situ by secondary ion mass spectrometry. A notable feature of the late-stage fillings was high variabilities in the δ13C values of calcite and the δ34S values of pyrite, which ranged from -53.8 ‰ to +31.6 ‰ and from -50.4 ‰ to +77.7 ‰, respectively. Based on the isotopic compositions of the fillings, several features in the past hydrogeochemical environment could be recognized. The isotopic composition of the fracture fillings indicate an environment which was stratified with respect to depth. Characteristic features include bacterial sulfate reduction (BSR) occurring at depths 50 m. It appears that methanic conditions were replaced by sulfate reduction at depths >50 m likely due to infiltration of SO42--rich brackish waters. Sulfate reducing bacteria used mainly surface derived organic carbon as electron donors. Some indication of minor methanotrophic activity was recognized in anomalously low δ13C values of calcite, down to -53.8 ‰, at the depth range of 34-54 m. This methanotrophic activity may have been related to bacteria using CH4 as an electron donor in BSR.

  12. Tsunami Evidence in South Coast Java, Case Study: Tsunami Deposit along South Coast of Cilacap

    Science.gov (United States)

    Rizal, Yan; Aswan; Zaim, Yahdi; Dwijo Santoso, Wahyu; Rochim, Nur; Daryono; Dewi Anugrah, Suci; Wijayanto; Gunawan, Indra; Yatimantoro, Tatok; Hidayanti; Herdiyani Rahayu, Resti; Priyobudi

    2017-06-01

    Cilacap Area is situated in coastal area of Southern Java and directly affected by tsunami hazard in 2006. This event was triggered by active subduction in Java Trench which active since long time ago. To detect tsunami and active tectonic in Southern Java, paleo-tsunami study is performed which is targeted paleo-tsunami deposit older than fifty years ago. During 2011 - 2016, 16 locations which suspected as paleo-tsunami location were visited and the test-pits were performed to obtain characteristic and stratigraphy of paleo-tsunami layers. Paleo-tsunami layer was identified by the presence of light-sand in the upper part of paleo-soil, liquefaction fine grain sandstone, and many rip-up clast of mudstone. The systematic samples were taken and analysis (micro-fauna, grainsize and dating analysis). Micro-fauna result shows that paleo-tsunami layer consist of benthonic foraminifera assemblages from different bathymetry and mixing in one layer. Moreover, grainsize shows random grain distribution which characterized as turbulence and strong wave deposit. Paleo-tsunami layers in Cilacap area are correlated using paleo-soil as marker. There are three paleo-tsunami layers and the distribution can be identified as PS-A, PS-B and PS-C. The samples which were taken in Glempang Pasir layer are being dated using Pb - Zn (Lead-Zinc) method. The result of Pb - Zn (Lead-Zinc) dating shows that PS-A was deposited in 139 years ago, PS-B in 21 years ago, and PS C in 10 years ago. This result indicates that PS -1 occurred in 1883 earthquake activity while PS B formed in 1982 earthquake and PS-C was formed by 2006 earthquake. For ongoing research, the older paleo-tsunami layers were determined in the Gua Nagaraja, close to Selok location and 6 layers of Paleo-tsunami suspect found which shown a similar characteristic with the layers from another location. The three layers deeper approximately have an older age than another location in Cilacap.

  13. Organizational impact of evidence-informed decision making training initiatives: a case study comparison of two approaches.

    Science.gov (United States)

    Champagne, François; Lemieux-Charles, Louise; Duranceau, Marie-France; MacKean, Gail; Reay, Trish

    2014-05-02

    The impact of efforts by healthcare organizations to enhance the use of evidence to improve organizational processes through training programs has seldom been assessed. We therefore endeavored to assess whether and how the training of mid- and senior-level healthcare managers could lead to organizational change. We conducted a theory-driven evaluation of the organizational impact of healthcare leaders' participation in two training programs using a logic model based on Nonaka's theory of knowledge conversion. We analyzed six case studies nested within the two programs using three embedded units of analysis (individual, group and organization). Interviews were conducted during intensive one-week data collection site visits. A total of 84 people were interviewed. We found that the impact of training could primarily be felt in trainees' immediate work environments. The conversion of attitudes was found to be easier to achieve than the conversion of skills. Our results show that, although socialization and externalization were common in all cases, a lack of combination impeded the conversion of skills. We also identified several individual, organizational and program design factors that facilitated and/or impeded the dissemination of the attitudes and skills gained by trainees to other organizational members. Our theory-driven evaluation showed that factors before, during and after training can influence the extent of skills and knowledge transfer. Our evaluation went further than previous research by revealing the influence--both positive and negative--of specific organizational factors on extending the impact of training programs.

  14. A prospective multiple case study of the impact of emerging scientific evidence on established colorectal cancer screening programs: a study protocol.

    Science.gov (United States)

    Geddie, Hannah; Dobrow, Mark J; Hoch, Jeffrey S; Rabeneck, Linda

    2012-06-01

    Health-policy decision making is a complex and dynamic process, for which strong evidentiary support is required. This includes scientifically produced research, as well as information that relates to the context in which the decision takes place. Unlike scientific evidence, this "contextual evidence" is highly variable and often includes information that is not scientifically produced, drawn from sources such as political judgement, program management experience and knowledge, or public values. As the policy decision-making process is variable and difficult to evaluate, it is often unclear how this heterogeneous evidence is identified and incorporated into "evidence-based policy" decisions. Population-based colorectal cancer screening poses an ideal context in which to examine these issues. In Canada, colorectal cancer screening programs have been established in several provinces over the past five years, based on the fecal occult blood test (FOBT) or the fecal immunochemical test. However, as these programs develop, new scientific evidence for screening continues to emerge. Recently published randomized controlled trials suggest that the use of flexible sigmoidoscopy for population-based screening may pose a greater reduction in mortality than the FOBT. This raises the important question of how policy makers will address this evidence, given that screening programs are being established or are already in place. This study will examine these issues prospectively and will focus on how policy makers monitor emerging scientific evidence and how both scientific and contextual evidence are identified and applied for decisions about health system improvement. This study will employ a prospective multiple case study design, involving participants from Ontario, Alberta, Manitoba, Nova Scotia, and Quebec. In each province, data will be collected via document analysis and key informant interviews. Documents will include policy briefs, reports, meeting minutes, media

  15. Evidence: Study Guide. Revision

    National Research Council Canada - National Science Library

    1997-01-01

    ...) correct application of principles of military rules of evidence. This study guide is also intended to be a convenient reference for use by Navy and Marine Corps judge advocates and Coast Guard law...

  16. High-performance work systems in health care management, part 2: qualitative evidence from five case studies.

    Science.gov (United States)

    McAlearney, Ann Scheck; Garman, Andrew N; Song, Paula H; McHugh, Megan; Robbins, Julie; Harrison, Michael I

    2011-01-01

    : A capable workforce is central to the delivery of high-quality care. Research from other industries suggests that the methodical use of evidence-based management practices (also known as high-performance work practices [HPWPs]), such as systematic personnel selection and incentive compensation, serves to attract and retain well-qualified health care staff and that HPWPs may represent an important and underutilized strategy for improving quality of care and patient safety. : The aims of this study were to improve our understanding about the use of HPWPs in health care organizations and to learn about their contribution to quality of care and patient safety improvements. : Guided by a model of HPWPs developed through an extensive literature review and synthesis, we conducted a series of interviews with key informants from five U.S. health care organizations that had been identified based on their exemplary use of HPWPs. We sought to explore the applicability of our model and learn whether and how HPWPs were related to quality and safety. All interviews were recorded, transcribed, and subjected to qualitative analysis. : In each of the five organizations, we found emphasis on all four HPWP subsystems in our conceptual model-engagement, staff acquisition/development, frontline empowerment, and leadership alignment/development. Although some HPWPs were common, there were also practices that were distinctive to a single organization. Our informants reported links between HPWPs and employee outcomes (e.g., turnover and higher satisfaction/engagement) and indicated that HPWPs made important contributions to system- and organization-level outcomes (e.g., improved recruitment, improved ability to address safety concerns, and lower turnover). : These case studies suggest that the systematic use of HPWPs may improve performance in health care organizations and provide examples of how HPWPs can impact quality and safety in health care. Further research is needed to specify

  17. CASE STUDY

    African Journals Online (AJOL)

    2011-06-02

    Jun 2, 2011 ... immunosuppression associated with HIV/AIDS puts them at a higher risk of developing oesophageal cancer. 47. CASE STUDY. A 49-year-old man was diagnosed as HIV infected, with a CD4 count of 60 cells/µl. He was started on an antiretroviral treatment regimen comprising zidovudine, lamivudine and ...

  18. Effect of evidence-based approach on the customer orientation (Case study: Physicians Health Centers in Isfahan province in 2014)

    Science.gov (United States)

    Esfahani, NG; Maharati, Y

    2015-01-01

    Introduction: The purpose of this research was to examine the approach, based on evidence to customer-orientation attending physicians in the region, them being the subject collection. Research method: This is a definitive-analytic and cross-sectional configuration, which was completed in 2014. The statistical community in this research consists of 212 doctors in the healthcare hubs. The working physicians chose 200 patients by means of a simple accidental sampling. The analysis means was the researcher built survey whose efficacy and reliability were verified. In this research, the fundamental equation design and partial least square technique were applied to examine the presumptions and fitness pattern and the structural design was agreed as adequate. Findings: The outcomes showed four cases linked to the character, a behavior which was meant to treat; traditional origins of evidence were employed to retrieve data based on the reliable evidence and the shortage of limitations to the performance of client orientation strategy of evidence-based influences were meaningful. Two ranges of the doctor's information, the absence of restrictions, and the finding of the sign of dimensions about the client orientation approach were according to the evidence that had no meaningful influence. Conclusion: The utilization of evidence-based training not only increased awareness, character, and abilities of the doctors but also allowed them to answer to the requirements of clients in choosing excellent decisions and presenting a better quality of healthcare, by decreasing treatment prices for patients, bringing satisfaction of patients, and finally having a better effectiveness for patients and institutions. PMID:28316691

  19. Cerebral organization of oral and signed language responses: case study evidence from amytal and cortical stimulation studies.

    Science.gov (United States)

    Mateer, C A; Rapport, R L; Kettrick, C

    1984-01-01

    A normally hearing left-handed patient familiar with American Sign Language (ASL) was assessed under sodium amytal conditions and with left cortical stimulation in both oral speech and signed English. Lateralization was mixed but complementary in each language mode: the right hemisphere perfusion severely disrupted motoric aspects of both types of language expression, the left hemisphere perfusion specifically disrupted features of grammatical and semantic usage in each mode of expression. Both semantic and syntactic aspects of oral and signed responses were altered during left posterior temporal-parietal stimulation. Findings are discussed in terms of the neurological organization of ASL and linguistic organization in cases of early left hemisphere damage.

  20. Horizontal rotation of the local stress field in response to magmatic activity: Evidence from case studies and modeling

    Science.gov (United States)

    Roman, D. C.

    2003-12-01

    A complete understanding of the initiation, evolution, and termination of volcanic eruptions requires reliable monitoring techniques to detect changes in the conduit system during periods of activity, as well as corresponding knowledge of conduit structure and of magma physical properties. Case studies of stress field orientation prior to, during, and after magmatic activity can be used to relate changes in stress field orientation to the state of the magmatic conduit system. These relationships may be tested through modeling of induced stresses. Here I present evidence from case studies and modeling that horizontal rotation of the axis of maximum compressive stress at an active volcano indicates pressurization of a magmatic conduit, and that this rotation, when observed, may also be indicative of the physical properties of the ascending magma. Changes in the local stress field orientation during the 1992 eruption sequence at Crater Peak (Mt. Spurr), Alaska were analyzed by calculating and inverting subsets of over 150 fault-plane solutions. Local stress tensors for four time periods, corresponding approximately to changes in activity at the volcano, were calculated based on the misfit of individual fault-plane solutions to a regional stress tensor. Results indicate that for nine months prior to the eruption, local maximum compressive stress was oriented perpendicular to regional maximum compressive stress. A similar horizontal rotation was observed beginning in November of 1992, coincident with an episode of elevated earthquake and tremor activity indicating intrusion of magma into the conduit. During periods of quiescence the local stress field was similar to the regional stress field. Similar horizontal rotations have been observed at Mt. Ruapehu, New Zealand (Miller and Savage 2001, Gerst 2003), Usu Volcano, Japan (Fukuyama et al. 2001), Unzen Volcano, Japan (Umakoshi et al. 2001), and Mt. St. Helens Volcano, USA (Moran 1994) in conjunction with eruptive

  1. Narrative and evidence. How can case studies from the history of science support claims in the philosophy of science?

    Science.gov (United States)

    Kinzel, Katherina

    2015-02-01

    A common method for warranting the historical adequacy of philosophical claims is that of relying on historical case studies. This paper addresses the question as to what evidential support historical case studies can provide to philosophical claims and doctrines. It argues that in order to assess the evidential functions of historical case studies, we first need to understand the methodology involved in producing them. To this end, an account of historical reconstruction that emphasizes the narrative character of historical accounts and the theory-laden character of historical facts is introduced. The main conclusion of this paper is that historical case studies are able to provide philosophical claims with some evidential support, but that, due to theory-ladenness, their evidential import is restricted. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. Clarifying the distinction between case series and cohort studies in systematic reviews of comparative studies: potential impact on body of evidence and workload

    Directory of Open Access Journals (Sweden)

    Tim Mathes

    2017-07-01

    Full Text Available Abstract Distinguishing cohort studies from case series is difficult. We propose a conceptualization of cohort studies in systematic reviews of comparative studies. The main aim of this conceptualization is to clarify the distinction between cohort studies and case series. We discuss the potential impact of the proposed conceptualization on the body of evidence and workload. All studies with exposure-based sampling gather multiple exposures (with at least two different exposures or levels of exposure and enable calculation of relative risks that should be considered cohort studies in systematic reviews, including non-randomized studies. The term “enables/can” means that a predefined analytic comparison is not a prerequisite (i.e., the absolute risks per group and/or a risk ratio are provided. Instead, all studies for which sufficient data are available for reanalysis to compare different exposures (e.g., sufficient data in the publication are classified as cohort studies. There are possibly large numbers of studies without a comparison for the exposure of interest but that do provide the necessary data to calculate effect measures for a comparison. Consequently, more studies could be included in a systematic review. Therefore, on the one hand, the outlined approach can increase the confidence in effect estimates and the strengths of conclusions. On the other hand, the workload would increase (e.g., additional data extraction and risk of bias assessment, as well as reanalyses.

  3. The integration and evaluation of a social-media facilitated journal club to enhance the student learning experience of evidence-based practice: A case study.

    Science.gov (United States)

    Ferguson, Caleb; DiGiacomo, Michelle; Gholizadeh, Leila; Ferguson, Leila E; Hickman, Louise D

    2017-01-01

    Nurses are required to interpret and apply knowledge so communities will receive care based on best available evidence, as opposed to care that is simply based on tradition or authority. Fostering nursing students' critical appraisal skills will assist in their capacity to engage with, interpret and use best evidence. Journal clubs are frequently used approach to engage learners with research and develop critical appraisal skills. Given new flipped and blended approaches to teaching and learning there is need to rejuvenate how research is utilised and integrated within journal clubs to maximise engagement and translation of evidence. This paper provides a case study of a single site Australian university experience of transitioning a traditional physical journal club, to a social media-facilitated club within a postgraduate health subject to stimulate and facilitate engagement with the chosen manuscripts. This case study is based on our own experiences, supported by literature and includes qualitative comments obtained via student feedback surveys during November 2015. Case study. Social media-facilitated journal clubs offer an efficient way to continue developing critical appraisal skills in nursing students. The integration of a social media-facilitated journal clubs increased student attention, engagement with presented activities and overall student satisfaction within this evidence-based practice subject. Future rigorously-designed, large-scale studies are required to evaluate the impact of online journal clubs on the uptake of evidence-based practice, including those resulting in improved patient outcomes. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. [Case and studies].

    Science.gov (United States)

    Schubert, András

    2015-11-15

    Case studies and case reports form an important and ever growing part of scientific and scholarly literature. The paper deals with the share and citation rate of these publication types on different fields of research. In general, evidence seems to support the opinion that an excessive number of such publications may negatively influence the impact factor of the journal. In the literature of scientometrics, case studies (at least the presence of the term "case study" in the titles of the papers) have a moderate share, but their citation rate is practically equal to that of other publication types.

  5. Casing study

    Energy Technology Data Exchange (ETDEWEB)

    Roche, P.

    2000-12-01

    An unorthodox method of casing drilling used by Tesco Corporation at a gas well in Wyoming to drill deeper using casings as drillpipe is discussed. The process involves either rotating the casing as drill string or using a downhole mud motor to rotate the bit. In this instance, the surface hole and the production hole were casing-drilled to a record 8,312 feet by rotating the casing. The 8 1/2-inch surface hole was drilled with 7-inch casing to 1,200 feet using a Tesco underreamer and a polycrystalline pilot bit; drilling and cementing was completed in 12 1/2 hours. The 6 1/4-inch production hole was drilled with 4 1/2-inch casing and the bottomhole assembly was retrieved after 191 hours rotating. This case was the first in which the entire well was casing-drilled from surface to TD. Penetration rate compared favorably with conventional methods: 12 1/2 hours for casing-drilling to 18.9 hours for conventional drilling, despite the fact that the casing-drilling technology is still in its infancy. It is suggested that casing-drilling has the potential to eliminate the need for the drillpipe entirely. If these expectations were to be realised, casing-drilling could be one of the most radical drilling changes in the history of the oil and gas industry. 1 photo.

  6. The identification and treatment of poor durability Karoo dolerite base course aggregate – evidence from case studies

    CSIR Research Space (South Africa)

    Leyland, RC

    2016-03-01

    Full Text Available that the poor performance of the case study materials was likely due to the poor durability of the materials, manifesting as a reduction in resistance to abrasion and attrition. The identification of the observed poor durability could not have been performed...

  7. The Mortality Penalty of Incarceration: Evidence from a Population-based Case-control Study of Working-age Males.

    Science.gov (United States)

    Pridemore, William Alex

    2014-06-01

    There is a growing body of research on the effects of incarceration on health, though there are few studies in the sociological literature of the association between incarceration and premature mortality. This study examined the risk of male premature mortality associated with incarceration. Data came from the Izhevsk (Russia) Family Study, a large-scale population-based case-control design. Cases (n = 1,750) were male deaths aged 25 to 54 in Izhevsk between October 2003 and October 2005. Controls (n = 1,750) were selected at random from a city population register. The key independent variable was lifetime prevalence of incarceration. I used logistic regression to estimate mortality odds ratios, controlling for age, hazardous drinking, smoking status, marital status, and education. Seventeen percent of cases and 5 percent of controls had been incarcerated. Men who had been incarcerated were more than twice as likely as those who had not to experience premature mortality (odds ratio = 2.2, 95 percent confidence interval: 1.6-3.0). Relative to cases with no prior incarceration, cases who had been incarcerated were more likely to die from infectious diseases, respiratory diseases, non-alcohol-related accidental poisonings, and homicide. Taken together with other recent research, these results from a rigorous case-control design reveal not only that incarceration has durable effects on illness, but that its consequences extend to a greater risk of early death. I draw on the sociology of health literature on exposure, stress, and social integration to speculate about the reasons for this mortality penalty of incarceration. © American Sociological Association 2014.

  8. [Study of echocardiographic parameters of rheumatoid arthritis black African without clinically evident cardiovascular manifestations: A cross-sectional study of 73 cases in Senegal].

    Science.gov (United States)

    Dodo-Siddo, M N; Diao, M; Ndiaye, M B; Ndongo, S; Kane, A; Mbaye, A; Bodian, M; Sarr, S A; Sarr, M; Ba, S; Diop, T M

    2016-04-01

    Research of cardiac involvement in patients with rheumatoid arthritis can prevent complications and place in a logical secondary prevention. The objective of this study was to investigate the echocardiographic parameters in a population of Senegalese patients with rheumatoid arthritis without clinically evident cardiovascular manifestations. We conducted a descriptive cross-sectional study, which included prospectively from outpatients in the internal medicine department of university hospital center Aristide Le Dantec in Dakar, Senegal, with a diagnosis of rheumatoid arthritis without clinically evident cardiovascular disease. It focused on a sample of 73 patients of both sexes aged at least 18 years. Following clinical examination, we conducted laboratory tests (CRP, fibrinogen, ESR, rheumatoid factors: Latex and Waaler-Rose, anti-CCP, antinuclear factors and anti-ENA antibodies), ECG, echocardiography standard. Data were analyzed using a descriptive study of the different variables with the calculation of proportions for categorical variables, and the positional parameters and dispersion for quantitative variables. A total of 73 patients with rheumatoid arthritis without obvious cardiac events and meeting the criteria of definition of the ACR 1987 were included in the study. The mean age was 44.17±14.43 years with extremes of 18 and 75 years. The mean duration of RA was 5.93±4.78 years. The concept of family inflammatory arthritis was reported in 35.60% of cases and almost one in six patients had at least a factor of cardiovascular risk (16.96%). The abnormalities found in Doppler echocardiography were dominated by diastolic LV dysfunction (42.46%), increased left ventricular mass in 35.61%. Valvular leaks of variable grades were highlighted regarding all orifices but were rarely significant. The realization of echocardiography in patients with rheumatoid arthritis without clinically evident cardiovascular manifestations helps to highlight cardiovascular

  9. Evidence-Based Best Practice is More Political than It Looks: A Case Study of the "Scottish Approach"

    Science.gov (United States)

    Cairney, Paul

    2017-01-01

    National governments use evidence selectively to argue that a successful policy intervention in one local area should be emulated in others ("evidence-based best practice"). However, the value of such evidence is always limited because there is: disagreement on the best way to gather evidence of policy success, uncertainty regarding the…

  10. Provincial prenatal record revision: a multiple case study of evidence-based decision-making at the population-policy level

    Directory of Open Access Journals (Sweden)

    Olson Joanne

    2008-12-01

    Full Text Available Abstract Background There is a significant gap in the knowledge translation literature related to how research evidence actually contributes to health care decision-making. Decisions around what care to provide at the population (rather than individual level are particularly complex, involving considerations such as feasibility, cost, and population needs in addition to scientific evidence. One example of decision-making at this "population-policy" level involves what screening questions and intervention guides to include on standardized provincial prenatal records. As mandatory medical reporting forms, prenatal records are potentially powerful vehicles for promoting population-wide evidence-based care. However, the extent to which Canadian prenatal records reflect best-practice recommendations for the assessment of well-known risk factors such as maternal smoking and alcohol consumption varies markedly across Canadian provinces and territories. The goal of this study is to better understand the interaction of contextual factors and research evidence on decision-making at the population-policy level, by examining the processes by which provincial prenatal records are reviewed and revised. Methods Guided by Dobrow et al.'s (2004 conceptual model for context-based evidence-based decision-making, this study will use a multiple case study design with embedded units of analysis to examine contextual factors influencing the prenatal record revision process in different Canadian provinces and territories. Data will be collected using multiple methods to construct detailed case descriptions for each province/territory. Using qualitative data analysis techniques, decision-making processes involving prenatal record content specifically related to maternal smoking and alcohol use will be compared both within and across each case, to identify key contextual factors influencing the uptake and application of research evidence by prenatal record review

  11. CASE STUDY

    African Journals Online (AJOL)

    HIV infection has several oral manifestations, including oral candidiasis and oral hairy leucoplakia. Occasionally unusual presentations requiring rigorous investigations are seen, and in these cases the diagnosis sometimes remains a dilemma owing to limited investigation facilities.1-3 We present the case of a patient who.

  12. Declarative memory and skill-related knowledge: Evidence from a case study of amnesia and implications for theories of memory.

    Science.gov (United States)

    Gregory, Emma; McCloskey, Michael; Ovans, Zoe; Landau, Barbara

    2016-01-01

    Theoretical and empirical studies of memory have long been framed by a distinction between declarative and non-declarative memory. We question the sharpness of the distinction by reporting evidence from amnesic L.S.J., who despite retrograde memory losses in declarative knowledge domains, shows sparing of declarative knowledge related to premorbid skill (e.g., playing an instrument). We previously showed that L.S.J. had severe losses of retrograde declarative knowledge across areas of premorbid expertise (e.g., artists of famous works) and everyday knowledge (e.g., company names for logos). Here we present evidence that L.S.J. has sparing of what we call skill-related declarative knowledge, in four domains in which she had premorbid skill (art, music, aviation, driving). L.S.J.'s pattern of loss and sparing raises questions about the strict separation between classically-defined memory types and aligns with a recent proposal by Stanley and Krakauer [2013. Motor skill depends on knowledge of facts. Frontiers in Human Neuroscience, 7,1-11].

  13. case study

    African Journals Online (AJOL)

    Elton

    particularly in patients who commence ART with low CD4 counts and established opportunistic infections. IRIS results from a pathological inflammatory response to pre-existing infective, host or other antigens, alive or dead, causing clinical deterioration in HIV-infected patients after initiating ART.1 A case definition for IRIS ...

  14. CASE STUDY

    African Journals Online (AJOL)

    2010-09-01

    Sep 1, 2010 ... of the two diseases surgery can be successful, recovery can be similar to that .... lymphocytes predominated in 68% of cases, and that there was an .... using ferritin is the fact that it acts as an acute-phase reactant and will be ...

  15. Type 2 diabetes is associated with a common mitochondrial variant: evidence from a population-based case-control study.

    Science.gov (United States)

    Poulton, Joanna; Luan, Jian'an; Macaulay, Vincent; Hennings, Susie; Mitchell, Jo; Wareham, Nicholas J

    2002-06-15

    Variants in mitochondrial DNA (mtDNA) could be associated with type 2 diabetes because ATP plays a critical role in the production and release of insulin. Diabetes can be precipitated both by mtDNA mutations and by exposure to mitochondrial poisons. The risk of inheriting diabetes from an affected mother is greater than that from an affected father, but this is not explained by maternally inherited diabetes and/or deafness (MIDD) caused by the 3243G : C mtDNA point mutation, which accounts for less than 0.5% of cases of diabetes. A common mtDNA variant (the 16189 variant) is positively correlated with blood fasting insulin, but there are no definitive studies demonstrating that it is associated with diabetes. We demonstrated a significant association between the 16189 variant and type 2 diabetes in a population-based case-control study in Cambridgeshire, UK (n=932, odds ratio=1.61 (1.0-2.7, P=0.048), which was greatly magnified in individuals with a family history of diabetes from the father's side (odds ratio=infinity; P<0.001).

  16. Methods to place a value on additional evidence are illustrated using a case study of corticosteroids after traumatic brain injury

    NARCIS (Netherlands)

    McKenna, Claire; Griffin, Susan; Koffijberg, Hendrik; Claxton, Karl

    2016-01-01

    OBJECTIVES: To establish whether evidence about the effectiveness of a health care intervention is sufficient to justify the use of the intervention in practice and show how value of information (VOI) analysis can be used to place a value on the need for additional evidence and inform research

  17. Factors Associated with Injuries among Commercial Motorcyclists: Evidence from a Matched Case Control Study in Kampala City, Uganda.

    Directory of Open Access Journals (Sweden)

    Nazarius M Tumwesigye

    Full Text Available Road traffic injuries are the eighth leading cause of death globally and the most affected are young people aged 15-29. By 2030 road traffic deaths will become the fifth leading cause of death unless urgent action is taken. Motorcyclists are among the most vulnerable road users and in Uganda they contribute 41% of all road traffic injuries. This paper establishes factors associated with the injuries of commercial motorcycle riders also known as boda-boda riders in Kampala, Uganda's capital city.The study was matched case-control with a case being a boda-boda rider that was seen at one of the 5 major city hospitals with a road traffic injury while a control was a boda-boda rider that was at the parking stage where the case operated from before the injury. The sample size was 289 riders per arm and data collection took 7 months. A structured questionnaire was used to collect data on background and exposing factors. Being matched case-control data conditional logistic regression was used in the analysis.Factors independently associated with injury among motorcyclists were younger age group, being a current alcohol drinker (OR = 2.30, 95%CI: 1.19-4.45, lower engine capacity (<100 cc (OR = 5.03, 95%CI: 2.91-8.70, riding experience of less than 3 years, not changing a motorcycle in past 1 year (OR = 2.04, 95%CI: 1.19-3.52, riding for a longer time in a day (OR = 6.05, 95%CI: 2.58-14.18 and sharing a motorcycle (OR = 8.25, 95%CI:2.62-25.9. Other factors associated with injury were low level of knowledge of traffic rules, being stopped by police for checks on condition of motorcycle/license/insurance, working till late.More road safety sensitization is required among riders to raise awareness against sharing motorcycles, working for a longer time and alcohol consumption. Police enforcement of drink-driving laws should include riders of commercial motorcycles. Investigate the validity of motorcycle riding licenses and test the riding competency of all

  18. Against Contextualism: Belief, Evidence, & the Bank Cases

    Directory of Open Access Journals (Sweden)

    Logan Paul Gage

    2013-04-01

    Full Text Available http://dx.doi.org/10.5007/1808-1711.2013v17n1p57 Contextualism (the view that ‘knowledge’ and its variants are context-sensitive has been supported in large part through appeal to intuitions about Keith DeRose’s Bank Cases. Recently, however, the contextualist construal of these cases has come under fire from Kent Bach and Jennifer Nagel who question whether the Bank Case subject’s confidence can remain constant in both low- and high-stakes cases. Having explained the Bank Cases and this challenge to them, I argue that DeRose has given a reasonable reply to this initial challenge. However, I proceed to argue that the current stalemate can be broken. Seeking to extend the Bach–Nagel critique, I offer a novel interpretation of the Bank Cases according to which the subject’s evidence changes between low- and high-stakes cases. If I am correct, then, given the amount of support the Bank Cases have been thought to lend contextualism, the case for contextualism is seriously weakened.

  19. Case Study: Testing with Case Studies

    Science.gov (United States)

    Herreid, Clyde Freeman

    2015-01-01

    This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. This month's issue discusses using case studies to test for knowledge or lessons learned.

  20. Physicians' perception of alternative displays of clinical research evidence for clinical decision support - A study with case vignettes.

    Science.gov (United States)

    Slager, Stacey L; Weir, Charlene R; Kim, Heejun; Mostafa, Javed; Del Fiol, Guilherme

    2017-07-01

    To design alternate information displays that present summaries of clinical trial results to clinicians to support decision-making; and to compare the displays according to efficacy and acceptability. A 6-between (information display presentation order) by 3-within (display type) factorial design. Two alternate displays were designed based on Information Foraging theory: a narrative summary that reduces the content to a few sentences; and a table format that structures the display according to the PICO (Population, Intervention, Comparison, Outcome) framework. The designs were compared with the summary display format available in PubMed. Physicians were asked to review five clinical studies retrieved for a case vignette; and were presented with the three display formats. Participants were asked to rate their experience with each of the information displays according to a Likert scale questionnaire. Twenty physicians completed the study. Overall, participants rated the table display more highly than either the text summary or PubMed's summary format (5.9vs. 5.4vs. 3.9 on a scale between 1 [strongly disagree] and 7 [strongly agree]). Usefulness ratings of seven pieces of information, i.e. patient population, patient age range, sample size, study arm, primary outcome, results of primary outcome, and conclusion, were high (average across all items=4.71 on a 1 to 5 scale, with 1=not at all useful and 5=very useful). Study arm, primary outcome, and conclusion scored the highest (4.9, 4.85, and 4.85 respectively). Participants suggested additional details such as rate of adverse effects. The table format reduced physicians' perceived cognitive effort when quickly reviewing clinical trial information and was more favorably received by physicians than the narrative summary or PubMed's summary format display. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Impact and effectiveness of risk mitigation strategies on the insurability of nanomaterial production: evidences from industrial case studies.

    Science.gov (United States)

    Bergamaschi, Enrico; Murphy, Finbarr; Poland, Craig A; Mullins, Martin; Costa, Anna L; McAlea, Eamonn; Tran, Lang; Tofail, Syed A M

    2015-01-01

    Workers involved in producing nanomaterials or using nanomaterials in manufacturing plants are likely to have earlier and higher exposure to manufactured/engineered nanomaterials (ENM) than the general population. This is because both the volume handled and the probability of the effluence of 'free' nanoparticles from the handled volume are much higher during a production process than at any other stage in the lifecycle of nanomaterials and nanotechnology-enabled products. Risk assessment (RA) techniques using control banding (CB) as a framework for risk transfer represents a robust theory but further progress on implementing the model is required so that risk can be transferred to insurance companies. Following a review of RA in general and hazard measurement in particular, we subject a Structural Alert Scheme methodology to three industrial case studies using ZrO2 , TiO2 , and multi-walled carbon nanotubes (MWCNT). The materials are tested in a pristine state and in a remediated (coated) state, and the respective emission and hazard rates are tested alongside the material performance as originally designed. To our knowledge, this is the first such implementation of a CB RA in conjunction with an ENM performance test and offers both manufacturers and underwriters an insight into future applications. © 2015 The Authors. WIREs Nanomedicine and Nanobiotechnology published by Wiley Periodicals, Inc.

  2. How Does Paying for Ecosystem Services Contribute to Sustainable Development? Evidence from Case Study Research in Germany and the UK

    Directory of Open Access Journals (Sweden)

    Kristin Nicolaus

    2014-05-01

    Full Text Available Payments for ecosystem services (PES are currently being discussed as one of the most promising tools in environmental and sustainability governance. However, much criticism has been voiced against overly optimistic assumptions of PES’ management potential towards sustainability. Several contributions to the debate show that PES fail both in reducing poverty and strengthening social justice. Additionally, they neglect problems of deliberation in decision-making, as well as the legitimacy of the applied environmental practices. Our empirical investigation on participatory and deliberative structures in already existing PES initiated by non-state actors contributes to the latter body of research. Based on the assumption that playing an active part in scheme design facilitates the consideration of justice and fairness, our case studies from Germany and the UK. present interesting results on the involvement of conflicting interests and their argumentation in the design process. Summing up these findings, we conclude that paying for ES rarely contributes to sustainable development in and of itself, but deliberatively designed schemes provide a formal setting to take aspects of justice into account.

  3. Evidence and future scenarios of a low-carbon energy transition in Central America: a case study in Nicaragua

    Science.gov (United States)

    Barido, Diego Ponce de Leon; Johnston, Josiah; Moncada, Maria V.; Callaway, Duncan; Kammen, Daniel M.

    2015-10-01

    The global carbon emissions budget over the next decades depends critically on the choices made by fast-growing emerging economies. Few studies exist, however, that develop country-specific energy system integration insights that can inform emerging economies in this decision-making process. High spatial- and temporal-resolution power system planning is central to evaluating decarbonization scenarios, but obtaining the required data and models can be cost prohibitive, especially for researchers in low, lower-middle income economies. Here, we use Nicaragua as a case study to highlight the importance of high-resolution open access data and modeling platforms to evaluate fuel-switching strategies and their resulting cost of power under realistic technology, policy, and cost scenarios (2014-2030). Our results suggest that Nicaragua could cost-effectively achieve a low-carbon grid (≥80%, based on non-large hydro renewable energy generation) by 2030 while also pursuing multiple development objectives. Regional cooperation (balancing) enables the highest wind and solar generation (18% and 3% by 2030, respectively), at the least cost (US127 MWh-1). Potentially risky resources (geothermal and hydropower) raise system costs but do not significantly hinder decarbonization. Oil price sensitivity scenarios suggest renewable energy to be a more cost-effective long-term investment than fuel oil, even under the assumption of prevailing cheap oil prices. Nicaragua’s options illustrate the opportunities and challenges of power system decarbonization for emerging economies, and the key role that open access data and modeling platforms can play in helping develop low-carbon transition pathways.

  4. Adoption of an Evidence-Based Teen Pregnancy Prevention Curriculum: A Case Study in a South Carolina School District

    Science.gov (United States)

    Workman, Lauren M.; Flynn, Shannon; Kenison, Kelli; Prince, Mary

    2015-01-01

    Continued efforts are needed to reduce teenage pregnancy in the United States. Implementation of evidence-based curricula in schools is one strategy toward meeting this goal. In 2010, the South Carolina Campaign to Prevent Teen Pregnancy (SC Campaign) received funding to implement a teen pregnancy prevention (TPP) curriculum. Congruent with South…

  5. Integrating evidence-based practices for increasing cancer screenings in safety net health systems: a multiple case study using the Consolidated Framework for Implementation Research.

    Science.gov (United States)

    Liang, Shuting; Kegler, Michelle C; Cotter, Megan; Emily, Phillips; Beasley, Derrick; Hermstad, April; Morton, Rentonia; Martinez, Jeremy; Riehman, Kara

    2016-08-02

    Implementing evidence-based practices (EBPs) to increase cancer screenings in safety net primary care systems has great potential for reducing cancer disparities. Yet there is a gap in understanding the factors and mechanisms that influence EBP implementation within these high-priority systems. Guided by the Consolidated Framework for Implementation Research (CFIR), our study aims to fill this gap with a multiple case study of health care safety net systems that were funded by an American Cancer Society (ACS) grants program to increase breast and colorectal cancer screening rates. The initiative funded 68 safety net systems to increase cancer screening through implementation of evidence-based provider and client-oriented strategies. Data are from a mixed-methods evaluation with nine purposively selected safety net systems. Fifty-two interviews were conducted with project leaders, implementers, and ACS staff. Funded safety net systems were categorized into high-, medium-, and low-performing cases based on the level of EBP implementation. Within- and cross-case analyses were performed to identify CFIR constructs that influenced level of EBP implementation. Of 39 CFIR constructs examined, six distinguished levels of implementation. Two constructs were from the intervention characteristics domain: adaptability and trialability. Three were from the inner setting domain: leadership engagement, tension for change, and access to information and knowledge. Engaging formally appointed internal implementation leaders, from the process domain, also distinguished level of implementation. No constructs from the outer setting or individual characteristics domain differentiated systems by level of implementation. Our study identified a number of influential CFIR constructs and illustrated how they impacted EBP implementation across a variety of safety net systems. Findings may inform future dissemination efforts of EBPs for increasing cancer screening in similar settings. Moreover

  6. Risk of Stroke after Herpes Zoster - Evidence from a German Self-Controlled Case-Series Study.

    Science.gov (United States)

    Schink, Tania; Behr, Sigrid; Thöne, Kathrin; Bricout, Hélène; Garbe, Edeltraut

    2016-01-01

    Herpes zoster (HZ) is caused by reactivation of the latent varicella-zoster virus (VZV). A severe complication of HZ is VZV vasculopathy which can result in ischemic or hemorrhagic stroke. The aims of our study were to assess the risk of stroke after the onset of HZ and to investigate the roles of stroke subtype, HZ location and the time interval between HZ onset and stroke. A self-controlled case-series study was performed on a cohort of patients with incident stroke recorded in the German Pharmacoepidemiological Research Database (GePaRD), which covers about 20 million persons throughout Germany. We estimated adjusted incidence rate ratios (IRR) by comparing the rate of stroke in risk periods (i.e., periods following HZ) with the rate of stroke in control periods (i.e., periods without HZ) in the same individuals, controlling for both time-invariant and major potentially time-variant confounders. The cohort included 124,462 stroke patients, of whom 6,035 (5%) had at least one HZ diagnosis identified in GePaRD either as main hospital discharge diagnosis or as HZ treated with antivirals. The risk of stroke was about 1.3 times higher in the risk periods 3 months after HZ onset, than in the control periods (IRR: 1.29; 95% confidence interval: 1.16-1.44). An elevated risk of similar magnitude was observed for ischemic and unspecified stroke, but a 1.5-fold higher risk was observed for hemorrhagic stroke. A slightly stronger effect on the risk of stroke was also observed during the 3 months after HZ ophthalmicus (HZO) onset (1.59; 1.10-2.32). The risk was highest 3 and 4 weeks after HZ onset and decreased thereafter. Our study corroborates an increased risk of stroke after HZ, which is highest 3 to 4 weeks after HZ onset. The results suggest that the risk is more pronounced after HZO and is numerically higher for hemorrhagic than for ischemic stroke.

  7. Exploring the uptake and framing of research evidence on universal screening for intimate partner violence against women: a knowledge translation case study.

    Science.gov (United States)

    Wathen, C Nadine; Macgregor, Jennifer Cd; Sibbald, Shannon L; Macmillan, Harriet L

    2013-04-12

    Significant emphasis is currently placed on the need to enhance health care decision-making with research-derived evidence. While much has been written on specific strategies to enable these "knowledge-to-action" processes, there is less empirical evidence regarding what happens when knowledge translation (KT) processes do not proceed as planned. The present paper provides a KT case study using the area of health care screening for intimate partner violence (IPV). A modified citation analysis method was used, beginning with a comprehensive search (August 2009 to October 2012) to capture scholarly and grey literature, and news reports citing a specific randomized controlled trial published in a major medical journal on the effectiveness of screening women, in health care settings, for exposure to IPV. Results of the searches were extracted, coded and analysed using a multi-step mixed qualitative and quantitative content analysis process. The trial was cited in 147 citations from 112 different sources in journal articles, commentaries, books, and government and news reports. The trial also formed part of the evidence base for several national-level practice guidelines and policy statements. The most common interpretations of the trial were "no benefit of screening", "no harms of screening", or both. Variation existed in how these findings were represented, ranging from summaries of the findings, to privileging one outcome over others, and to critical qualifications, especially with regard to methodological rigour of the trial. Of note, interpretations were not always internally consistent, with the same evidence used in sometimes contradictory ways within the same source. Our findings provide empirical data on the malleability of "evidence" in knowledge translation processes, and its potential for multiple, often unanticipated, uses. They have implications for understanding how research evidence is used and interpreted in policy and practice, particularly in

  8. Assessing the Economic Cost of Landslide Damage in Low-Relief Regions: Case Study Evidence from the Flemish Ardennes (Belgium)

    Science.gov (United States)

    Vranken, L.; Van Turnhout, P.; Van Den Eeckhaut, M.; Vandekerckhove, L.; Vantilt, G.; Poesen, J.

    2012-04-01

    Several regions around the globe are at risk to incur damage from landslides. These landslides cause significant structural and functional damage to public and private buildings and infrastructure. Numerous studies investigated how natural factors and human activities control the (re-)activation of landslides. However, few studies have concentrated on a quantitative estimate of the overall damage caused by landslides at a regional scale. This study therefore starts with a quantitative economic assessment of the direct and indirect damage caused by landslides in the Flemish Ardennes (Belgium), a low-relief region (area=ca. 700 km2) susceptible to landslides. Based on focus interviews as well as on semi-structured interviews with homeowners, civil servants (e.g. from the technical services from the various towns), or with the owners and providers of lifelines such as electricity and sewage, we have quantitatively estimated the direct and indirect damage induced by landsliding and this for a 10 to 30 year period (depending on the type of infrastructure or buildings). Economic damage to public infrastructure and buildings was estimated for the entire region, while for private damage 10 cases with severe to small damage were quantified. For example, in the last 10 year, costs of road repair augmented to 814 560 €. Costs to repair damaged roads that have not yet been repaired, were estimated at 669 318 €. In the past 30 years, costs of measures to prevent road damage augmented to at least 14 872 380 €. More than 90% of this budget for preventive measures was spent 30 years ago, when an important freeway was damaged and had to be repaired. These preventive measures (building a grout wall and improving the drainage system) were effective as no further damage has been reported until present. To repair and prevent damage to waterworks and sewage systems, expenditures amounted to 551 044 € and this for the last 30 years. In the past 10 years, a new railway line

  9. The role of corporate foresight in exploring new markets – evidence from 3 case studies in the BOP markets

    DEFF Research Database (Denmark)

    Højland, Jakob; Rohrbeck, René

    2018-01-01

    markets, we use various data sources to reconstruct timelines and map corporate foresight activities. We selected the cases to maximise their heterogeneity in firm size, industry, nature of the product and ownership structure. Our findings suggest that the probing (experimental search) phase...

  10. Occupational exposure to diesel engine emissions and risk of lung cancer: evidence from two case-control studies in Montreal, Canada.

    Science.gov (United States)

    Pintos, Javier; Parent, Marie-Elise; Richardson, Lesley; Siemiatycki, Jack

    2012-11-01

    To examine the risk of lung cancer among men associated with exposure to diesel engine emissions incurred in a wide range of occupations and industries. 2 population-based lung cancer case-control studies were conducted in Montreal. Study I (1979-1986) comprised 857 cases and 533 population controls; study II (1996-2001) comprised 736 cases and 894 population controls. A detailed job history was obtained, from which we inferred lifetime occupational exposure to 294 agents, including diesel engine emissions. ORs were estimated for each study and in the pooled data set, adjusting for socio-demographic factors, smoking history and selected occupational carcinogens. While it proved impossible to retrospectively estimate absolute exposure concentrations, there were estimates and analyses by relative measures of cumulative exposure. Increased risks of lung cancer were found in both studies. The pooled analysis showed an OR of lung cancer associated with substantial exposure to diesel exhaust of 1.80 (95% CI 1.3 to 2.6). The risk associated with substantial exposure was higher for squamous cell carcinomas (OR 2.09; 95% CI 1.3 to 3.2) than other histological types. Joint effects between diesel exhaust exposure and tobacco smoking are compatible with a multiplicative synergistic effect. Our findings provide further evidence supporting a causal link between diesel engine emissions and risk of lung cancer. The risk is stronger for the development of squamous cell carcinomas than for small cell tumours or adenocarcinomas.

  11. Testing the emergence of New Caledonia: fig wasp mutualism as a case study and a review of evidence.

    Directory of Open Access Journals (Sweden)

    Astrid Cruaud

    Full Text Available While geologists suggest that New Caledonian main island (Grande Terre was submerged until ca 37 Ma, biologists are struck by the presence of supposedly Gondwanan groups on the island. Among these groups are the Oreosycea fig trees (Ficus, Moraceae and their Dolichoris pollinators (Hymenoptera, Agaonidae. These partners are distributed in the Paleotropics and Australasia, suggesting that their presence on New Caledonia could result from Gondwanan vicariance. To test this hypothesis, we obtained mitochondrial and nuclear markers (5.3 kb from 28 species of Dolichoris, used all available sequences for Oreosycea, and conducted phylogenetic and dating analyses with several calibration strategies. All our analyses ruled out a vicariance scenario suggesting instead that New Caledonian colonization by Dolichoris and Oreosycea involved dispersal across islands from Sundaland ca 45.9-32.0 Ma. Our results show that successful long-distance dispersal of obligate mutualists may happen further suggesting that presence of intimate mutualisms on isolated islands should not be used as a priori evidence for vicariance. Comparing our results to a review of all the published age estimates for New Caledonian plant and animal taxa, we showed that support for a vicariant origin of the island biota is still lacking. Finally, as demonstrating a causal relationship between geology and biology requires independent evidence, we argue that a priori assumptions about vicariance or dispersal should not be used to constrain chronograms. This circular reasoning could lead to under or overestimation of age estimates.

  12. CASE STUDY CRITIQUE; UPPER CLINCH CASE STUDY

    Science.gov (United States)

    Case study critique: Upper Clinch case study (from Research on Methods for Integrating Ecological Economics and Ecological Risk Assessment: A Trade-off Weighted Index Approach to Integrating Economics and Ecological Risk Assessment). This critique answers the questions: 1) does ...

  13. Some empirical evidence on business-IT alignment processes in the public sector: A case study report

    NARCIS (Netherlands)

    Santana Tapia, R.G.; van Oene, L.

    2008-01-01

    An empirical study that explores business-IT alignment processes in a networked organization among the province Overijssel, the municipalities Zwolle and Enschede, the water board district Regge & Dinkel and Royal Grolsch N.V. in The Netherlands, is summarized in this report. The aim of the study

  14. Neighbourhood effects as indirect effects: evidence from a Dutch case study on the significance of neighbourhood for employment trajectories

    NARCIS (Netherlands)

    Pinkster, F.M.

    2014-01-01

    One of the key challenges in the study of neighbourhood effects on work is to understand the pathways through which disadvantaged neighbourhoods impact the employment opportunities of residents. Endogenous explanations for neighbourhood effects focus on social life in these neighbourhoods,

  15. A Test of Leading Explanations for the College Racial-Ethnic Achievement Gap: Evidence from a Longitudinal Case Study

    Science.gov (United States)

    Martin, Nathan D.; Spenner, Kenneth I; Mustillo, Sarah A.

    2017-01-01

    In this study, we examined racial/ethnic differences in grade point average (GPA) among students at a highly selective, private university who were surveyed before matriculation and during the first, second and fourth college years, and assessed prominent explanations for the Black-White and Latino-White college achievement gap. We found that…

  16. Impact of policy support on uptake of evidence-based continuous quality improvement activities and the quality of care for Indigenous Australians: a comparative case study.

    Science.gov (United States)

    Bailie, Ross; Matthews, Veronica; Larkins, Sarah; Thompson, Sandra; Burgess, Paul; Weeramanthri, Tarun; Bailie, Jodie; Cunningham, Frances; Kwedza, Ru; Clark, Louise

    2017-10-05

    To examine the impact of state/territory policy support on (1) uptake of evidence-based continuous quality improvement (CQI) activities and (2) quality of care for Indigenous Australians. Mixed-method comparative case study methodology, drawing on quality-of-care audit data, documentary evidence of policies and strategies and the experience and insights of stakeholders involved in relevant CQI programmes. We use multilevel linear regression to analyse jurisdictional differences in quality of care. Indigenous primary healthcare services across five states/territories of Australia. 175 Indigenous primary healthcare services. A range of national and state/territory policy and infrastructure initiatives to support CQI, including support for applied research. PRIMARY AND SECONDARY OUTCOME MEASURES: (i) Trends in the consistent uptake of evidence-based CQI tools available through a research-based CQI initiative (the Audit and Best Practice in Chronic Disease programme) and (ii) quality of care (as reflected in adherence to best practice guidelines). Progressive uptake of evidence-based CQI activities and steady improvements or maintenance of high-quality care occurred where there was long-term policy and infrastructure support for CQI. Where support was provided but not sustained there was a rapid rise and subsequent fall in relevant CQI activities. Health authorities should ensure consistent and sustained policy and infrastructure support for CQI to enable wide-scale and ongoing improvement in quality of care and, subsequently, health outcomes. It is not sufficient for improvement initiatives to rely on local service managers and clinicians, as their efforts are strongly mediated by higher system-level influences. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  17. Comprehensive Evidence-Based Assessment and Prioritization of Potential Antidiabetic Medicinal Plants: A Case Study from Canadian Eastern James Bay Cree Traditional Medicine

    Directory of Open Access Journals (Sweden)

    Pierre S. Haddad

    2012-01-01

    Full Text Available Canadian Aboriginals, like others globally, suffer from disproportionately high rates of diabetes. A comprehensive evidence-based approach was therefore developed to study potential antidiabetic medicinal plants stemming from Canadian Aboriginal Traditional Medicine to provide culturally adapted complementary and alternative treatment options. Key elements of pathophysiology of diabetes and of related contemporary drug therapy are presented to highlight relevant cellular and molecular targets for medicinal plants. Potential antidiabetic plants were identified using a novel ethnobotanical method based on a set of diabetes symptoms. The most promising species were screened for primary (glucose-lowering and secondary (toxicity, drug interactions, complications antidiabetic activity by using a comprehensive platform of in vitro cell-based and cell-free bioassays. The most active species were studied further for their mechanism of action and their active principles identified though bioassay-guided fractionation. Biological activity of key species was confirmed in animal models of diabetes. These in vitro and in vivo findings are the basis for evidence-based prioritization of antidiabetic plants. In parallel, plants were also prioritized by Cree Elders and healers according to their Traditional Medicine paradigm. This case study highlights the convergence of modern science and Traditional Medicine while providing a model that can be adapted to other Aboriginal realities worldwide.

  18. The 5-HTTLPR confers susceptibility to anorexia nervosa in Han Chinese: evidence from a case-control and family-based study.

    Science.gov (United States)

    Chen, Jue; Kang, Qing; Jiang, Wenhui; Fan, Juan; Zhang, Mingdao; Yu, Shunying; Zhang, Chen

    2015-01-01

    Accumulating evidence has implied that serotonin system dysfunction may be involved in the etiology of anorexia nervosa (AN). Serotonin-transporter-linked promoter region (5-HTTLPR) polymorphism is the genetic variant coding for the serotonin transporter and has a modulatory effect on its expression. This study aimed to investigate the possible association between the 5-HTTLPR and the susceptibility and severity of AN in Han Chinese using a case-control (255 patients and 351 controls) and family based study (198 trios). Eating disorder examination was used to measure the severity of AN behavioral symptoms. For the case-control study, the 5-HTTLPR showed significant association with AN in our sample (genotypic P = 0.03). The frequency of S allele was significantly higher in patients than that in controls (OR = 1.38, 95%CI: 1.06-1.79, P = 0.017). For the family-based study, the S allele of 5-HTTLPR was preferentially transmitted rather than non-transmitted from the parents to affected offspring (P = 0.013). The results of ANCOVA test revealed no significant association between the 5-HTTLPR polymorphism and severity of AN. Our findings suggested that 5-HTTLPR is able to confer susceptibility to AN in Han Chinese.

  19. The 5-HTTLPR confers susceptibility to anorexia nervosa in Han Chinese: evidence from a case-control and family-based study.

    Directory of Open Access Journals (Sweden)

    Jue Chen

    Full Text Available Accumulating evidence has implied that serotonin system dysfunction may be involved in the etiology of anorexia nervosa (AN. Serotonin-transporter-linked promoter region (5-HTTLPR polymorphism is the genetic variant coding for the serotonin transporter and has a modulatory effect on its expression. This study aimed to investigate the possible association between the 5-HTTLPR and the susceptibility and severity of AN in Han Chinese using a case-control (255 patients and 351 controls and family based study (198 trios. Eating disorder examination was used to measure the severity of AN behavioral symptoms. For the case-control study, the 5-HTTLPR showed significant association with AN in our sample (genotypic P = 0.03. The frequency of S allele was significantly higher in patients than that in controls (OR = 1.38, 95%CI: 1.06-1.79, P = 0.017. For the family-based study, the S allele of 5-HTTLPR was preferentially transmitted rather than non-transmitted from the parents to affected offspring (P = 0.013. The results of ANCOVA test revealed no significant association between the 5-HTTLPR polymorphism and severity of AN. Our findings suggested that 5-HTTLPR is able to confer susceptibility to AN in Han Chinese.

  20. Future gender relations in global restructuring processes case study evidence from knowledge-intensive, manufacturing and service occupations

    OpenAIRE

    Linda Nierling

    2008-01-01

    Global restructuring processes have not only strong implications for European working and living realities, but also have specific outcomes with regard to gender relations. The following contribution analyses in which way global restructuring shapes current gender relations in order to identify important trends and developments for future gender (in)equalities at the workplace. On the basis of a large qualitative study on global restructuring and impacts on different occupational groups it ar...

  1. The Need for Formal Evidence Synthesis in Food Policy: A Case Study of Willingness-to-Pay

    Directory of Open Access Journals (Sweden)

    Beth Clark

    2017-03-01

    Full Text Available Meta-analysis is increasingly utilised in the understanding of consumer behaviour, including in relation to farm animal welfare. However, the issue of publication bias has received little attention. As willingness-to-pay (WTP is widely used in policy, it is important to explore publication bias. This research aimed to evaluate publication bias in WTP, specifically public WTP for farm animal welfare. A systematic review of four databases yielded 54 studies for random effects meta-analysis. Publication bias was assessed by the Egger test, rank test, contour-enhanced funnel plots, and the Vevea and Hedges weight-function model. Results consistently indicated the presence of publication bias, highlighting an overestimation of WTP for farm animal welfare. Stakeholders should be wary of WTP estimates that have not been critically evaluated for publication bias.

  2. Social and political perceptions of the Borat phenomenon in Kazakhstan: evidence from a case study of university students

    Directory of Open Access Journals (Sweden)

    Donnacha Ó Beacháin

    2011-11-01

    Full Text Available This article begins by chronicling and evaluating the reaction of the government of Kazakhstan to Sacha Baron Cohen’s film Borat—Cultural Learnings of America for Make Benefit Glorious Nation of Kazakhstan. It then compares and contrasts the official government reaction with the expressed attitudes of local members of Kazakhstan’s young English-speaking elites. This study is based on the results of a survey of almost five hundred young university students conducted in March 2007 at the Kazakhstan Institute of Management, Economics and Strategic Research (KIMEP, the most prestigious university in the country. The sample gives a snapshot of those most likely to have been aware of Borat – the young, internet-savvy, educated urban elite – and inter alia provides insights into how respondents in Kazakhstan thought the movie impacted their country and would influence how they were treated abroad. The survey results suggest that while responses to Borat were heterogeneous, most students accepted that the choice of Kazakhstan as a target for satire was coincidental rather than conspiratorial. Despite official efforts to ban the movie, a majority of the respondents had seen the film and believed that the ban was a mistake. Also, while recognising that Borat would raise Kazakhstan’s profile in the world, respondents doubted it would increase knowledge, and some feared a change in their treatment when travelling abroad.

  3. Examination of forensic entomology evidence using computed tomography scanning: case studies and refinement of techniques for estimating maggot mass volumes in bodies.

    Science.gov (United States)

    Johnson, Aidan; Archer, Melanie; Leigh-Shaw, Lyndie; Pais, Mike; O'Donnell, Chris; Wallman, James

    2012-09-01

    A new technique has recently been developed for estimating the volume of maggot masses on deceased persons using post-mortem CT scans. This allows volume to be measured non-invasively and factored into maggot mass temperature calculations for both casework and research. Examination of admission scans also allows exploration of entomological evidence in anatomical areas not usually exposed by autopsy (e.g. nasal cavities and facial sinuses), and before autopsy disrupts the maggot distribution on a body. This paper expands on work already completed by providing the x-ray attenuation coefficient by way of Hounsfield unit (HU) values for various maggot species, maggot masses and human tissue adjacent to masses. Specifically, this study looked at the HU values for four forensically important blowfly larvae: Lucilia cuprina, L. sericata, Calliphora stygia and C. vicina. The Calliphora species had significantly lower HU values than the Lucilia species. This might be explained by histological analysis, which revealed a non-significant trend, suggesting that Calliphora maggots have a higher fat content than the Lucilia maggots. It is apparent that the variation in the x-ray attenuation coefficient usually precludes its use as a tool for delineating the maggot mass from human tissue and that morphology is the dominant method for delineating a mass. This paper also includes three case studies, which reveal different applications for interpreting entomological evidence using post-mortem CT scans.

  4. Evidence for α-helices in the gas phase: a case study using Melittin from honey bee venom.

    Science.gov (United States)

    Florance, Hannah V; Stopford, Andrew P; Kalapothakis, Jason M; McCullough, Bryan J; Bretherick, Andrew; Barran, Perdita E

    2011-09-07

    Gas phase methodologies are increasingly used to study the structure of proteins and peptides. A challenge to the mass spectrometrist is to preserve the structure of the system of interest intact and unaltered from solution into the gas phase. Small peptides are very flexible and can present a number of conformations in solution. In this work we examine Melittin a 26 amino acid peptide that forms the active component of honey bee venom. Melittin is haemolytic and has been shown to form an α-helical tetrameric structure by X-ray crystallography [M. Gribskov et al., The RCSB Protein Data Bank, 1990] and to be helical in high concentrations of methanol. Here we use ion mobility mass spectrometry, molecular dynamics and gas-phase HDX to probe its structure in the gas phase and specifically interrogate whether the helical form can be preserved. All low energy calculated structures possess some helicity. In our experiments we examine the peptide following nano-ESI from solutions with varying methanol content. Ion mobility gives collision cross sections (CCS) that compare well with values found from molecular modelling and from other reported structures, but with inconclusive results regarding the effect of solvent. There is only a slight increase in CCS with charge, showing minimal coloumbically driven unfolding. HDX supports preservation of some helical content into the gas phase and again shows little difference in the exchange rates of species sprayed from different solvents. The [M + 3H](3+) species has two exchanging populations both of which exhibit faster exchange rates than observed for the [M + 2H](2+) species. One interpretation for these results is that the time spent being analysed is sufficient for this peptide to form a helix in the 'ultimate' hydrophobic environment of a vacuum.

  5. Medio-dorsal thalamus and confabulations: Evidence from a clinical case and combined MRI/DTI study

    Directory of Open Access Journals (Sweden)

    Valeria Onofrj

    2016-01-01

    Full Text Available The Medio-Dorsal Nuclei (MDN including the thalamic magnocellular and parvocellular thalamic regions has been implicated in verbal memory function. In a 77 year old lady, with a prior history of a clinically silent infarct of the left MDN, we observed the acute onset of spontaneous confabulations when an isolated new infarct occurred in the right MDN. The patient and five age-matched healthy subjects underwent Magnetic Resonance Imaging (MRI and Diffusion Tensor Imaging (DTI. The thalamic lesions were localized by overlapping Morel Thalamic Atlas with structural MRI data. DTI was used to assess: i white matter alterations (Fractional Anisotropy, FA within fibers connecting the ischemic areas to cortex; ii the micro-structural damage (Mean Diffusivity within the thalamic sub-regions defined by their structural connectivity to the Anterior Cingulate Cortex (ACC and to the temporal lobes. These target regions were chosen because their damage is considered associated with the appearance of confabulations. Thalamic lesions were localized within the parvocellular regions of the right and left MDNs. The structural connectivity study showed that the fiber tracts, connecting the bilaterally damaged thalamic regions with the frontal cortex, corresponded to the anterior thalamic radiations (ATR. FA within these tracts was significantly lower in the patient as compared to controls. Mean diffusivity within the MDNs projecting to Broadman area (BA 24, BA25 and BA32 of ACC was significantly higher in the patient than in control group. Mean diffusivity values within the MDN projecting to temporal lobes in contrast were not different between patient and controls. Our findings suggest the involvement of bilateral MDNs projections to ACC in the genesis of confabulations and help provide clarity to the longstanding debate on the origin of confabulations.

  6. Environmental exposure to BDE47 is associated with increased diabetes prevalence: Evidence from community-based case-control studies and an animal experiment

    Science.gov (United States)

    Zhang, Zhan; Li, Shushu; Liu, Lu; Wang, Li; Xiao, Xue; Sun, Zhenzhen; Wang, Xichen; Wang, Chao; Wang, Meilin; Li, Lei; Xu, Qiujin; Gao, Weimin; Wang, Shou-Lin

    2016-06-01

    Brominated flame retardants exposure has been associated with increasing trends of diabetes and metabolic disease. Thus, the purpose of this study was to provide evidence of polybrominated diphenyl ethers (PBDEs) exposure in relation to diabetes prevalence and to reveal the potential underlying mechanism in epidemiological and animal studies. All the participants received a questionnaire, health examination, and the detection of 7 PBDE congeners in serum in two independent community-based studies from 2011 to 2012 in China. Male rats were exposed to 2,2’4,4’-tetrabromodiphenyl ether (BDE47) for 8 weeks to explore its effects on glucose homeostasis and potential mechanisms using high-throughput genomic analysis. Among the 7 congeners, BDE47 showed significant high detection rate and concentration in cases in Study I and Study II. Every tertile of BDE47 exposure significantly increased the risk of diabetes prevalence in Study I (Ptrend = 0.001) and Study II (Ptrend treatments induced hyperglycemia in rats. Furthermore, gene microarray analysis showed that diabetes pathway and three gene ontology terms involved in glucose transport were enriched. The results indicated that environmental exposure to BDE47 was associated with increased diabetes prevalence. However, further prospective and mechanistic studies are needed to the causation of diabetes in relation to BDE47.

  7. Final report on case studies

    DEFF Research Database (Denmark)

    Ljungberg, Daniel; McKelvey, Maureen; Lassen, Astrid Heidemann

    2012-01-01

    Case study as a research design means investigating a single or multiple instance(s) or setting(s) (i.e. a case) and its entire context to explain a phenomenon and its processes. This is achieved through detailed understanding, usually comprised of multiple sources of information. In this way, case...... studies attempt to provide as a complete an understanding of a (complex) phenomenon as possible. Within the AEGIS project, survey and case study research are complementary. They are complementary in the sense that the former can provide more generalizable evidence on a phenomenon in terms of cross......-sectional data, while the latter can provide more in-depth (qualitative) understanding on specific issues. In systematically examining the case studies, however, this report goes beyond a typical single case study. Here we provide a synthesis of 86 case studies. Multiple case studies, following similar focus...

  8. Combining evidence from multiple electronic health care databases: performances of one-stage and two-stage meta-analysis in matched case-control studies.

    Science.gov (United States)

    La Gamba, Fabiola; Corrao, Giovanni; Romio, Silvana; Sturkenboom, Miriam; Trifirò, Gianluca; Schink, Tania; de Ridder, Maria

    2017-10-01

    Clustering of patients in databases is usually ignored in one-stage meta-analysis of multi-database studies using matched case-control data. The aim of this study was to compare bias and efficiency of such a one-stage meta-analysis with a two-stage meta-analysis. First, we compared the approaches by generating matched case-control data under 5 simulated scenarios, built by varying: (1) the exposure-outcome association; (2) its variability among databases; (3) the confounding strength of one covariate on this association; (4) its variability; and (5) the (heterogeneous) confounding strength of two covariates. Second, we made the same comparison using empirical data from the ARITMO project, a multiple database study investigating the risk of ventricular arrhythmia following the use of medications with arrhythmogenic potential. In our study, we specifically investigated the effect of current use of promethazine. Bias increased for one-stage meta-analysis with increasing (1) between-database variance of exposure effect and (2) heterogeneous confounding generated by two covariates. The efficiency of one-stage meta-analysis was slightly lower than that of two-stage meta-analysis for the majority of investigated scenarios. Based on ARITMO data, there were no evident differences between one-stage (OR = 1.50, CI = [1.08; 2.08]) and two-stage (OR = 1.55, CI = [1.12; 2.16]) approaches. When the effect of interest is heterogeneous, a one-stage meta-analysis ignoring clustering gives biased estimates. Two-stage meta-analysis generates estimates at least as accurate and precise as one-stage meta-analysis. However, in a study using small databases and rare exposures and/or outcomes, a correct one-stage meta-analysis becomes essential. Copyright © 2017 John Wiley & Sons, Ltd.

  9. Evidence of system: A network model case-study of seventh grade science assessment practices from classrooms to the state test

    Science.gov (United States)

    Piety, Philip John

    With science education in the United States entering a period of greater accountability, this study investigated how student learning in science was assessed by educators within one state, asking what systemic assessment approaches existed and how the information from them was used. Conducted during the 20o6-2007 school year, this research developed and piloted a network-model case study design that included teachers, principals, administrators, and the state test development process, as well as several state-level professional associations. The data analyzed included observations, interviews, surveys, and both public and private documents. Some data were secondary. This design produced an empirical depiction of practice with a web of related cases. The network model expands on the hierarchical (nested) models often assumed in the growing literature on how information is used in educational contexts by showing multiple ways in which individuals are related through organizational structures. Seven case study teachers, each employing assessment methods largely unique and invisible to others in their schools, illustrate one set of assessment practices. The only alternative to classroom assessments that could be documented was the annual state accountability test. These two assessment species were neither tightly coupled nor distinct. Some teachers were partners in developing state test instruments, and in some cases the annual test could be seen as a school management resource. Boundary practices---activities where these two systems connected---were opportunities to identify challenges to policy implementation in science education. The challenges include standards, cognition, vocabulary, and classroom equipment. The boundary practices, along with the web of connections, provide the outlines of potential (and often unrealized) synergistic relationships. This model shows diverse indigenous practices and adaptations by actors responding to pressures of change and

  10. Hair analysis as evidence in forensic cases.

    Science.gov (United States)

    Moeller, M R; Fey, P; Sachs, H

    1993-12-01

    Because hair analysis can be used for the determination of drug use months after drug consumption, hair analysis data can often act as important and even decisive evidence in the courtroom. More recently developed GC/MS methods offer excellent sensitivity and can make the distinction between chronic heroin and codeine use, which was not possible earlier with radioimmunoassay techniques. From more than a thousand hair analyses, the morphine/codeine ratios necessary to determine heroin use were set at 5:1 for low morphine concentrations (< 1 ng/mg hair) and 2:1 for concentrations above 1 ng/mg hair. The distinction can be further focused with the additional analysis of the metabolite monoacetylmorphine (MAM). As can be seen from several case examples, hair analysis cannot pinpoint an exact date of opiate use, but it can be used to validate or invalidate a subject's statement concerning his/her drug consumption. Interpretations should always be made cautiously. Ranges, means and medians are also listed for amphetamine, cocaine and cannabis and work is under way to draw similar safety guidelines for these drugs.

  11. Ancestral state reconstructions require biological evidence to test evolutionary hypotheses: A case study examining the evolution of reproductive mode in squamate reptiles.

    Science.gov (United States)

    Griffith, Oliver W; Blackburn, Daniel G; Brandley, Matthew C; Van Dyke, James U; Whittington, Camilla M; Thompson, Michael B

    2015-09-01

    To understand evolutionary transformations it is necessary to identify the character states of extinct ancestors. Ancestral character state reconstruction is inherently difficult because it requires an accurate phylogeny, character state data, and a statistical model of transition rates and is fundamentally constrained by missing data such as extinct taxa. We argue that model based ancestral character state reconstruction should be used to generate hypotheses but should not be considered an analytical endpoint. Using the evolution of viviparity and reversals to oviparity in squamates as a case study, we show how anatomical, physiological, and ecological data can be used to evaluate hypotheses about evolutionary transitions. The evolution of squamate viviparity requires changes to the timing of reproductive events and the successive loss of features responsible for building an eggshell. A reversal to oviparity requires that those lost traits re-evolve. We argue that the re-evolution of oviparity is inherently more difficult than the reverse. We outline how the inviability of intermediate phenotypes might present physiological barriers to reversals from viviparity to oviparity. Finally, we show that ecological data supports an oviparous ancestral state for squamates and multiple transitions to viviparity. In summary, we conclude that the first squamates were oviparous, that frequent transitions to viviparity have occurred, and that reversals to oviparity in viviparous lineages either have not occurred or are exceedingly rare. As this evidence supports conclusions that differ from previous ancestral state reconstructions, our paper highlights the importance of incorporating biological evidence to evaluate model-generated hypotheses. © 2015 Wiley Periodicals, Inc.

  12. Project management case studies

    CERN Document Server

    Kerzner, Harold R

    2013-01-01

    A new edition of the most popular book of project management case studies, expanded to include more than 100 cases plus a ""super case"" on the Iridium Project Case studies are an important part of project management education and training. This Fourth Edition of Harold Kerzner''s Project Management Case Studies features a number of new cases covering value measurement in project management. Also included is the well-received ""super case,"" which covers all aspects of project management and may be used as a capstone for a course. This new edition:Contains 100-plus case studies drawn from re

  13. Case Study Research Methodology

    Directory of Open Access Journals (Sweden)

    Mark Widdowson

    2011-01-01

    Full Text Available Commenting on the lack of case studies published in modern psychotherapy publications, the author reviews the strengths of case study methodology and responds to common criticisms, before providing a summary of types of case studies including clinical, experimental and naturalistic. Suggestions are included for developing systematic case studies and brief descriptions are given of a range of research resources relating to outcome and process measures. Examples of a pragmatic case study design and a hermeneutic single-case efficacy design are given and the paper concludes with some ethical considerations and an exhortation to the TA community to engage more widely in case study research.

  14. Calcium Channel Blockers in Secondary Cardiovascular Prevention and Risk of Acute Events: Real-World Evidence from Nested Case-Control Studies on Italian Hypertensive Elderly.

    Science.gov (United States)

    Bettiol, Alessandra; Lucenteforte, Ersilia; Vannacci, Alfredo; Lombardi, Niccolò; Onder, Graziano; Agabiti, Nera; Vitale, Cristiana; Trifirò, Gianluca; Corrao, Giovanni; Roberto, Giuseppe; Mugelli, Alessandro; Chinellato, Alessandro

    2017-12-01

    Antihypertensive treatment with calcium channel blockers (CCBs) is consolidated in clinical practice; however, different studies observed increased risks of acute events for short-acting CCBs. This study aimed to provide real-world evidence on risks of acute cardiovascular (CV) events, hospitalizations and mortality among users of different CCB classes in secondary CV prevention. Three case-control studies were nested in a cohort of Italian elderly hypertensive CV-compromised CCBs users. Cases were subjects with CV events (n = 25,204), all-cause hospitalizations (n = 19,237), or all-cause mortality (n = 17,996) during the follow-up. Up to four controls were matched for each case. Current or past exposition to CCBs at index date was defined based on molecule, formulation and daily doses of the last CCB delivery. The odds ratio (OR) and 95% confidence intervals (CI) were estimated using conditional logistic regression models. Compared to past users, current CCB users had significant reductions in risks of CV events [OR 0.88 (95% CI: 0.84-0.91)], hospitalization [0.90 (0.88-0.93)] and mortality [0.48 (0.47-0.49)]. Current users of long-acting dihydropyridines (DHPs) had the lowest risk [OR 0.87 (0.84-0.90), 0.86 (0.83-0.90), 0.55 (0.54-0.56) for acute CV events, hospitalizations and mortality], whereas current users of short-acting CCBs had an increased risk of acute CV events [OR 1.77 (1.13-2.78) for short-acting DHPs; 1.19 (1.07-1.31) for short-acting non-DHPs] and hospitalizations [OR 1.84 (0.96-3.51) and 1.23 (1.08-1.42)]. The already-existing warning on short-acting CCBs should be potentiated, addressing clinicians towards the choice of long-acting formulations.

  15. “Non-Aviation” activities and the introduction of new thinking and ideas in the airport business: Empirical evidence from an Italian case study

    Directory of Open Access Journals (Sweden)

    Vincenzo Fasone

    2012-05-01

    Full Text Available Purpose: This paper aims to describe the main changes occurring in the airport industry with particular attention to the increasing relevance of the non-aviation activities. In fact, during the most recent decades, the airport business has evolved into a dynamic and competitive industry. In order to reduce their deficits airport management policies have progressively favoured the commercial aspects in order to produce greater profit margins. In many countries, greater management elasticity in business administration has occurred, and important modifications have been introduced in the national and international regulations according to a market oriented perspective.Design/methodology/approach: The method used is the case study approach and the analysis utilizes empirical data originating from the airport in Olbia.Findings: Findings show how the choice to invest in the non-aviation sector can be ascribed to the strategic orientation adopted by airport managers.Originality/value: Empirical evidence can highlight certain trends in the industry, whose values can lead to a core definition of the new paths of development for the airport business to follow in the non-aviation dimension, and identifying at the same time innovative business ideas for opening up new market scenarios.

  16. Addressing post-stroke care in rural areas with Peru as a case study. Placing emphasis on evidence-based pragmatism.

    Science.gov (United States)

    Miranda, J Jaime; Moscoso, Miguel G; Yan, Lijing L; Diez-Canseco, Francisco; Málaga, Germán; Garcia, Hector H; Ovbiagele, Bruce

    2017-04-15

    Stroke is a major cause of death and disability, with most of its burden now affecting low- and middle-income countries (LMIC). People in rural areas of LMIC who have a stroke receive very little acute stroke care and local healthcare workers and family caregivers in these regions lack the necessary knowledge to assist them. Intriguingly, a recent rapid growth in cell-phone use and digital technology in rural areas has not yet been appropriately exploited for health care training and delivery purposes. What should be done in rural areas, at the community setting-level, where access to healthcare is limited remains a challenge. We review the evidence on improving post-stroke outcomes including lowering the risks of functional disability, stroke recurrence, and mortality, and propose some approaches, to target post-stroke care and rehabilitation, noting key challenges in designing suitable interventions and emphasizing the advantages mHealth and communication technologies can offer. In the article, we present the prevailing stroke care situation and technological opportunities in rural Peru as a case study. As such, by addressing major limitations in rural healthcare systems, we investigate the potential of task-shifting complemented with technology to utilize and strengthen both community-based informal caregivers and community healthcare workers. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Understanding juror perceptions of forensic evidence: investigating the impact of case context on perceptions of forensic evidence strength.

    Science.gov (United States)

    Smith, Lisa L; Bull, Ray; Holliday, Robyn

    2011-03-01

    The most widely accepted model of juror decision making acknowledges the importance of both the case-specific information presented in the courtroom, as well as the prior general knowledge and beliefs held by each juror. The studies presented in this paper investigated whether mock jurors could differentiate between evidence of varying strengths in the absence of case information and then followed on to determine the influence that case context (and therefore the story model) has on judgments made about the strength of forensic DNA evidence. The results illustrated that mock jurors correctly identified various strengths of evidence when it was not presented with case information; however, the perceived strength of evidence was significantly inflated when presented in the context of a criminal case, particularly when the evidence was of a weak or ambiguous standard. These findings are discussed in relation to the story model, and the potential implications for real juries. © 2011 American Academy of Forensic Sciences.

  18. Traditional and Alternative Approaches to the Method of Situational Analysis in Russia: Evidence from the Case Study “Istanbul in the Life and Works of Martiros Saryan”

    Directory of Open Access Journals (Sweden)

    Olga Fedotova

    2017-09-01

    Full Text Available The article analyzes the transformation of the methodological toolkit for teaching humanities and sciences in the Russian Federation. The method of case study, being widely spread in modern higher education research, is used as an example to illustrate the attempts to implement the best practices of foreign educational technology into tertiary academic process in Russia. The author provides some historical aspects of introducing case studies in modern teaching practice. The article features peculiarities of the Soviet approach to the structure of cases. Content analysis helps identify similarities and differences in Soviet/post-Soviet approaches to case study construction and brings into focus the problem points which reveal misinterpretation and/or misuse of didactic materials designated as cases. The approach suggested in the article implies presenting the content of a case study as a collection of documents related to a certain topic. The case study "Istanbul in the life and work of the artist Martiros Saryan" demonstrates that a case can have invariable and variable parts to reflect the specificity of the didactic task within the discipline. Such approach is expected to support students’ cognitive activity, develop creativity in searching additional sources and missing materials, improve efficiency of students’ autonomous work on solving complex problem solution.

  19. Plausibility and evidence: the case of homeopathy.

    Science.gov (United States)

    Rutten, Lex; Mathie, Robert T; Fisher, Peter; Goossens, Maria; van Wassenhoven, Michel

    2013-08-01

    Homeopathy is controversial and hotly debated. The conclusions of systematic reviews of randomised controlled trials of homeopathy vary from 'comparable to conventional medicine' to 'no evidence of effects beyond placebo'. It is claimed that homeopathy conflicts with scientific laws and that homoeopaths reject the naturalistic outlook, but no evidence has been cited. We are homeopathic physicians and researchers who do not reject the scientific outlook; we believe that examination of the prior beliefs underlying this enduring stand-off can advance the debate. We show that interpretations of the same set of evidence--for homeopathy and for conventional medicine--can diverge. Prior disbelief in homeopathy is rooted in the perceived implausibility of any conceivable mechanism of action. Using the 'crossword analogy', we demonstrate that plausibility bias impedes assessment of the clinical evidence. Sweeping statements about the scientific impossibility of homeopathy are themselves unscientific: scientific statements must be precise and testable. There is growing evidence that homeopathic preparations can exert biological effects; due consideration of such research would reduce the influence of prior beliefs on the assessment of systematic review evidence.

  20. Applying a Health Network approach to translate evidence-informed policy into practice: A review and case study on musculoskeletal health

    Directory of Open Access Journals (Sweden)

    Briggs Andrew M

    2012-11-01

    Full Text Available Abstract Background While translation of evidence into health policy and practice is recognised as critical to optimising health system performance and health-related outcomes for consumers, mechanisms to effectively achieve these goals are neither well understood, nor widely communicated. Health Networks represent a framework which offers a possible solution to this dilemma, particularly in light of emerging evidence regarding the importance of establishing relationships between stakeholders and identifying clinical leaders to drive evidence integration and translation into policy. This is particularly important for service delivery related to chronic diseases. In Western Australia (WA, disease and population-specific Health Networks are comprised of cross-discipline stakeholders who work collaboratively to develop evidence-informed policies and drive their implementation. Since establishment of the Health Networks in WA, over 50 evidence-informed Models of Care (MoCs have been produced across 18 condition or population-focused Networks. The aim of this paper is to provide an overview of the Health Network framework in facilitating the translation of evidence into policy and practice with a particular focus on musculoskeletal health. Case presentation A review of activities of the WA Musculoskeletal Health Network was undertaken, focussing on outcomes and the processes used to achieve them in the context of: development of policy, procurement of funding, stakeholder engagement, publications, and projects undertaken by the Network which aligned to implementation of MoCs. The Musculoskeletal Health Network has developed four MoCs which reflect Australian National Health Priority Areas. Establishment of community-based services for consumers with musculoskeletal health conditions is a key recommendation from these MoCs. Through mapping barriers and enablers to policy implementation, working groups, led by local clinical leaders and supported by

  1. Adverse outcome pathway (AOP) development and weight of evidence evaluation as illustrated by ecological case studies using online tools such as ECOTOX and SeqAPASS

    Data.gov (United States)

    U.S. Environmental Protection Agency — The majority of this dataset includes the query output from online databases ECOTOX and SeqAPASS used to support the ecological AOP case studies described within the...

  2. Validity of Qualis database as a predictor of evidence hierarchy and risk of bias in randomized controlled trials: a case study in dentistry

    Directory of Open Access Journals (Sweden)

    Christiane Alves Ferreira

    2011-01-01

    Full Text Available OBJECTIVE: To evaluate the validity of the Qualis database in identifying the levels of scientific evidence and the quality of randomized controlled trials indexed in the Lilacs database. METHODS: We selected 40 open-access journals and performed a page-by-page hand search, to identify published articles according to the type of study during a period of six years. Classification of studies was performed by independent reviewers assessed for their reliability. Randomized controlled trials were identified for separate evaluation of risk of bias using four dimensions: generation of allocation sequence, allocation concealment, blinding, and incomplete outcome data. The Qualis classification was considered to be the outcome variable. The statistical tests used included Kappa, Spearman's correlation, Kendall-tau and ordinal regressions. RESULTS: Studies with low levels of scientific evidence received similar Qualis classifications when compared to studies with high levels of evidence. In addition, randomized controlled trials with a high risk of bias for the generation of allocation sequences and allocation concealment were more likely to be published in journals with higher Qualis levels. DISCUSSION: The hierarchy level of the scientific evidence as classified by type of research design, as well as by the validity of studies according to the bias control level, was not correlated or associated with Qualis stratification. CONCLUSION: Qualis classifications for journals are not an approximate or indirect predictor of the validity of randomized controlled trials published in these journals and are therefore not a legitimate or appropriate indicator of the validity of randomized controlled trials.

  3. 451 Case studies Cardiac

    African Journals Online (AJOL)

    Marinda

    Case Studies. 29 ... A case of a 26-year-old ASA I physical status male undergoing septoplasty had an abrupt ... myocardial infarction, severe hypertensive crisis, cerebral .... or no formal management is required in an ASA I patient.8 One.

  4. The SLC4A7 variant rs4973768 is associated with breast cancer risk: evidence from a case-control study and a meta-analysis.

    Science.gov (United States)

    Chen, Wei; Zhong, Rong; Ming, Jie; Zou, Li; Zhu, Beibei; Lu, Xuzai; Ke, Juntao; Zhang, Yu; Liu, Li; Miao, Xiaoping; Huang, Tao

    2012-12-01

    Recent genome-wide association study has identified a genetic variant rs4973768, located in 3'-UTR of solute carrier family 4, sodium bicarbonate cotransporter, member 7 (SLC4A7), was associated with increased risk of breast cancer (BC). However, several following replication studies cannot yield consistent results. We thus conducted a hospital-based case-control study including 485 patients and 514 controls, combined a meta-analysis including 108,632 cases and 135,818 controls to explore the relationship between this variant and BC risk. Our case-control study showed that rs4973768 was significantly associated with increased BC risk with the odds ratio (OR) of 1.29 (95 % confidence interval [CI]: 1.04-1.60) under the allelic model. In addition, the meta-analysis also indicated that the variant slightly increased the risk of BC with the pooled OR of the per-allele effect being 1.08 (95 % CI: 1.04-1.11) although with significant heterogeneity between studies. Stratified analyses showed that ethnicity, sample size, and study design may explain part of the heterogeneity. Moreover, the bioinformatics analysis suggested that this variant may influence the transcriptional capacity of SLC4A7. In summary, our results showed that the SLC4A7 variant, rs4973768, is associated with risk of BC although the underlying biologic mechanism warrants further studies.

  5. Encephalopathy after whole-cell pertussis or measles vaccination: lack of evidence for a causal association in a retrospective case-control study.

    Science.gov (United States)

    Ray, Paula; Hayward, Jean; Michelson, David; Lewis, Edwin; Schwalbe, Joan; Black, Steve; Shinefield, Henry; Marcy, Michael; Huff, Ken; Ward, Joel; Mullooly, John; Chen, Robert; Davis, Robert

    2006-09-01

    Whole-cell pertussis (wP) and measles vaccines are effective in preventing disease but have also been suspected of increasing the risk of encephalopathy or encephalitis. Although many countries now use acellular pertussis vaccines, wP vaccine is still widely used in the developing world. It is therefore important to evaluate whether wP vaccine increases the risk of neurologic disorders. A retrospective case-control study was performed at 4 health maintenance organizations. Records from January 1, 1981, through December 31, 1995, were examined to identify children aged 0 to 6 years old hospitalized with encephalopathy or related conditions. The cause of the encephalopathy was categorized as known, unknown or suspected but unconfirmed. Up to 3 controls were matched to each case. Conditional logistic regression was used to analyze the relative risk of encephalopathy after vaccination with diphtheria-tetanus-pertussis (DTP) or measles-mumps-rubella (MMR) vaccines in the 90 days before disease onset as defined by chart review compared with an equivalent period among controls indexed by matching on case onset date. Four-hundred fifty-two cases were identified. Cases were no more likely than controls to have received either vaccine during the 90 days before disease onset. When encephalopathies of known etiology were excluded, the odds ratio for case children having received DTP within 7 days before onset of disease was 1.22 (95% confidence interval [CI] = 0.45-3.31, P = 0.693) compared with control children. For MMR in the 90 days before onset of encephalopathy, the odds ratio was 1.23 (95% confidence interval = 0.51-2.98, P = 0.647). In this study of more than 2 million children, DTP and MMR vaccines were not associated with an increased risk of encephalopathy after vaccination.

  6. Case Reports, Case Series - From Clinical Practice to Evidence-Based Medicine in Graduate Medical Education.

    Science.gov (United States)

    Sayre, Jerry W; Toklu, Hale Z; Ye, Fan; Mazza, Joseph; Yale, Steven

    2017-08-07

    Case reports and case series or case study research are descriptive studies that are prepared for illustrating novel, unusual, or atypical features identified in patients in medical practice, and they potentially generate new research questions. They are empirical inquiries or investigations of a patient or a group of patients in a natural, real-world clinical setting. Case study research is a method that focuses on the contextual analysis of a number of events or conditions and their relationships. There is disagreement among physicians on the value of case studies in the medical literature, particularly for educators focused on teaching evidence-based medicine (EBM) for student learners in graduate medical education. Despite their limitations, case study research is a beneficial tool and learning experience in graduate medical education and among novice researchers. The preparation and presentation of case studies can help students and graduate medical education programs evaluate and apply the six American College of Graduate Medical Education (ACGME) competencies in the areas of medical knowledge, patient care, practice-based learning, professionalism, systems-based practice, and communication. A goal in graduate medical education should be to assist residents to expand their critical thinking, problem-solving, and decision-making skills. These attributes are required in the teaching and practice of EBM. In this aspect, case studies provide a platform for developing clinical skills and problem-based learning methods. Hence, graduate medical education programs should encourage, assist, and support residents in the publication of clinical case studies; and clinical teachers should encourage graduate students to publish case reports during their graduate medical education.

  7. Procedures and Claims among US Evidence-Producing Organisations: The Case of the Incredible Years Programme

    Science.gov (United States)

    Karlsson, Patrik; Bergmark, Anders; Lundström, Tommy

    2014-01-01

    We explore how four evidence-producing organisations in the US go ahead when they rate the evidence base for psychosocial interventions, using the Incredible Years programme as our case study. The findings demonstrate variation in the procedures and resulting evidence claims across the organisations, with some organisations being strict and some…

  8. The hOGG1 Ser326Cys polymorphism contributes to digestive system cancer susceptibility: evidence from 48 case-control studies.

    Science.gov (United States)

    Wang, Yang; Gao, Xujie; Wei, Feng; Zhang, Xinwei; Yu, Jinpu; Zhao, Hua; Sun, Qian; Yan, Fan; Yan, Cihui; Li, Hui; Ren, Xiubao

    2015-02-01

    The Ser326Cys polymorphism in the human 8-oxogunaine DNA glycosylase (hOGG1) gene had been implicated in cancer susceptibility. Studies investigating the associations between the Ser326Cys polymorphism and digestion cancer susceptibility showed conflicting results. Therefore, a meta-analysis was performed to derive a more precise estimation of the relationship. We conducted a meta-analysis of 48 studies that included 12,073 cancer cases and 19,557 case-free controls. We assessed the strength of the association using odds ratios (ORs) with 95% confidence intervals (CIs). In our analysis, the hOGG1 Ser326Cys polymorphism was significantly associated with the risk of digestive system cancers (Cys/Cys vs. Ser/Ser: OR = 1.17, 95% CI = 1.00-1.35, P digestive cancers.

  9. Septic Systems Case Studies

    Science.gov (United States)

    A collection of septic systems case studies to help community planners, elected officials, health department staff, state officials, and interested citizens explore alternatives for managing their decentralized wastewater treatment systems.

  10. HYDROGEOLOGIC CASE STUDIES

    Science.gov (United States)

    Hydrogeology is the foundation of subsurface site characterization for evaluations of monitored natural attenuation (MNA). Three case studies are presented. Examples of the potentially detrimental effects of drilling additives on ground-water samples from monitoring wells are d...

  11. A Psychobiographical Case Study

    African Journals Online (AJOL)

    man, and cancer fighter. This psychobiographical case study entailed a psychosocial-historical ... does not draw more attention as a research method, as this approach has .... of the applied Levinsonian theory to the life of Jobs against the ...

  12. Autonomic dysfunction in mild cognitive impairment: evidence from power spectral analysis of heart rate variability in a cross-sectional case-control study.

    Directory of Open Access Journals (Sweden)

    Paola Nicolini

    Full Text Available Mild cognitive impairment (MCI is set to become a major health problem with the exponential ageing of the world's population. The association between MCI and autonomic dysfunction, supported by indirect evidence and rich with clinical implications in terms of progression to dementia and increased risk of mortality and falls, has never been specifically demonstrated.To conduct a comprehensive assessment of autonomic function in subjects with MCI by means of power spectral analysis (PSA of heart rate variability (HRV at rest and during provocative manoeuvres.This cross-sectional study involved 80 older outpatients (aged ≥ 65 consecutively referred to a geriatric unit and diagnosed with MCI or normal cognition (controls based on neuropsychological testing. PSA was performed on 5-minute electrocardiographic recordings under three conditions--supine rest with free breathing (baseline, supine rest with paced breathing at 12 breaths/minute (parasympathetic stimulation, and active standing (orthosympathetic stimulation--with particular focus on the changes from baseline to stimulation of indices of sympathovagal balance: normalized low frequency (LFn and high frequency (HFn powers and the LF/HF ratio. Blood pressure (BP was measured at baseline and during standing. Given its exploratory nature in a clinical population the study included subjects on medications with a potential to affect HRV.There were no significant differences in HRV indices between the two groups at baseline. MCI subjects exhibited smaller physiological changes in all three HRV indices during active standing, consistently with a dysfunction of the orthosympathetic system. Systolic BP after 10 minutes of standing was lower in MCI subjects, suggesting dysautonomia-related orthostatic BP dysregulation.Our study is novel in providing evidence of autonomic dysfunction in MCI. This is associated with orthostatic BP dysregulation and the ongoing follow-up of the study population will

  13. Qualitative Case Study Guidelines

    Science.gov (United States)

    2013-11-01

    Introduction to Sociological Methods. 2nd ed. New York, McGraw-Hill 14. Denzin , N. K. and Lincoln , Y. S. (2011) The SAGE Handbook of Qualitative...The Art of Science. In: Denzin , N. K. and Lincoln , Y. S. (eds.) Handbook of Qualitative Research. Thousand Oaks, Sage 19. GAO (1990) Case Study...Rinehart & Winston 39. Stake, R. E. (1994) Case Studies. In: Denzin , N. K. and Lincoln , Y. S. (eds.) Handbook of Qualitative Research. Thousand Oaks, Sage

  14. Exposure to welding fumes increases lung cancer risk among light smokers but not among heavy smokers: evidence from two case-control studies in Montreal.

    Science.gov (United States)

    Vallières, Eric; Pintos, Javier; Lavoué, Jérôme; Parent, Marie-Élise; Rachet, Bernard; Siemiatycki, Jack

    2012-08-01

    We investigated relationships between occupational exposure to gas and arc welding fumes and the risk of lung cancer among workers exposed to these agents throughout the spectrum of industries. Two population-based case-control studies were conducted in Montreal. Study I (1979-1986) included 857 cases and 1066 controls, and Study II (1996-2001) comprised 736 cases and 894 controls. Detailed job histories were obtained by interview and evaluated by an expert team of chemist-hygienists to estimate degree of exposure to approximately 300 substances for each job. Gas and arc welding fumes were among the agents evaluated. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) of lung cancer using logistic regression, adjusting for smoking history and other covariates. The two studies provided similar results, so a pooled analysis was conducted. Among all subjects, no significant association was found between lung cancer and gas welding fumes (OR = 1.1; 95% CI = 0.9-1.4) or arc welding fumes (OR = 1.0; 95% CI = 0.8-1.2). However, when restricting attention to light smokers, there was an increased risk of lung cancer in relation to gas welding fumes (OR = 2.9; 95% CI = 1.7-4.8) and arc welding fumes (OR = 2.3; 95% CI = 1.3-3.8), with even higher OR estimates among workers with the highest cumulative exposures. In conclusion, there was no detectable excess risk of lung cancer due to welding fumes among moderate to heavy smokers; but among light smokers we found an excess risk related to both types of welding fumes.

  15. Using mixed methods evaluation to assess the feasibility of online clinical training in evidence based interventions: a case study of cognitive behavioural treatment for low back pain.

    Science.gov (United States)

    Richmond, Helen; Hall, Amanda M; Hansen, Zara; Williamson, Esther; Davies, David; Lamb, Sarah E

    2016-06-18

    Cognitive behavioural (CB) approaches are effective in the management of non-specific low back pain (LBP). We developed the CB Back Skills Training programme (BeST) and previously provided evidence of clinical and cost effectiveness in a large pragmatic trial. However, practice change is challenged by a lack of treatment guidance and training for clinicians. We aimed to explore the feasibility and acceptability of an online programme (iBeST) for providing training in a CB approach. This mixed methods study comprised an individually randomised controlled trial of 35 physiotherapists and an interview study of 8 physiotherapists. Participants were recruited from 8 National Health Service departments in England and allocated by a computer generated randomisation list to receive iBeST (n = 16) or a face-to-face workshop (n = 19). Knowledge (of a CB approach), clinical skills (unblinded assessment of CB skills in practice), self-efficacy (reported confidence in using new skills), attitudes (towards LBP management), and satisfaction were assessed after training. Engagement with iBeST was assessed with user analytics. Interviews explored acceptability and experiences with iBeST. Data sets were analysed independently and jointly interpreted. Fifteen (94 %) participants in the iBeST group and 16 (84 %) participants in the workshop group provided data immediately after training. We observed similar scores on knowledge (MD (95 % CI): 0.97 (-1.33, 3.26)), and self-efficacy to deliver the majority of the programme (MD (95 % CI) 0.25 (-1.7; 0.7)). However, the workshop group showed greater reduction in biomedical attitudes to LBP management (MD (95 % CI): -7.43 (-10.97, -3.89)). Clinical skills were assessed in 5 (33 %) iBeST participants and 7 (38 %) workshop participants within 6 months of training and were similar between groups (MD (95 % CI): 0.17(-0.2; 0.54)). Interviews highlighted that while initially sceptical, participants found iBeST acceptable. A number

  16. The impact of stakeholder values and power relations on community-based health insurance coverage: qualitative evidence from three Senegalese case studies.

    Science.gov (United States)

    Mladovsky, Philipa; Ndiaye, Pascal; Ndiaye, Alfred; Criel, Bart

    2015-07-01

    Continued low rates of enrolment in community-based health insurance (CBHI) suggest that strategies proposed for scaling up are unsuccessfully implemented or inadequately address underlying limitations of CBHI. One reason may be a lack of incorporation of social and political context into CBHI policy. In this study, the hypothesis is proposed that values and power relations inherent in social networks of CBHI stakeholders can explain levels of CBHI coverage. To test this, three case studies constituting Senegalese CBHI schemes were studied. Transcripts of interviews with 64 CBHI stakeholders were analysed using inductive coding. The five most important themes pertaining to social values and power relations were: voluntarism, trust, solidarity, political engagement and social movements. Analysis of these themes raises a number of policy and implementation challenges for expanding CBHI coverage. First is the need to subsidize salaries for CBHI scheme staff. Second is the need to develop more sustainable internal and external governance structures through CBHI federations. Third is ensuring that CBHI resonates with local values concerning four dimensions of solidarity (health risk, vertical equity, scale and source). Government subsidies is one of the several potential strategies to achieve this. Fourth is the need for increased transparency in national policy. Fifth is the need for CBHI scheme leaders to increase their negotiating power vis-à-vis health service providers who control the resources needed for expanding CBHI coverage, through federations and a social movement dynamic. Systematically addressing all these challenges would represent a fundamental reform of the current CBHI model promoted in Senegal and in Africa more widely; this raises issues of feasibility in practice. From a theoretical perspective, the results suggest that studying values and power relations among stakeholders in multiple case studies is a useful complement to traditional health

  17. Evidence from a rare case-study for Hebbian-like changes in structural connectivity induced by long-term deep brain stimulation

    Directory of Open Access Journals (Sweden)

    Tim J Van Hartevelt

    2015-06-01

    Full Text Available It is unclear whether Hebbian-like learning occurs at the level of long-range white matter connections in humans, i.e. where measurable changes in structural connectivity are correlated with changes in functional connectivity. However, the behavioral changes observed after deep brain stimulation (DBS suggest the existence of such Hebbian-like mechanisms occurring at the structural level with functional consequences. In this rare case study, we obtained the full network of white matter connections of one patient with Parkinson's disease before and after long-term DBS and combined it with a computational model of ongoing activity to investigate the effects of DBS-induced long-term structural changes. The results show that the long-term effects of DBS on resting-state functional connectivity is best obtained in the computational model by changing the structural weights from the subthalamic nucleus to the putamen and the thalamus in a Hebbian-like manner. Moreover, long-term DBS also significantly changed the structural connectivity towards normality in terms of model-based measures of segregation and integration of information processing, two key concepts of brain organization. This novel approach using computational models to model the effects of Hebbian-like changes in structural connectivity allowed us to causally identify the possible underlying neural mechanisms of long-term DBS using rare case study data. In time, this could help predict the efficacy of individual DBS targeting and identify novel DBS targets.

  18. Effects of Evidence-Based Fall Reduction Programing on the Functional Wellness of Older Adults in a Senior Living Community: A Clinical Case Study.

    Science.gov (United States)

    Harnish, Andrew; Dieter, William; Crawford, Albert; Shubert, Tiffany E

    2016-01-01

    Older adults at a high risk of falls may be referred to a physical therapist. A physical therapy episode of care is designed for the transition of an older adult from a high fall risk to a moderate to low fall risk. However, these episodes of care are limited in time and duration. There is compelling evidence for the efficacy of group-based exercise classes to address risk, and transitioning an older adult from physical therapy to a group-based program may be an effective way to manage risk through the continuum of care. The purpose of this study was to translate research findings into a "real world" setting, and demonstrate the efficacy of integrating evidence-based fall prevention exercises into pre-existing exercise classes at a senior living facility as a "proof of concept" model for future programing. Twenty-four participants aged 65 years and older living in a senior living community and the community were stratified into group-based exercise classes. Cutoff scores from functional outcome measures were used to stratify participants. Exercises from The Otago Exercise Program were implemented into the classes. Functional outcome measures collected included the 10-Meter Walk Test, 30-Second Sit to Stand, and Timed Up and Go (TUG). Number of falls, hospitalizations, and physical therapy episodes of care were also tracked. Data were compared to a control group in a different senior living community that offered classes with similar exercises aimed at improving strength and mobility. The classes were taught by an exercise physiologist and were of equal duration and frequency. Participants demonstrated significant improvements in all functional outcome measures. TUG mean improved from 13.5 to 10.4 s ( p  = 0.034). The 30-Second Sit to Stand mean improved from 10.5 to 13.4 ( p  = 0.002). The 10-Meter Walk Test improved from 0.81 to 0.98 m/s ( p  falls or hospitalizations, and two participants required physical therapy episodes of care. Implementing an

  19. The Impact of a Values-Based Supply Chain (VBSC on Farm-Level Viability, Sustainability and Resilience: Case Study Evidence

    Directory of Open Access Journals (Sweden)

    Teresa Hooks

    2017-02-01

    Full Text Available The ‘Agriculture of the Middle’ (AotM development paradigm emphasises that in order to survive, family farms must transition from a supply chain approach to a values-based supply chain (VBSC approach, involving amendments to both product type and actor dynamics within the chain. This paper presents a qualitative case study of a beef co-operative integrated to a VBSC. We use an analytical framework of viability, sustainability and resilience to analyse impacts at farm-level. Our analysis highlights a number of positive effects on farm-level viability, sustainability and resilience. These benefits stemmed largely from improvements to market orientation, price stability, and members’ capacities in responding to problems. However, the autonomy of the co-operative was challenged by VBSC chain members, which impacted negatively on the stability of the co-operative.

  20. Objectivist case study research

    DEFF Research Database (Denmark)

    Ridder, Hanne Mette Ochsner; Fachner, Jörg

    2016-01-01

    be achieved through the use of objectivist case study research. The strength of the case study design is that it allows for uncovering or suggesting causal relationships in real-life settings through an intensive and rich collection of data. According to Hilliard (1993), the opposite applies for extensive......In order to comprehend the impact of music therapy or music therapy processes, a researcher might look for an approach where the topic under investigation can be understood within a broader context. This calls for a rich inclusion of data and consequently a limited number of participants and may...... designs, in which a small amount of data is gathered on a large number of subjects. With the richness of data, the intensive design is ―the primary pragmatic reason for engaging in single-case or small N research‖ (p. 374) and for working from an idiographic rather than a nomothetic perspective....

  1. Função materna e mito familiar: evidências a partir de um estudo de caso Maternal role and familiar myth: evidences from a case study

    Directory of Open Access Journals (Sweden)

    Andrea Gabriela Ferrari

    2010-12-01

    Full Text Available Discute-se a importância do mito familiar para a função materna. Este mito se refere ao lugar do bebê, revelado por meio do discurso dirigido ao personagem que ele encarna na fantasia fundamental dos pais e que está relacionado àquilo que o precede. Consideramos que este mito tem impacto fundamental na constituição subjetiva do futuro sujeito. Tais aspectos conceituais receberam apoio no estudo de caso de uma mãe, da gestação até os oito meses do bebê. A partir deste caso se percebe o efeito e a importância da montagem imaginativa materna desde antes do nascimento do bebê.This article discusses the importance of the family myth for the maternal role. This myth refers to the infant's place revealed through the discourse directed towards the character that the infant embodies in the parents' fundamental fantasy and it is related to that which precedes him. We consider that this myth has a fundamental impact on the subjective constitution of the future subject. Such conceptual aspects were supported by a case study involving a mother, from her pregnancy to the child's eighth month of life. Based on this case the effect and importance of maternal imaginative process from before the infant's birth are highlighted.

  2. Case Studies - Cervical Cancer

    Centers for Disease Control (CDC) Podcasts

    Dr. Alan Waxman, a professor of obstetrics and gynecology at the University of New Mexico and chair of the American College of Obstetricians and Gynecologists (ACOG) committee for the underserved, talks about several case studies for cervical cancer screening and management.

  3. Nuclear forensics case studies

    International Nuclear Information System (INIS)

    Fedchenko, Vitaly

    2016-01-01

    The objective of this presentation is to share three case studies from the Institute of Transuranium Elements (ITU) which describe the application of nuclear forensics to events where nuclear and other radioactive material was found to be out of regulatory control

  4. SCA12 case study

    Indian Academy of Sciences (India)

    Home; Journals; Journal of Genetics; Volume 88; Issue 1. Utilizing linkage disequilibrium information from Indian Genome Variation Database for mapping mutations: SCA12 case study. Samira Bahl Ikhlak Ahmed The Indian Genome Variation Consortium Mitali Mukerji. Research Article Volume 88 Issue 1 April 2009 pp 55- ...

  5. national Case study

    African Journals Online (AJOL)

    This national case study reports on the development of a national network, ... system under the new policy), tends to be limited by content on problems and ... 20 credit programme; and within two Post Graduate Certificate of Education contexts, ...... descriptive with an issues focus (empirical) towards awareness production to.

  6. Human Lung Cancer Risks from Radon – Part III - Evidence of Influence of Combined Bystander and Adaptive Response Effects on Radon Case-Control Studies - A Microdose Analysis

    Science.gov (United States)

    Leonard, Bobby E.; Thompson, Richard E.; Beecher, Georgia C.

    2012-01-01

    Since the publication of the BEIR VI (1999) report on health risks from radon, a significant amount of new data has been published showing various mechanisms that may affect the ultimate assessment of radon as a carcinogen, in particular the potentially deleterious Bystander Effect (BE) and the potentially beneficial Adaptive Response radio-protection (AR). The case-control radon lung cancer risk data of the pooled 13 European countries radon study (Darby et al 2005, 2006) and the 8 North American pooled study (Krewski et al 2005, 2006) have been evaluated. The large variation in the odds ratios of lung cancer from radon risk is reconciled, based on the large variation in geological and ecological conditions and variation in the degree of adaptive response radio-protection against the bystander effect induced lung damage. The analysis clearly shows Bystander Effect radon lung cancer induction and Adaptive Response reduction in lung cancer in some geographical regions. It is estimated that for radon levels up to about 400 Bq m−3 there is about a 30% probability that no human lung cancer risk from radon will be experienced and a 20% probability that the risk is below the zero-radon, endogenic spontaneous or perhaps even genetically inheritable lung cancer risk rate. The BEIR VI (1999) and EPA (2003) estimates of human lung cancer deaths from radon are most likely significantly excessive. The assumption of linearity of risk, by the Linear No-Threshold Model, with increasing radon exposure is invalid. PMID:22942874

  7. MRI case studies

    International Nuclear Information System (INIS)

    Huggett, S.; Barber, J.

    1989-01-01

    Three case studies are presented to show the value of magnetic resonance imaging used in conjunction with other imaging techniques. In each case MRI proved a vital diagnostic tool and superior to CT in showing firstly the haematoma in a patient with aphasia and right-sided weakness, secondly the size of the disc herniation in a patient with severe leg and ankle pains and thirdly the existence of a metastatic lesion in a patient with a previous history of breast cancer. 11 figs

  8. A method for co-creation of an evidence-based patient workbook to address alcohol use when quitting smoking in primary care: a case study.

    Science.gov (United States)

    Minian, Nadia; Noormohamed, Aliya; Zawertailo, Laurie; Baliunas, Dolly; Giesbrecht, Norman; Le Foll, Bernard; Rehm, Jürgen; Samokhvalov, Andriy; Selby, Peter L

    2018-01-01

    The purpose of this paper is to describe a patient engagement event designed to create an educational workbook with smokers who drink alcohol at harmful levels. The goal was to create a workbook that combined scientific evidence with patients' values, preferences, and needs. Fourteen adult smokers who drink alcohol were invited to the Centre for Addiction and Mental Health (CAMH) to take part in a four-hour event to help design the workbook with the CAMH research team. Participants provided their opinions and ideas to create an outline for the workbook, including activities, images, and titles. The workbook - called Self-Awareness - is currently being offered in a smoking cessation program in 221 primary care clinics across Ontario to help smokers quit or reduce their harmful alcohol use. The patient engagement event was a useful way to co-create educational materials that incorporate both scientific research and patient needs. Background Evidence-based medicine is the integration of best research evidence with clinical expertise and patient values. There are few methodologies on how to design evidence-based programs and resources to include patient values. The latter is an important aspect of patient-centered care, and is essential for patients to trust the recommendations and empower them as consumers to make informed choices. This manuscript describes a participatory research approach to design patient-facing educational materials that incorporate both evidence-based and community-sensitive principles. These materials are intended to support smokers to reduce or stop harmful alcohol consumption. Methods Adult smokers who report consuming alcohol were invited to a co-creation meeting at the Centre for Addiction and Mental Health's Nicotine Dependence Service to guide the adaptation of evidence-based materials. The four-hour event consisted of individual reflections, group discussions, and consensus-building interactions. Detailed notes were taken and then

  9. HIGH-SPEED RAILWAY AND TOURISM: IS THERE AN IMPACT ON INTERMEDIATE CITIES? EVIDENCE FROM TWO CASE STUDIES IN CASTILLA-LA MANCHA (SPAIN

    Directory of Open Access Journals (Sweden)

    Carmen VÁZQUEZ VARELA

    2016-12-01

    Full Text Available The expectations of cities served by High Speed Rail are numerous. Improvements in a destination’s accessibility could lead to an increase in transport demand and the revitalization of urban and business tourism. However, High Speed Rail services do not automatically affect the choice of destination even if they improve accessibility. Even so, they can improve visitation rates when tourist amenities are located near High Speed Rail stations becoming therefore easily accessible. The development of tourism is also influenced by the collective strategies of local stakeholders. Larger cities also appear able to leverage higher tourist volumes from the construction of High Speed Rail and most analyses to date have focused upon them. Thus we focus here on how the arrival of High Speed Rail services has impacted tourism on medium sized cities. Using a diachronic study of different socio-economic variables and tourist features, this article analyses the impact that the new rail infrastructure can have on tourism in two selected cases in Spain: Cuenca and Toledo.

  10. Applying a Health Network approach to translate evidence-informed policy into practice: a review and case study on musculoskeletal health.

    Science.gov (United States)

    Briggs, Andrew M; Bragge, Peter; Slater, Helen; Chan, Madelynn; Towler, Simon C B

    2012-11-14

    While translation of evidence into health policy and practice is recognised as critical to optimising health system performance and health-related outcomes for consumers, mechanisms to effectively achieve these goals are neither well understood, nor widely communicated. Health Networks represent a framework which offers a possible solution to this dilemma, particularly in light of emerging evidence regarding the importance of establishing relationships between stakeholders and identifying clinical leaders to drive evidence integration and translation into policy. This is particularly important for service delivery related to chronic diseases. In Western Australia (WA), disease and population-specific Health Networks are comprised of cross-discipline stakeholders who work collaboratively to develop evidence-informed policies and drive their implementation. Since establishment of the Health Networks in WA, over 50 evidence-informed Models of Care (MoCs) have been produced across 18 condition or population-focused Networks. The aim of this paper is to provide an overview of the Health Network framework in facilitating the translation of evidence into policy and practice with a particular focus on musculoskeletal health. A review of activities of the WA Musculoskeletal Health Network was undertaken, focussing on outcomes and the processes used to achieve them in the context of: development of policy, procurement of funding, stakeholder engagement, publications, and projects undertaken by the Network which aligned to implementation of MoCs.The Musculoskeletal Health Network has developed four MoCs which reflect Australian National Health Priority Areas. Establishment of community-based services for consumers with musculoskeletal health conditions is a key recommendation from these MoCs. Through mapping barriers and enablers to policy implementation, working groups, led by local clinical leaders and supported by the broader Network and government officers, have

  11. Case study - Czechoslovakia

    International Nuclear Information System (INIS)

    Kovar, P.

    1986-01-01

    In the lecture Case Study - Czechoslovakia with the sub-title 'Unified System of Personnel Preparation for Nuclear Programme in Czechoslovakia' the actual status and the current experience of NPP personnel training and preparation in Czechoslovakia are introduced. The above mentioned training system is presented and demonstrated by the story of a proxy person who is going to become shift engineer in a nuclear power plant in Czechoslovakia. (orig./HP)

  12. Case Studies - Cervical Cancer

    Centers for Disease Control (CDC) Podcasts

    2010-10-15

    Dr. Alan Waxman, a professor of obstetrics and gynecology at the University of New Mexico and chair of the American College of Obstetricians and Gynecologists (ACOG) committee for the underserved, talks about several case studies for cervical cancer screening and management.  Created: 10/15/2010 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Cancer Prevention and Control (DCPC).   Date Released: 6/9/2010.

  13. Risk of new acute myocardial infarction hospitalization associated with use of oral and parenteral non-steroidal anti-inflammation drugs (NSAIDs: a case-crossover study of Taiwan's National Health Insurance claims database and review of current evidence

    Directory of Open Access Journals (Sweden)

    Shau Wen-Yi

    2012-02-01

    Full Text Available Abstract Background Previous studies have documented the increased cardiovascular risk associated with the use of some nonsteroidal anti-inflammatory drugs (NSAIDs. Despite this, many old NSAIDs are still prescribed worldwide. Most of the studies to date have been focused on specific oral drugs or limited by the number of cases examined. We studied the risk of new acute myocardial infarction (AMI hospitalization with current use of a variety of oral and parenteral NSAIDs in a nationwide population, and compared our results with existing evidence. Methods We conducted a case-crossover study using the Taiwan's National Health Insurance claim database, identifying patients with new AMI hospitalized in 2006. The 1-30 days and 91-120 days prior to the admission were defined as case and matched control period for each patient, respectively. Uses of NSAIDs during the respective periods were compared using conditional logistic regression and adjusted for use of co-medications. Results 8354 new AMI hospitalization patients fulfilled the study criteria. 14 oral and 3 parenteral NSAIDs were selected based on drug utilization profile among 13.7 million NSAID users. The adjusted odds ratio, aOR (95% confidence interval, for risk of AMI and use of oral and parenteral non-selective NSAIDs were 1.42 (1.29, 1.56 and 3.35 (2.50, 4.47, respectively, and significantly greater for parenteral than oral drugs (p for interaction Conclusions The collective evidence revealed the tendency of increased AMI risk with current use of some NSAIDs. A higher AMI risk associated with use of parenteral NSAIDs was observed in the present study. Ketorolac had the highest associated risk in both oral and parenteral NSAIDs studied. Though further investigation to confirm the association is warranted, prescribing physicians and the general public should be cautious about the potential risk of AMI when using NSAIDs.

  14. Operational risk in bank governance and control: How to save capital requirement through a risk transfer strategy. Evidences from a simulated case study

    Directory of Open Access Journals (Sweden)

    Enzo Scannella

    2015-06-01

    Full Text Available Operational risk management in banking has assumed such importance during the last decade. It has become increasingly important to measure, manage, and assess the impact of operational risk in the economics of banking. The purpose of this paper is to demonstrate how an effective operational risk management provides mitigating effects on capital-at-risk in banking. The paper provides evidences that an implementation of an operational risk transfer strategy reduces bank capital requirement. The paper adopts the loss distribution approach, the Monte Carlo simulation, and copula methodologies to estimate the regulatory capital and simulate an operational risk transfer strategy in banking.

  15. Case Study - Alpha

    Directory of Open Access Journals (Sweden)

    Stephen Leybourne

    2016-11-01

    Full Text Available This case study was developed from an actual scenario by Dr. Steve Leybourne of Boston University.  The case documents the historical evolution of an organization, and has been used successfully in courses dealing with organizational and cultural change, and the utilization of ‘soft skills’ in project-based management. This is a short case, ideal for classroom use and discussion.  The issues are easily accessible to students, and there is a single wide ranging question that allows for the inclusion of many issues surrounding strategic decision-making, and behavioural and cultural change. Alpha was one of the earlier companies in the USA to invest in large, edge-of-town superstores, with plentiful free vehicle parking, selling food and related household products. Alpha was created in the 1950s as a subsidiary of a major publicly quoted retail group.  It started business by opening a string of very large discount stores in converted industrial and warehouse premises in the south of the United States. In the early days shoppers were offered a limited range of very competitively priced products. When Alpha went public in 1981 it was the fourth largest food retailer in the US, selling an ever-widening range of food and non-food products.  Its success continued to be based on high volume, low margins and good value for money, under the slogan of ‘Alpha Price.’

  16. NOx trade. Case studies

    International Nuclear Information System (INIS)

    Jantzen, J.

    2002-01-01

    Some of the questions with respect to the trade of nitrogen oxides that businesses in the Netherlands have to deal with are dealt with: should a business buy or sell rights for NOx emission; which measures must be taken to reduce NOx emission; how much must be invested; and how to deal with uncertainties with regard to prices. Simulations were carried out with the MOSES model to find the answers to those questions. Results of some case studies are presented, focusing on the chemical sector in the Netherlands. Finally, the financial (dis)advantages of NOx trade and the related uncertainties for a single enterprise are discussed [nl

  17. OBSESSIONS: CASE REPORT STUDY

    Directory of Open Access Journals (Sweden)

    Miloš Židanik

    2004-01-01

    Full Text Available Background. Obsessions are one of the most refractory psychiatric disorders. The therapeutic guidelines include a psychopharmacotherapy and the use of behavioural and supportive psychotherapy.Methods. This case report study presents a patient with a homicide obsessions at the forefront and narcissistic personality disorder in background. The use of analytical oriented psychotherapy, which helped to resolve axis-1 symptoms, is described.Conclusions. In the therapy of patients it is important to have the knowledge about the national therapeutic guidelines and critical distance toward them as well. Which therapy to use should be decided by the individual patient’s needs.

  18. The evidences of progressive pressurization of volcanic conduit as driving forces of unrest phenomena analyzed via modelling of multiplatform geodetic measurements: Fernandina (GALAPAGOS) and Maunaloa (HAWAII) case studies

    Science.gov (United States)

    Pepe, Susi; Castaldo, Raffaele; Casu, Francesco; D'Auria, Luca; De Luca, Claudio; De Novellis, Vincenzo; Solaro, Giuseppe; Tizzani, Pietro

    2017-04-01

    collection, we determined the source responsible of deformation observed and in particular the results of our inversions show that the pipe source contributes substantially to both the ground deformation pattern and the cost function. In the case of Fernandina Volcano (Galápagos) we exploited the advanced Differential SAR Interferometry (DInSAR) techniques to analyze the 2012-2013 uplift episode by using X-band data from the COSMO-SkyMed (CSK) satellite constellation. This volcano falls among those not well monitored, therefore, the availability of CSK data, acquired with a repeat time ranging from 4 to 12 days and with a ground resolution of 3 meters, represents a unique opportunity to perform a detailed study of the space and time ground deformation field changes (Sansosti et al., 2014). In addition, in this case study we computed the ground deformation time series by applying the Small BAseline Subset (SBAS)-DInSAR approach (Berardino et al., 2002) to CSK data, acquired from both ascending and descending orbits. The results of their combination (vertical and horizontal E-W components) are used in order to evaluate, through a cross correlation analysis (Tizzani et al., 2009; 2015), the volcanic areas that are characterized by similar uplift temporal behavior. Subsequently, we determine the geometry, location and the temporal evolution of the geodetic source responsible for the 2012 - 2013 uplift event by applying an inverse method to the DInSAR measurements. We search for its geometrical parameters and volume variation that minimize the difference between the observed data and the modelled ground deformation field. We tested various analytical models and finally, using the Akaike Information Criterion (Akaike, 1965) among the tested analytical sources, we selected the tilted pipe. The pipe model is similar to the prolate ellipsoid, but the size of the smaller axis is kept fixed to a very small value (i.e., 10 m). Despite having a similar fit with the prolate ellipsoid

  19. Evidence Study Guide. Revision (Naval Justice School)

    Science.gov (United States)

    1992-07-01

    404(b). See United States v. Thomas, 11 M.J. 388 (C.M.A. 1981) and United States v. Dawkins 2 M.J. 898 (A.C.M.R. 1976) (pre-Mil.R.Evid. cases applying...criminal activity). 1313 BODY INTRUSiONS (Key N-;i-,crs 1049 et seq) A. Genes - 1. Mil.R.Evid. 312. Certain searches, such as searches of body cavities...inflammatory. For example, the trial counsel may not assert that the members are " selfish , self-centered and are not fulfilling [their] responsibility to

  20. A journal club is an effective tool for assisting librarians in the practice of evidence-based librarianship: a case study.

    Science.gov (United States)

    Pearce-Smith, Nicola

    2006-03-01

    To establish a journal club for librarians, which aimed to develop appraisal skills and assist in the application of research to practice. Fourteen health librarians were invited to attend a journal club. Each month a librarian was responsible for preparing a scenario, choosing a research paper, and selecting a checklist. The paper was appraised by the club, and a critically appraised topic (CAT) prepared. Six months later, a questionnaire was sent to all librarians. Six out of 14 librarians attended the journal club and five out of six returned the questionnaire. All five agreed that attending the journal club helped them develop appraisal skills, write a CAT and be more critical of research. Four agreed they always identified a research paper first, then formulated a question. One librarian agreed that applying results to their own practice was difficult, one disagreed and three were neutral. Journal clubs can be effective at developing appraisal skills and writing a CAT, as well as increasing the reading of library research. Librarians still need assistance in identifying and using questions directly from their own practice. The journal club has helped some librarians to apply evidence to practice, but others find the research is not always directly relevant.

  1. Rapid precipitation of silica (opal-A) disguises evidence of biogenicity in high-temperature geothermal deposits: Case study from Dagunguo hot spring, China

    Science.gov (United States)

    Peng, Xiaotong; Jones, Brian

    2012-06-01

    Dagunguo Spring, located in the Tengchong geothermal area in the western part of Yunnan Province, China, is a very active spring with water temperatures of 78 to 97 °C and pH of 7.7 to 8.8. The vent pool, 5.6 m in diameter and up to 1.5 m deep, is lined with opal-A that was precipitated from the near-boiling spring waters. A glass suspended in the pool was coated with opal-A in two months and two PVC pipes that drained water from the pool in late 2010 became lined with opal-A precipitates in less than three months. The opal-A accumulated at rates of 0.5 to 0.75 mm/month in the spring pool and 2.5 to 3.5 mm/month in the PVC pipes. The opal-A precipitates, irrespective of where they developed, are formed primarily of silicified microbes and opal-A spheres along with minor amounts of native sulfur, detrital quartz, and clay (mainly kaolinite). The fabrics in these opal-A deposits were dictated largely by the growth patterns of the filamentous and rod-shaped microbes that dominate this low-diversity biota and the amount of opal-A that was precipitated around them. Many of the microbes were preserved as rapid opal-A was precipitated on and around them before the cells decayed. With continued precipitation, however, the microbes became quickly engulfed in the opal-A precipitates and morphological evidence of their presence was lost. In essence, the process that controls their preservation ultimately disguised them to the point where cannot be seen. Critically, this loss of morphological identity takes places even before opal-A starts its diagenetic transformation towards quartz.

  2. Disturbances in Body Ownership in Schizophrenia: Evidence from the Rubber Hand Illusion and Case Study of a Spontaneous Out-of-Body Experience

    OpenAIRE

    Thakkar, Katharine N.; Nichols, Heathman S.; McIntosh, Lindsey G.; Park, Sohee

    2011-01-01

    Background A weakened sense of self may contribute to psychotic experiences. Body ownership, one component of self-awareness, can be studied with the rubber hand illusion (RHI). Watching a rubber hand being stroked while one's unseen hand is stroked synchronously can lead to a sense of ownership over the rubber hand, a shift in perceived position of the real hand, and a limb-specific drop in stimulated hand temperature. We aimed to assess the RHI in schizophrenia using quantifiable measures: ...

  3. Product Attributes and Purchasing Behaviour: How Parents' Food Choices Can Act on Their Children's BMI? Empirical Evidence from a Case Study.

    Science.gov (United States)

    Telese, Antonietta; Scarpato, Debora; Rotondo, Giacomo; Simeone, Mariarosaria

    2016-01-01

    Given the epidemic proportions and economic costs associated with nutrition related diseases in Western countries, an empirical study was carried-out between September and December 2014 in Campania, the Italian region with the highest prevalence of obese children. The survey was conducted in a secondary school and involved 145 children, aged 11 to 14, and their parents, with the ultimate aim of studying the relationship between the behaviour of parents regarding the use of nutrition labels, the attention to product quality and the body weight of their children. The results from our study showed that unhealthy diet concerned stems from the misguided food choices of their parents, who are responsible for their children's dietary habits, lifestyle and body weight. In order to incentivise adults and young people to change their food choices and eating behaviour in favour of healthy and sustainable lifestyles, some useful measures could involve the improvement of political marketing and advertising, labelling clarity and better information and awareness campaigns to do sport and eat healthily. Finally some recent patents related to healthy reformulated food products and communication strategies, with specific regard to healthy eating, have been reviewed.

  4. The limits of evidence in drug approval and availability: a case study of cilostazol and naftidrofuryl for the treatment of intermittent claudication.

    Science.gov (United States)

    Hong, Haeyeon; Mackey, William C

    2014-08-01

    Despite numerous efforts to develop effective medications for the treatment of intermittent claudication (IC) over the past 4 decades, a gold standard medical management option has yet to be defined. Although not life-threatening, IC interferes with mobility and activities of daily living, significantly impairing quality of life and potentially causing depression. Cilostazol, the leading pharmacologic agent for IC in the United States, was approved by the US Food and Drug Administration (FDA) in 1999 based on controversial data. Meanwhile, naftidrofuryl, the first-line pharmacologic agent for IC in the United Kingdom and Europe, has never been approved by the FDA and therefore is not available in the United States. The clinical data for cilostazol and naftidrofuryl are plagued by flaws related to lack of protocol standardization, objective endpoints, and strict eligibility criteria in study subjects, making identification of a true treatment effect impossible. Furthermore, no prospective randomized trial comparing the efficacy of cilostazol and naftidrofuryl has been conducted, because the manufacturers of these agents have much to lose and little to gain from such a study. This article provides an overview of the pharmacology of cilostazol and naftidrofuryl, and the clinical studies leading to their approval and clinical acceptance. It further explores the possible sources of bias in analyzing these clinical trials, some of which have been brought to light by the National Institute for Health and Clinical Excellence (NICE) of the United Kingdom in its technology appraisal guidance. It also speculates the ways in which economic incentives may affect drug-marketing decisions. A literature review of pharmacology and clinical trials for cilostazol and naftidrofuryl was performed in PubMed. The majority of included clinical trials were initially identified through the most recent Cochrane review articles as well as the FDA's approval packet for cilostazol. The

  5. Goiania incident case study

    International Nuclear Information System (INIS)

    Petterson, J.S.

    1988-06-01

    The reasons for wanting to document this case study and present the findings are simple. According to USDOE technical risk assessments (and our own initial work on the Hanford socioeconomic study), the likelihood of a major accident involving exposure to radioactive materials in the process of site characterization, construction, operation, and closure of a high-level waste repository is extremely remote. Most would agree, however, that there is a relatively high probability that a minor accident involving radiological contamination will occur sometime during the lifetime of the repository -- for example, during transport, at an MRS site or at the permanent site itself during repacking and deposition. Thus, one of the major concerns of the Yucca Mountain Socioeconomic Study is the potential impact of a relatively minor radiation-related accident. A large number of potential impact of a relatively minor radiation-related accident. A large number of potential accident scenarios have been under consideration (such as a transportation or other surface accident which results in a significant decline in tourism, the number of conventions, or the selection of Nevada as a retirement residence). The results of the work in Goiania make it clear, however, that such a significant shift in established social patterns and trends is not likely to occur as a direct outcome of a single nuclear-related accident (even, perhaps, a relatively major one), but rather, are likely to occur as a result of the enduring social interpretations of such an accident -- that is, as a result of the process of understanding, communicating, and socially sustaining a particular set of associations with respect to the initial incident

  6. FMCT verification: Case studies

    International Nuclear Information System (INIS)

    Hui Zhang

    2001-01-01

    Full text: How to manage the trade-off between the need for transparency and the concern about the disclosure of sensitive information would be a key issue during the negotiations of FMCT verification provision. This paper will explore the general concerns on FMCT verification; and demonstrate what verification measures might be applied to those reprocessing and enrichment plants. A primary goal of an FMCT will be to have the five declared nuclear weapon states and the three that operate unsafeguarded nuclear facilities become parties. One focus in negotiating the FMCT will be verification. Appropriate verification measures should be applied in each case. Most importantly, FMCT verification would focus, in the first instance, on these states' fissile material production facilities. After the FMCT enters into force, all these facilities should be declared. Some would continue operating to produce civil nuclear power or to produce fissile material for non- explosive military uses. The verification measures necessary for these operating facilities would be essentially IAEA safeguards, as currently being applied to non-nuclear weapon states under the NPT. However, some production facilities would be declared and shut down. Thus, one important task of the FMCT verifications will be to confirm the status of these closed facilities. As case studies, this paper will focus on the verification of those shutdown facilities. The FMCT verification system for former military facilities would have to differ in some ways from traditional IAEA safeguards. For example, there could be concerns about the potential loss of sensitive information at these facilities or at collocated facilities. Eventually, some safeguards measures such as environmental sampling might be seen as too intrusive. Thus, effective but less intrusive verification measures may be needed. Some sensitive nuclear facilities would be subject for the first time to international inspections, which could raise concerns

  7. Sources of sulphate minerals in limestone cave-a possible evidence of anthropogenic activity: a case study in Črna Jama Cave (Slovenia).

    Science.gov (United States)

    Jarc, Simona; Miler, Miloš; Šebela, Stanka; Zupančič, Nina

    2017-12-01

    In the caves, the formation of cave minerals is a consequence of a variety of chemical reactions, some of them also due to human activity. There are many caves in Slovenia, but sulphate minerals are not very often reported and analysed. In this study, the presence of sulphate minerals is detected by SEM/EDS analysis of speleothems from Črna Jama, a cave near Kočevje (southern Slovenia). The cave is characterised by its dark, almost black colour on cave walls, floor and speleothems. Anthropogenic influence in the cave is still visible, including the remains of a fireplace, some inscriptions on the walls and wooden containers. The analyses of some of the black-coated speleothems reveal the presence of calcium sulphate, confirmed by XRD as gypsum. Gypsum crystals are around 50 μm in size, and they occur in thin crusts. Additionally, some rare authigenic baryte crystals a few micrometres in size are detected. The sulphates δ 34 S value in gypsum found on dark coloured speleothems is + 10.4‰ Vienna Canyon Diablo Troilite (VCDT), while the sulphate δ 34 S of the bedrock is + 8.6‰ VCDT. The more likely source of sulphate ions is thus biomass burning rather than bedrock. Also, bedrock and biomass ash are a very probable source of calcium and barium. The highly probable pyrogenous origin of sulphates draws attention to human impact on cave mineralogy.

  8. Disturbances in body ownership in schizophrenia: evidence from the rubber hand illusion and case study of a spontaneous out-of-body experience.

    Directory of Open Access Journals (Sweden)

    Katharine N Thakkar

    Full Text Available A weakened sense of self may contribute to psychotic experiences. Body ownership, one component of self-awareness, can be studied with the rubber hand illusion (RHI. Watching a rubber hand being stroked while one's unseen hand is stroked synchronously can lead to a sense of ownership over the rubber hand, a shift in perceived position of the real hand, and a limb-specific drop in stimulated hand temperature. We aimed to assess the RHI in schizophrenia using quantifiable measures: proprioceptive drift and stimulation-dependent changes in hand temperature.The RHI was elicited in 24 schizophrenia patients and 21 matched controls by placing their unseen hand adjacent to a visible rubber hand and brushing real and rubber hands synchronously or asynchronously. Perceived finger location was measured before and after stimulation. Hand temperature was taken before and during stimulation. Subjective strength of the illusion was assessed by a questionnaire.Across groups, the RHI was stronger during synchronous stimulation, indicated by self-report and proprioceptive drift. Patients reported a stronger RHI than controls. Self-reported strength of RHI was associated with schizotypy in controls Proprioceptive drift was larger in patients, but only following synchronous stimulation. Further, we observed stimulation-dependent changes in skin temperature. During right hand stimulation, temperature dropped in the stimulated hand and rose in the unstimulated hand. Interestingly, induction of RHI led to an out-of-body experience in one patient, linking body disownership and psychotic experiences.The RHI is quantitatively and qualitatively stronger in schizophrenia. These findings suggest that patients have a more flexible body representation and weakened sense of self, and potentially indicate abnormalities in temporo-parietal networks implicated in body ownership. Further, results suggest that these body ownership disturbances might be at the heart of a subset of

  9. Disturbances in Body Ownership in Schizophrenia: Evidence from the Rubber Hand Illusion and Case Study of a Spontaneous Out-of-Body Experience

    Science.gov (United States)

    Thakkar, Katharine N.; Nichols, Heathman S.; McIntosh, Lindsey G.; Park, Sohee

    2011-01-01

    Background A weakened sense of self may contribute to psychotic experiences. Body ownership, one component of self-awareness, can be studied with the rubber hand illusion (RHI). Watching a rubber hand being stroked while one's unseen hand is stroked synchronously can lead to a sense of ownership over the rubber hand, a shift in perceived position of the real hand, and a limb-specific drop in stimulated hand temperature. We aimed to assess the RHI in schizophrenia using quantifiable measures: proprioceptive drift and stimulation-dependent changes in hand temperature. Methods The RHI was elicited in 24 schizophrenia patients and 21 matched controls by placing their unseen hand adjacent to a visible rubber hand and brushing real and rubber hands synchronously or asynchronously. Perceived finger location was measured before and after stimulation. Hand temperature was taken before and during stimulation. Subjective strength of the illusion was assessed by a questionnaire. Results Across groups, the RHI was stronger during synchronous stimulation, indicated by self-report and proprioceptive drift. Patients reported a stronger RHI than controls. Self-reported strength of RHI was associated with schizotypy in controls Proprioceptive drift was larger in patients, but only following synchronous stimulation. Further, we observed stimulation-dependent changes in skin temperature. During right hand stimulation, temperature dropped in the stimulated hand and rose in the unstimulated hand. Interestingly, induction of RHI led to an out-of-body experience in one patient, linking body disownership and psychotic experiences. Conclusions The RHI is quantitatively and qualitatively stronger in schizophrenia. These findings suggest that patients have a more flexible body representation and weakened sense of self, and potentially indicate abnormalities in temporo-parietal networks implicated in body ownership. Further, results suggest that these body ownership disturbances might be at

  10. 425 Case study

    African Journals Online (AJOL)

    Marinda

    Anaesthesia management of acute aortic dissection type B in ... of a severe, constant abdominal and chest pain radiating to the ... Continuous spinal anaesthesia was induced ... these cases surgical intervention is critical.1,2 Type B of AAD is.

  11. Employee Turnover: Evidence from a Case Study.

    Science.gov (United States)

    Borland, Jeff

    1997-01-01

    Patterns of employee turnover from a medium-sized law firm in Australia were examined in regard to theories of worker mobility (matching, sectoral shift, and incentive). Results support a role for matching effects, but personnel practices affect the timing of turnover. Matching and incentive-based theories do not explain the high rates of turnover…

  12. Agreement between the results of meta-analyses from case reports and from clinical studies regarding the efficacy of laronidase therapy in patients with mucopolysaccharidosis type I who initiated enzyme replacement therapy in adult age: An example of case reports meta-analyses as an useful tool for evidence-based medicine in rare diseases.

    Science.gov (United States)

    Sampayo-Cordero, Miguel; Miguel-Huguet, Bernat; Pardo-Mateos, Almudena; Moltó-Abad, Marc; Muñoz-Delgado, Cecilia; Pérez-López, Jordi

    2018-02-01

    Case reports might have a prominent role in the rare diseases field, due to the small number of patients affected by one such disease. A previous systematic review regarding the efficacy of laronidase therapy in patients with mucopolysaccharidosis type I (MPS-I) who initiated enzyme replacement therapy (ERT) in adult age has been published. The review included a meta-analysis of 19 clinical studies and the description of eleven case reports. It was of interest to perform a meta-analysis of those case reports to explore the role of such meta-analyses as a tool for evidence-based medicine in rare diseases. The study included all case reports with standard treatment regimen. Primary analysis was the percentage of case reports showing an improvement in a specific outcome. Only when that percentage was statistically higher than 5%, the improvement was confirmed as such. The outcomes that accomplished this criterion were ranked and compared to the GRADE criteria obtained by those same outcomes in the previous meta-analysis of clinical studies. There were three outcomes that had a significant improvement: Urine glycosaminoglycans, liver volume and 6-minute walking test. Positive and negative predictive values, sensitivity and specificity for the results of the meta-analysis of case reports as compared to that of clinical studies were 100%, 88.9%, 75% and 100%, respectively. Accordingly, absolute (Rho=0.82, 95%CI: 0.47 to 0.95) and relative agreement (Kappa=0.79, 95%CI: 0.593 to 0.99) between the number of case reports with improvement in a specific outcome and the GRADE evidence score for that outcome were good. Sensitivity analysis showed that agreement between the meta-analysis of case reports and that of the clinical studies were good only when using a strong confirmatory strategy for outcome improvement in case reports. We found an agreement between the results of meta-analyses from case reports and from clinical studies in the efficacy of laronidase therapy in

  13. Engaging in Argument from Evidence and the Ocean Sciences Sequence for Grades 3-5: A case study in complementing professional learning experiences with instructional materials aligned to instructional goals

    Science.gov (United States)

    Schoedinger, S. E.; Weiss, E. L.

    2016-12-01

    K-5 science teachers, who often lack a science background, have been tasked with a huge challenge in implementing NGSS—to completely change their instructional approach from one that views science as a body of knowledge to be imparted to one that is epistemic in nature. We have found that providing high-quality professional learning (PL) experiences is often not enough and that teachers must have instructional materials that align with their instructional goals. We describe a case study in which the Lawrence Hall of Science (the Hall) used the Hall-developed Ocean Sciences Sequence for Grades 3-5 (OSS 3-5) to support a rigorous PL program for grade 3-5 teachers focused on the NGSS science and engineering practice, engaging in argument from evidence. Developed prior to the release of NGSS, the Ocean Literacy Framework and the NGSS precursor, A Framework for K-12 Science Education, informed the content and instructional approaches of OSS 3-5. OSS 3-5 provides a substantial focus on making evidence-based explanations (and other science practices), while building students' ocean sciences content knowledge. From 2013-2015, the Hall engaged cohorts of teachers in a rigorous PL experience focused on engaging in argument from evidence. During the summer, teachers attended a week-long institute, in which exemplar activities from OSS 3-5 were used to model instructional practices to support arguing from evidence and related practices, e.g., developing and using models and constructing explanations. Immediately afterward, teachers enacted what they'd learned during a two-week summer school practicum. Here, they team-taught the OSS 3-5 curriculum, participated in video reflection groups, and received coaching and just-in-time input from instructors. In the subsequent academic year, many teachers began by teaching OSS 3-5 so that they could practice engaging students in argumentation in curriculum they'd already used for that purpose. Throughout the year, teachers

  14. Higher blood 25(OHD level may reduce the breast cancer risk: evidence from a Chinese population based case-control study and meta-analysis of the observational studies.

    Directory of Open Access Journals (Sweden)

    Peizhan Chen

    Full Text Available Experimental data suggest a protective effect of vitamin D on breast cancer; however, epidemiologic results remain inclusive. With a Chinese population-based case-control study and meta-analysis of the observational studies, we here systematically evaluated the association of blood 25(OHD level and breast cancer risk. With 593 breast cancer cases and 580 cancer-free controls from Shanghai, China, we found that 80% of the normal women had severe vitamin D deficiency (less than 20 ng/mL and 15.2% had mild deficiency (20 to 30 ng/mL and only 4.8% of women had sufficient vitamin D level (>30 ng/mL while the proportion was 96.1%, 3.2% and 0.7% respectively for the breast cancer patients. Compared to those with the lowest quartile of plasma 25(OHD level, women with highest quartile 25(OHD level showed a significant decreased breast cancer risk (Q4 vs.Q1: OR = 0.10, 95% CI = 0.06-0.15 and every 1 ng/ml increment of plasma 25(OHD level led to a 16% lower odds of breast cancer (OR = 0.84, 95% CI = 0.81-0.87; P<0.001. From the meta-analysis of the observational studies, we found that women with highest quantile of blood 25(OHD level was associated with a significantly reduced breast cancer risk compared to those with lowest quantile of blood 25(OHD level for the 11 nested case-control and retrospective studies (pooled OR = 0.86, 95% CI = 0.75-1.00 and 10 case-control studies (7 population based, OR = 0.35, 95% CI = 0.24-0.52; 3 hospital based, OR = 0.08, 95% CI = 0.02-0.33. These results suggest that vitamin D may have a chemo-preventive effect against breast cancer.

  15. Emotion, Engagement, and Case Studies

    Science.gov (United States)

    Herreid, Clyde Freeman; Terry, David R.; Lemons, Paula; Armstrong, Norris; Brickman, Peggy; Ribbens, Eric

    2014-01-01

    Three college faculty taught large general biology classes using case studies and personal response systems (clickers). Each instructor taught the same eight cases in two different sections, except the questions within the cases differed. In one section the questions were lower order (LO) factual inquiries, and in the other they were largely…

  16. Evidence-informed health policy 4 – Case descriptions of organizations that support the use of research evidence

    Directory of Open Access Journals (Sweden)

    Oxman Andrew D

    2008-12-01

    Full Text Available Abstract Background Previous efforts to produce case descriptions have typically not focused on the organizations that produce research evidence and support its use. External evaluations of such organizations have typically not been analyzed as a group to identify the lessons that have emerged across multiple evaluations. Case descriptions offer the potential for capturing the views and experiences of many individuals who are familiar with an organization, including staff, advocates, and critics. Methods We purposively sampled a subgroup of organizations from among those that participated in the second (interview phase of the study and (once from among other organizations with which we were familiar. We developed and pilot-tested a case description data collection protocol, and conducted site visits that included both interviews and documentary analyses. Themes were identified from among responses to semi-structured questions using a constant comparative method of analysis. We produced both a brief (one to two pages written description and a video documentary for each case. Results We conducted 51 interviews as part of the eight site visits. Two organizational strengths were repeatedly cited by individuals participating in the site visits: use of an evidence-based approach (which was identified as being very time-consuming and existence of a strong relationship between researchers and policymakers (which can be challenged by conflicts of interest. Two organizational weaknesses – a lack of resources and the presence of conflicts of interest – were repeatedly cited by individuals participating in the site visits. Participants offered two main suggestions for the World Health Organization (and other international organizations and networks: 1 mobilize one or more of government support, financial resources, and the participation of both policymakers and researchers; and 2 create knowledge-related global public goods. Conclusion The findings from

  17. Crime event 3D reconstruction based on incomplete or fragmentary evidence material--case report.

    Science.gov (United States)

    Maksymowicz, Krzysztof; Tunikowski, Wojciech; Kościuk, Jacek

    2014-09-01

    Using our own experience in 3D analysis, the authors will demonstrate the possibilities of 3D crime scene and event reconstruction in cases where originally collected material evidence is largely insufficient. The necessity to repeat forensic evaluation is often down to the emergence of new facts in the course of case proceedings. Even in cases when a crime scene and its surroundings have undergone partial or complete transformation, with regard to elements significant to the course of the case, or when the scene was not satisfactorily secured, it is still possible to reconstruct it in a 3D environment based on the originally-collected, even incomplete, material evidence. In particular cases when no image of the crime scene is available, its partial or even full reconstruction is still potentially feasible. Credibility of evidence for such reconstruction can still satisfy the evidence requirements in court. Reconstruction of the missing elements of the crime scene is still possible with the use of information obtained from current publicly available databases. In the study, we demonstrate that these can include Google Maps(®*), Google Street View(®*) and available construction and architecture archives. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  18. Building theories from case study research: the progressive case study

    NARCIS (Netherlands)

    Steenhuis, H.J.; de Bruijn, E.J.

    2006-01-01

    Meredith (1998) argues for more case and field research studies in the field of operations management. Based on a literature review, we discuss several existing approaches to case studies and their characteristics. These approaches include; the Grounded Theory approach which proposes no prior

  19. Theory Testing Using Case Studies

    DEFF Research Database (Denmark)

    Møller, Ann-Kristina Løkke; Dissing Sørensen, Pernille

    2014-01-01

    The appropriateness of case studies as a tool for theory testing is still a controversial issue, and discussions about the weaknesses of such research designs have previously taken precedence over those about its strengths. The purpose of the paper is to examine and revive the approach of theory...... testing using case studies, including the associated research goal, analysis, and generalisability. We argue that research designs for theory testing using case studies differ from theorybuilding case study research designs because different research projects serve different purposes and follow different...... research paths....

  20. Cocoa Polyphenols: Evidence from Epidemiological Studies.

    Science.gov (United States)

    Matsumoto, Chisa

    2018-01-01

    Accumulating evidence suggests potential preventive effects of chocolate/cocoa on the risk of cardio vascular disease (CVD). However, cocoa products also contain high levels of sugar and fat, which increase CVD risk factors. Even, the identity of the substance in chocolate/cocoa that has a favorable effect on CVD and CVD risk factors remains unclear, growing evidence from experimental studies suggests that cocoa polyphenols might be a major contributor to cardiovascular-protective effects. However, epidemiological studies, which are necessary to evaluate an association between the risk of CVD and cocoa polyphenol, remain sparse. We will discuss recent evidence regarding the association between cocoa polyphenol consumption and the risks of CVD and its risk factors by reviewing recent epidemiological studies. We shall also provide some guidance for patient counseling and will discuss the public health implications for recommending cocoa polyphenol consumption to prevent CVD. Epidemiological studies evaluating the association between cocoa polyphenol itself and the risk of CVD are sparse. However, evidence from limited epidemiological studies suggests that cocoa polyphenol consumption may lower the risk of CVD. Given the potential adverse effects of the consumption of cocoa products with high fat and sugar and the fact that the most appropriate dose of cocoa polyphenol for cardio-protective effects has not yet been established, health care providers should remain cautious about recommending cocoa/cocoa polyphenol consumption to their patients to reduce the risk of CVD, taking the characteristics of individual patients into careful consideration. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  1. Theory testing using case studies

    DEFF Research Database (Denmark)

    Dissing Sørensen, Pernille; Løkke Nielsen, Ann-Kristina

    2006-01-01

    on the strengths of theory-testing case studies. We specify research paths associated with theory testing in case studies and present a coherent argument for the logic of theoretical development and refinement using case studies. We emphasize different uses of rival explanations and their implications for research...... design. Finally, we discuss the epistemological logic, i.e., the value to larger research programmes, of such studies and, following Lakatos, conclude that the value of theory-testing case studies lies beyond naïve falsification and in their contribution to developing research programmes in a progressive......Case studies may have different research goals. One such goal is the testing of small-scale and middle-range theories. Theory testing refers to the critical examination, observation, and evaluation of the 'why' and 'how' of a specified phenomenon in a particular setting. In this paper, we focus...

  2. Fuzzy-Set Case Studies

    Science.gov (United States)

    Mikkelsen, Kim Sass

    2017-01-01

    Contemporary case studies rely on verbal arguments and set theory to build or evaluate theoretical claims. While existing procedures excel in the use of qualitative information (information about kind), they ignore quantitative information (information about degree) at central points of the analysis. Effectively, contemporary case studies rely on…

  3. Methodology for the case studies

    NARCIS (Netherlands)

    Smits, M.J.W.; Woltjer, G.B.

    2017-01-01

    This document is about the methodology and selection of the case studies. It is meant as a guideline for the case studies, and together with the other reports in this work package can be a source of inform ation for policy officers, interest groups and researchers evaluating or performing impact

  4. Case study - Argentina

    International Nuclear Information System (INIS)

    Diaz, E.

    1986-01-01

    Antecedents and experience of nuclear activities in Argentina; the Atomic Energy Commission (CNEA). First development and research activities. Research reactors and radioisotopes plants. Health physics and safety regulations. - Feasibility studies for the first nuclear power plant. Awarding the first plant CNA I (Atucha I). Relevant data related to the different project stages. Plant performance. - Feasibility study for the second nuclear power plant. Awarding the second plant CNE (Central Nuclear Embalse). Relevant data related to established targets. Differences compared with the first station targets. Local participation. Plant performance. (orig./GL)

  5. Case Study: Shiraz Women

    Directory of Open Access Journals (Sweden)

    Bijan Khajehnoori

    2011-04-01

    Full Text Available This study investigated the relationship between lifestyle which seems as a scale of globalization process with body image. Required data was collected by systematic random sampling among 508 women in Shiraz. Based on existing theories and studies theoretical framework has constituted based on Giddens theory. Six hypotheses have been established. For collecting information, survey method and self reported questionnaire were used. In data analysis and explanation, multiple regression and unilateral dispersion analyses were used. The result showed that among effective factors on body image, modern musical lifestyle, religious' lifestyle, leisure lifestyle and participative lifestyle explained 23 percent of variations of body image. Among these variables, only religious lifestyle had negative relationship with body image and other variables had positive relationship with dependant variable.

  6. Centrifugal compressor case study

    Energy Technology Data Exchange (ETDEWEB)

    Eckert, B.

    2010-10-15

    Three centrifugal compressors at a pipeline station were retrofitted with higher head impellers in 2008. The owners of the station experienced vibration problems over the following 2 years that caused transmitter and position failures that were assumed to be flow-induced pulsations. A vibration and pulsation analysis indicated that the shell mode piping vibration excited by the blade pass pulsation was responsible for the failures. This study outlined factors that contributed to the vibration problem. Interferences between the compressor and shell mode piping natural frequencies were predicted, and potential excitation sources were examined. The study demonstrated how centrifugal vibration analyses can be used during the design phase to avoid costly adjustments. Recommendations included the addition of stiffeners to alter the shell modes, and the addition of constrained layer damping material to reduce resonant responses. 2 refs., 1 tab., 12 figs.

  7. Case study: Tourism marketing

    OpenAIRE

    Kennell, James

    2014-01-01

    Tourism can be a challenging subject for students because it is both dynamic and susceptible to economic turbulence and shifts in trends. Tourism: A Modern Synthesis is an essential textbook for tourism students looking for a clear and comprehensive introduction to their studies which helps overcome these challenges. The authors apply a strong business approach to the subject reflecting developments in the teaching and content of modern courses and the text covers both key principles and cont...

  8. Case Study: Derechos Digitales

    Directory of Open Access Journals (Sweden)

    Cameron Neylon

    2017-10-01

    Full Text Available Derechos Digitales is a Latin American advocacy and research network focussed on freedom on the internet, privacy and copyright reform. For the pilot project a specific IDRC funded project was the notional focus of study. However in practice the effort for considering data sharing was aimed at being organisation wide. The organisation already shares reports and other resources (particularly images and infographics by default. While open data was described as being “in the DNA of the organisation” there was little practice across the network of sharing preliminary and in-process materials. Some aspects of data collection on research projects, particularly to do with copyright and legal issues, have significant privacy issues and as the organisation focuses on privacy as one of its advocacy areas this is taken very seriously. Many materials from research projects are not placed online at all. Derechos Digitales run distributed projects and this creates challenges for consistent management. Alongside this the main contact at DD changed during the course of the pilot. This exchange exemplified the challenges of maintaining organisational systems and awareness through a personnel change.

  9. Case study: Khoramdareh County

    Directory of Open Access Journals (Sweden)

    Vahid Riahi Riahi

    2016-10-01

    Full Text Available Environmental sustainability of rural settlements based on a systematic viewpoint may be defined as a realization of sustainable development in different social, economic and environmental aspects of rural areas. Achieving this goal requires that we pay more attention to effective elements and factors through a set of sustainability indices. This research was meant to analyze sustainable factors of rural settlement in three dimensions: environmental, social and economic context using multi-criteria decision analysis and explanation of the relationships between its active and effective factors in the rural area of the Khorramdarreh County in the province of Zanjan. The research method used is the descriptive analytic approach. Data from 287 households were sampled randomly from a total of 1143 households in the four villages including: Rahmat Abad, Alvand, Baghdareh and, Sukhariz (out of 15 villages in the Khorramdarreh County. In the process of doing this research and after calculating the weights, the difference in the sustainability of environmental, social, economic and physical aspects in rural areas of this county have been determined. Data was collected using library and field research through questionnaires. Data analysis was performed by the One-Sample t Test and the Vikur and path analysis techniques, using statistical software SPSS. The findings show that environmental sustainability in the study area is half desirable. Among the different aspects of environmental sustainability, the most effective factors are physical, economic, social and environmental aspects, respectively. Little attention of policy-making –system to socio-cultural and environmental aspects, especially in practice, and rapid and unplanned utilization of production resources are the most important factors affecting this situation in two given dimensions. Although, in programmed documents the planning system agents emphasize on the socio-cultural sustainability

  10. Case studies of uncommon headaches.

    Science.gov (United States)

    Evans, Randolph W

    2006-05-01

    The following interesting and uncommon headache disorders are presented through case studies: exploding head syndrome, hypnic headache, neck-tongue syndrome, "Alice in Wonderland" syndrome, nummular headache, red ear syndrome, burning mouth syndrome, spontaneous intracranial hypotension syndrome, and cardiac cephalalgia.

  11. HYDROGEOLOGIC CASE STUDIES (DENVER PRESENTATION)

    Science.gov (United States)

    Hydrogeology is the foundation of subsurface site characterization for evaluations of monitored natural attenuation (MNA). Three case studies are presented. Examples of the potentially detrimental effects of drilling additives on ground-water samples from monitoring wells are d...

  12. HYDROGEOLOGIC CASE STUDIES (CHICAGO, IL)

    Science.gov (United States)

    Hydrogeology is the foundation of subsurface site characterization for evaluations of monitored natural attenuation (MNA). Three case studies are presented. Examples of the potentially detrimental effects of drilling additives on ground-water samples from monitoring wells are d...

  13. Hydrogeologic Case Studies (Seattle, WA)

    Science.gov (United States)

    Hydrogeology is the foundation of subsurface site characterization for evaluations of monitored natural attenuation (MNA). Three case studies are presented. Examples of the potentially detrimental effects of drilling additives on ground-water samples from monitoring wells are d...

  14. a case study ondo state

    African Journals Online (AJOL)

    user

    the design of a Government Cloud (G-Cloud) network for Ondo State Government which will ... network for a developing economy; a case study of ... France is one of those countries that favour .... Arequipa city. .... Where region 0 = Akure, 1 =.

  15. Specialized Accounting Expert Evidence on Economic and Financial Crimes: Analysis of the DMG Case

    OpenAIRE

    Ramírez, Maricela; Universidad Pedagógica y Tecnológica de Colombia.; Robayo-Nieto, Natalia; Universidad Pedagógica y Tecnológica de Colombia; Parra-Castiblanco, Lina María; Universidad Pedagógica y Tecnológica de Colombia.

    2016-01-01

    Generally, in the cases related to economic and financial fraud crimes defined in the Code of Criminal Procedure the performance of accounting experts is necessary, as to assist the justice system. Thus, the appointed professional creates an expert report of its evidence analysis and research work, and comes before the court in a public oral trial as to be questioned and cross-examined. In this context, this study –derived from formal research activities– will determine the requirements of th...

  16. An evidence-based case of acoustic/vestibular schwannoma

    Directory of Open Access Journals (Sweden)

    Girish Gupta

    2015-01-01

    Full Text Available A vestibular schwannoma, often called an acoustic neuroma/schwannoma, is a benign primary intracranial tumor of the myelin-forming cells of the vestibulo-cochlear nerve (8 th cranial nerve. This tumor arises from the Schwann cells responsible for the myelin sheath that helps keep peripheral nerves insulated. [1] Approximately, 3000 cases are diagnosed each year in the United States with a prevalence of about 1 in 100,000 worldwide. It comprises 5-10% of all intracranial neoplasms in adults. Incidence peaks in the fifth and sixth decades and both sexes are affected equally. Studies in Denmark published in 2004 show the incidence of 17.4/million. Most acoustic neuromas are diagnosed in patients between the ages of 30 and 60, and men and women appear to be affected equally. [2] The case illustrated here is a rare one of acoustic/vestibular schwannoma a surgical conditions, treated with Lycopodium, which produced improvement on both subjective and objective parameters.

  17. The Economic Burden of Urinary Tract Infection and Pressure Ulceration in Acute Traumatic Spinal Cord Injury Admissions: Evidence for Comparative Economics and Decision Analytics from a Matched Case-Control Study.

    Science.gov (United States)

    White, Barry A B; Dea, Nicolas; Street, John T; Cheng, Christiana L; Rivers, Carly S; Attabib, Najmedden; Kwon, Brian K; Fisher, Charles G; Dvorak, Marcel F

    2017-10-15

    Secondary complications of spinal cord injury (SCI) are a burden to affected individuals and the rest of society. There is limited evidence of the economic burden or cost of complications in SCI populations in Canada, however, which is necessary for comparative economic analyses and decision analytic modeling of possible solutions to these common health problems. Comparative economic analyses can inform resource allocation decisions, but the outputs are only as good as the inputs. In this article, new evidence of the excess or incremental costs of urinary tract infection (UTI) and pressure ulceration (PU) in acute traumatic SCI from an exploratory case series analysis of admissions to a Level I specialized Canadian spine facility (2008-2013) is presented. Participants in a national SCI registry were case-control matched (1:1) on the predicted probability of experiencing UTI or PU during initial acute SCI admission. The excess costs of UTI and PU are estimated as the mean of the differences in total direct acute SCI admission costs (length of stay, accommodation, nursing, pharmacy) from the perspective of the admitting facility between participants matched or paired on demographic and SCI characteristics. Even relatively minor UTI and PU, respectively, added an average of $7,790 (standard deviation [SD] $6,267) and $18,758 (SD $27,574) to the direct cost of acute SCI admission in 2013 Canadian dollars (CAD). This case series analysis established evidence of the excess costs of UTI and PU in acute SCI admissions, which will support decision-informing analyses in SCI.

  18. Case Study: The Mystery of the Seven Deaths--A Case Study in Cellular Respiration

    Science.gov (United States)

    Gazdik, Michaela

    2014-01-01

    Cellular respiration, the central component of cellular metabolism, can be a difficult concept for many students to fully understand. In this interrupted, problem-based case study, students explore the purpose of cellular respiration as they play the role of medical examiner, analyzing autopsy evidence to determine the mysterious cause of death…

  19. In the teeth of the evidence: the curious case of evidence-based medicine.

    Science.gov (United States)

    Davidoff, F

    1999-03-01

    For a very long time, evidence from research has contributed to clinical decision making. Over the past 50 years, however, the nature of clinical research evidence has drastically changed compared with previous eras: its standards are higher, the tools for assembling and analyzing it are more powerful, and the context in which it is used is less authoritarian. The consequence has been a shift in both the concept and the practice of clinical decision making known as evidence-based medicine. Evidence-based decisions, by definition, use the strongest available evidence, are often more quantitatively informed than decisions made in the traditional fashion; and sometimes run counter to expert opinion. The techniques of evidence-based medicine are also helpful in resolving conflicting opinions. Evidence-based medicine did not simply appear in vacuo; its roots extend back at least as far as the great French Encyclopedia of the 18th century, and the subsequent work of Pierre Louis in Paris in the early 19th century. The power of the evidence-based approach has been enhanced in recent years by the development of the techniques of systematic review and meta-analysis. While this approach has its critics, we would all want the best available evidence used in making decisions about our care if we got sick. It is only fair that the patients under our care receive nothing less.

  20. Case report evidence of relationships between hepatocellular carcinoma and ochratoxicosis.

    Directory of Open Access Journals (Sweden)

    Ahmed S Ibrahim

    Full Text Available PURPOSE: The incidence of Hepatocellular carcinoma (HCC is on the rise, but what is causing that trend has remained a mystery. Mycotoxins are almost entirely ignored health problems, and sometimes actually naively belittled in advanced medical care. Ochratoxin A (OTA is one of the most abundant food contaminating mycotoxins worldwide that is carcinogenic, but no studies have evaluated its levels in HCC patients. Therefore, this study was designed to monitor the presence of OTA in the serum of HCC patients and to quantify the strength of the association between OTA and HCC. METHODS: We conducted a case control-based study on 61 participants. Thirty-nine were HCC cases identified between 2010 and 2012 and individually matched by age, sex, residence and date of recruitment to 22 healthy controls. Serum OTA and alpha-fetoprotein levels were measured by using high-performance liquid chromatography (HPLC and enzyme-linked immunosorbent assay, respectively. RESULTS: HPLC analysis of 61 serum samples indicated that the highest incidence of elevated OTA was found in the HCC group and was 5-fold higher than in the control group. The concentration of OTA in the HCC group ranged between 0.129 and 10.93 ng/mL with a mean value±SD of 1.1±0.3 ng/mL, while in the normal group it ranged between 0.005 and 0.50 ng/mL with a mean value±SD of 0.201±0.02 ng/mL. The odds ratio for HCC patients presenting OTA levels above the cut-off of 0.207 (calculated by the receiver operating characteristic curve was 9.78 (95% confidence interval = 2.9095-32.9816, P = 0.0002 with respect to normal controls, suggesting that HCC is 9.8 times as frequent in the exposed group to OTA. CONCLUSION: Our results reveal a strong association between the presence of OTA and HCC, which may offer a coherent explanation for much of the descriptive epidemiology of HCC and suggest new avenues for analytical research.

  1. Case-control studies in neurosurgery.

    Science.gov (United States)

    Nesvick, Cody L; Thompson, Clinton J; Boop, Frederick A; Klimo, Paul

    2014-08-01

    Observational studies, such as cohort and case-control studies, are valuable instruments in evidence-based medicine. Case-control studies, in particular, are becoming increasingly popular in the neurosurgical literature due to their low cost and relative ease of execution; however, no one has yet systematically assessed these types of studies for quality in methodology and reporting. The authors performed a literature search using PubMed/MEDLINE to identify all studies that explicitly identified themselves as "case-control" and were published in the JNS Publishing Group journals (Journal of Neurosurgery, Journal of Neurosurgery: Pediatrics, Journal of Neurosurgery: Spine, and Neurosurgical Focus) or Neurosurgery. Each paper was evaluated for 22 descriptive variables and then categorized as having either met or missed the basic definition of a case-control study. All studies that evaluated risk factors for a well-defined outcome were considered true case-control studies. The authors sought to identify key features or phrases that were or were not predictive of a true case-control study. Those papers that satisfied the definition were further evaluated using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. The search detected 67 papers that met the inclusion criteria, of which 32 (48%) represented true case-control studies. The frequency of true case-control studies has not changed with time. Use of odds ratios (ORs) and logistic regression (LR) analysis were strong positive predictors of true case-control studies (for odds ratios, OR 15.33 and 95% CI 4.52-51.97; for logistic regression analysis, OR 8.77 and 95% CI 2.69-28.56). Conversely, negative predictors included focus on a procedure/intervention (OR 0.35, 95% CI 0.13-0.998) and use of the word "outcome" in the Results section (OR 0.23, 95% CI 0.082-0.65). After exclusion of nested case-control studies, the negative correlation between focus on a procedure

  2. Teaching Case: Enterprise Architecture Specification Case Study

    Science.gov (United States)

    Steenkamp, Annette Lerine; Alawdah, Amal; Almasri, Osama; Gai, Keke; Khattab, Nidal; Swaby, Carval; Abaas, Ramy

    2013-01-01

    A graduate course in enterprise architecture had a team project component in which a real-world business case, provided by an industry sponsor, formed the basis of the project charter and the architecture statement of work. The paper aims to share the team project experience on developing the architecture specifications based on the business case…

  3. Theory Testing Using Case Studies

    DEFF Research Database (Denmark)

    Sørensen, Pernille Dissing; Løkke, Ann-Kristina

    2006-01-01

    design. Finally, we discuss the epistemological logic, i.e., the value to larger research programmes, of such studies and, following Lakatos, conclude that the value of theory-testing case studies lies beyond naïve falsification and in their contribution to developing research programmes in a progressive...

  4. Case Study of 'moral injury' : Format Dutch Case Studies Project

    NARCIS (Netherlands)

    Korver, Sjaak; Walton, Martin N.; van Loenen, Guus

    2017-01-01

    The case study ‘Moral Injury’ traces care provided by a chaplain in a mental health institution to a former military marksman named Hans. Hans was in care at a specialized unit for military veterans with traumas. He sought contact with a chaplain “to set things right with God” and wanted the

  5. eCompetence Case Studies

    DEFF Research Database (Denmark)

    Jensen, Helle Bækkelund

    2006-01-01

    In this paper we present some details of the processes undertaken in the European eCompetence Initiative. We present two illustrative and representative case studies. The research aims to identify and understand patterns of individual and organisational eCompetence approaches.......In this paper we present some details of the processes undertaken in the European eCompetence Initiative. We present two illustrative and representative case studies. The research aims to identify and understand patterns of individual and organisational eCompetence approaches....

  6. Case Study on Logistics Performance

    Directory of Open Access Journals (Sweden)

    Shahryar Sorooshian

    2013-05-01

    Full Text Available The paper presents research carried out at a medium‐size manufacturing organization in east Asia. The study tries to highlight the importance of supply chain management; specifically, our aim for this study is to understand logistics and performance measurement in the logistics and supply chain, and we include a theoretical discussion of online data collected and a case study of the logistic performance of a real organization. The study also examines the performance of the selected company, identifies the problems and provides recommendations for improvements. This study can be a guide for business advisers and those interested in analysing company performance, especially from a logistics viewpoint. We also suggest the methodology of this case study for those who want to have a better understanding of a business environment before starting their own business, or for benchmarking practice during strategic planning.

  7. BioFleet case studies

    International Nuclear Information System (INIS)

    2007-01-01

    These six case studies examined the use of different biodiesel blends as fuel supply sources for businesses in British Columbia (BC). In the first case study, 6 municipalities participated in a pilot program designed to compare the performance of biodiesel and diesel fuels. Each municipality operated 2 base vehicles running on conventional diesel along with 2 similar vehicles which used biodiesel. Real time emissions tests and analyses of the vehicles using biodiesel were also conducted by 2 of the participating municipalities. All municipalities participating in the study agreed to purchase significant volumes of biodiesel. The second case study described a pilot study conducted by the City of Vancouver's equipment services branch in 2004. As a result of the study, the city now has over 530 types of equipment that use biodiesel. The third case study described a program designed by TSI Terminals in Vancouver to assess the emission reduction impact of using biodiesel at its port facility. Six different pieces of equipment were used to confirm that biodiesel could be used throughout the terminal. Test results confirmed that biodiesel blends could be used to reduce emissions. Overall emissions were reduced by 30 per cent. The fourth case study described a waste renderer that used a fleet of 36 trucks to deliver raw products to its plants. The company made the decision to use only biodiesel for its entire fleet of trucks. Since July 2005, the company has logged over 1.7 million km using biodiesel blends. The fifth case study described a salmon hatchery that switched from diesel to biodiesel in order to reduce emissions. The biodiesel blends are used to fuel the hatchery's 2 diesel generators. The hatchery has reduced emissions of greenhouse gases (GHGs) by an estimated 1800 tonnes annually. The sixth case study described how the Township of Langley has started using biodiesel for its entire fleet of of approximately 250 pieces of equipment. The township has not

  8. Case Studies in Sports Nutrition.

    Science.gov (United States)

    Clark, Nancy

    1988-01-01

    This article presents case studies of two athletes who wanted to affect a change in their body weight in order to enhance athletic performance. Each athlete's problem and the nutrition approach used to solve it are discussed. Caloric values of fast foods are listed. (JL)

  9. Shea case study Burkina Faso

    NARCIS (Netherlands)

    S. Drost (Sarah); J.C.A.C. van Wijk (Jeroen); S.R. Vellema (Sietze)

    2012-01-01

    textabstractThis shea case study is part of a larger Partnerships Resource Centre (PrC) project elaborated in tandem with two Dutch non-governmental organisations (NGOs); ICCO and Oxfam Novib. The endeavour of this ‘action research’ project is to combine the expert knowledge of development

  10. The reflexive case study method

    DEFF Research Database (Denmark)

    Rittenhofer, Iris

    2015-01-01

    This paper extends the international business research on small to medium-sized enterprises (SME) at the nexus of globalization. Based on a conceptual synthesis across disciplines and theoretical perspectives, it offers management research a reflexive method for case study research of postnational...

  11. Case Study in Evidence-Based Practice in Clinical Child and Adolescent Psychology: The Use of the Coping Power Program to Treat a 10-Year-Old Girl with Disruptive Behaviors

    Science.gov (United States)

    Lochman, John E.; Boxmeyer, Caroline; Powell, Nicole; Wojnaroski, Mary; Yaros, Anna

    2007-01-01

    This article describes the successful application of the Coping Power program by school-based clinicians to address a 10-year-old girl's disruptive behavior symptoms. Coping Power is an empirically supported cognitive-behavioral program for children at risk for serious conduct problems and their parents. The following case study illustrates the…

  12. A Hospitalidade e a Gestão de Restaurantes: Evidências de um Estudo Múltiplo de Casos em São Paulo, Brasil / The hospitality and restaurant management: evidences from a multiple case study in São Paulo, SP, Brazil

    Directory of Open Access Journals (Sweden)

    Mario da Silva Oliveira

    2015-04-01

    Full Text Available O setor dos serviços de alimentação mudou significativamente nas últimas três décadas. O estilo familiar que antes imperava deu lugar a empreendimentos profissionalizados. Este artigo busca compreender esta evolução a partir da relação entre os conceitos da gestão de restaurantes e a hospitalidade. Para atender este objetivo elaborou-se um estudo múltiplo de caso envolvendo quatro restaurantes de diferentes posicionamentos, em São Paulo/SP, todos reconhecidos por seu sucesso há mais de quinze anos. O estudo da identidade dos estabelecimentos possibilita a concepção de processos operacionais e sua relação com a hospitalidade. Os resultados do estudo sugerem que a gestão da hospitalidade nos restaurantes pesquisados é prioritária para seus dirigentes, que atestam sua importância na complexa gestão do negócio efazem-no eficientemente. Conclui-se que um plano inicial de ação e o posicionamento temático são, assim como o plano de negóciose procedimentos financeiros,indispensáveis para o sucesso e perenidade destes empreendimentos.  The hospitality and restaurant management: evidences from a multiple case study in São Paulo, SP, Brazil - The sector of food service has changed significantly over the past three decades. The familiar style that prevailed before gave way to professionalized endeavors. This article seeks to understand this evolution from the relationship between the concepts of hospitality and restaurant management. To meet this goal was prepared a multiple case study involving four different positions restaurants in São Paulo (Brazil, all recognized for their success for over fifteen years. The study of the identity of establishments enables the design of business processes and their relationship with the hospitality. The study results suggest that hospitality management in the surveyed restaurants is a priority for their leaders to attest to its importance in the complex management of the business and do

  13. Synthesizing Econometric Evidence: The Case of Demand Elasticity Estimates.

    Science.gov (United States)

    DeCicca, Philip; Kenkel, Don

    2015-06-01

    Econometric estimates of the responsiveness of health-related consumer demand to higher prices are often key ingredients for risk policy analysis. We review the potential advantages and challenges of synthesizing econometric evidence on the price-responsiveness of consumer demand. We draw on examples of research on consumer demand for health-related goods, especially cigarettes. We argue that the overarching goal of research synthesis in this context is to provide policy-relevant evidence for broad-brush conclusions. We propose three main criteria to select among research synthesis methods. We discuss how in principle and in current practice synthesis of research on the price-elasticity of smoking meets our proposed criteria. Our analysis of current practice also contributes to academic research on the specific policy question of the effectiveness of higher cigarette prices to reduce smoking. Although we point out challenges and limitations, we believe more work on research synthesis in this area will be productive and important. © 2015 Society for Risk Analysis.

  14. Drive Electric Vermont Case Study

    Energy Technology Data Exchange (ETDEWEB)

    Wagner, Fred [Energetics Incorporated, Columbia, MD (United States); Roberts, Dave [Vermont Energy Investment Corporation (VEIC), Burlington, VT (United States); Francfort, Jim [Idaho National Lab. (INL), Idaho Falls, ID (United States); White, Sera [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2016-03-01

    Currently in the United States, the heavy majority of plug-in electric vehicle (PEV) sales have been in highly conducive, selected, metropolitan areas; opposed to more broad distribution across the country. The U.S. Department of Energy’s EV Everywhere Grand Challenge is looking carefully at the barriers and opportunities that exist to enable small and midsize communities to partake in the PEV market and benefit from the economic and environmental advantages of PEVs. In order to gain insight into these challenges and barriers, DOE selected a success story (i.e., Drive Electric Vermont) as the subject of this case study, as the state of Vermont is tied with Detroit, Michigan in having the highest percentage of 2014 (most recent complete data) PEV registrations for cold weather U.S. cities and has seen more than a sixfold increase in charging stations over the last three years. The overall objective of this case study was to use the lessons learned from Drive Electric Vermont to determine what activities are most effective at encouraging acquisitions of PEVs and deployment of charging infrastructure in small to midsize communities, prioritizing and sequencing their implementation, identifying robust means for extrapolation, and applying this understanding to other small to midsize communities across the nation. The Drive Electric Vermont Program was formed in 2012 with a goal of increasing the use of electrified transportation in Vermont through policy development, education and outreach, and infrastructure development. The Drive Electric Vermont Program can be broadly broken into four components: (1) strategic planning/leadership, (2) stakeholder/partnership development, (3) education and outreach, and (4) incentives. The early phases of the program focused heavily on strategic planning, and stakeholder and partnership development, followed by a transition to education and outreach activities, charging infrastructure development, and grant and incentive programs

  15. Institutional total energy case studies

    Energy Technology Data Exchange (ETDEWEB)

    Wulfinghoff, D.

    1979-07-01

    Profiles of three total energy systems in institutional settings are provided in this report. The plants are those of Franciscan Hospital, a 384-bed facility in Rock Island, Illinois; Franklin Foundation Hospital, a 100-bed hospital in Franklin, Louisiana; and the North American Air Defense Command Cheyenne Mountain Complex, a military installation near Colorado Springs, Colorado. The case studies include descriptions of plant components and configurations, operation and maintenance procedures, reliability, relationships to public utilities, staffing, economic efficiency, and factors contributing to success.

  16. Stochastic efficiency: five case studies

    International Nuclear Information System (INIS)

    Proesmans, Karel; Broeck, Christian Van den

    2015-01-01

    Stochastic efficiency is evaluated in five case studies: driven Brownian motion, effusion with a thermo-chemical and thermo-velocity gradient, a quantum dot and a model for information to work conversion. The salient features of stochastic efficiency, including the maximum of the large deviation function at the reversible efficiency, are reproduced. The approach to and extrapolation into the asymptotic time regime are documented. (paper)

  17. Case Study: Guidelines for Producing Videos to Accompany Flipped Cases

    Science.gov (United States)

    Prud'homme-Généreux, Annie; Schiller, Nancy A.; Wild, John H.; Herreid, Clyde Freeman

    2017-01-01

    Three years ago, the "National Center for Case Study Teaching in Science" (NCCSTS) was inspired to merge the case study and flipped classroom approaches. The resulting project aimed to create the materials required to teach a flipped course in introductory biology by assigning videos as homework and case studies in the classroom. Three…

  18. CAREM X INPRO case study

    International Nuclear Information System (INIS)

    Florido, P.C.; Brasnarof, D.; Delmastro, D.; Azpitarte, O.E.

    2004-01-01

    In order to assess and compare the performance of innovative nuclear energy systems INPRO has defined a set of basic principles, user requirements and criteria to be met in different areas (economics, sustainability and environment, safety, waste management and proliferation). This paper illustrates the use of INPRO methodology to a particular reactor system. Argentina is performing CAREM X Nuclear System Case Study based on CAREM nuclear reactor and Once Through Fuel Cycle, using SIGMA for enriched uranium production, and a deep geological repository for final disposal of high level waste after surface intermediate storage in horizontal natural convection silos, to verify INPRO (International Project on Innovative Nuclear Reactors and Fuel Cycles) methodology. 6 aspects have been considered: 1) enrichment based on Sigma enrichment plant (gas diffusion technology), 2) conversion to UO 2 , 3) fuel manufacturing, 4) CAREM-300 based reactor technology, 5) intermediate spent fuel storage, and 6) deep geological repository of spent fuels. Projections show that developing countries could play a crucial role in the deployment of nuclear energy, in the next fifty years. This case study will be highly useful for checking INPRO methodology for this scenario. In this paper, the preliminary findings of the Case Study are presented, including proposals to improve the INPRO methodology

  19. A case study of Impetigo

    Directory of Open Access Journals (Sweden)

    Mansouri P

    1993-05-01

    Full Text Available This is a report of a case study on 234 patients with impetigo who referred to Razi Dermatology Hospital from April to November, 1989. Treatment was started immediately after obtaining direct smear and performing culture and antibiotic sensitivity test. The most common organism responsible for impetigo was the coagulase-positive staphylococcus (71%. In 13.7% of the cases, the coagulase-negative staphylococcus was grown on culture media, but none of the cultures showed streptococcus as the main organism. Treatment was started with oral penicillin V, oral erythromycin, benzathine penicillin G injection, oral cephalexin, and topical fuccidin. Clinical and bacteriological evaluation after 3-7 days showed that it is preferable to use oral cephalexin instead of other protocols such as oral erythromycin, which has previously been the drug of choice for impetigo. In addition, topical fuccidin with a 75% curative rate was the first drug for treatment, with the same effect as the oral cephalexin

  20. Rigour in qualitative case-study research.

    Science.gov (United States)

    Houghton, Catherine; Casey, Dympna; Shaw, David; Murphy, Kathy

    2013-03-01

    To provide examples of a qualitative multiple case study to illustrate the specific strategies that can be used to ensure the credibility, dependability, confirmability and transferability of a study. There is increasing recognition of the valuable contribution qualitative research can make to nursing knowledge. However, it is important that the research is conducted in a rigorous manner and that this is demonstrated in the final research report. A multiple case study that explored the role of the clinical skills laboratory in preparing students for the real world of practice. Multiple sources of evidence were collected: semi-structured interviews (n=58), non-participant observations at five sites and documentary sources. Strategies to ensure the rigour of this research were prolonged engagement and persistent observation, triangulation, peer debriefing, member checking, audit trail, reflexivity, and thick descriptions. Practical examples of how these strategies can be implemented are provided to guide researchers interested in conducting rigorous case study research. While the flexible nature of qualitative research should be embraced, strategies to ensure rigour must be in place.

  1. Weight-of-evidence on environmental impact assessment of metal contaminated sediments in the São Francisco river (Três Marias - Minas Gerais - Brazil: a case study

    Directory of Open Access Journals (Sweden)

    DF. Almeida

    Full Text Available The weight-of-evidence - WOE approach was used to assess the environmental impact of sediments contaminated by metals in the São Francisco river and one of its tributaries, Consciência creek, both affected by anthropic activities, in the region of Três Marias (Minas Gerais/Brazil. The assessment provided support to a risk management decision. The WOE was based on bulk metal analysis, AVS-SEM assays, elutriate tests, ecotoxicity assays, benthic community assessment and a comparison for the reference area. Brazilian legislation and other available literature were used as criteria to evaluate the lines of evidence. All samples, except for the reference area, presented some contamination. However, geochemical testing for bioavailability studies showed that toxicity is unlikely as suggested by the chemical results. Ecotoxicity and benthic structure studies provided further information to support decision making. Metal acid volatile sulfide formation mechanisms were identified, which can eventually attenuate metal toxicity observed. The removal of active sources of contamination (for example, from tailings dumps associated with Monitoring Natural Recovery could be sufficient to eventually lessen the risk of the biota in São Francisco river sediments.

  2. Biological Evidence Management for DNA Analysis in Cases of Sexual Assault

    Science.gov (United States)

    Magalhães, Teresa; Dinis-Oliveira, Ricardo Jorge; Silva, Benedita; Corte-Real, Francisco; Nuno Vieira, Duarte

    2015-01-01

    Biological evidence with forensic interest may be found in several cases of assault, being particularly relevant if sexually related. Sexual assault cases are characterized by low rates of disclosure, reporting, prosecution, and conviction. Biological evidence is sometimes the only way to prove the occurrence of sexual contact and to identify the perpetrator. The major focus of this review is to propose practical approaches and guidelines to help health, forensic, and law enforcement professionals to deal with biological evidence for DNA analysis. Attention should be devoted to avoiding contamination, degradation, and loss of biological evidence, as well as respecting specific measures to properly handle evidence (i.e., selection, collection, packing, sealing, labeling, storage, preservation, transport, and guarantee of the chain custody). Biological evidence must be carefully managed since the relevance of any finding in Forensic Genetics is determined, in the first instance, by the integrity and quantity of the samples submitted for analysis. PMID:26587562

  3. Biological Evidence Management for DNA Analysis in Cases of Sexual Assault

    Directory of Open Access Journals (Sweden)

    Teresa Magalhães

    2015-01-01

    Full Text Available Biological evidence with forensic interest may be found in several cases of assault, being particularly relevant if sexually related. Sexual assault cases are characterized by low rates of disclosure, reporting, prosecution, and conviction. Biological evidence is sometimes the only way to prove the occurrence of sexual contact and to identify the perpetrator. The major focus of this review is to propose practical approaches and guidelines to help health, forensic, and law enforcement professionals to deal with biological evidence for DNA analysis. Attention should be devoted to avoiding contamination, degradation, and loss of biological evidence, as well as respecting specific measures to properly handle evidence (i.e., selection, collection, packing, sealing, labeling, storage, preservation, transport, and guarantee of the chain custody. Biological evidence must be carefully managed since the relevance of any finding in Forensic Genetics is determined, in the first instance, by the integrity and quantity of the samples submitted for analysis.

  4. Interpreting Ex-Dividend Evidence: The Citizens Utilities Case Reconsidered

    OpenAIRE

    James M. Poterba

    1983-01-01

    Numerous empirical studies have attempted to measure the effect of changes in dividend policy on corporate equity values. One of the most popular study methodologies has been an examination of share price changes around ex-dividend days. Comparing the movement in a stock's price with its nominal dividend payment leads to estimates of the stock market's relative valuation of dividends and capital gains. Ex-day price studies are often interpreted as showing that investors recognize their tax li...

  5. Single-Case Research Design: An Alternative Strategy for Evidence-Based Practice

    Science.gov (United States)

    Stapleton, Drue; Hawkins, Andrew

    2015-01-01

    Objective: The trend of utilizing evidence-based practice (EBP) in athletic training is now requiring clinicians, researchers, educators, and students to be equipped to both engage in and make judgments about research evidence. Single-case design (SCD) research may provide an alternative approach to develop such skills and inform clinical and…

  6. Empirical evidence in consumer law cases: what are 'up to' claims up to?

    NARCIS (Netherlands)

    Luzak, J.; Heiderhoff, B.; Schulze, R.

    2016-01-01

    In this contribution I argue that in certain consumer law cases providing empirical evidence is necessary and that specific standards of proof should then apply. Only through analysing evidence of actual consumer behaviour as well as of trader’s commercial practices courts and enforcement

  7. MULTIPLE PERSONALITY: CASE REPORT STUDY

    Directory of Open Access Journals (Sweden)

    Miloš Židanik

    2004-07-01

    Full Text Available Background. Multiple personality disorder is characterised by splited individual ego-states and splited professional community arguing whether this disorder actually exists or not.Methods. In this case report study a supportive psychodynamic psychotherapy of a patient with multiple personality disorder is presented, that lasted for 4.5 years and resulted in ego-reintegration.Conclusions. The spliting between different ego-states is powered by unneutralised aggression with the possibility of hetero- and autoaggressive behaviour. Therefore the patient in the analytically oriented psychotherapeutic process is at high risk and a safe therapeutic (e. g. in-patient setting has to be provided.

  8. Overview of the Case Studies

    DEFF Research Database (Denmark)

    Cameron, Ian; Gani, Rafiqul

    2011-01-01

    A series of case studies are used to illustrate many of the underlying modelling principles within the book. To facilitate this, the ICAS-MoT modelling tool has been used. A wide range of application areas have been chosen to ensure that the principal concepts of effective and efficient modelling...... are exercised. Conceptual frameworks for single and multiscale problems are given and explained. The importance of the steps is also explained, through annotated schematic diagrams. The important issues around workflow and data flow are given in diagrammatic form....

  9. Naval Justice School Evidence Study Guide. Revision

    Science.gov (United States)

    1989-01-01

    it may even be necessary for the military judge to breach a privilege in order to see if that privilege exists. See, eq., Lutwak v. United States, 344...other. Mil.R.Evid. 504(c)(2)(B). See also Lutwak v. United States, 344 U.S. 604 (1953) (describes factual situation which depicts a marital sham). 6...only against the actor or declarant. See, eg., Lutwak v. United States, 344 U.S. 604 (1953); United States v. Beverly, 14 C.M.A. 468, 34 C.M.R. 248

  10. Hospital Waste Management - Case Study

    Directory of Open Access Journals (Sweden)

    Beatriz Edra

    2017-07-01

    Full Text Available The importance of waste management in hospitals is indisputable in preserving the environment and protecting public health, but management models are rarely discussed. This study presents the legal and conceptual frameworks of good waste management practices applicable to hospitals and associated indicators. As a case study, the overall performance of Hospital Centre of São João, in Porto, was analysed based on published reports. Data on the production of waste in their different typologies were collected from 2010 to 2016, enabling a correlation of the waste production with the kg/bed/day indicator. The aim of this study was to gather data and discuss trends in a real scenario of evolution over a six-year period in order to contribute to a future research proposal on indicators that can be used as reference for benchmarking the construction of methodological guides for hospital waste management.

  11. Qualitative Case Study Research as Empirical Inquiry

    Science.gov (United States)

    Ellinger, Andrea D.; McWhorter, Rochell

    2016-01-01

    This article introduces the concept of qualitative case study research as empirical inquiry. It defines and distinguishes what a case study is, the purposes, intentions, and types of case studies. It then describes how to determine if a qualitative case study is the preferred approach for conducting research. It overviews the essential steps in…

  12. Evident?

    DEFF Research Database (Denmark)

    Plant, Peter

    2012-01-01

    Quality assurance and evidence in career guidance in Europe are often seen as self-evident approaches, but particular interests lie behind......Quality assurance and evidence in career guidance in Europe are often seen as self-evident approaches, but particular interests lie behind...

  13. A parathyroid scintigraphy case study

    International Nuclear Information System (INIS)

    O'Leary, Desiree

    2005-01-01

    Background: There has been much debate concerning the most suitable protocol for parathyroid scintigraphy; the merits of various radiopharmaceuticals versus the correct imaging protocol to visualise both ectopic and anatomically placed adenomas against the various equipment choices have been debated. Aim: To demonstrate, through the use of a case study, the necessity of changing imaging protocols for parathyroid scintigraphy where a definitive imaging diagnosis is absent in the face of strong clinical suspicion. Method: Use is made of Tc99mMIBI, full field chest scintigraphy, a clearly defined imaging protocol and SPECT imaging to locate ectopic parathyroid tissue in a female patient with significant symptoms of parathyroid hyperfunction. Results: A single hyperfunctioning adenoma is located in the pre-carinal area of the mediastinum. Using a radioguided surgical technique the hyperfunctioning tissue is excised and confirmed by histopathology. Conclusion: Whilst a dramatic reduction in patient symptoms was not seen immediately in this patient, the symptoms of the illness have been subsiding since January 2003. This case study demonstrates the necessity of changing imaging protocols for parathyroid scintigraphy where a definitive imaging diagnosis is absent in the face of strong clinical suspicion

  14. Smoking is associated with an increased risk of developing ACPA-positive but not ACPA-negative rheumatoid arthritis in Asian populations: evidence from the Malaysian MyEIRA case-control study.

    Science.gov (United States)

    Yahya, Abqariyah; Bengtsson, Camilla; Lai, Too Chun; Larsson, Per T; Mustafa, Amal Nasir; Abdullah, Nor Aini; Muhamad, Norasiah; Hussein, Heselynn; Klareskog, Lars; Alfredsson, Lars; Murad, Shahnaz

    2012-08-01

    We investigated the association between cigarette smoking and the risk of developing rheumatoid arthritis (RA) in the Malaysian population. A total of 1,056 RA patients and 1,416 matched controls aged 18-70 years within a defined area of Peninsular Malaysia were evaluated in a case-control study between August 2005 and December 2009. A case was defined as a person with early diagnosed RA using the 1987 American College of Rheumatology criteria for RA. Controls were randomly selected matched for sex, age, and residential area. Cases and controls answered a questionnaire on a broad range of issues, including lifestyle factors and smoking habits wherein current and former smoking was classified as ever-smoking. The presence of anti-citrullinated peptide antibodies (ACPA) was determined for cases and controls. We found that ever-smokers had an increased risk of developing ACPA-positive RA [odds ratio (OR) = 4.1, 95% confidence interval (CI) 1.9-9.2] but not ACPA-negative RA (OR = 0.7, 95% CI 0.3-2.0), compared with never-smokers. A significant dose-response relationship between cumulative dose of smoking and risk of ACPA-positive RA was observed (<20 pack-years OR = 3.3, 95% CI 1.1-9.8; at least 20 pack-years OR = 5.2, 95% CI 1.6-17.6). Hence, smoking is associated with an increased risk of ACPA-positive RA in the Malaysian population, in which the genetic context is similar to several other Asian countries.

  15. Selection and Interpretation of Scientific Evidence in Preparation for Policy Decisions: A Case Study Regarding Introduction of Rotavirus Vaccine Into National Immunization Programs in Sweden, Norway, Finland, and Denmark

    Directory of Open Access Journals (Sweden)

    Gry St-Martin

    2018-05-01

    Full Text Available The World Health Organization recommends inclusion of rotavirus vaccines in national immunization programs (NIPs worldwide. Nordic countries are usually considered comparable in terms of demographics and health-care services and have comparable rotavirus disease burden. Nevertheless, the countries have reached different decisions regarding rotavirus vaccine: Norway and Finland have already introduced rotavirus vaccines into their NIPs and Sweden is currently changing its recommendation and vaccines will now be introduced on a national scale while Denmark has decided against it. This study focuses on the selection and interpretation of medical and epidemiological evidence used during the decision-making processes in Sweden, Norway, Finland, and Denmark. The so-called “severity criteria” is identified as one of the main reasons for the different policy decisions reached across the Nordic countries.

  16. Evidence from the national health account: the case of Dubai

    OpenAIRE

    Hamidi, Samer

    2014-01-01

    Samer Hamidi School of Health and Environmental Studies, Hamadan Bin Mohammad Smart University, Dubai, United Arab Emirates Introduction: National health accounts (NHAs) provide useful information to aid in understanding the health care financing system. This article aims to present a profile of health system financing in Dubai using data from the NHA. We also aim to compare the provider structure of financing schemes in Dubai with those of the State of Qatar and selected Organization for Ec...

  17. A congruence analysis of the inequality-conflict nexus: Evidence from 16 cases

    DEFF Research Database (Denmark)

    Bartusevicius, Henrikas

    2017-01-01

    finds evidence to support some of the main pathways proposed in the quantitative literature. Furthermore, the analysis finds that different types of inequalities relate to different conflict categories. Specifically, vertical inequalities relate to non-ethnic governmental conflicts (via an “individual......The relationship between inequality and civil conflict has attracted considerable interest in conflict research. Recent large-N studies have shown that inequalities significantly contribute to the outbreak of civil conflict and have proposed a number of causal pathways to account for this....... These pathways, however, have rarely been assessed in systematic case-based research. This study implements a “middle-N” qualitative congruence analysis of 16 conflicts, focusing on the observable implications of the pathways through which inequalities are typically theorized to influence conflict. The study...

  18. Neural mechanisms of mindfulness and meditation: Evidence from neuroimaging studies

    Institute of Scientific and Technical Information of China (English)

    William; R; Marchand

    2014-01-01

    Mindfulness is the dispassionate,moment-by-moment awareness of sensations,emotions and thoughts.Mindfulness-based interventions are being increasingly used for stress,psychological well being,coping with chronic illness as well as adjunctive treatments for psychiatric disorders.However,the neural mechanisms associated with mindfulness have not been well characterized.Recent functional and structural neuroimaging studies are beginning to provide insights into neural processes associated with the practice of mindfulness.A review of this literature revealed compelling evidence that mindfulness impacts the function of the medial cortex and associated default mode network as well as insula and amygdala.Additionally,mindfulness practice appears to effect lateral frontal regions and basal ganglia,at least in some cases.Structural imaging studies are consistent with these findings and also indicate changes in the hippocampus.While many questions remain unanswered,the current literature provides evidence of brain regions and networks relevant for understanding neural processes associated with mindfulness.

  19. Using Correspondence Analysis in Multiple Case Studies

    NARCIS (Netherlands)

    Kienstra, Natascha; van der Heijden, Peter G.M.

    2015-01-01

    In qualitative research of multiple case studies, Miles and Huberman proposed to summarize the separate cases in a so-called meta-matrix that consists of cases by variables. Yin discusses cross-case synthesis to study this matrix. We propose correspondence analysis (CA) as a useful tool to study

  20. Using correspondence analysis in multiple case studies

    NARCIS (Netherlands)

    Kienstra, N.H.H.; van der Heijden, P.G.M.

    2015-01-01

    In qualitative research of multiple case studies, Miles and Huberman proposed to summarize the separate cases in a so-called meta-matrix that consists of cases by variables. Yin discusses cross-case synthesis to study this matrix. We propose correspondence analysis (CA) as a useful tool to study

  1. Judicial Understanding of the Reliability of Eyewitness Evidence: A Tale of Two Cases

    Directory of Open Access Journals (Sweden)

    Lirieka Meintjes-van der Walt

    2016-06-01

    Full Text Available One of the most significant consequences of the use of post-conviction DNA testing in the criminal justice system has been the growing recognition that eyewitness identification testimony is simply not as reliable as it was previously considered to be. In approximately 75% of DNA exonerations in the United States, mistaken eyewitness identifications were the principal cause of wrongful convictions. Notwithstanding scientific advances regarding human memory and other factors that could influence identifications by eyewitnesses, courts have not shown eagerness in utilising such scientific knowledge in reaching legal decisions. Two cases have been chosen for discussion in this article. In S v Henderson 27 A 3d 872 (NJ 2011 the New Jersey Supreme Court was the first in State and Federal jurisdictions in the US that adopted a science-based approach to the evaluation of eyewitness evidence. The other case under discussion is S v Mdlongwa 2010 2 SACR 419 (SCA, a South African Supreme Court of Appeal judgment, where the identification of the perpetrator was based on an eyewitness account and the evidence of an expert on CCTV images. In part one of this article the research findings with regard to estimator variables that were acknowledged in S v Henderson are discussed. Part two specifically scrutinizes S v Mdlongwa to determine the extent to which psychological eyewitness research findings are recognised in South Africa as having an influence on the reliability of eyewitness evidence. In Henderson the court recognised that the legal standards governing the admissibility and use of identification evidence lagged far behind the findings of numerous studies in the social sciences. The new wave introduced by S v Henderson has not gone unnoticed in other State courts in the USA. In Massachusetts, for example, the Justices of the Supreme Judicial Court convened a study group on Eyewitness Evidence and the resulting report inter alia recommended judicial

  2. Systems Thinking Tools for Improving Evidence-Based Practice: A Cross-Case Analysis of Two High School Leadership Teams

    Science.gov (United States)

    Kensler, Lisa A. W.; Reames, Ellen; Murray, John; Patrick, Lynne

    2012-01-01

    Teachers and administrators have access to large volumes of data but research suggests that they lack the skills to use data effectively for continuous school improvement. This study involved a cross-case analysis of two high school leadership teams' early stages of evidence-based practice development; differing forms of external support were…

  3. [A health system's neoliberal reform: evidence from the Mexican case].

    Science.gov (United States)

    López-Arellano, Oliva; Jarillo-Soto, Edgar C

    2017-07-27

    This study addressed the shaping of Mexico's health system in recent years, with an analysis of the social determination conditioning the system's current formulation, the consequences for the population's living and working conditions, and the technical and legal reform measures that shaped the system's transformation. The article then analyzes the survival of social security institutions and the introduction of an individual insurance model and its current implications and consequences. From the perspective of the right to health, the article compares the measures, resources, and interventions in both health care models and highlights the relevance of the social security system for Popular Insurance. The article concludes that the measures implemented to reform the Mexican health system have failed to achieve the intended results; on the contrary, they have led to a reduction in interventions, rising costs, and a decrease in the installed capacity and professional personnel for the system's operation, thus falling far short of solving the problem, rather aggravating the inequities without solving the system's structural contradictions. Health systems face new challenges, inevitably requiring that the analyses be situated in a broader framework rather than merely focusing on the functional, administrative, and financial operation of the systems in the respective countries.

  4. Case Study: A Picture Worth a Thousand Words? Making a Case for Video Case Studies

    Science.gov (United States)

    Pai, Aditi

    2014-01-01

    A picture, they say, is worth a thousand words. If a mere picture is worth a thousand words, how much more are "moving pictures" or videos worth? The author poses this not merely as a rhetorical question, but because she wishes to make a case for using videos in the traditional case study method. She recommends four main approaches of…

  5. Case studies in ultrasonic testing

    International Nuclear Information System (INIS)

    Prasad, V.; Satheesh, C.; Varde, P.V.

    2015-01-01

    Ultrasonic testing is widely used Non Destructive Testing (NDT) method and forms the essential part of In-service inspection programme of nuclear reactors. Main application of ultrasonic testing is for volumetric scanning of weld joints followed by thickness gauging of pipelines and pressure vessels. Research reactor Dhruva has completed the first In Service Inspection programme in which about 325 weld joints have been volumetrically scanned, in addition to thickness gauging of 300 meters of pipe lines of various sizes and about 24 nos of pressure vessels. Ultrasonic testing is also used for level measurements, distance measurements and cleaning and decontamination of tools. Two case studies are brought out in this paper in which ultrasonic testing is used successfully for identification of butterfly valve opening status and extent of choking in pipe lines in Dhruva reactor systems

  6. STS Case Study Development Support

    Science.gov (United States)

    Rosa de Jesus, Dan A.; Johnson, Grace K.

    2013-01-01

    The Shuttle Case Study Collection (SCSC) has been developed using lessons learned documented by NASA engineers, analysts, and contractors. The SCSC provides educators with a new tool to teach real-world engineering processes with the goal of providing unique educational materials that enhance critical thinking, decision-making and problem-solving skills. During this third phase of the project, responsibilities included: the revision of the Hyper Text Markup Language (HTML) source code to ensure all pages follow World Wide Web Consortium (W3C) standards, and the addition and edition of website content, including text, documents, and images. Basic HTML knowledge was required, as was basic knowledge of photo editing software, and training to learn how to use NASA's Content Management System for website design. The outcome of this project was its release to the public.

  7. Evidence from the national health account: the case of Dubai

    Directory of Open Access Journals (Sweden)

    Hamidi S

    2014-09-01

    Full Text Available Samer Hamidi School of Health and Environmental Studies, Hamadan Bin Mohammad Smart University, Dubai, United Arab Emirates Introduction: National health accounts (NHAs provide useful information to aid in understanding the health care financing system. This article aims to present a profile of health system financing in Dubai using data from the NHA. We also aim to compare the provider structure of financing schemes in Dubai with those of the State of Qatar and selected Organization for Economic Cooperation and Development (OECD countries. Methods: The author analyzed secondary data published in NHAs for Dubai and Qatar, and data collected by the OECD countries and publicly available from the Statistical Office of the European Union (Eurostat, for 25 OECD countries for comparative analysis. All health financing measures used are as defined in the international System of Health Accounts (SHA. Results: In Dubai, only 33% of current health expenditure (CHE is funded by the government. However, the public sector is the main source of health funding in Qatar and most OECD countries, with an average of 79% and 72%, respectively. Households in Dubai spent about 22% of CHE, equivalent to an average US$187 per capita, ranking the highest among Gulf Cooperation Council (GCC countries, and compared with 20% of CHE across OECD countries. Hospitals in Dubai accounted for 48% of CHE, which is much higher than Qatar (40% and the OECD average (36%. Conclusion: The Dubai health care financing system differs substantially from that in OECD countries, as it is more private oriented. The findings point to several potential opportunities for growth and improvement. Policy areas that may be addressed using the information presented in this article are broad and include the following: shift from hospital care to ambulatory and day care, sustainability of health finance, shift the cost of health care to the private sector, introduce cost-containment measures, revise

  8. Um Estudo sobre o Uso da Evidência Física como Forma de Gerar Percepções de Qualidade de Serviços: casos de hospitais brasileirosA Study of the use of Physical Evidence as a way of Generating Perception of Service Quality: a case study of Brazilian hospitalsUn Estudio sobre el Uso de la Evidencia Física como Forma de Generar Percepciones de Calidad de Servicios: casos de hospitales brasileños

    Directory of Open Access Journals (Sweden)

    CAMPOMAR, Marcos Cortez

    2005-01-01

    Full Text Available RESUMOO presente artigo tem por objetivo estudar o uso da evidência física como forma de gerar percepções de qualidade de serviços por parte de clientes em prestadores de serviços hospitalares. A natureza exploratória do trabalho está diretamente relacionada à baixa produção acadêmica existente sobre o tema no Brasil. O artigo está dividido em três partes. Na primeira parte faz-se uma revisão da literatura pertinente ao tema em que se abrange: importância dos serviços; serviços de saúde; qualidade de serviços; e evidência física. Na segunda parte apresentam-se a metodologia e os resultados de uma pesquisa de campo realizada com o uso do método de estudo de casos para verificar de que maneira os conceitos de evidência física são aplicados por hospitais brasileiros. Na terceira parte conclui-se que, em geral, as ações desenvolvidas pelas organizações pesquisadas são coerentes com as práticas descritas na literatura internacional. Também na terceira parte são apresentadas as limitações do estudo e oferecidas sugestões para futuras pesquisas sobre o tema.ABSTRACTThe aim of this paper is to study the use of physical evidence as a way to generate service quality perceptions from clients of hospitals. The realization of an exploratory research is directly related to the low academic production on the subject in Brazil. In the first part of the paper we present a literature review including: the importance of services; health care services; service quality; and physical evidence. In the second part of the paper are presented the methodology and the results of a field research made with the use of the case study method in order to verify how the concept of physical evidence is practiced by Brazilian hospitals. In the third part we conclude that in general the actions developed by the researched organizations are coherent with the practices described in the international literature. Also in the third part we present

  9. Using Bayesian networks to guide the assessment of new evidence in an appeal case.

    Science.gov (United States)

    Smit, Nadine M; Lagnado, David A; Morgan, Ruth M; Fenton, Norman E

    2016-05-25

    When new forensic evidence becomes available after a conviction there is no systematic framework to help lawyers to determine whether it raises sufficient questions about the verdict in order to launch an appeal. This paper presents such a framework driven by a recent case, in which a defendant was convicted primarily on the basis of audio evidence, but where subsequent analysis of the evidence revealed additional sounds that were not considered during the trial. The framework is intended to overcome the gap between what is generally known from scientific analyses and what is hypothesized in a legal setting. It is based on Bayesian networks (BNs) which have the potential to be a structured and understandable way to evaluate the evidence in a specific case context. However, BN methods suffered a setback with regards to the use in court due to the confusing way they have been used in some legal cases in the past. To address this concern, we show the extent to which the reasoning and decisions within the particular case can be made explicit and transparent. The BN approach enables us to clearly define the relevant propositions and evidence, and uses sensitivity analysis to assess the impact of the evidence under different assumptions. The results show that such a framework is suitable to identify information that is currently missing, yet clearly crucial for a valid and complete reasoning process. Furthermore, a method is provided whereby BNs can serve as a guide to not only reason with incomplete evidence in forensic cases, but also identify very specific research questions that should be addressed to extend the evidence base and solve similar issues in the future.

  10. Evidence in clinical reasoning: a computational linguistics analysis of 789,712 medical case summaries 1983-2012.

    Science.gov (United States)

    Seidel, Bastian M; Campbell, Steven; Bell, Erica

    2015-03-21

    Better understanding of clinical reasoning could reduce diagnostic error linked to 8% of adverse medical events and 30% of malpractice cases. To a greater extent than the evidence-based movement, the clinical reasoning literature asserts the importance of practitioner intuition—unconscious elements of diagnostic reasoning. The study aimed to analyse the content of case report summaries in ways that explored the importance of an evidence concept, not only in relation to research literature but also intuition. The study sample comprised all 789,712 abstracts in English for case reports contained in the database PUBMED for the period 1 January 1983 to 31 December 2012. It was hypothesised that, if evidence and intuition concepts were viewed by these clinical authors as essential to understanding their case reports, they would be more likely to be found in the abstracts. Computational linguistics software was used in 1) concept mapping of 21,631,481 instances of 201 concepts, and 2) specific concept analyses examining 200 paired co-occurrences for 'evidence' and research 'literature' concepts. 'Evidence' is a fundamentally patient-centred, intuitive concept linked to less common concepts about underlying processes, suspected disease mechanisms and diagnostic hunches. In contrast, the use of research literature in clinical reasoning is linked to more common reasoning concepts about specific knowledge and descriptions or presenting features of cases. 'Literature' is by far the most dominant concept, increasing in relevance since 2003, with an overall relevance of 13% versus 5% for 'evidence' which has remained static. The fact that the least present types of reasoning concepts relate to diagnostic hunches to do with underlying processes, such as what is suspected, raises questions about whether intuitive practitioner evidence-making, found in a constellation of dynamic, process concepts, has become less important. The study adds support to the existing corpus of

  11. Flash-flood potential assessment and mapping by integrating the weights-of-evidence and frequency ratio statistical methods in GIS environment - case study: Bâsca Chiojdului River catchment (Romania)

    Science.gov (United States)

    Costache, Romulus; Zaharia, Liliana

    2017-06-01

    Given the significant worldwide human and economic losses caused due to floods annually, reducing the negative consequences of these hazards is a major concern in development strategies at different spatial scales. A basic step in flood risk management is identifying areas susceptible to flood occurrences. This paper proposes a methodology allowing the identification of areas with high potential of accelerated surface run-off and consequently, of flash-flood occurrences. The methodology involves assessment and mapping in GIS environment of flash flood potential index (FFPI), by integrating two statistical methods: frequency ratio and weights-of-evidence. The methodology was applied for Bâsca Chiojdului River catchment (340 km2), located in the Carpathians Curvature region (Romania). Firstly, the areas with torrential phenomena were identified and the main factors controlling the surface run-off were selected (in this study nine geographical factors were considered). Based on the features of the considered factors, many classes were set for each of them. In the next step, the weights of each class/category of the considered factors were determined, by identifying their spatial relationships with the presence or absence of torrential phenomena. Finally, the weights for each class/category of geographical factors were summarized in GIS, resulting the FFPI values for each of the two statistical methods. These values were divided into five classes of intensity and were mapped. The final results were used to estimate the flash-flood potential and also to identify the most susceptible areas to this phenomenon. Thus, the high and very high values of FFPI characterize more than one-third of the study catchment. The result validation was performed by (i) quantifying the rate of the number of pixels corresponding to the torrential phenomena considered for the study (training area) and for the results' testing (validating area) and (ii) plotting the ROC (receiver operating

  12. Five Misunderstandings About Case-Study Research

    DEFF Research Database (Denmark)

    Flyvbjerg, Bent

    2006-01-01

    This article examines five common misunderstandings about case-study research: (a) theoretical knowledge is more valuable than practical knowledge; (b) one cannot generalize from a single case, therefore, the single-case study cannot contribute to scientific development; (c) the case study is most...... useful for generating hypotheses, whereas other methods are more suitable for hypotheses testing and theory building; (d) the case study contains a bias toward verification; and (e) it is often difficult to summarize specific case studies. This article explains and corrects these misunderstandings one...

  13. [Case-non case studies: Principles, methods, bias and interpretation].

    Science.gov (United States)

    Faillie, Jean-Luc

    2017-10-31

    Case-non case studies belongs to the methods assessing drug safety by analyzing the disproportionality of notifications of adverse drug reactions in pharmacovigilance databases. Used for the first time in the 1980s, the last few decades have seen a significant increase in the use of this design. The principle of the case-non case study is to compare drug exposure in cases of a studied adverse reaction with that of cases of other reported adverse reactions and called "non cases". Results are presented in the form of a reporting odds ratio (ROR), the interpretation of which makes it possible to identify drug safety signals. This article describes the principle of the case-non case study, the method of calculating the ROR and its confidence interval, the different modalities of analysis and how to interpret its results with regard to the advantages and limitations of this design. Copyright © 2017 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.

  14. Concentrated photovoltaics, a case study

    Directory of Open Access Journals (Sweden)

    Antonini Piergiorgio

    2014-01-01

    Full Text Available Concentrated Photovoltaics (CPV, once a niche technology, has now reached the maturity and reliability for large scale power generation. Especially in regions where temperatures are very high, the use of high efficiency triple junction solar cells with concentrating optics allows stable energy yield. Thus CPV can be seen as complementary and not in concurrence with silicon photovoltaics. The state of the art, the advantages and limitations of this technology will be shown. Among the main advantages of CPV is the possibility of a much higher energy supply, when compared to silicon photovoltaics, both comparing CPV and silicon with same area or the same installed power. The use of recycled and recyclable materials allows a more environmentally friendly production. The possibility to couple CPV with desalination facilities, energy storage will be analysed. As an example a case study of a CPV installation in Northern Italy is discussed. Here the use of mature technologies, derived from automotive and lighting sectors resulted in a simple and efficient module.

  15. Case Studies of Environmental Visualization

    Directory of Open Access Journals (Sweden)

    Panagiotis Patlakas

    2017-09-01

    Full Text Available The performance gap between simulation and reality has been identified as a major challenge to achieving sustainability in the Built Environment. While Post-Occupancy Evaluation (POE surveys are an integral part of better understanding building performance, and thus addressing this issue, the importance of POE remains relatively unacknowledged within the wider Built Environment community. A possible reason that has been highlighted is that POE survey data is not easily understood and utilizable by non-expert stakeholders, including designers. A potential method by which to address this is the visualization method, which has well established benefits for communication of big datasets. This paper presents two case studies where EnViz (short for “Environmental Visualization”, a prototype software application developed for research purposes, was utilized and its effectiveness tested via a range of analysis tasks. The results are discussed and compared with those of previous work that utilized variations of the methods presented here. The paper concludes by presenting the lessons drawn from the five-year period of EnViz, emphasizing the potential of environmental visualization for decision support in environmental design and engineering for the built environment, and suggests directions for future development.

  16. Catalog of NASA-Related Case Studies

    Data.gov (United States)

    National Aeronautics and Space Administration — The OCKO has developed over 50 case studies to enhance learning at workshops, training, retreats and conferences. Case studies make mission knowledge attractive and...

  17. Study types and reliability of Real World Evidence compared with experimental evidence used in Polish reimbursement decision-making processes.

    Science.gov (United States)

    Wilk, N; Wierzbicka, N; Skrzekowska-Baran, I; Moćko, P; Tomassy, J; Kloc, K

    2017-04-01

    The aim of this study was to identify the relationship and impact between Real World Evidence (RWE) and experimental evidence (EE) in Polish decision-making processes for the drugs from selected Anatomical Therapeutic Chemical (ATC) groups. Descriptive study. A detailed analysis was performed for 58 processes from five ATC code groups in which RWE for effectiveness, or effectiveness and safety were cited in Agency for Health Technology Assessment and Tariff System's (AOTMiT) documents published between January 2012 and September 2015: Verification Analysis of AOTMiT, Statement of the Transparency Council of AOTMiT, and Recommendation of the President of AOTMiT. In 62% of the cases, RWE supported the EE and confirmed its main conclusions. The majority of studies in the EE group showed to be RCTs (97%), and the RWE group included mainly cohort studies (89%). There were more studies without a control group within RWE compared with the EE group (10% vs 1%). Our results showed that EE are more often assessed using Jadad, NICE or NOS scale by AOTMiT compared with RWE (93% vs 48%). When the best evidence within a given decision-making process is analysed, half of RWE and two-thirds of EE are considered high quality evidence. RWE plays an important role in the decision-making processes on public funding of drugs in Poland, contributing to nearly half (45%) of all the evidence considered. There exist such processes in which the proportion of RWE is dominant, with one process showing RWE as the only evidence presented. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  18. Grenada School Nutrition Study: Evidence to Inform Policy

    International Development Research Centre (IDRC) Digital Library (Canada)

    Grenada School Nutrition Study: Evidence to Inform ... research focusing on the main risk factors for NCDs: tobacco use, unhealthy diet, alcohol misuse, and physical inactivity. ... study predicts that non-communicable diseases associated.

  19. THE POSITION OF INDIRECT EVIDENCE AS VERIFICATION TOOLS IN THE CARTEL CASE

    Directory of Open Access Journals (Sweden)

    Veri Antoni

    2014-06-01

    Full Text Available Indirect (circumstantial evidence, either economic evidence or communication evidence, has been used in cartel cases in many countries such as United States of America, Japan, Australia, Brazil, Malaysia, and others. According to Indonesia criminal procedure law, the position of indirect (circumstantial evidence is categorized as an indication (clue evidence whereas according to Indonesia civil procedure law, indirect (circumstantial evidence is categorized as presumption. Considering the characteristics the antimonopoly law which aims to find material truth, the position of indirect evidence is more properly said to be an indication. Owing to its status as an indication, indirect evidence should be exhibited together with the other direct evidence.   Indirect evidenceatau bukti tidak langsung, baik bukti ekonomi atau bukti komunikasi, telah digunakan dalam kasus-kasus kartel di banyak negara, seperti Amerika Serikat, Jepang, Australia, Brazil, Malaysia, dan lain-lain. Menurut hukum acara pidana Indonesia, posisi bukti tidak langsung dikategorikan sebagai indikasi (bukti petunjuk, padahal menurut hukum acara perdata Indonesia, bukti tidak langsung dikategorikan sebagai praduga. Mengingat karakteristik hukum anti-monopoli yang bertujuan untuk mencari kebenaran materiil, posisi bukti tidak langsung lebih tepat dikatakan indikasi. Karena statusnya sebagai indikasi, bukti tidak langsung harus dipamerkan bersama dengan bukti langsung lainnya.

  20. a South African case study

    African Journals Online (AJOL)

    User

    learn different algorithms to solve problems, but in many cases cannot solve .... centre of Piaget‟s work is a fundamental cognitive process, which he termed ..... concept definition of continuity in calculus through collaborative instructional ...

  1. Evidence-based policy versus morality policy: the case of syringe access programs.

    Science.gov (United States)

    de Saxe Zerden, Lisa; O'Quinn, Erin; Davis, Corey

    2015-01-01

    Evidence-based practice (EBP) combines proven interventions with clinical experience, ethics, and client preferences to inform treatment and services. Although EBP is integrated into most aspects of social work and public health, at times EBP is at odds with social policy. In this article the authors explore the paradox of evidence-based policy using syringe access programs (SAP) as a case example, and review methods of bridging the gap between the emphasis on EBP and lack of evidence informing SAP policy. Analysis includes the overuse of morality policy and examines historical and current theories why this paradox exists. Action steps are highlighted for creating effective policy and opportunities for public health change. Strategies on reframing the problem and shifting target population focus to garner support for evidence-based policy change are included. This interdisciplinary understanding of the way in which these factors converge is a critical first step in moving beyond morality-based policy toward evidence-based policy.

  2. Case Study: The Chemistry of Cocaine

    Science.gov (United States)

    Dewprashad, Brahmadeo

    2011-01-01

    This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. This month's case study focuses on the chemistry of cocaine to teach a number of core concepts in organic chemistry. It also requires that students read and analyze an original research paper on…

  3. Writing case studies in information systems research

    NARCIS (Netherlands)

    van der Blonk, H.C.

    Case study research can be reported in different ways. This paper explores the various ways in which researchers may choose to write down their case studies and then introduces a subsequent typology of writing case studies. The typology is based on a 2 x 2 matrix, resulting in four forms of writing

  4. Summary of case studies for cooperation mechanisms

    DEFF Research Database (Denmark)

    Longa, Francesco Dalla; Klinge Jacobsen, Henrik; Hansen, Lise-Lotte Pade

    2012-01-01

    This document is a summary report highlighting the main aspect analyzed in the RES4LESS case studies. The document starts with an introductory chapter where the background that led to the selection of the case studies is outlined. In the following three chapters the case studies are presented, hi...

  5. Electric property evidences of carbonification of organic matters in marine shales and its geologic significance: A case study of the Lower Cambrian Qiongzhusi shale in the southern Sichuan Basin

    Directory of Open Access Journals (Sweden)

    Yuman Wang

    2014-12-01

    Full Text Available Searching for some reliable evidences that can verify the carbonification of organic matters in marine shales is a major scientific issue in selecting shale gas fairways in old strata. To this end, based on core, logging and testing data, the electric property of two organic-rich shale layers in the Lower Cambrian Qiongzhusi Fm. and the Lower Silurian Longmaxi Fm. in the southern Sichuan Basin was compared to examine the carbonification signs of organic matters in the Qiongzhusi shale and its influence on gas occurrence in the shales. The following conclusions were reached: (1 the electric property experiment shows that the Qiongzhusi shale in the study area has had carbonification of organic matters. The low resistivity of dry samples from this highly mature organic-rich shale and ultra-low resistivity on downhole logs can be used to directly judge the degree of organic matter carbonification and the quality of source rocks; (2 in the Changning area, the Qiongzhusi shale shows low resistivity of dry samples and low to ultra-low resistivity on logs, indicating that organic matters are seriously carbonized, while in the Weiyuan area, the Qiongzhusi shale shows a basically normal resistivity on log curves, indicating its degree of graphitization between the Longmaxi Fm. and Qiongzhusi Fm. in the Changning area; (3 shale with medium-to-high resistivity is remarkably better than that with ultra-low resistivity in terms of gas generation potential, matrix porosity and gas adsorption capacity; (4 industrial gas flow has been tested in the organic shales with medium-to-high resistivity in the Jianwei–Weiyuan–Tongnan area in the north, where the Qiongzhusi shale is a favorable shale gas exploration target.

  6. Lymphedema during pregnancy - case study

    Directory of Open Access Journals (Sweden)

    Katarzyna Korabiusz

    2017-06-01

    Full Text Available Pregnancy is a period when woman’s body undergoes a lot of changes in her hormonal balance, lymphatic system, musculoskeletal system and cardiovascular system. As a result of disorders in defense mechanisms, a significant amount of liquid accumulates in spaces between tissues. A clinical manifestation of this condition is swelling located around ankles and lower legs. Sedentary lifestyle, unhealthy eating habits, excessive weight and pregnancy are also well known causes of lymphatic swelling. Comprehensive anti-swelling therapy that is used in treating lymphatic swelling in pregnant patients includes: patients’ education, manual lymphatic drainage, kinesitherapy, multilayer bandaging, skin care, drainage positions and kinesiotaping. Dissertation’s objective: Dissertation’s objective is to evaluate implementation of manual lymphatic drainage and anti-swelling kinesiotaping in pregnant woman with lymphatic swelling of lower legs. Research methods: Research methods were collected basing on: interview with a patient, medical documentation analysis and physical examination conduced before and after therapy. Research was conducted between 34th and 36th week of pregnancy. Case study: 38 year old patient in her fourth singleton pregnancy. Two prior pregnancies in 2009 and 2010 were delivered with C-section and one missed abortion in 2015 occurred. During this pregnancy patient gained over 30kg. She was diagnosed with lymphatic swelling of metatarsus, lower legs and ankles in 34th week of pregnancy. Lymphatic drainage of lower limbs and anti-swelling kinesiotaping was implemented. Results: After two weeks of therapy decrease in swelling was observed in left lower limb: in metatarsus by 8cm, in ankles by 9cm and in lower legs by 6cm. In right lower limb swelling decreased accordingly by 7cm, 10cm and 5cm. Conclusion: Anti-swelling lymphatic drainage, kinesiotherapy and kinesiotaping are effective physiotherapy methods used in treating lymphedema

  7. SPHENOCHOANAL POLYP: A CASE STUDY

    Directory of Open Access Journals (Sweden)

    Gaurav

    2015-09-01

    Full Text Available Sphenochoanal polyp is a rare clinical occurrence as compared to the much common antro - choanal polyp. It originates from the sphenoid sinus and extends into the choana via the sphenoid ostium. We present a case of spheno - choanal polyp and its clinical features and surgical management is discussed. Our aim in this case was to properly d elineate the origin of the polyp and differentiate it from other lesions such as the antro - choanal polyp and meningocele, followed by meticulous endoscopic excision of the polyp

  8. Using Case Studies to Enrich Field Experience.

    Science.gov (United States)

    Florio-Ruane, Susan; Clark, Christopher M.

    1990-01-01

    This paper discusses the use of field experience in teacher education and how it can be augmented by phenomenological case studies. It summarizes a particular case study involving three teacher education classes, noting that reflective analysis of cases can prepare students to observe in the field. (SM)

  9. Transanal rectopexy - twelve case studies

    Directory of Open Access Journals (Sweden)

    Rubens Henrique Oleques Fernandes

    2012-06-01

    Full Text Available OBJECTIVES: This study analyzed the results of transanal rectopexy and showed the benefits of this surgical technique. METHOD: Twelve patients were submitted to rectopexy between 1997 and 2011. The surgical technique used was transanal rectopexy, where the mesorectum was fixed to the sacrum with nonabsorbable suture. Three patients had been submitted to previous surgery, two by the Delorme technique and one by the Thiersch technique. RESULTS: Postoperative hospital stay ranged from 1 to 4 days. One patient (8.3% had intraoperative hematoma, which was treated with local compression and antibiotics. One patient (8.3% had residual mucosal prolapse, which was resected. Prolapse recurrence was seen in one case (8.3%. Improved incontinence occurred in 75% of patients and one patient reported obstructed evacuation in the first month after surgery. No death occurred. CONCLUSION: Transanal rectopexy is a simple, low cost technique, which has shown good efficacy in rectal prolapse control.OBJETIVO: O presente estudo analisou os resultados da retopexia pela via transanal e expôs os benefícios desta técnica cirúrgica. MÉTODO: Doze pacientes com prolapso foram operados no período de 1997 a 2011. A técnica cirúrgica usada foi a retopexia transanal, onde o mesorreto foi fixado ao sacro com fio inabsorvível. Três pacientes tinham cirurgia prévia, dois pela técnica de Delorme e um pela técnica de Thiersch. RESULTADOS: A permanência hospitalar pós-operatória variou de 1- 4 dias. Uma paciente (8,3% apresentou hematoma transoperatório que foi tratado com compressão local e antibioticoterapia. Um paciente apresentou prolapso mucoso residual (8,3%, que foi ressecado. Houve recidiva da procidência em um caso (8,3%. A melhora da incontinência ocorreu em 75% dos pacientes e uma paciente apresentou bloqueio evacuatório no primeiro mês após a cirurgia. Não houve mortalidade entre os pacientes operados. CONCLUSÃO: A retopexia transanal é uma t

  10. CASE STUDY: Kampala, Uganda — From the ground up: Urban ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2006-04-21

    Apr 21, 2006 ... English · Français ... CASE STUDY: Kampala, Uganda — From the ground up: Urban ... Azuba has used this kind of evidence to convert more than one ... a bottomup approach was needed to draft ordinances that would work.

  11. WP4 Case study Report

    DEFF Research Database (Denmark)

    Elle, Morten; van Gameren, Valentine; Pel, Bonno

    The INFORSE case consists of an analysis of the transnational network INFORSE (International Network for Sustainable Energy), the Danish local initiative VE and the Belgian local initiative APERe. All three are dealing with renewable energy and energy savings. The link between INFORSE and VE...

  12. 20 CFR 10.116 - What additional evidence is needed in cases based on occupational disease?

    Science.gov (United States)

    2010-04-01

    ... based on occupational disease? 10.116 Section 10.116 Employees' Benefits OFFICE OF WORKERS' COMPENSATION... of Proof § 10.116 What additional evidence is needed in cases based on occupational disease? (a) The... occupational diseases. The medical report should also include the information specified on the checklist for...

  13. Five misunderstandings about Case-study Research

    DEFF Research Database (Denmark)

    Flyvbjerg, Bent

    This article examines five common misunderstandings about case-study research: (1) Theoretical knowledge is more valuable than practical knowledge; (2) One cannot generalize from a single case, therefore the single case study cannot contribute to scientific development; (3) The case study is most...... useful for generating hypotheses, while other methods aremore suitable for hypotheses testing and theory building; (4) The case study contains a bias toward verification; and (5) It is often difficult to summarize specific case studies. The article explains and corrects these misunderstandings one by one...... and concludes with the Kuhnian insight that a scientific discipline without a large number of thoroughly executed case studies is a discipline without systematic production of exemplars, and that a discipline without  exemplars is an ineffective one. Social science may be strengthened by the execution of more...

  14. Five misunderstandings about case study research

    DEFF Research Database (Denmark)

    Flyvbjerg, Bent

    2004-01-01

    This article examines five common misunderstandings about case-study research: (1) Theoretical knowledge is more valuable than practical knowledge; (2) One cannot generalize from a single case, therefore the single case study cannot contribute to scientific development; (3) The case study is most...... useful for generating hypotheses, while other methods aremore suitable for hypotheses testing and theory building; (4) The case study contains a bias toward verification; and (5) It is often difficult to summarize specific case studies. The article explains and corrects these misunderstandings one by one...... and concludes with the Kuhnian insight that a scientific discipline without a large number of thoroughly executed case studies is a discipline without systematic production of exemplars, and that a discipline without exemplars is an ineffective one. Social science may be strengthened by the execution of more...

  15. Grenada School Nutrition Study: Evidence to Inform Policy | CRDI ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Grenada School Nutrition Study: Evidence to Inform Policy ... LMICs can direct their efforts to changing the environments and habits that promote ... Report Card that will be suited for advocacy work, and could be used to influence policy.

  16. How safe are regional techniques? Evidence from large studies with ...

    African Journals Online (AJOL)

    meta-analysis are inappropriate for a proper assessment of rare events, such as neurological injury.2 Most of the references to adverse effects, particularly those associated with peripheral ... Evidence from large studies with big data.

  17. Roadmaster Roading Contractors Case Study

    Directory of Open Access Journals (Sweden)

    Hazel Taylor

    1999-01-01

    Full Text Available Systems analysis students seldom experience the practical difficulties of the initial investigation into a client’s requirements. They get little chance to practice the skills they need to investigate complex and confused problem situations, or to appreciate the wider organizational issues that can impact on a situation. This teaching case is designed to give students the opportunity to practice and apply investigation skills and to challenge them to consider the wider work environment when considering possible solutions to a problem situation. The case is conducted as a role-play, with students acting as systems analysts and teaching staff role-playing the clients. The students develop a report analyzing the client’s situation based on the issues that arise during the interviews. Feed-back sessions focus on discussing how well the students applied various interviewing strategies previously covered in lectures, and on the wider organizational problems that could impact proposed information system solutions.

  18. Case-Cohort Studies: Design and Applicability to Hand Surgery.

    Science.gov (United States)

    Vojvodic, Miliana; Shafarenko, Mark; McCabe, Steven J

    2018-04-24

    Observational studies are common research strategies in hand surgery. The case-cohort design offers an efficient and resource-friendly method for risk assessment and outcomes analysis. Case-cohorts remain underrepresented in upper extremity research despite several practical and economic advantages over case-control studies. This report outlines the purpose, utility, and structure of the case-cohort design and offers a sample research question to demonstrate its value to risk estimation for adverse surgical outcomes. The application of well-designed case-cohort studies is advocated in an effort to improve the quality and quantity of observational research evidence in hand and upper extremity surgery. Copyright © 2018 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  19. Bioremediation case studies: Abstracts. Final report

    International Nuclear Information System (INIS)

    Devine, K.

    1992-03-01

    The report contains abstracts of 132 case studies of bioremediation technology applied to hazardous waste clean-up. It was prepared to compile bioremediation studies in a variety of locations and treating diverse contaminants, most of which were previously undocumented. All data are based on vendor-supplied information and there was no opportunity to independently confirm its accuracy. These 132 case studies, from 10 different biotechnology companies, provide users with reference information about on-going and/or completed field applications and studies. About two-thirds of the cases were at full-scale clean-up level with the remainder at pilot or laboratory scale. In 74 percent of the cases, soil was at least one of the media treated. Soil alone accounts for 46 percent of the cases. Petroleum-related wastes account for the largest contaminant with 82 cases. Thirty-one states are represented in the case studies

  20. Dynamics behind the scale up of evidence-based obesity prevention: protocol for a multi-site case study of an electronic implementation monitoring system in health promotion practice.

    Science.gov (United States)

    Conte, Kathleen P; Groen, Sisse; Loblay, Victoria; Green, Amanda; Milat, Andrew; Persson, Lina; Innes-Hughes, Christine; Mitchell, Jo; Thackway, Sarah; Williams, Mandy; Hawe, Penelope

    2017-12-06

    The effectiveness of many interventions to promote health and prevent disease has been well established. The imperative has therefore shifted from amassing evidence about efficacy to scale-up to maximise population-level health gains. Electronic implementation monitoring, or 'e-monitoring', systems have been designed to assist and track the delivery of preventive policies and programs. However, there is little evidence on whether e-monitoring systems improve the dissemination, adoption, and ongoing delivery of evidence-based preventive programs. Also, given considerable difficulties with e-monitoring systems in the clinical sector, scholars have called for a more sophisticated re-examination of e-monitoring's role in enhancing implementation. In the state of New South Wales (NSW), Australia, the Population Health Information Management System (PHIMS) was created to support the dissemination of obesity prevention programs to 6000 childcare centres and elementary schools across all 15 local health districts. We have established a three-way university-policymaker-practice research partnership to investigate the impact of PHIMS on practice, how PHIMS is used, and how achievement of key performance indicators of program adoption may be associated with local contextual factors. Our methods encompass ethnographic observation, key informant interviews and participatory workshops for data interpretation at a state and local level. We use an on-line social network analysis of the collaborative relationships across local health district health promotion teams to explore the relationship between PHIMS use and the organisational structure of practice. Insights will be sensitised by institutional theory, practice theory and complex adaptive system thinking, among other theories which make sense of socio-technical action. Our working hypothesis is that the science of getting evidence-based programs into practice rests on an in-depth understanding of the role they play in the on

  1. Liverpool Telecare Pilot: case studies

    Directory of Open Access Journals (Sweden)

    Nigel Barnes

    2006-09-01

    Full Text Available Telecare services use information and communications technology (ICT to support the provision of care to people in their own homes. This paper describes a pilot telecare service employed by Liverpool (UK City Council to support a sample of their frail and elderly social services users. The pilot has been running for over two years and has been deployed for 21 individuals in Liverpool. In this paper we present the pilot system and provide real example cases which help to illustrate the benefits of such a system.

  2. Associative Visual Agnosia: A Case Study

    OpenAIRE

    Charnallet, A.; Carbonnel, S.; David, D.; Moreaud, O.

    2008-01-01

    We report a case of massive associative visual agnosia. In the light of current theories of identification and semantic knowledge organization, a deficit involving both levels of structural description system and visual semantics must be assumed to explain the case. We suggest, in line with a previous case study [1], an alternative account in the framework of (non abstractive) episodic models of memory [4].

  3. Associative visual agnosia: a case study.

    Science.gov (United States)

    Charnallet, A; Carbonnel, S; David, D; Moreaud, O

    2008-01-01

    We report a case of massive associative visual agnosia. In the light of current theories of identification and semantic knowledge organization, a deficit involving both levels of structural description system and visual semantics must be assumed to explain the case. We suggest, in line with a previous case study, an alternative account in the framework of (non abstractive) episodic models of memory.

  4. Study on Case Teaching of Financial Management

    Science.gov (United States)

    Che, Zhenghong; Che, Zhengmei

    2011-01-01

    Case teaching is an efficient teaching method of management. It plays an important role to enhance the students' ability to practice the theory. However, case teaching of financial management has not achieved the expected results. The paper aims to study the importance, characteristics and corresponding methods of case teaching method of financial…

  5. Evidence of tuberculosis among children in medieval (13th–15th century Wrocław: A case study of hip joint tuberculosis in a juvenile skeleton excavated from the crypt of the St. Elizabeth church

    Directory of Open Access Journals (Sweden)

    Cieślik Agata Izabela

    2017-06-01

    Full Text Available Paleopathological examinations of the skeletal remains of people who died centuries ago are material source of knowledge about health and diseases in the past. In this article, a case of skeletal tuberculosis from historical (13th-15th c. Wrocław, Poland has been presented. The juvenile skeleton excavated from grave No 93, from the crypt located under the church of St. Elizabeth, displayed pathological lesions within the right hip joint resulting from a chronic inflammation, which might have been assigned to signs typical for skeletal tuberculosis. The results of macroscopic and radiological analyses appeared to be consistent, and allowed to determine a reliable diagnosis of this paleopathological case.

  6. Case Study of the NENE Code Project

    National Research Council Canada - National Science Library

    Kendall, Richard; Post, Douglass; Mark, Andrew

    2007-01-01

    ...) Program is sponsoring a series of case studies to identify the life cycles, workflows, and technical challenges of computational science and engineering code development that are representative...

  7. How To Set Up Your Own Small Business. Service Company Case Study. Manufacturing Firm Case Study. Retail Store Case Study.

    Science.gov (United States)

    Fallek, Max

    This collection of case studies is intended for use in a course in setting up a small business. The first, a case study of the process of setting up a service company, covers analyzing the pros and cons of starting one's own business, assessing the competition and local market, and selecting a site for and financing the business. The principal…

  8. Facilitating Case Studies in Massage Therapy Clinical Education

    Science.gov (United States)

    Baskwill, Amanda

    2013-01-01

    The integration of evidence into reflective health care practice has been on the rise in recent years and is a phenomenon that has affected all health care professions, including massage therapy. Clinical case studies are a research design that follows one patient or subject, making the studies ideal for use in clinical practice. They are valuable for communicating information from clinical practice to the broader community. Case studies have face validity that may be more valuable to individual practitioners than homogeneous randomized controlled trials, as the practitioner may recognize a complex patient in the case report. At Humber College, Student Massage Therapists (SMTs) create, conduct, and communicate results of a clinical case study prior to graduation. This article describes the process and experience. PMID:23730397

  9. Religious Europe, Russia and Serbia: Past and present (Arguments of empirical evidence: The case of Europe

    Directory of Open Access Journals (Sweden)

    Blagojević Mirko

    2008-01-01

    Full Text Available The author has envisaged to publish three articles in three issues of "Philosophy and Society" magazine in which, relying on the empirical scientific evidence, plans to reveal the scope and level of religiousness in some European countries, then to study the case of Russia in a separate text and finally to analyze religiousness of people in Serbia and their attachment to the church and religion. This sequence of publication has its own logics looking forward to the empirical research called "European Values Study" - a longitudinal and international comparative survey of human values - in almost all European countries including, for the first time, Serbia in 2008, the author first aims to present results of previous sociological research which are representative for the area of Europe, and then for the Orthodox area in the country with the highest number of Orthodox believers in the world. Therefore, in the last article the author will be able to compare the religious situation in Serbia not only with the (non-religious Europe but the (non-religious Orthodox Russia as well.

  10. Case studies in conservation science

    Science.gov (United States)

    Bisulca, Christina

    The research presented in this dissertation covers three separate topics of conservation as defined by the National Science Foundation: 1) Materials Stabilization, Strengthening, Monitoring, and Repair; 2. Understanding Material Degradation and Aging; and 3) Materials and Structural Characterization of Cultural Heritage Objects (the 'technical study'). The first topic is addressed through a study to assess the consolidant tetraethoxysilane for the stabilization of alum treated wood. Falling under materials degradation studies is a study published in American Museum Novitates to understand how environmental conditions affect the aging of fossil resins from five different deposits. Two separate studies are included in technical study of cultural heritage objects which comprises the third research area of materials characterization. The first is a survey of red dyes used in Chinese paintings from the Ming Dynasty to the Early Republic (1364-1911). The second is a study of the pigments, dyes and binders used in Hawaiian barkcloth (kapa) from the 19th century.

  11. When general practitioners meet new evidence: an exploratory ethnographic study.

    Science.gov (United States)

    Olsen, Ole

    2017-12-01

    To explore how general practitioners (GPs) think and act when presented with new evidence in relation to planned home birth and a proposal to change information practices. Exploratory ethnographic study of GPs. The GPs were encountered one or more times during a two-year period, 2011-2013, while the author tried to set up formal focus group interviews. Dialogues about the evidence, personal experiences, values and other issues unavoidably occurred. Field notes were written concomitantly. Danish GPs, primarily in Copenhagen. Fifty Danish GPs. The GPs reacted very differently, both spontaneously and later. Spontaneous reactions were often emotional involving private and professional experiences whereas later reactions were more influenced by rational deliberations. Approximately half the GPs (n = 18) who were asked whether they would personally hand out the local information leaflet about home birth were prepared to do so. The time lag between presentation of the evidence and the GPs' decision to hand out the leaflets was up to one and a half year. A significant number of GPs were prepared to change their information practices. However, for many GPs, the new evidence challenged previous perceptions, and ample time and resources for dialogue, deliberations and adaptation to local circumstances were required to accommodate change. Changing information practices on a larger scale will require a systematic approach involving key stakeholders. Key Points Current awareness•Patients and pregnant women should receive evidence-based information about possible choices of care - also in relation to place of birth. Most important results•Doctors often find the new evidence supporting planned home birth counterintuitive and spontaneously react emotionally rather than rationally to the evidence.•The new evidence challenging previous views elicits fast, emotional reactions, later deliberate reflections, perhaps cognitive dissonance and, finally, for some, change in

  12. Development of Evidence-Based Health Policy Documents in Developing Countries: A Case of Iran

    Science.gov (United States)

    Imani-Nasab, Mohammad Hasan; Seyedin, Hesam; Majdzadeh, Reza; Yazdizadeh, Bahareh; Salehi, Masoud

    2014-01-01

    Background: Evidence-based policy documents that are well developed by senior civil servants and are timely available can reduce the barriers to evidence utilization by health policy makers. This study examined the barriers and facilitators in developing evidence-based health policy documents from the perspective of their producers in a developing country. Methods: In a qualitative study with a framework analysis approach, we conducted semi-structured interviews using purposive and snowball sampling. A qualitative analysis software (MAXQDA-10) was used to apply the codes and manage the data. This study was theory-based and the results were compared to exploratory studies about the factors influencing evidence-based health policymaking. Results: 18 codes and three main themes of behavioral, normative, and control beliefs were identified. Factors that influence the development of evidence-based policy documents were identified by the participants: behavioral beliefs included quality of policy documents, use of resources, knowledge and innovation, being time-consuming and contextualization; normative beliefs included policy authorities, policymakers, policy administrators, and co-workers; and control beliefs included recruitment policy, performance management, empowerment, management stability, physical environment, access to evidence, policy making process, and effect of other factors. Conclusion: Most of the cited barriers to the development of evidence-based policy were related to control beliefs, i.e. barriers at the organizational and health system levels. This study identified the factors that influence the development of evidence-based policy documents based on the components of the theory of planned behavior. But in exploratory studies on evidence utilization by health policymakers, the identified factors were only related to control behaviors. This suggests that the theoretical approach may be preferable to the exploratory approach in identifying the barriers

  13. Development of evidence-based health policy documents in developing countries: a case of Iran.

    Science.gov (United States)

    Imani-Nasab, Mohammad Hasan; Seyedin, Hesam; Majdzadeh, Reza; Yazdizadeh, Bahareh; Salehi, Masoud

    2014-02-07

    Evidence-based policy documents that are well developed by senior civil servants and are timely available can reduce the barriers to evidence utilization by health policy makers. This study examined the barriers and facilitators in developing evidence-based health policy documents from the perspective of their producers in a developing country. In a qualitative study with a framework analysis approach, we conducted semi-structured interviews using purposive and snowball sampling. A qualitative analysis software (MAXQDA-10) was used to apply the codes and manage the data. This study was theory-based and the results were compared to exploratory studies about the factors influencing evidence-based health policy-making. 18 codes and three main themes of behavioral, normative, and control beliefs were identified. Factors that influence the development of evidence-based policy documents were identified by the participants: behavioral beliefs included quality of policy documents, use of resources, knowledge and innovation, being time-consuming and contextualization; normative beliefs included policy authorities, policymakers, policy administrators, and co-workers; and control beliefs included recruitment policy, performance management, empowerment, management stability, physical environment, access to evidence, policy making process, and effect of other factors. Most of the cited barriers to the development of evidence-based policy were related to control beliefs, i.e. barriers at the organizational and health system levels. This study identified the factors that influence the development of evidence-based policy documents based on the components of the theory of planned behavior. But in exploratory studies on evidence utilization by health policymakers, the identified factors were only related to control behaviors. This suggests that the theoretical approach may be preferable to the exploratory approach in identifying the barriers and facilitators of a behavior.

  14. Environmental injustice: case studies from the South

    International Nuclear Information System (INIS)

    Cifuentes, Enrique; Frumkin, Howard

    2007-01-01

    We selected three case studies to illustrate environmental injustice issues in the South. These examples relate to migrant agricultural workers, the maquiladora industry and artisanal mining, while reviewing some of the major mechanisms involved, e.g. multinational corporations, the development of free trade zones, multilateral free trade agreements and the export of hazards. A series of strategies are discussed in order to address environmental injustice and health disparities that exist on a global scale. Some of the recommendations involve policy initiatives; others, such as research and mentorship, fall within the traditional domain of public health practice. In this paper, special attention is given to concerned environmental and occupational health professionals using evidence-based data for advocacy. For lasting changes to be made, however, stronger institutions and legislation are required. Those who have the 'right to know' about environmental injustice issues include communities of concern, workers' representatives and lawyers. Government officials and company officials may eventually work on the basis of conflict resolution, compensation and remediation, to quote some examples. Systematic approaches to protect both the environment and public health must be updated

  15. Environmental injustice: case studies from the South

    Science.gov (United States)

    Cifuentes, Enrique; Frumkin, Howard

    2007-10-01

    We selected three case studies to illustrate environmental injustice issues in the South. These examples relate to migrant agricultural workers, the maquiladora industry and artisanal mining, while reviewing some of the major mechanisms involved, e.g. multinational corporations, the development of free trade zones, multilateral free trade agreements and the export of hazards. A series of strategies are discussed in order to address environmental injustice and health disparities that exist on a global scale. Some of the recommendations involve policy initiatives; others, such as research and mentorship, fall within the traditional domain of public health practice. In this paper, special attention is given to concerned environmental and occupational health professionals using evidence-based data for advocacy. For lasting changes to be made, however, stronger institutions and legislation are required. Those who have the 'right to know' about environmental injustice issues include communities of concern, workers' representatives and lawyers. Government officials and company officials may eventually work on the basis of conflict resolution, compensation and remediation, to quote some examples. Systematic approaches to protect both the environment and public health must be updated.

  16. Skeletal Indicators of Shark Feeding on Human Remains: Evidence from Florida Forensic Anthropology Cases.

    Science.gov (United States)

    Stock, Michala K; Winburn, Allysha P; Burgess, George H

    2017-11-01

    This research examines a series of six Florida forensic anthropology cases that exhibit taphonomic evidence of marine deposition and shark-feeding activities. In each case, we analyzed patterns of trauma/damage on the skeletal remains (e.g., sharp-force bone gouges and punctures) and possible mechanisms by which they were inflicted during shark predation/scavenging. In some cases, shark teeth were embedded in the remains; in the absence of this evidence, we measured interdental distance from defects in the bone to estimate shark body length, as well as to draw inferences about the potential species responsible. We discuss similarities and differences among the cases and make comparisons to literature documenting diagnostic shark-inflicted damage to human remains from nearby regions. We find that the majority of cases potentially involve bull or tiger sharks scavenging the remains of previously deceased, adult male individuals. This scavenging results in a distinctive taphonomic signature including incised gouges in cortical bone. © 2017 American Academy of Forensic Sciences.

  17. Proof of causation through expert opinion evidence in low-level radiation cases

    International Nuclear Information System (INIS)

    Heideck, R.E.

    1985-01-01

    Tort law requires that the injured person prove that the injury was caused by a particular exposure to radiation for which the defendant is responsible. Heideck shows how expert evidence helps the court or jury resolve this question. The author analyzes a recent effort to bridge the gap between the legal requirement of proof of causation in individual cases and the conclusions that derive from group statistics. Some scientists argue that this approach is more technically sound than traditional tort law because it attempts to develop a probability of causation in individual cases

  18. An evidence-based approach to case management model selection for an acute care facility: is there really a preferred model?

    Science.gov (United States)

    Terra, Sandra M

    2007-01-01

    This research seeks to determine whether there is adequate evidence-based justification for selection of one acute care case management model over another. Acute Inpatient Hospital. This article presents a systematic review of published case management literature, resulting in classification specific to terms of level of evidence. This review examines the best available evidence in an effort to select an acute care case management model. Although no single case management model can be identified as preferred, it is clear that adequate evidence-based literature exists to acknowledge key factors driving the acute care model and to form a foundation for the efficacy of hospital case management practice. Although no single case management model can be identified as preferred, this systematic review demonstrates that adequate evidence-based literature exists to acknowledge key factors driving the acute care model and forming a foundation for the efficacy of hospital case management practice. Distinctive aspects of case management frameworks can be used to guide the development of an acute care case management model. The study illustrates: * The effectiveness of case management when there is direct patient contact by the case manager regardless of disease condition: not only does the quality of care increase but also length of stay (LOS) decreases, care is defragmented, and both patient and physician satisfaction can increase. * The preferred case management models result in measurable outcomes that can directly relate to, and demonstrate alignment with, organizational strategy. * Acute care management programs reduce cost and LOS, and improve outcomes. * An integrated case management program that includes social workers, as well as nursing, is the most effective acute care management model. * The successful case management model will recognize physicians, as well as patients, as valued customers with whom partnership can positively affect financial outcomes in terms of

  19. Confronting evidence: individualised care and the case for shared decision-making.

    LENUS (Irish Health Repository)

    Ryan, P

    2014-11-01

    In many clinical scenarios there exists more than one clinically appropriate intervention strategy. When these involve subjective trade-offs between potential benefits and harms, patients\\' preferences should inform decision-making. Shared decision-making is a collaborative process, where clinician and patient reconcile the best available evidence with respect for patients\\' individualized care preferences. In practice, clinicians may be poorly equipped to participate in this process. Shared decision-making is applicable to many conditions including stable coronary artery disease, end-of-life care, and numerous small decisions in chronic disease management. There is evidence of more clinically appropriate care patterns, improved patient understanding and sense of empowerment. Many trials reported a 20% reduction in major surgery in favour of conservative treatment, although demand tends to increase for some interventions. The generalizability of international evidence to Ireland is unclear. Considering the potential benefits, there is a case for implementing and evaluating shared decision-making pilot projects in Ireland.

  20. Using Case Studies to Teach Courtesy Strategies.

    Science.gov (United States)

    Moore, Patrick

    1990-01-01

    Explains some courtesy techniques that technical professionals can use to deal with interpersonal problems that arise in writing situations. Presents three case studies with sample responses to show how case studies can teach these courtesy strategies to technical writing students. (MM)

  1. A Comparative Comment on the Case Studies

    DEFF Research Database (Denmark)

    Kjeldsen, Christian Christrup; Ley, Thomas; Jensen, Niels Rosendal

    2012-01-01

    Denne konklusion sammenfatter hovedtrækkene af de gennemførte case studies i WorkAble-projektet. Vigtige pointer er, at unge på tværs af de forskellige case studies har vanskeligt ved at blive hørt og taget alvorligt. I stedet spises de af med "realistisk vejledning" eller dårlige uddannelses- og...

  2. Reverse logistics: A review of case studies

    NARCIS (Netherlands)

    Brito, de M.P.; Dekker, Rommert; Flapper, S.D.P.; Fleischmann, B.; Klose, A.

    2004-01-01

    This paper gives an overview of scientific literature that describes and discusses cases of reverse logistics activities in practice. Over sixty case studies are considered. Based on these studies we are able to indicate critical factors for the practice of reverse logistics. In addition we compare

  3. A Case Study of "Empathetic Teaching Artistry"

    Science.gov (United States)

    Risner, Doug

    2014-01-01

    This case study is one of twenty cases derived from Anderson and Risner's international study of teaching artists in dance, and theatre, which investigated participants' (n=172) artistic and academic preparation in dance, and theatre, initial entry into the teaching artist field, rewards, challenges, and obstacles in participants' work, artists'…

  4. The Danish National Case Study Report

    DEFF Research Database (Denmark)

    Brodersen, Søsser; Jørgensen, Michael Søgaard

    Three case studies from Danish science shops within the environmental field are analysed with respect to societal background, interaction between the involved actors and the societal impact of the co-operation. The report is one of the seven national case study reports from the EU...

  5. Outage management: A case study

    International Nuclear Information System (INIS)

    Haber, S.B.; Barriere, M.T.; Roberts, K.H.

    1992-01-01

    Outage management issues identified from a field study conducted at a two-unit commercial pressurized water reactor (PWR), when one unit was in a refueling outage and the other unit was at full power operation, are the focus of this paper. The study was conduced as part of the US Nuclear Regulatory Commission's (NRC) organizational factors research program, and therefore the issues to be addressed are from an organizational perspective. Topics discussed refer to areas identified by the NRC as critical for safety during shutdown operations, including outage planning and control, personnel stress, and improvements in training and procedures. Specifically, issues in communication, management attention, involvement and oversight, administrative processes, organizational culture, and human resources relevant to each of the areas are highlighted by example from field data collection. Insights regarding future guidance in these areas are presented based upon additional data collection subsequent to the original study

  6. TrueAllele casework on Virginia DNA mixture evidence: computer and manual interpretation in 72 reported criminal cases.

    Directory of Open Access Journals (Sweden)

    Mark W Perlin

    Full Text Available Mixtures are a commonly encountered form of biological evidence that contain DNA from two or more contributors. Laboratory analysis of mixtures produces data signals that usually cannot be separated into distinct contributor genotypes. Computer modeling can resolve the genotypes up to probability, reflecting the uncertainty inherent in the data. Human analysts address the problem by simplifying the quantitative data in a threshold process that discards considerable identification information. Elevated stochastic threshold levels potentially discard more information. This study examines three different mixture interpretation methods. In 72 criminal cases, 111 genotype comparisons were made between 92 mixture items and relevant reference samples. TrueAllele computer modeling was done on all the evidence samples, and documented in DNA match reports that were provided as evidence for each case. Threshold-based Combined Probability of Inclusion (CPI and stochastically modified CPI (mCPI analyses were performed as well. TrueAllele's identification information in 101 positive matches was used to assess the reliability of its modeling approach. Comparison was made with 81 CPI and 53 mCPI DNA match statistics that were manually derived from the same data. There were statistically significant differences between the DNA interpretation methods. TrueAllele gave an average match statistic of 113 billion, CPI averaged 6.68 million, and mCPI averaged 140. The computer was highly specific, with a false positive rate under 0.005%. The modeling approach was precise, having a factor of two within-group standard deviation. TrueAllele accuracy was indicated by having uniformly distributed match statistics over the data set. The computer could make genotype comparisons that were impossible or impractical using manual methods. TrueAllele computer interpretation of DNA mixture evidence is sensitive, specific, precise, accurate and more informative than manual

  7. Five case studies of multifamily weatherization programs

    Energy Technology Data Exchange (ETDEWEB)

    Kinney, L; Wilson, T.; Lewis, G. [Synertech Systems Corp. (United States); MacDonald, M. [Oak Ridge National Lab., TN (United States)

    1997-12-31

    The multifamily case studies that are the subject of this report were conducted to provide a better understanding of the approach taken by program operators in weatherizing large buildings. Because of significant variations in building construction and energy systems across the country, five states were selected based on their high level of multifamily weatherization. This report summarizes findings from case studies conducted by multifamily weatherization operations in five cities. The case studies were conducted between January and November 1994. Each of the case studies involved extensive interviews with the staff of weatherization subgrantees conducting multifamily weatherization, the inspection of 4 to 12 buildings weatherized between 1991 and 1993, and the analysis of savings and costs. The case studies focused on innovative techniques which appear to work well.

  8. A case study of Douala

    Indian Academy of Sciences (India)

    In this paper, demand of energy (heating/cooling) in the buildings is discussed in Douala, Cameroon. Daily data of the last 40 years coming from five weather stations of Cameroon have been studied. Some forecasts have been carried out with 14 GCM models, associated to three future climate scenarios B1, A2, and A1B.

  9. A chromite ore case study

    African Journals Online (AJOL)

    2009-05-15

    May 15, 2009 ... of Cr(VI). If this is true, it could have serious consequences for South African chromite mines and the local environment. ... study proved that the Cr(VI) content of chromite samples is .... used during pulvizising experiments was dried at 40ºC for 1 d ... This is the simplest Cr(VI) extraction method and is similar.

  10. Case Study on Quality Education

    Science.gov (United States)

    Habib, Zahida

    2011-01-01

    Quality of Education, especially at Primary level, is an important issue to be discussed at the International Forum. This study highlights the quality of primary education through a comparison of the quality of Community Model Schools and Govt. Girls Primary Schools in Pakistan. Community Model Schools were established under Girls Primary…

  11. Theoretical pluralism in psychoanalytic case studies.

    Science.gov (United States)

    Willemsen, Jochem; Cornelis, Shana; Geerardyn, Filip M; Desmet, Mattias; Meganck, Reitske; Inslegers, Ruth; Cauwe, Joachim M B D

    2015-01-01

    The aim of this study is to provide an overview of the scientific activity of different psychoanalytic schools of thought in terms of the content and production of case studies published on ISI Web of Knowledge. Between March 2013 and November 2013, we contacted all case study authors included in the online archive of psychoanalytic and psychodynamic case studies (www.singlecasearchive.com) to inquire about their psychoanalytic orientation during their work with the patient. The response rate for this study was 45%. It appears that the two oldest psychoanalytic schools, Object-relations psychoanalysis and Ego psychology or "Classical psychoanalysis" dominate the literature of published case studies. However, most authors stated that they feel attached to two or more psychoanalytic schools of thought. This confirms that the theoretical pluralism in psychoanalysis stretches to the field of single case studies. The single case studies of each psychoanalytic school are described separately in terms of methodology, patient, therapist, or treatment features. We conclude that published case studies features are fairly similar across different psychoanalytic schools. The results of this study are not representative of all psychoanalytic schools, as some do not publish their work in ISI ranked journals.

  12. Theoretical pluralism in psychoanalytic case studies

    Science.gov (United States)

    Willemsen, Jochem; Cornelis, Shana; Geerardyn, Filip M.; Desmet, Mattias; Meganck, Reitske; Inslegers, Ruth; Cauwe, Joachim M. B. D.

    2015-01-01

    The aim of this study is to provide an overview of the scientific activity of different psychoanalytic schools of thought in terms of the content and production of case studies published on ISI Web of Knowledge. Between March 2013 and November 2013, we contacted all case study authors included in the online archive of psychoanalytic and psychodynamic case studies (www.singlecasearchive.com) to inquire about their psychoanalytic orientation during their work with the patient. The response rate for this study was 45%. It appears that the two oldest psychoanalytic schools, Object-relations psychoanalysis and Ego psychology or “Classical psychoanalysis” dominate the literature of published case studies. However, most authors stated that they feel attached to two or more psychoanalytic schools of thought. This confirms that the theoretical pluralism in psychoanalysis stretches to the field of single case studies. The single case studies of each psychoanalytic school are described separately in terms of methodology, patient, therapist, or treatment features. We conclude that published case studies features are fairly similar across different psychoanalytic schools. The results of this study are not representative of all psychoanalytic schools, as some do not publish their work in ISI ranked journals. PMID:26483725

  13. Making a case for case studies in psychotherapy training

    DEFF Research Database (Denmark)

    Mackrill, Thomas Edward; Iwakabe, Shigeru

    2013-01-01

    articulated explicitly or researched systematically in spite of its cardinal importance. An analysis of the role of case studies in psychotherapy training is presented. Reading, watching, or hearing about cases can offer novice psychotherapists access to a closed world; access to psychological theory...... in action; access to whole courses of therapy; access to different approaches; access to significant moments; access to the therapeutic relationship; access to a wide range of client types; access to working in different contexts; and the opportunity of identifying with therapists and clients. Writing...

  14. Arctic bioremediation -- A case study

    International Nuclear Information System (INIS)

    Smallbeck, D.R.; Ramert, P.C.; Liddell, B.V.

    1994-01-01

    This paper discusses the use of bioremediation as an effective method to clean up diesel-range hydrocarbon spills in northern latitudes. The results of a laboratory study of microbial degradation of hydrocarbons under simulated arctic conditions showed that bioremediation can be effective in cold climates and led to the implementation of a large-scale field program. The results of 3 years of field testing have led to a significant reduction in diesel-range hydrocarbon concentrations in the contaminated area

  15. Schematic representation of case study research designs.

    Science.gov (United States)

    Rosenberg, John P; Yates, Patsy M

    2007-11-01

    The paper is a report of a study to demonstrate how the use of schematics can provide procedural clarity and promote rigour in the conduct of case study research. Case study research is a methodologically flexible approach to research design that focuses on a particular case - whether an individual, a collective or a phenomenon of interest. It is known as the 'study of the particular' for its thorough investigation of particular, real-life situations and is gaining increased attention in nursing and social research. However, the methodological flexibility it offers can leave the novice researcher uncertain of suitable procedural steps required to ensure methodological rigour. This article provides a real example of a case study research design that utilizes schematic representation drawn from a doctoral study of the integration of health promotion principles and practices into a palliative care organization. The issues discussed are: (1) the definition and application of case study research design; (2) the application of schematics in research; (3) the procedural steps and their contribution to the maintenance of rigour; and (4) the benefits and risks of schematics in case study research. The inclusion of visual representations of design with accompanying explanatory text is recommended in reporting case study research methods.

  16. Associative Visual Agnosia: A Case Study

    Directory of Open Access Journals (Sweden)

    A. Charnallet

    2008-01-01

    Full Text Available We report a case of massive associative visual agnosia. In the light of current theories of identification and semantic knowledge organization, a deficit involving both levels of structural description system and visual semantics must be assumed to explain the case. We suggest, in line with a previous case study [1], an alternative account in the framework of (non abstractive episodic models of memory [4].

  17. Case Study Methodology and Homelessness Research

    Directory of Open Access Journals (Sweden)

    Jill Pable

    2013-10-01

    Full Text Available This paper describes the potential suitability of case study methodology for inquiry with the homeless population. It references a research study that uses case study research method to build theory. This study's topic is the lived experience of destitute individuals who reside in homeless shelters, and explores the homeless shelter built environment's potential influence on resident satisfaction and recovery. Case study methodology may be appropriate because it explores real-life contextual issues that characterize homelessness and can also accommodate the wide range of homeless person demographics that make this group difficult to study in a generalized fashion. Further, case study method accommodates the need within research in this area to understand individualized treatments as a potential solution for homelessness.

  18. INTERIORITY - a prefab case study

    DEFF Research Database (Denmark)

    Hvejsel, Marie Frier

    Dealing with the general theme of domestic architectural quality, the PhD thesis ‘INTERIORITY’ takes its point of departure in the continuous and increasing need to improve our capability as architects to theoretically articulate the intangible concept of quality, and to reveal it through an active...... been motivated by the particular hypothesis that an introduction of the notion of interiority, as an ability of the spatial envelope itself to address the sensuous scale of furniture, unfolds a particular dual critical potential signifying our experience of domestic architectural quality: On the one......, tectonically. Hence, it has been a particular idea of the study to explore the relation between furniture, the spatial envelope itself, and its construct by using furniture as an architectural concept. Consequently, the thesis has specifically investigated whether this notion of interiority, describing...

  19. Case study on printed matter

    DEFF Research Database (Denmark)

    – how important are emissions of chemicals? J Clean Prod 17, 115 – 128. Larsen HF (2004). Assessment of chemical emissions in life cycle impact assessment - focus on low substance data availability and ecotoxicity effect indicators. Ph.D. Thesis, October 2004. Department of Manufacturing, Engineering...... and Management. Technical University of Denmark. http://www.tempo.ipl.dtu.dk/ipl/upload/publ/PhD-thesis-rev.pdf Figure 1 Comparison of weighted LCA profiles with or without chemical related impact categories included (percentage of total, milli-person-equivalents-targeted, mPET). The avoided energy consumptions...... global warming, acidification and nutrification. The studies focus on energy consumption including the emissions and impact categories related to energy. The chemical-related impact categories comprising ecotoxicity and human toxicity are not included at all or only to a limited degree. In this paper we...

  20. Antiphospholipid syndrome: A case study

    International Nuclear Information System (INIS)

    Davies, T.

    1998-01-01

    Full text: A forty-two-year-old male presented to the Royal Adelaide Hospital with symptoms of increasing shortness of breath, swelling in both ankles, petechial rash and blood in his sputum. Initial investigations showed cardiomegaly, right ventricular hypertrophy, patchy lung infiltrates, a platelet count of 1500 and a clotting time of 60 seconds. A V/Q scan indicated a high probability of pulmonary embolism. Further investigations showed that the patient was positive for lupus anticoagulant and cardiolipin antibodies. A diagnosis of primary antiphospholipid syndrome was made. The patient''s high risk of strokes and hemorrhaging prompted investigation by a 99 mTc-HMPAO brain scan. Further V/Q scans were performed to follow up the initial finding of multiple pulmonary embolism and a R-L shunt study was performed to investigate a left subclavian murmur. The patient was admitted for four weeks and began treatment which included cyclaphosphamide, corticosteroids and plasmaphoresis and was discharged when stable. Over the next six months he was re admitted three times for relapse of antiphospholipid syndrome. On his fourth admission he collapsed and died five hours after admission. Cause of death was due to cardiac arrhythmia secondary to severe right ventricular hypertrophy and dilation. The effects of antiphospholipid syndrome was believed to be responsible for this outcome

  1. Antiphospholipid syndrome: A case study

    Energy Technology Data Exchange (ETDEWEB)

    Davies, T. [Royal Adelaide Hospital, Adelaide, SA (Australia). Department of Nuclear Medicine

    1998-03-01

    Full text: A forty-two-year-old male presented to the Royal Adelaide Hospital with symptoms of increasing shortness of breath, swelling in both ankles, petechial rash and blood in his sputum. Initial investigations showed cardiomegaly, right ventricular hypertrophy, patchy lung infiltrates, a platelet count of 1500 and a clotting time of 60 seconds. A V/Q scan indicated a high probability of pulmonary embolism. Further investigations showed that the patient was positive for lupus anticoagulant and cardiolipin antibodies. A diagnosis of primary antiphospholipid syndrome was made. The patient``s high risk of strokes and hemorrhaging prompted investigation by a {sup 99}mTc-HMPAO brain scan. Further V/Q scans were performed to follow up the initial finding of multiple pulmonary embolism and a R-L shunt study was performed to investigate a left subclavian murmur. The patient was admitted for four weeks and began treatment which included cyclaphosphamide, corticosteroids and plasmaphoresis and was discharged when stable. Over the next six months he was re admitted three times for relapse of antiphospholipid syndrome. On his fourth admission he collapsed and died five hours after admission. Cause of death was due to cardiac arrhythmia secondary to severe right ventricular hypertrophy and dilation. The effects of antiphospholipid syndrome was believed to be responsible for this outcome.

  2. Case-control vaccine effectiveness studies: Preparation, design, and enrollment of cases and controls.

    Science.gov (United States)

    Verani, Jennifer R; Baqui, Abdullah H; Broome, Claire V; Cherian, Thomas; Cohen, Cheryl; Farrar, Jennifer L; Feikin, Daniel R; Groome, Michelle J; Hajjeh, Rana A; Johnson, Hope L; Madhi, Shabir A; Mulholland, Kim; O'Brien, Katherine L; Parashar, Umesh D; Patel, Manish M; Rodrigues, Laura C; Santosham, Mathuram; Scott, J Anthony; Smith, Peter G; Sommerfelt, Halvor; Tate, Jacqueline E; Victor, J Chris; Whitney, Cynthia G; Zaidi, Anita K; Zell, Elizabeth R

    2017-06-05

    Case-control studies are commonly used to evaluate effectiveness of licensed vaccines after deployment in public health programs. Such studies can provide policy-relevant data on vaccine performance under 'real world' conditions, contributing to the evidence base to support and sustain introduction of new vaccines. However, case-control studies do not measure the impact of vaccine introduction on disease at a population level, and are subject to bias and confounding, which may lead to inaccurate results that can misinform policy decisions. In 2012, a group of experts met to review recent experience with case-control studies evaluating the effectiveness of several vaccines; here we summarize the recommendations of that group regarding best practices for planning, design and enrollment of cases and controls. Rigorous planning and preparation should focus on understanding the study context including healthcare-seeking and vaccination practices. Case-control vaccine effectiveness studies are best carried out soon after vaccine introduction because high coverage creates strong potential for confounding. Endpoints specific to the vaccine target are preferable to non-specific clinical syndromes since the proportion of non-specific outcomes preventable through vaccination may vary over time and place, leading to potentially confusing results. Controls should be representative of the source population from which cases arise, and are generally recruited from the community or health facilities where cases are enrolled. Matching of controls to cases for potential confounding factors is commonly used, although should be reserved for a limited number of key variables believed to be linked to both vaccination and disease. Case-control vaccine effectiveness studies can provide information useful to guide policy decisions and vaccine development, however rigorous preparation and design is essential. Published by Elsevier Ltd.

  3. Music in context : Four case studies

    NARCIS (Netherlands)

    Randwijck, R.J.C. van

    2008-01-01

    In his thesis entitled “Music in Context. Four Case Studies”, R.J.C. van Randwijck investigates the context in which music has been created. It is a search in Four Case Studies, approaching four pieces of music from the context in which they were written in order to understand their meaning. The

  4. Case Study: A Separation of Powers Lesson.

    Science.gov (United States)

    Jenkins, Steve

    1986-01-01

    Presents a case study involving students in the issue of separation of powers as applied to the 1952 Immigration and Nationality Act. Students examine the case of Jagdish Rai Chadha, an immigrant threatened with deportation whose problems resulted in 1983 U.S. Supreme Court decision declaring legislative veto provision of Immigration and…

  5. Implementing Product Platforms: A Case Study

    DEFF Research Database (Denmark)

    Nielsen, Ole Fiil; Mortensen, Niels Henrik

    2006-01-01

    The paper describes a case study dealing with the process of creating and implementing a product platform. The paper espessially deals with the fact that to obtain the benefits of platforms a permanent change in behaviour in product development must be ensured. This change in behaviour requires...... acceptance and approval from the organisation in general and the commitment from management to enforce agreed-upon decisions. The case study itself was performed in the Danish company LEGO Group. The case study had two objectives: To create a technical architecture and align this architecture...

  6. Case Study: Mini-Case Studies: Small Infusions of Active Learning for Large-Lecture Courses

    Science.gov (United States)

    Carloye, Lisa

    2017-01-01

    In this article, the author introduces the usage of case studies to be an excellent method for engaging students through stories. The author notes she developed a series of mini-case studies that can be implemented, with a little advance preparation, within a 10- to 15-minute window during lecture. What makes them "mini" case studies?…

  7. Impacts of energy legislation on organizational motivation: a case study

    OpenAIRE

    Roberts, C.; Bobrova, Y.; Marjanovic-Halburd, L.

    2017-01-01

    In an attempt to reduce operational energy use in non-domestic buildings and mitigate climate change, the UK government has introduced Energy Savings Opportunity Scheme (ESOS) legislation to motivate large organizations to implement energy-efficiency (EE) measures. However, evidence suggests that an organization’s behaviour with regard to EE measures does not follow rational cost minimization, demonstrating potential ESOS weakness. A case study is presented that assesses whether ESOS can lead...

  8. Interrelations between business and technology : a case study

    OpenAIRE

    2014-01-01

    M.Ing. (Engineering Management) The current research investigated the inter-relationship between Steve Jobs and Apple Company. The study looked at Steve if he launched Apple with business orientation. The researcher used Yin’s (1994) single case, holistic design research method and looked at the data gathered from thirty-seven authors. Steve Jobs’ business orientation was measured using Snaddon (2008) business measures. Symbols were used to indicate whether the evidence found from differen...

  9. Ramadan fasting: Evidence or expert opinion? Results of preliminary studies

    Directory of Open Access Journals (Sweden)

    1Maryam Kazemi

    2013-11-01

    Full Text Available Each year, over a billion Muslims fast worldwide during the month of Ramadan. Through this religious practice, not only will one have spiritual growth, but can improve his/her diet, which is of pivotal importance in this month. Conversely, the available evidence regarding the health benefits of Ramadan fasting is scarce and highly contentious. Although Islam exempts patients from fasting, many of them fast conceivably and their clinical condition is prone to deteriorate. This is due to the persistent gap between current expert knowledge and conclusive, strong evidence regarding the pathophysiologic and metabolic alterations by fasting, and the consensus that healthcare professionals should reach, in order to manage various patient groups during this month. In this review, we summarize the results of our initial studies regarding the effects of Ramadan fasting on some clinical conditions including alterations of body composition. We also go through the important clinical results of patients who have had previous history of cardiovascular disease, type 2 diabetes, asthma and renal colic. Our studies have presented some evidence in favor of Ramadan fasting and encourage those with mentioned diseases to consult their physicians and follow medical and scientific recommendations. We attempt to present some relevant evidence clarify future scopes in this area of study, and provide suggestions for future investigations.

  10. Ramadan fasting: Evidence or expert opinion? Results of preliminary studies

    Directory of Open Access Journals (Sweden)

    Maryam Kazemi

    2013-12-01

    Full Text Available Each year, over a billion Muslims fast worldwide during the month of Ramadan.  Through this religious practice, not only will one have spiritual growth, but can improve his/her diet, which is of pivotal importance in this month. Conversely, the available evidence regarding the health benefits of Ramadan fasting is scarce and highly contentious. Although Islam exempts patients from fasting, many of them fast conceivably and their clinical condition is prone to deteriorate. This is due to the persistent gap between current expert knowledge and conclusive, strong evidence regarding the pathophysiologic and metabolic alterations by fasting, and the consensus that healthcare professionals should reach, in order to manage various patient groups during this month. In this review, we summarize the results of our initial studies regarding the effects of Ramadan fasting on some clinical conditions including alterations of body composition. We also go through the important clinical results of patients who have had previous history of cardiovascular disease, type 2 diabetes, asthma and renal colic. Our studies have presented some evidence in favor of Ramadan fasting and encourage those with mentioned diseases to consult their physicians and follow medical and scientific recommendations. We attempt to present some relevant evidence clarify future scopes in this area of study, and provide suggestions for future investigations.

  11. Transnational Criminal Proceedings, Witness Evidence and Confrontation: Lessons from the ECtHR’s Case Law

    Directory of Open Access Journals (Sweden)

    Lorena Bachmaier Winter

    2013-09-01

    Full Text Available A single European area of freedom, security and justice requires new models of judicial cooperation in criminal matters to be put in place in order to efficiently combat transnational organized crime. However, this should not be done while disregarding the protection of the individual rights of the suspect and the accused: a transnational criminal procedure should not entail a lowering of the procedural safeguards identified by the European Court of Human Rights. The tension between the efficiency in the cooperation and the need to protect the fundamental rights of the defendant is particularly visible in matters of the transnational gathering of evidence, its transfer and its admissibility as evidence against the accused. This paper intends to identify general principles and rules that should be applied in European transnational criminal proceedings with regard to witness evidence. Departing from the ECHR’s case law, this paper will try to identify the principles regarding the hearing of witnesses who reside in another Member State, the admissibility of pre-trial statements as evidence and the need to foster the use of the live video link for witness questioning.

  12. The sexual and reproductive health of young people in Latin America: evidence from WHO case studies La salud sexual y reproductiva de los jóvenes en América Latina: evidencia derivada de estudios de la OMS

    Directory of Open Access Journals (Sweden)

    Kate Kostrzewa

    2008-02-01

    Full Text Available This original article addresses the sexual and reproductive health needs of young people aged 15 to 24 in Latin America. It introduces five articles from original research projects in three countries: Argentina, Brazil, and Peru. These projects were funded by the World Health Organization. This article explains the importance of studies that address the sexual and reproductive health of young people in developing countries. It provides an overview of sexual and reproductive health issues in Latin America and a discussion these issues in the three study countries. The five articles deal with difficult and challenging issues, including: knowledge of STIs and HIV/AIDS; pregnancy related practices; quality of care; the role of young men in couple formation, pregnancy and adoption of contraceptive practice; and, the role of obstetricians and gynecologists in public policy debate about family planning and abortion. The four articles in this special section help to improve our understanding of the factors that contribute to risky sexual behavior and negative reproductive health outcomes among youth in Latin America. The findings are useful to help inform and improve health care interventions in various contexts.Este artículo original trata de las necesidades de salud sexual y reproductiva de jóvenes entre 15 y 24 años de edad en América Latina. Se presentan cuatro artículos derivados de investigaciones originales en tres países: Argentina, Brasil y Perú. Estos proyectos fueron patrocinados por la Organización Mundial de la Salud. Este artículo elucida la importancia de los estudios que tratan de la salud sexual y reproductiva de jóvenes en países en desarollo. Se ilustra el panorama general en cuestiones de salud sexual y reproductiva en América Latina y una discusión de estas cuestiones en los tres países de donde provienen los estudios. Los cinco artículos discuten cuestiones difíciles y controversiales, como los conocimientos sobre

  13. Especialización y concentración espacial de barrios comerciales: evidencias en base al caso de la comuna de Santiago./ Specialization and spatial concentration of commercial neighborhoods: evidence based on the Santiago central area case study

    Directory of Open Access Journals (Sweden)

    Carlos Sandoval

    2013-12-01

    Full Text Available El objetivo del trabajo es analizar y comprender las causas y dinámicas de la especialización de los barrios comerciales de la comuna de Santiago, asumiendo la pregunta: ¿Por qué y cómo, algunos barrios comerciales de la comuna de Santiago se especializan en la venta de ciertos bienes y/o servicios, concentrando su oferta con un patrón espacial definido, siendo que su localización podría presentarse diversificada sectorialmente y/o diseminada dentro de la ciudad? La investigación utiliza un conjunto de métodos cuantitativos y cualitativos, para proponer una metodología de análisis de la actividad comercial, considerando su nivel de especialización y arreglo espacial, al mismo tiempo que se identifican un conjunto de barrios concentrados, los cuales que se presentan en dos formas específicas: de manera polarizada (caso de los barrios Brasil y Diez de Julio y como un sistema de barrios especializados (casos de los barrios de San Diego en sus segmentos de libros, bicicletas y de cueros y calzados. La principal contribución de la investigación, es la aplicación de una metodología de identificación de barrios que permite proponer un conjunto de causas posibles para explicar el origen de la especialización comercial al interior de la ciudad./ This article focuses on analyzing the Santiago district, in order to understanding the causes specialization of commercial neighborhoods and their dynamics, by addressing the following question: Why and how does commercial specialization occur in some neighborhoods of the Central Santiago district, concentrating their in a defined spatial pattern, instead of spreading through the urban fabric?Qualitative and quantitative methods are used to develop an in depth analysis of commercial activities, taking into consideration their specialization level and spatial arrangement. Through this study, a series of specialized commercial neighborhoods where identified and classified, revealing two specific

  14. War And Reconstruction: Four Comparative Case Studies

    African Journals Online (AJOL)

    The four case studies are taken from four different continents, four different wars under .... and revolutionary changes in the structures and power relations in society and ..... general public accept nowadays that although states' rights were the ...

  15. BTS Case Study: The Galloway Family Home

    International Nuclear Information System (INIS)

    Brandegee Group

    1999-01-01

    Case study of an energy-efficient Habitat for Humanity house that uses 30% less energy than conventional residential construction. The project was part of the Jimmy Carter Work Project in rural Appalachia in 1997

  16. Abstracts of Remediation Case Studies, Volume 9

    Science.gov (United States)

    This report, published by the Federal Remediation Technologies Roundtable (FRTR), is a collection of recently published abstracts summarizing 13 cost and performance case studies on the use of remediation technologies at contaminated sites.

  17. Review of ORD Nanomaterial Case Studies Workshop

    Science.gov (United States)

    The following is a letter report from the Executive Committee of the BOSC concerning the review of the ORD Nanomaterial Case Studies Workshop: Developing a Comprehensive Environmental Assessment Research Strategy for Nanoscale Titanium Dioxide.

  18. Case Study: Pancreas cancer with Whipple's operation

    African Journals Online (AJOL)

    Keywords: pancreas cancer, Whipple procedure, SASPEN case study ..... Grade A. Grade B. Grade C. Nasogastric tube required. 4-7 days or reinserted > postoperative day 3 .... malabsorption and vitamin and mineral deficiencies are the most.

  19. Innovative Interpretive Qualitative Case Study Research Method ...

    African Journals Online (AJOL)

    lc2o

    The combined use of case study and systems theory is rarely discussed in the ... Scott, 2002), the main benefit of doing qualitative research is the patience ..... Teaching ICT to teacher candidates ... English Language Teachers. London: Arnold.

  20. Memory and Learning: A Case Study.

    Science.gov (United States)

    Webster, Raymond E.

    1986-01-01

    The usefulness of the Learning Efficency Test (LET), an approach to assessing the learning efficiency and short-term memory recall capacity in children, is described via a case study demonstrating the test's use to develop instructional strategies. (CL)

  1. Towards More Case Study Research in Entrepreneurship

    Directory of Open Access Journals (Sweden)

    Tom Duxbury

    2012-03-01

    Full Text Available Entrepreneurship as an emerging discipline has made good strides, but according to some, has fallen short of bringing its theory and literature up to the standards of others in the management sciences. Rich with the descriptive detail needed for insightful theory building in entrepreneurship, scholars have called for more case study research, particularly those incorporating non-retrospective and longitudinal observations. At the same time however, it has become rare to find such research published in A-level journals dedicated to entrepreneurship. A survey presented here of major entrepreneurship journals over the past six years revealed a publication rate of only 3% using the case study method. This presents a major impediment for developing fresh research in this field based upon the study of real cases. The author explores how the case study method has been applied to entrepreneurship research and provides recommendations for improved publication rates.

  2. Travel Efficiency Assessment Method: Three Case Studies

    Science.gov (United States)

    This slide presentation summarizes three case studies EPA conducted in partnership with Boston, Kansas City, and Tucson, to assess the potential benefits of employing travel efficiency strategies in these areas.

  3. Modalities of Generalization Through Single Case Studies.

    Science.gov (United States)

    Zittoun, Tania

    2017-06-01

    The value of case studies for theory building is still doubted in psychology. The paper argues for the importance of case studies and the possibility of generalizing from these for a specific sociocultural understanding of human development. The paper first clarifies the notion of abduction within case studies, drawing on pragmatists James and Peirce and expanding it with the work of Lewin, and argues that it is the core mechanism that allows generalization from case studies. The second section presents the possibility of generalizing from individual single case studies, for which not only the subjective perspective, but also the dynamics by which the social and cultural environment guide and enable the person's development, have to be accounted for. The third section elaborates the question of institutional case studies, where the challenge is to account both for institutional dynamics, and for persons' trajectories within; this is exemplified with an ongoing study on the process of obtaining citizenship in Switzerland. The paper briefly concludes by highlighting two possible implications of the paper, one concerning the process of theoretical reasoning, the other, the fact that sociocultural psychology could itself be seen as an institution in-the-making.

  4. Educational Potential of Case-Study Technology

    OpenAIRE

    Fedorinova, Zoya; Vorobeva, Victoria; Malyanova, Marina

    2015-01-01

    This article presents the results of phenomenological and typological analysis of case-study technology educational potential. The definition “educational potential of case-study technology” is given, the main characteristics of which are changed in communication and collaborative activity quality, appearance of educational initiatives, change of participants’ position in learning process, formation of “collective subject” in collaborative activity, increase of learning (subject) results. Dep...

  5. Performable Case Studies in Ethics Education.

    Science.gov (United States)

    Robeson, Richard; King, Nancy M P

    2017-09-12

    Bioethics education often includes the study of short stories, novels, plays, and films, because such materials present case examples that can highlight relevant issues and questions especially vividly for a wide range of students. In addition, creative writing is widely used in the education of health professional students and in continuing education settings for health professionals. There are very few academic or professional disciplines that do not use case studies, but the case study in dialogic form has not been standard practice for thousands of years. Dramatic arts casuistry-the creation and performance of short case studies designed specifically to raise bioethics issues for discussion-represents an application of literature and the medical humanities that is both unique and uniquely valuable. This essay describes the development and history of a course that has been successfully taught to medical students and graduate bioethics students, in which the class researches, writes, and performs a case study designed to elicit reflection and discussion about a topic and set of bioethics issues of current interest to both academic and general audiences. The model is also suited to the presentation and discussion of existing case studies, both live and via on-demand audio.

  6. Video Gaming and Gender Dysphoria: Some Case Study Evidence

    OpenAIRE

    Griffiths, Mark D.; Arcelus, Jon; Bouman, Walter Pierre

    2016-01-01

    Video gaming has become an established area of psychological research over the last two decades. Over\\ud the past few years there has been increasing research into online gender swapping, showing that for many groups\\ud or individuals it can have positive psychological benefits (e.g., as a way to explore gender roles and boundaries in a safe environment). To date, no research has ever examined online gender swapping among individuals with gender dysphoria – people with acknowledged gender-ide...

  7. Transformational change in healthcare: an examination of four case studies.

    Science.gov (United States)

    Charlesworth, Kate; Jamieson, Maggie; Davey, Rachel; Butler, Colin D

    2016-04-01

    Objectives Healthcare leaders around the world are calling for radical, transformational change of our health and care systems. This will be a difficult and complex task. In this article, we examine case studies in which transformational change has been achieved, and seek to learn from these experiences. Methods We used the case study method to investigate examples of transformational change in healthcare. The case studies were identified from preliminary doctoral research into the transition towards future sustainable health and social care systems. Evidence was collected from multiple sources, key features of each case study were displayed in a matrix and thematic analysis was conducted. The results are presented in narrative form. Results Four case studies were selected: two from the US, one from Australia and one from the UK. The notable features are discussed for each case study. There were many common factors: a well communicated vision, innovative redesign, extensive consultation and engagement with staff and patients, performance management, automated information management and high-quality leadership. Conclusions Although there were some notable differences between the case studies, overall the characteristics of success were similar and collectively provide a blueprint for transformational change in healthcare. What is known about the topic? Healthcare leaders around the world are calling for radical redesign of our systems in order to meet the challenges of modern society. What does this paper add? There are some remarkable examples of transformational change in healthcare. The key factors in success are similar across the case studies. What are the implications for practitioners? Collectively, these key factors can guide future attempts at transformational change in healthcare.

  8. [Burden of proof in medical cases--presumption of fact and prima facie evidence. II. Presumption of fact and prima facie evidence].

    Science.gov (United States)

    Sliwka, Marcin

    2004-01-01

    The aim of this paper was to present the main rules concerning the burden of proof in polish civil trials, including medical cases. The standard rules were presented with all the important exclusions such as presumption of law and fact or prima facie evidence. The author analyses the effect of these institutions on burden of proof in medical cases. The difference between presumptions of fact and prima facie evidence was analysed and explained. This paper also describes the importance of the res ipsa loquitur rule in United Kingdom and USA. This paper includes numerous High Court sentences on evidential and medical issues.

  9. A Case Study about Communication Strategies

    Science.gov (United States)

    Lin, Grace Hui Chin

    2011-01-01

    The primary purpose of this case study was to identify what were Taiwanese University English as a Foreign Language (EFL) learners' perceptions about learning communication strategies. This study collected qualitative data about students' beliefs and attitudes as they learned communication strategies. The research question guiding the study was:…

  10. Predicting Students Drop Out: A Case Study

    Science.gov (United States)

    Dekker, Gerben W.; Pechenizkiy, Mykola; Vleeshouwers, Jan M.

    2009-01-01

    The monitoring and support of university freshmen is considered very important at many educational institutions. In this paper we describe the results of the educational data mining case study aimed at predicting the Electrical Engineering (EE) students drop out after the first semester of their studies or even before they enter the study program…

  11. FIRE (facilitating implementation of research evidence: a study protocol

    Directory of Open Access Journals (Sweden)

    Seers Kate

    2012-03-01

    Full Text Available Abstract Background Research evidence underpins best practice, but is not always used in healthcare. The Promoting Action on Research Implementation in Health Services (PARIHS framework suggests that the nature of evidence, the context in which it is used, and whether those trying to use evidence are helped (or facilitated affect the use of evidence. Urinary incontinence has a major effect on quality of life of older people, has a high prevalence, and is a key priority within European health and social care policy. Improving continence care has the potential to improve the quality of life for older people and reduce the costs associated with providing incontinence aids. Objectives This study aims to advance understanding about the contribution facilitation can make to implementing research findings into practice via: extending current knowledge of facilitation as a process for translating research evidence into practice; evaluating the feasibility, effectiveness, and cost-effectiveness of two different models of facilitation in promoting the uptake of research evidence on continence management; assessing the impact of contextual factors on the processes and outcomes of implementation; and implementing a pro-active knowledge transfer and dissemination strategy to diffuse study findings to a wide policy and practice community. Setting and sample Four European countries, each with six long-term nursing care sites (total 24 sites for people aged 60 years and over with documented urinary incontinence Methods and design Pragmatic randomised controlled trial with three arms (standard dissemination and two different programmes of facilitation, with embedded process and economic evaluation. The primary outcome is compliance with the continence recommendations. Secondary outcomes include proportion of residents with incontinence, incidence of incontinence-related dermatitis, urinary tract infections, and quality of life. Outcomes are assessed at baseline

  12. The use of full spectrum digital photography for evidence collection and preservation in cases involving forensic odontology.

    Science.gov (United States)

    Wright, Franklin D; Golden, Gregory S

    2010-09-10

    Photography often represents the best method to collect and preserve evidence in forensic cases. This is especially true in forensic odontology with cases involving dental identification, human abuse and, perhaps most significantly, bitemark cases. Basic visible light photography is adequate in most dental identification cases; however, full spectrum digital photography is best utilized to collect all available evidence in cases of human abuse and bitemarks. This paper will discuss the types of photographic evidence that should be collected with various forensic odontological cases and the specific techniques utilized in full spectrum forensic digital photography. The use of full spectrum photography captures the forensic injuries using special techniques recording the injuries in each of the four resultant events that occur when light strikes skin. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  13. Case Study Research Methodology in Nursing Research.

    Science.gov (United States)

    Cope, Diane G

    2015-11-01

    Through data collection methods using a holistic approach that focuses on variables in a natural setting, qualitative research methods seek to understand participants' perceptions and interpretations. Common qualitative research methods include ethnography, phenomenology, grounded theory, and historic research. Another type of methodology that has a similar qualitative approach is case study research, which seeks to understand a phenomenon or case from multiple perspectives within a given real-world context.

  14. Case Study Report about Gender Impact Assessment

    DEFF Research Database (Denmark)

    Faber, Stine Thidemann; Agustin, Lise Rolandsen

    2013-01-01

    The aim of this national case study report is to take a closer look at the use of Gender Impact Assessments in Denmark in order to describe the Danish implementation of this specific Gender Mainstreaming method. By way of analyzing two selected cases (two law proposals put forward by The Danish...... Ministry of Employment and the Danish Ministry of Transport, respectively) the aim is to assess the transformative potential of GIA as it is performed in Denmark....

  15. Gigantic Suprapubic Lymphedema: A Case Study

    Directory of Open Access Journals (Sweden)

    Roozbeh Tanhaeivash

    2016-08-01

    Full Text Available We present the first case study of idiopathic gigantic suprapubic lymphedema and buried penis treated with puboscrotal reconstruction in a patient with initial extreme obesity after an extensive weight reduction (120 kg. Massive localized lymphedema of the suprapubic region should be differentiated from the scrotal type. Severe lymphedema could not resolve on its own and weight reduction does not seem to be helpful in such cases.

  16. Chemical elemental distribution and soil DNA fingerprints provide the critical evidence in murder case investigation.

    Directory of Open Access Journals (Sweden)

    Giuseppe Concheri

    Full Text Available BACKGROUND: The scientific contribution to the solution of crime cases, or throughout the consequent forensic trials, is a crucial aspect of the justice system. The possibility to extract meaningful information from trace amounts of samples, and to match and validate evidences with robust and unambiguous statistical tests, are the key points of such process. The present report is the authorized disclosure of an investigation, carried out by Attorney General appointment, on a murder case in northern Italy, which yielded the critical supporting evidence for the judicial trial. METHODOLOGY/PRINCIPAL FINDINGS: The proportional distribution of 54 chemical elements and the bacterial community DNA fingerprints were used as signature markers to prove the similarity of two soil samples. The first soil was collected on the crime scene, along a corn field, while the second was found in trace amounts on the carpet of a car impounded from the main suspect in a distant location. The matching similarity of the two soils was proven by crossing the results of two independent techniques: a elemental analysis via inductively coupled plasma mass spectrometry (ICP-MS and optical emission spectrometry (ICP-OES approaches, and b amplified ribosomal DNA restriction analysis by gel electrophoresis (ARDRA. CONCLUSIONS: Besides introducing the novel application of these methods to forensic disciplines, the highly accurate level of resolution observed, opens new possibilities also in the fields of soil typing and tracking, historical analyses, geochemical surveys and global land mapping.

  17. Case Study Research: Foundations and Methodological Orientations

    Directory of Open Access Journals (Sweden)

    Helena Harrison

    2017-01-01

    Full Text Available Over the last forty years, case study research has undergone substantial methodological development. This evolution has resulted in a pragmatic, flexible research approach, capable of providing comprehensive in-depth understanding of a diverse range of issues across a number of disciplines. Change and progress have stemmed from parallel influences of historical transformations in approaches to research and individual researcher's preferences, perspectives, and interpretations of this design. Researchers who have contributed to the development of case study research come from diverse disciplines with different philosophical perspectives, resulting in a variety of definitions and approaches. For the researcher new to using case study, such variety can create a confusing platform for its application. In this article, we explore the evolution of case study research, discuss methodological variations, and summarize key elements with the aim of providing guidance on the available options for researchers wanting to use case study in their work. URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs1701195

  18. Collaborative Assessment: Middle School Case Study

    Science.gov (United States)

    Parkison, Paul T.

    2014-01-01

    Utilizing a participant observer research model, a case study of the efficacy of a collaborative assessment methodology within a middle school social studies class was conducted. A review of existing research revealed that students' perceptions of assessment, evaluation, and accountability influence their intrinsic motivation to learn. A…

  19. Case Studies in Library Computer Systems.

    Science.gov (United States)

    Palmer, Richard Phillips

    Twenty descriptive case studies of computer applications in a variety of libraries are presented in this book. Computerized circulation, serial and acquisition systems in public, high school, college, university and business libraries are included. Each of the studies discusses: 1) the environment in which the system operates, 2) the objectives of…

  20. Prader-Willi Disease: A Case Study.

    Science.gov (United States)

    Forbus, William R., III

    A case study focuses on the characteristics and physical management of a 15-year-old with Prader-Willi Syndrome, a birth defect associated with hypotonia, insatiable appetite, hypogonadism, central nervous system dysfunction, and abnormal growth and development . A literature review addresses studies dealing with behavior modification of obesity…

  1. Qualitative case study data analysis: an example from practice.

    Science.gov (United States)

    Houghton, Catherine; Murphy, Kathy; Shaw, David; Casey, Dympna

    2015-05-01

    To illustrate an approach to data analysis in qualitative case study methodology. There is often little detail in case study research about how data were analysed. However, it is important that comprehensive analysis procedures are used because there are often large sets of data from multiple sources of evidence. Furthermore, the ability to describe in detail how the analysis was conducted ensures rigour in reporting qualitative research. The research example used is a multiple case study that explored the role of the clinical skills laboratory in preparing students for the real world of practice. Data analysis was conducted using a framework guided by the four stages of analysis outlined by Morse ( 1994 ): comprehending, synthesising, theorising and recontextualising. The specific strategies for analysis in these stages centred on the work of Miles and Huberman ( 1994 ), which has been successfully used in case study research. The data were managed using NVivo software. Literature examining qualitative data analysis was reviewed and strategies illustrated by the case study example provided. Discussion Each stage of the analysis framework is described with illustration from the research example for the purpose of highlighting the benefits of a systematic approach to handling large data sets from multiple sources. By providing an example of how each stage of the analysis was conducted, it is hoped that researchers will be able to consider the benefits of such an approach to their own case study analysis. This paper illustrates specific strategies that can be employed when conducting data analysis in case study research and other qualitative research designs.

  2. Mining Product Data Models: A Case Study

    Directory of Open Access Journals (Sweden)

    Cristina-Claudia DOLEAN

    2014-01-01

    Full Text Available This paper presents two case studies used to prove the validity of some data-flow mining algorithms. We proposed the data-flow mining algorithms because most part of mining algorithms focuses on the control-flow perspective. First case study uses event logs generated by an ERP system (Navision after we set several trackers on the data elements needed in the process analyzed; while the second case study uses the event logs generated by YAWL system. We offered a general solution of data-flow model extraction from different data sources. In order to apply the data-flow mining algorithms the event logs must comply a certain format (using InputOutput extension. But to respect this format, a set of conversion tools is needed. We depicted the conversion tools used and how we got the data-flow models. Moreover, the data-flow model is compared to the control-flow model.

  3. Cryostat design case studies, principles and engineering

    CERN Document Server

    2016-01-01

    This book enables the reader to learn the fundamental and applied aspects of practical cryostat design by examining previous design choices and resulting cryostat performance. Through a series of extended case studies the book presents an overview of existing cryostat design covering a wide range of cryostat types and applications, including the magnet cryostats that comprise the majority of the Large Hadron Collider at CERN, space-borne cryostats containing sensors operating below 1 K, and large cryogenic liquid storage vessels. It starts with an introductory section on the principles of cryostat design including practical data and equations. This section is followed by a series of case studies on existing cryostats, describing the specific requirements of the cryostat, the challenges involved and the design choices made along with the resulting performance of the cryostat. The cryostat examples used in the studies are chosen to cover a broad range of cryostat applications and the authors of each case are ...

  4. Assessment of human decision reliability - a case study

    International Nuclear Information System (INIS)

    Pyy, P

    1998-01-01

    In his discussion of this case study, the author indicates that human beings are not merely machines who use rules. Thus, more focus needs to be put on studying decision making situations and their contexts. Decision theory (both normative and descriptive) and contextual psychological approaches may offer tools to cope with operator decision making. Further an ideal decision space needs to be defined for operators. The case study specifically addressed a loss of feedwater scenario and the various operator decisions that were involved in that scenario. It was concluded from this particular study that there are significant differences in the crew decision behaviours that are not explained by process variables. Through use of evidence from simulator tests with expert judgement, an approach to estimate probabilities has been developed. The modelling approach presented in this discussion is an extension of current HRA paradigms, but a natural one since all human beings make decisions

  5. Evidence for declining numbers of Ebola cases--Montserrado County, Liberia, June-October 2014.

    Science.gov (United States)

    Nyenswah, Tolbert G; Westercamp, Matthew; Kamali, Amanda Ashraf; Qin, Jin; Zielinski-Gutierrez, Emily; Amegashie, Fred; Fallah, Mosaka; Gergonne, Bernadette; Nugba-Ballah, Roselyn; Singh, Gurudev; Aberle-Grasse, John M; Havers, Fiona; Montgomery, Joel M; Bawo, Luke; Wang, Susan A; Rosenberg, Ronald

    2014-11-21

    The epidemic of Ebola virus disease (Ebola) in West Africa that began in March 2014 has caused approximately 13,200 suspected, probable, and confirmed cases, including approximately 6,500 in Liberia. About 50% of Liberia's reported cases have been in Montserrado County (population 1.5 million), the most populous county, which contains the capital city, Monrovia. To examine the course of the Ebola epidemic in Montserrado County, data on Ebola treatment unit (ETU) admissions, laboratory testing of patient blood samples, and collection of dead bodies were analyzed. Each of the three data sources indicated consistent declines of 53%-73% following a peak incidence in mid-September. The declines in ETU admissions, percentage of patients with reverse transcription-polymerase chain reaction (RT-PCR) test results positive for Ebola, and dead bodies are the first evidence of reduction in disease after implementation of multiple prevention and response measures. The possible contributions of these interventions to the decline is not yet fully understood or corroborated. A reduction in cases suggests some progress; however, eliminating Ebola transmission is the critical goal and will require greatly intensified efforts for complete, high-quality surveillance to direct and drive the rapid intervention, tracking, and response efforts that remain essential.

  6. Clean Cities Case Study: Barwood Cab Fleet Study Summary

    International Nuclear Information System (INIS)

    Whalen, P.

    1999-01-01

    Barwood Cab Fleet Study Summary is the second in a new series called''Alternative Fuel Information Case Studies,'' designed to present real-world experiences with alternative fuels to fleet managers and other industry stakeholders

  7. Repurposing legacy data innovative case studies

    CERN Document Server

    Berman, Jules J

    2015-01-01

    Repurposing Legacy Data: Innovative Case Studies takes a look at how data scientists have re-purposed legacy data, whether their own, or legacy data that has been donated to the public domain. Most of the data stored worldwide is legacy data-data created some time in the past, for a particular purpose, and left in obsolete formats. As with keepsakes in an attic, we retain this information thinking it may have value in the future, though we have no current use for it. The case studies in this book, from such diverse fields as cosmology, quantum physics, high-energy physics, microbiology,

  8. Case studies in atomic collision physics

    CERN Document Server

    McDaniel, E W

    1974-01-01

    Case Studies in Atomic Physics III focuses on case studies on atomic and molecular physics, including atomic collisions, transport properties of electrons, ions, molecules, and photons, interaction potentials, spectroscopy, and surface phenomena. The selection first discusses detailed balancing in the time-dependent impact parameter method, as well as time-reversal in the impact parameter method and coupled state approximation. The text also examines the mechanisms of electron production in ion. Topics include measurement of doubly differential cross sections and electron spectra, direct Coul

  9. Particulate matter and heart disease: Evidence from epidemiological studies

    International Nuclear Information System (INIS)

    Peters, Annette

    2005-01-01

    The association between particulate matter and heart disease was noted in the mid-nineties of last century when the epidemiological evidence for an association between air pollution and hospital admissions due to cardiovascular disease accumulated and first hypotheses regarding the pathomechanism were formulated. Nowadays, epidemiological studies have demonstrated coherent associations between daily changes in concentrations of ambient particles and cardiovascular disease mortality, hospital admission, disease exacerbation in patients with cardiovascular disease and early physiological responses in healthy individuals consistent with a risk factor profile deterioration. In addition, evidence was found that annual average PM 2.5 exposures are associated with increased risks for mortality caused by ischemic heart disease and dysrhythmia. Thereby, evidence is suggesting not only a short-term exacerbation of cardiovascular disease by ambient particle concentrations but also a potential role of particles in defining patients' vulnerability to acute coronary events. While this concept is consistent with the current understanding of the factors defining patients' vulnerability, the mechanisms and the time-scales on which the particle-induced vulnerability might operate are unknown

  10. Renal Artery Stenosis (RAS) Case study

    International Nuclear Information System (INIS)

    Zaater, M.K.

    2012-01-01

    Renal Artery Stenosis (RAS), is one of the causes of secondary hypertension; there are many causes of renal artery stenosis, as atherosclerosis of the renal artery which account for 90% of cases of RAS; fibromuscular dysplasia accounts for 10% of RAS. Various causes of thrombophilia either due congenital causes or acquired causes and can lead to RAS. Our patient was presented by acute attack of epistaxis and hypertension. Angiography of the Renal Arteries,are showed no sign of renal artery stenosis. However, the right kidney showed upper pole infarction, and the left kidney showed evidence of functional lower pole renal artery stenosis, although there is no anatomical stenosis detected in angiography. Work up for the cause of thrombophilia did not help in the diagnosis, which may be due to an undiscovered cause of thrombophilia

  11. Levels of Evidence: Cancer Genetics Studies (PDQ®)—Health Professional Version

    Science.gov (United States)

    Levels of Evidence for Cancer Genetics Studies addresses the process and challenges of developing evidence-based summaries. Get information about how to weigh the strength of the evidence from cancer genetics studies in this summary for clinicians.

  12. Financial Shenanigans : A Case Study in Malaysia

    OpenAIRE

    Ooi, Ki Wei

    2013-01-01

    This study investigates the financial shenanigan cases which subject to the enforcement actions by the Malaysian Securities Commission between 2006 and 2011 for alleged financial misreporting. The scope of this study includes the attempts used, causes and consequences of the financial shenanigans and the post-financial shenanigans recovery plans devised to turnaround the companies. This study finds that the most common attempt used by the sample companies is overstating the revenue, follows b...

  13. Financial Shenanigans : A Case Study of Nigeria

    OpenAIRE

    Onitilo, Nnenna Chidimma

    2015-01-01

    This study investigates the identified cases of financial shenanigans in between 2001 and 2009 in Nigeria. The scope of this study includes the identification of the common attempts and approaches used by companies and the motivations for financial shenanigans. A cross country comparison of the characteristics of the corporate reporting environments between Nigeria and Malaysia was also carried out. This study finds that the most common attempt used by the sample companies are majorly revenue...

  14. [Analysis of the knowledge and practices of health care workers in Emergency Departments regarding the protection and preservation of evidence in forensic cases].

    Science.gov (United States)

    Ilçe, Arzu; Yıldız, Dilek; Baysal, Gonca; Ozdoğan, Fatma; Taş, Fatma

    2010-11-01

    The frequency of violent incidents is increasing. This increase has made the role of Emergency Department (ED) staff more important in the collection, recording, protection, and storage of the evidence until the arrival of the responsible people concerned with the issue. Therefore, this study was designed to analyze the knowledge and practices of the nursing staff working in the EDs with respect to the protection and preservation of the evidence in forensic cases. This research, which was designed to be descriptive, was conducted with 44 health care workers in the hospitals with Emergency Departments in the center of Bolu province between October 2008 and January 2009. It was observed that 90.9% of the health care workers encountered forensic cases, 65.9% of them had not attended any training on forensic cases, and 22.7% of them did not use care when removing and storing the clothes of the patient. It was considered that 90.9% of the health care workers duly carry out their duties and responsibilities in forensic cases; however, 18.2% of them do not have sufficient knowledge or practical experience in the preservation and protection of evidence in forensic cases. It was observed that most health care workers do not have sufficient knowledge or practical experience in the preservation and protection of evidence in forensic cases.

  15. The neurophysiology of language processing shapes the evolution of grammar: evidence from case marking.

    Science.gov (United States)

    Bickel, Balthasar; Witzlack-Makarevich, Alena; Choudhary, Kamal K; Schlesewsky, Matthias; Bornkessel-Schlesewsky, Ina

    2015-01-01

    Do principles of language processing in the brain affect the way grammar evolves over time or is language change just a matter of socio-historical contingency? While the balance of evidence has been ambiguous and controversial, we identify here a neurophysiological constraint on the processing of language that has a systematic effect on the evolution of how noun phrases are marked by case (i.e. by such contrasts as between the English base form she and the object form her). In neurophysiological experiments across diverse languages we found that during processing, participants initially interpret the first base-form noun phrase they hear (e.g. she…) as an agent (which would fit a continuation like … greeted him), even when the sentence later requires the interpretation of a patient role (as in … was greeted). We show that this processing principle is also operative in Hindi, a language where initial base-form noun phrases most commonly denote patients because many agents receive a special case marker ("ergative") and are often left out in discourse. This finding suggests that the principle is species-wide and independent of the structural affordances of specific languages. As such, the principle favors the development and maintenance of case-marking systems that equate base-form cases with agents rather than with patients. We confirm this evolutionary bias by statistical analyses of phylogenetic signals in over 600 languages worldwide, controlling for confounding effects from language contact. Our findings suggest that at least one core property of grammar systematically adapts in its evolution to the neurophysiological conditions of the brain, independently of socio-historical factors. This opens up new avenues for understanding how specific properties of grammar have developed in tight interaction with the biological evolution of our species.

  16. The role of radionuclide studies in emergency cases

    International Nuclear Information System (INIS)

    Nishimura, Tsunehiko; Hayashida, Kohei; Uehara, Toshiisa

    1982-01-01

    Radionuclide studies have been performed popularly because of its noninvasive and simple method recently. In this study, we applied this technique for the evaluation of emergency cases in cardiovascular diseases. There were 93 cases (1.5%) out of 6163 cases, done during 1981. The subjects were 34 cases of cardiac studies (9 cases of sup(99m)Tc-PYP myocardial imaging, 12 cases of thallium myocardial imaging, 13 cases of cardioangiography), 23 cases of peripheral diseases (12 cases of peripheral angiography, 11 cases of venography), 16 cases of pulmonary imaging, 10 cases of renal studies (6 cases of renal angiography, 9 cases of renal imaging) and 5 cases of brain angiography. These studies were proven to be useful clinically for the evaluation of emergency cases and follow-up studies. In the near future, ''emergency radionuclide studies'' would be benefit for the high-risk patients noninvasively. (author)

  17. STUDY OF 200 CASES OF PLEURAL FLUID

    Directory of Open Access Journals (Sweden)

    Ramakrishna R

    2016-09-01

    Full Text Available BACKGROUND We have studied 200 patients of pleural fluid presenting to our tertiary care centre. Presence of cases of pleural fluid is a common presentation both in pulmonary and extrapulmonary diseases. We analysed the patients having both exudates and transudates and studied the results. MATERIALS AND METHODS We selected patients above 20 years of age and classified the patients with pleural fluid as having transudates and exudates. We studied the causes of transudates and exudates. A total of 200 patients are studied in this prospective study. Diagnosis of pleural exudates is made on the basis of Light’s criteria, chest x-ray, pleural fluid analysis, CT scan in selected patients, sputum examination, bronchoscopy and bronchial washings. Moribund and non-cooperative patients and HIV positives were excluded from the study. RESULTS Among the 200 patients, 91% have exudates. 9% have transudates by Light’s criteria. Tuberculosis is the commonest cause of effusions (64.83% followed by malignancy (13.73% and sympneumonic or parapneumonic effusions (9.89%. Pleural effusions occurred predominantly in males. Prevalence of diabetes Mellitus among cases of tuberculous pleural effusions is 13.56%. Tuberculous effusions are predominantly right-sided. CONCLUSION Predominant cases of pleural fluid are exudates. Commonest cause of pleural effusion is Tuberculosis followed by malignancy both pulmonary and extrapulmonary and sym. and parapneumonic effusions. Prevalence of Diabetes among Tuberculous pleural effusion cases is more or less same as in general population. Cough, expectoration fever, chest pain and breathlessness are the common symptoms occurring in three fourths of the patients of tuberculous pleural effusion. Most of the cases of Tuberculous effusion are above 30 years of age. In the diagnosis of tuberculous pleural effusion, Pleural fluid ADA is very important. Pleural fluid cytology, pleural biopsy, bronchoscopy, bronchial washings and sputum

  18. A Codesign Case Study in Computer Graphics

    DEFF Research Database (Denmark)

    Brage, Jens P.; Madsen, Jan

    1994-01-01

    The paper describes a codesign case study where a computer graphics application is examined with the intention to speed up its execution. The application is specified as a C program, and is characterized by the lack of a simple compute-intensive kernel. The hardware/software partitioning is based...

  19. Effective communication. A Platonic case study

    NARCIS (Netherlands)

    Wakker, Gerry C.; Wieling, Martijn; Kroon, Martin; Van Noord, Gertjan

    As a contribution to the valedictory volume for John Nerbonne I present a case study of two thematically similar passages in Plato where I will make use of an analysis based on discourse cohesion and above all on the rhetorical and manipulative use of particles to show how a single (leading)

  20. The Danish National Case Study Report

    DEFF Research Database (Denmark)

    Brodersen, Søsser; Jørgensen, Michael Søgaard

    the projects so it fits into the university schedule, without leaving out the time perspective of the clients, and secure the research is applicable for the clients and based on their need for knowledge. The case studies have shown different roles of a Science Shop. All Science Shops have a role as mediator...

  1. Portfolio Manager Selection – A Case Study

    DEFF Research Database (Denmark)

    Christensen, Michael

    2017-01-01

    Within a delegated portfolio management setting, this paper presents a case study of how the manager selection process can be operationalized in practice. Investors have to pursue a thorough screening of potential portfolio managers in order to discover their quality, and this paper discusses how...

  2. Acoustical case studies of three green buildings

    Science.gov (United States)

    Siebein, Gary; Lilkendey, Robert; Skorski, Stephen

    2005-04-01

    Case studies of 3 green buildings with LEED certifications that required extensive acoustical retrofit work to become satisfactory work environments for their intended user groups will be used to define areas where green building design concepts and acoustical design concepts require reconciliation. Case study 1 is an office and conference center for a city environmental education agency. Large open spaces intended to collect daylight through clerestory windows provided large, reverberant volumes with few acoustic finishes that rendered them unsuitable as open office space and a conference room/auditorium. Case Study 2 describes one of the first gold LEED buildings in the southeast whose primary design concepts were so narrowly focused on thermal and lighting issues that they often worked directly against basic acoustical requirements resulting in sound levels of NC 50-55 in classrooms and faculty offices, crosstalk between classrooms and poor room acoustics. Case study 3 is an environmental education and conference center with open public areas, very high ceilings, and all reflective surfaces made from wood and other environmentally friendly materials that result in excessive loudness when the building is used by the numbers of people which it was intended to serve.

  3. Advanced supplier partnership practices: a case study.

    Science.gov (United States)

    Williams, B R

    2000-05-01

    This article describes how a supplier partnership was set up to avoid the typical purchasing relationship--price being inversely proportional to quantity and having the purchaser take all the risk of product obsolescence. The case study also describes how rate-based replenishment replaced time-based delivery, and how all these advantages were achieved at reduced administrative costs.

  4. Management in Virtual Environments. Case Studies

    OpenAIRE

    Mazurek, Grzegorz; Gembicki, Michał; Krzemień, Grzegorz; Przegalińska, Aleksandra K.; Starostka, Justyna; Skorulska, Karolina; Prystupa-Rządca, Kaja

    2015-01-01

    The following publication consists of 12 case studies, which encompass various aspects of the ICT impact on contemporary businesses, focusing – among other things – on such concepts as: crowdsourcing, the internet of things, design thinking, digital entertainment, e-commerce, online and off-line distribution or social media marketing. EEA, Norway Grants Anna Goryńska

  5. Teaching Business Intelligence through Case Studies

    Science.gov (United States)

    Pomykalski, James J.

    2015-01-01

    In teaching business students about the application and implementation of technology, especially involving business intelligence, it is important to discover that project success in enterprise systems development efforts often depend on the non-technological problems or issues. The focus of this paper will be on the use of multiple case studies in…

  6. Business Registration Reform Case Studies : Malaysia

    OpenAIRE

    Olaisen, John

    2009-01-01

    This collection of case studies describes experiences and draws lessons from varied business registration reform programs in economies in vastly different stages of development: Bulgaria, Estonia, Ireland, Madagascar, and Malaysia. Over the last twenty years, a number of countries have recognized the importance of smooth and efficient business start up procedures. A functioning business re...

  7. Predicting students drop out : a case study

    NARCIS (Netherlands)

    Dekker, G.W.; Pechenizkiy, M.; Vleeshouwers, J.M.; Barnes, T.; Desmarais, M.; Romero, C.; Ventura, S.

    2009-01-01

    The monitoring and support of university freshmen is considered very important at many educational institutions. In this paper we describe the results of the educational data mining case study aimed at predicting the Electrical Engineering (EE) students drop out after the first semester of their

  8. WP6 - The Ag2020 Case Studies

    DEFF Research Database (Denmark)

    Hansen, Jens G; Borch, Kristian; Trombi, Giacomo

    2010-01-01

    of the Future are presented. Finally, in section 1.4, is described the structure of the present report,which is firmly followed by the four case studies involved in the Project, namely the Rhodope Mountainous region in Bulgaria (CS1), The Kastelli region (Herakleion nomos) in Greece (CS2), the Central Denmark...

  9. case study of ramat park benin city

    African Journals Online (AJOL)

    user

    SETTLEMENT: CASE STUDY OF RAMAT PARK BENIN CITY. E. S. Okonofua1, R. ... region on a daily basis. The movement of ... with major road networks [2]. In order to ease ... led to series of research and development of traffic noise models.

  10. CASE STUDY – HIV AND LUNG DISEASE

    African Journals Online (AJOL)

    2011-04-02

    Apr 2, 2011 ... pathology deep to the paraseptal bullae. An intercostal drain tip is seen in the left lateral pleural space. Fig. 2. Axial computed tomography scan on lung windows. Large bilateral paraseptal bullae are demonstrated with residual antero-medial pneumothorax. 37. CASE STUDY – HIV AND LUNG DISEASE ...

  11. A Case Study of the Vredefort Dome

    African Journals Online (AJOL)

    South Africa became a signatory to and ratified the World Heritage Convention, 1972 (WHC) in 1997. It thereby voluntarily agreed to identify and conserve world heritage areas of universal value for the benefit of mankind. This article presents a case study of the Vredefort Dome, one of South Africa\\'s World Heritage Sites ...

  12. Climate wise case study compendium: Report 1

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-02-01

    This case study compendium is one of several Climate Wise tools available to help interested companies identify cost-effective options. Climate Wise, a private-public partnership program, is a key Federal initiative to return greenhouse gas emissions to 1990 levels by 2000.

  13. Making Professional Development Flexible: A Case Study.

    Science.gov (United States)

    Forsyth, Rachel

    2002-01-01

    Presents a case study of an online course that was designed for staff professional development at Manchester Metropolitan University (United Kingdom). Discusses the flexibility of online courses; course design; activities for short online workshops; evaluation methods for course evaluation; and results of participant questionnaires. (LRW)

  14. Library Virtual Tours: A Case Study

    Science.gov (United States)

    Ashmore, Beth; Grogg, Jill E.

    2004-01-01

    Virtual tours delivered via the Web have become a common tool for both instruction and outreach. This article is a case study of the creation of a virtual tour for a university library and is intended to provide others interested in creating a virtual tour of their library the opportunity to learn from the mistakes and successes of fellow…

  15. Learning Machine Learning: A Case Study

    Science.gov (United States)

    Lavesson, N.

    2010-01-01

    This correspondence reports on a case study conducted in the Master's-level Machine Learning (ML) course at Blekinge Institute of Technology, Sweden. The students participated in a self-assessment test and a diagnostic test of prerequisite subjects, and their results on these tests are correlated with their achievement of the course's learning…

  16. Firefighter Workplace Learning: An Exploratory Case Study

    Science.gov (United States)

    Tracey, Edward A.

    2014-01-01

    Despite there being a significant amount of research investigating workplace learning, research exploring firefighter workplace learning is almost nonexistent. The purpose of this qualitative multi-case study was to explore how firefighters conceptualize, report, and practice workplace learning. The researcher also investigated how firefighters…

  17. Spicy Stonehenge : Proposing a SOA Case Study

    NARCIS (Netherlands)

    Espinha, T.A.; Chen, C.; Zaidman, A.E.; Gross, H.G.

    2012-01-01

    Prepint of paper published in: ICSE Workshop on Principles of Engineering Service Oriented Systems (PESOS), 4 June 2012; doi:10.1109/PESOS.2012.6225940 Maintenance research in the context of Service Oriented Architecture (SOA) is currently lacking a suitable standard case study that can be used by

  18. Collegiality in education: a case study

    African Journals Online (AJOL)

    Erna Kinsey

    This case study therefore investigated the effects of a collegial management style on teaching and learning ... resources cannot solely guarantee success at matriculation level. ... vily on school principals, their management teams and the governing .... may be necessary to employ the notion of building with a new member.

  19. It's Not Funny: A Case Study

    Science.gov (United States)

    Méndez-Morse, Sylvia

    2015-01-01

    This case study may be used with personnel supervision, school law, and other school leadership courses. It describes the behavior and actions of one teacher toward another. Student discussions can focus on supervision, workplace mobbing, workplace bullying, as well as sexual harassment. Students should focus on a school leader's role in such…

  20. Teaching the Holocaust through Case Study

    Science.gov (United States)

    Misco, Thomas

    2009-01-01

    This article responds to the curricular challenges teachers face with Holocaust education, including cursory treatments and a lack of focus on individual experiences. First, the author argues for a case-study approach to help students reengage concrete and complex features of the Holocaust as a point of departure for subsequent inquiry. In…

  1. A case study of Florida Road, Durban

    African Journals Online (AJOL)

    2006-06-29

    Jun 29, 2006 ... planning in mixed-use precincts: A case study of .... Technology, Faculty of Engineering and the Built Environment, Department of Town and Regional .... development process of contemporary cities. The origins of this realisation .... financing, and a lack of collaboration .... surrounded by a transport network,.

  2. Nanomaterial Case Studies: Nanoscale Titanium Dioxide ...

    Science.gov (United States)

    This draft document presents two case studies of nanoscale titanium dioxide (nano-TiO2) used (1) to remove arsenic from drinking water and (2) as an active ingredient in topical sunscreen. The draft case studies are organized around a comprehensive environmental assessment approach that combines a product life cycle framework with the risk assessment paradigm. The document does not draw conclusions about potential risks. Rather, the case studies are intended to help identify what needs to be known in order to conduct a comprehensive environmental assessment of the potential risks related to nano-TiO2. This draft document is part of a process that will inform the development of EPA’s research strategy to support nanomaterial risk assessments. The complex properties of various nanomaterials make evaluating them in the abstract or with generalizations difficult if not impossible. Thus, this document focuses on two specific uses of nano-TiO2, as a drinking water treatment and as topical sunscreen. These case studies do not represent completed or even preliminary assessments; rather, they present the structure for identifying and prioritizing research needed to support future assessments.

  3. Characterisation and comparison of case study findings

    DEFF Research Database (Denmark)

    Jørgensen, Michael Søgaard; Dorland, Jens; Pel, Bonno

    2015-01-01

    This report gives an overview and a comparative analysis of the findings from the 12 first case study reports in TRANSIT about aspects of transformative social innovation (TSI). Each of the 12 reports, on which the report is based, includes an analysis of a transnational social innovation network...

  4. Implementing Case Studies in a Plant Pathology Course: Impact on Student Learning and Engagement

    Science.gov (United States)

    Yadav, Aman; Beckerman, Janna L.

    2009-01-01

    Case studies have been used in undergraduate science education as a way to develop students' critical thinking and problem-solving skills. However, little empirical evidence exists on whether this teaching method is having the desired impact on students in plant pathology courses. This study evaluated the influence of the case teaching method on…

  5. Hydrocarbon storage caverns overhaul: A case study

    Energy Technology Data Exchange (ETDEWEB)

    McDougall, N. [Bayer Inc., Sarnia, ON (Canada)

    1998-09-01

    Case studies of four hydrocarbon storage cavern overhauls by Bayer Inc., of Sarnia during the period 1993 to 1997 were reviewed and the lessons learned were discussed. Discussions included inspection requirements for each of the caverns, the logistics and planning plant production around the cavern outages, site and cavern preparation, including removal of the casing slips from the well heads. It was emphasized that cavern overhauls can be expensive operations, unless preceded by proper planning. The largest variable cost is likely to be rig time at about $ 2,000 per day. Planning for the unexpected with thoughtful contingencies can reduce costs and avoid expensive delays.

  6. Accounting for control mislabeling in case-control biomarker studies.

    Science.gov (United States)

    Rantalainen, Mattias; Holmes, Chris C

    2011-12-02

    In biomarker discovery studies, uncertainty associated with case and control labels is often overlooked. By omitting to take into account label uncertainty, model parameters and the predictive risk can become biased, sometimes severely. The most common situation is when the control set contains an unknown number of undiagnosed, or future, cases. This has a marked impact in situations where the model needs to be well-calibrated, e.g., when the prediction performance of a biomarker panel is evaluated. Failing to account for class label uncertainty may lead to underestimation of classification performance and bias in parameter estimates. This can further impact on meta-analysis for combining evidence from multiple studies. Using a simulation study, we outline how conventional statistical models can be modified to address class label uncertainty leading to well-calibrated prediction performance estimates and reduced bias in meta-analysis. We focus on the problem of mislabeled control subjects in case-control studies, i.e., when some of the control subjects are undiagnosed cases, although the procedures we report are generic. The uncertainty in control status is a particular situation common in biomarker discovery studies in the context of genomic and molecular epidemiology, where control subjects are commonly sampled from the general population with an established expected disease incidence rate.

  7. Synthesis across social innovation case studies

    DEFF Research Database (Denmark)

    Jørgensen, Michael Søgaard; Avelino, Flor; Dorland, Jens

    2016-01-01

    Part 1 is an overview and a comparative analysis of the findings from the 20 case study reports in TRANSIT about aspects of transformative social innovation (TSI). Each of the 20 reports, which the report is based on, includes an analysis of a transnational social innovation network and at least...... two local social innovation initiatives. Part 2 consists of extended abstracts of 8 papers which either focus on empirical phenomena surfacing in different TRANSIT cases (e.g. alternative economic arrangements), take a societal or methodological issue as starting point (e.g. inclusivity or research...... relations), address propositions from TRANSIT proto-theory (institutionalization dialectics, responses to crisis), build upon thematic clusters used for case selection (e.g. spaces for/of innovation, inclusive society, new economy, transformative science) or inductively develop specific sensitizing concepts...

  8. Neonatal appendicitis: a survival case study

    Directory of Open Access Journals (Sweden)

    Izabela Linha Secco

    Full Text Available ABSTRACT Objective: To report a case of neonatal appendicitis in a children’s hospital in southern Brazil, demonstrating the impact on neonatal survival. Method: Case study with data collection from medical records, approved by the Institution and Ethics Committee for Research with Human Beings. Results: The clinical picture is initially characterized by food intolerance, evolving to hypoactivity, alteration of vital signs and septicemia due to intestinal perforation. Management is exclusively surgical, since no case described in the literature was diagnosed preoperatively and the findings usually point to acute abdomen. Conclusion: A focused clinical surveillance should be established when the infant presents peritoneal irritation. Follow-up of the evolution and the worsening of the symptoms by nurses, as part of the care team in partnership with the medical team, enables an early surgical intervention, thereby avoiding complications such as septicemia and death.

  9. Case studies on selected natural food antioxidants

    OpenAIRE

    Herrero, Miguel; Mendiola, J. A.; Cifuentes, Alejandro; Ibáñez, Elena

    2013-01-01

    In this chapter, a broad description of several case studies related to common antioxidants found in food-related products is presented. In this regard, special attention is put on the novel advanced environmentally-friendly extraction methods nowadays employed to extract and purify those potent antioxidants from natural matrices. A brief description of these extraction processes is provided together with some of the instrumentation needed. Besides, the studies carried out so f...

  10. Treating Selective Mutism Using Modular CBT for Child Anxiety: A Case Study

    Science.gov (United States)

    Reuther, Erin T.; Davis, Thompson E., III; Moree, Brittany N.; Matson, Johnny L.

    2011-01-01

    Selective mutism is a rare, debilitating condition usually seen in children. Unfortunately, there is little research examining effective treatments for this disorder, and designing an evidence-based treatment plan can be difficult. This case study presents the evidence-based treatment of an 8-year-old Caucasian boy with selective mutism using an…

  11. Long-term (5 years), high daily dosage of dietary agmatine--evidence of safety: a case report.

    Science.gov (United States)

    Gilad, Gad M; Gilad, Varda H

    2014-11-01

    There is presently a great interest in the therapeutic potential of agmatine, decarboxylated arginine, for various diseases. Recent clinical studies have already shown that oral agmatine sulfate given for up to 3 weeks provides a safe and, as compared with current therapeutics, more effective treatment for neuropathic pain. These studies have ushered in the use of dietary agmatine as a nutraceutical. However, in view of information paucity, assessment of long-term safety of oral agmatine treatment is now clearly required. The authors of this report undertook to assess their own health status during ongoing consumption of a high daily dosage of oral agmatine over a period of 4-5 years. A daily dose of 2.67 g agmatine sulfate was encapsulated in gelatin capsules; the regimen consists of six capsules daily, each containing 445 mg, three in the morning and three in the evening after meals. Clinical follow-up consists of periodic physical examinations and laboratory blood and urine analyses. All measurements thus far remain within normal values and good general health status is sustained throughout the study period, up to 5 years. This case study shows for the first time that the recommended high dosage of agmatine may be consumed for at least 5 years without evidence of any adverse effects. These initial findings are highly important as they provide significant evidence for the extended long-term safety of a high daily dosage of dietary agmatine--a cardinal advantage for its utility as a nutraceutical.

  12. On robust analysis of paycheck: case study

    Directory of Open Access Journals (Sweden)

    Michal Uherek

    2011-01-01

    Full Text Available Many statistical tests are constructed to check the validity of normal distribution. Here we propose a case study on analysis of paycheck where we employ the RT class of tests for normality firstly introduced in Střelec, Stehlík (2008. In particular such a study can be of interest for pension funds theoreticians and practitioners, which study the transitions of pension systems from one social security state to the another one. Our study illustrates some possible distributional deviations of salary residuals on a real data.

  13. Exploring inductive risk case studies of values in science

    CERN Document Server

    Richards, Ted

    2017-01-01

    Science is the most reliable means available for understanding the world around us and our place in it. But, since science draws conclusions based on limited empirical evidence, there is always a chance that a scientific inference will be incorrect. That chance, known as inductive risk, is endemic to science. Though inductive risk has always been present in scientific practice, the role of values in responding to it has only recently gained extensive attention from philosophers, scientists, and policy-makers. Exploring Inductive Risk brings together a set of eleven concrete case studies with the goals of illustrating the pervasiveness of inductive risk, assisting scientists and policymakers in responding to it, and moving theoretical discussions of this phenomenon forward. The case studies range over a wide variety of scientific contexts, including the drug approval process, high energy particle physics, dual-use research, climate science, research on gender disparities in employment, clinical trials, and to...

  14. Adopting an Evidence-Based Lifestyle Physical Activity Program: Dissemination Study Design and Methods.

    Science.gov (United States)

    Dunn, Andrea L; Buller, David B; Dearing, James W; Cutter, Gary; Guerra, Michele; Wilcox, Sara; Bettinghaus, Erwin P

    2012-06-01

    BACKGROUND: There is a scarcity of research studies that have examined academic-commercial partnerships to disseminate evidence-based physical activity programs. Understanding this approach to dissemination is essential because academic-commercial partnerships are increasingly common. Private companies have used dissemination channels and strategies to a degree that academicians have not, and declining resources require academicians to explore these partnerships. PURPOSE: This paper describes a retrospective case-control study design including the methods, demographics, organizational decision-making, implementation rates, and marketing strategy for Active Living Every Day (ALED), an evidence-based lifestyle physical activity program that has been commercially available since 2001. Evidence-based public health promotion programs rely on organizations and targeted sectors to disseminate these programs although relatively little is known about organizational-level and sector-level influences that lead to their adoption and implementation. METHODS: Cases (n=154) were eligible if they had signed an ALED license agreement with Human Kinetics (HK), publisher of the program's textbooks and facilitator manuals, between 2001 and 2008. Two types of controls were matched (2:2:1) and stratified by sector and region. Active controls (Control 1; n=319) were organizations that contacted HK to consider adopting ALED. Passive controls (Control 2; n=328) were organizations that received unsolicited marketing materials and did not initiate contact with HK. We used Diffusion of Innovations Theory (DIT) constructs as the basis for developing the survey of cases and controls. RESULTS: Using the multi-method strategy recommended by Dillman, a total of n=801 cases and controls were surveyed. Most organizations were from the fitness sector followed by medical, nongovernmental, governmental, educational, worksite and other sectors with significantly higher response rates from government

  15. Vitiligo: A study of 120 cases

    Directory of Open Access Journals (Sweden)

    Kar P

    2001-11-01

    Full Text Available Vitiligo is a common pignientary disorder and of major social and cosmetic concern in India. Purpose of the study was to find out age at onset and sex incidence in vitiligo, role of hereditary factors and associations with other diseases. 120 self reporting vitiligo patients attending out patient department of a service hospital were selected for the study and this data was analysed. In the present series out of 120 cases 62 (51.6% were males and 58(48.35%were females. There was practically no difference in sex incidence. The lowest age of onset was two years and the oldest was 65 years. In the majority of patients,52(43.2%, disease started before twenty years of age.8 (6.6% cases gave definite family history of vitiligo. Exposed areas of the body were commonly affected in majority (66.6% of cases. The legs were commonest site of involvement in 60(50% cases. Circunicript type of vitiligo (46.6% was heading the list. Majority of patients (56.6% had multiple lesions. Diabetes mellitus was found in 2 (2.6% patients. Cause of vitiligo is still idiopathic. Hereditary factors hardly play any role in manifestation of vitiligo

  16. Association between dietary nitrate and nitrite intake and sitespecific cancer risk: evidence from observational studies.

    Science.gov (United States)

    Xie, Li; Mo, Miao; Jia, Hui-Xun; Liang, Fei; Yuan, Jing; Zhu, Ji

    2016-08-30

    Epidemiological studies have reported inconsistent findings on the association between dietary nitrate and nitrite intake and cancer risk. We performed a meta-analysis of epidemiological studies to summarize available evidence on the association between dietary nitrate and nitrite intake and cancer risk from published prospective and case-control studies. PubMed database was searched to identify eligible publications through April 30th, 2016. Study-specific relative risks (RRs) with corresponding 95% confidence interval (CI) from individual studies were pooled by using random- or fixed- model, and heterogeneity and publication bias analyses were conducted. Data from 62 observational studies, 49 studies for nitrates and 51 studies for nitrites, including a total of 60,627 cancer cases were analyzed. Comparing the highest vs. lowest levels, dietary nitrate intake was inversely associated with gastric cancer risk (RR = 0.78; 95%CI = 0.67-0.91) with moderate heterogeneity (I2 = 42.3%). In contrast, dietary nitrite intake was positively associated with adult glioma and thyroid cancer risk with pooled RR of 1.21 (95%CI = 1.03-1.42) and 1.52 (95%CI = 1.12-2.05), respectively. No significant associations were found between dietary nitrate/nitrite and cancers of the breast, bladder, colorectal, esophagus, renal cell, non-Hodgkin lymphoma, ovarian, and pancreas. The present meta-analysis provided modest evidence that positive associations of dietary nitrate and negative associations of dietary nitrite with certain cancers.

  17. A case study in bifurcation theory

    Science.gov (United States)

    Khmou, Youssef

    This short paper is focused on the bifurcation theory found in map functions called evolution functions that are used in dynamical systems. The most well-known example of discrete iterative function is the logistic map that puts into evidence bifurcation and chaotic behavior of the topology of the logistic function. We propose a new iterative function based on Lorentizan function and its generalized versions, based on numerical study, it is found that the bifurcation of the Lorentzian function is of second-order where it is characterized by the absence of chaotic region.

  18. The Pendulum A Case Study in Physics

    CERN Document Server

    Baker, Gregory L

    2005-01-01

    The pendulum: a case study in physics is a unique book in several ways. Firstly, it is a comprehensive quantitative study of one physical system, the pendulum, from the viewpoint of elementary and more advanced classical physics, modern chaotic dynamics, and quantum mechanics. In addition, coupled pendulums and pendulum analogs of superconducting devices are also discussed. Secondly, this book treats the physics of the pendulum within a historical and cultural context,showing, for example, that the pendulum has been intimately connected with studies of the earth's density, the earth's motion,

  19. The Glioma International Case-Control Study

    DEFF Research Database (Denmark)

    Amirian, E. Susan; Armstrong, Georgina N; Zhou, Renke

    2016-01-01

    Decades of research have established only a few etiological factors for glioma, which is a rare and highly fatal brain cancer. Common methodological challenges among glioma studies include small sample sizes, heterogeneity of tumor subtypes, and retrospective exposure assessment. Here, we briefly...... describe the Glioma International Case-Control (GICC) Study (recruitment, 2010-2013), a study being conducted by the Genetic Epidemiology of Glioma International Consortium that integrates data from multiple data collection sites, uses a common protocol and questionnaire, and includes biospecimen...

  20. Case studies of nurseries in Malawi

    DEFF Research Database (Denmark)

    Namoto, M.; Likoswe, M.G.

    This study of 42 case studies of nurseries was made as part of a major sample survey of 360 nurseries in 6 districts in Malawi. The purpose of the study was to let the small nurseries in the country explain in their own words how they source seed, how and for whom they produce seedlings......, and to explain about their problems and opportunities in the nursery business. The assessment was made within the framework of Improved Seed Supply for Agroforestry in African Countries (ISSAAC), a Danida supported programme implemented in cooperation between Forest & Landscape Denmark and World Agroforestry...

  1. Management & Communication: Project Management Case Study

    CERN Multimedia

    Nathalie Dumeaux

    2004-01-01

    We are pleased to announce the recent launch of a new workshop on Project Management. This is designed for People with budgetary, scheduling and/or organizational responsibilities in a project or a sub-project. The objectives through a management case study specially suited to CERN are: to become familiar with modern management techniques in use for structuring, planning, scheduling, costing and progress monitoring of a project or a sub-project. to understand in-depth issues associated with Deliverable-oriented Project Management, Earned Value Management, Advanced Project Cost Engineering and Project Risk Management. The full description of this workshop can be found here. The next session will be held on 8 October 2004. If you are interested in this workshop, please contact Nathalie Dumeaux, email or 78144. Programme of Seminars October to December 2004 Situation : 21.09.2004 Séminaires bilingues Dates Jours Places disponibles Project Management Case study 8 October 1 oui Intr...

  2. Marketing and clinical trials: a case study

    Directory of Open Access Journals (Sweden)

    Entwistle Vikki A

    2007-11-01

    Full Text Available Abstract Background Publicly funded clinical trials require a substantial commitment of time and money. To ensure that sufficient numbers of patients are recruited it is essential that they address important questions in a rigorous manner and are managed well, adopting effective marketing strategies. Methods Using methods of analysis drawn from management studies, this paper presents a structured assessment framework or reference model, derived from a case analysis of the MRC's CRASH trial, of 12 factors that may affect the success of the marketing and sales activities associated with clinical trials. Results The case study demonstrates that trials need various categories of people to buy in – hence, to be successful, trialists must embrace marketing strategies to some extent. Conclusion The performance of future clinical trials could be enhanced if trialists routinely considered these factors.

  3. Marketing and clinical trials: a case study.

    Science.gov (United States)

    Francis, David; Roberts, Ian; Elbourne, Diana R; Shakur, Haleema; Knight, Rosemary C; Garcia, Jo; Snowdon, Claire; Entwistle, Vikki A; McDonald, Alison M; Grant, Adrian M; Campbell, Marion K

    2007-11-20

    Publicly funded clinical trials require a substantial commitment of time and money. To ensure that sufficient numbers of patients are recruited it is essential that they address important questions in a rigorous manner and are managed well, adopting effective marketing strategies. Using methods of analysis drawn from management studies, this paper presents a structured assessment framework or reference model, derived from a case analysis of the MRC's CRASH trial, of 12 factors that may affect the success of the marketing and sales activities associated with clinical trials. The case study demonstrates that trials need various categories of people to buy in - hence, to be successful, trialists must embrace marketing strategies to some extent. The performance of future clinical trials could be enhanced if trialists routinely considered these factors.

  4. Macroprudential Insurance Regulation: A Swiss Case Study

    Directory of Open Access Journals (Sweden)

    Philippe Deprez

    2016-12-01

    Full Text Available This article provides a case study that analyzes national macroprudential insurance regulation in Switzerland. We consider an insurance market that is based on data from the Swiss private insurance industry. We stress this market with several scenarios related to financial and insurance risks, and we analyze the resulting risk capitals of the insurance companies. This stress-test analysis provides insights into the vulnerability of the Swiss private insurance sector to different risks and shocks.

  5. Macroprudential Insurance Regulation: A Swiss Case Study

    OpenAIRE

    Philippe Deprez; Mario V. Wüthrich

    2016-01-01

    This article provides a case study that analyzes national macroprudential insurance regulation in Switzerland. We consider an insurance market that is based on data from the Swiss private insurance industry. We stress this market with several scenarios related to financial and insurance risks, and we analyze the resulting risk capitals of the insurance companies. This stress-test analysis provides insights into the vulnerability of the Swiss private insurance sector to different risks and sho...

  6. Concentrated Photo Voltaics (CPV: a case study

    Directory of Open Access Journals (Sweden)

    Centro S.

    2015-01-01

    Full Text Available Concentrated PhotoVoltaic (CPV, among green energy solutions, nowadays has the ambition to reach grid-parity without subside. CPV substitutes large areas of expensive semiconductor solar cells, with concentrating optics made of cheap materials. Moreover the cells that are suitable for CPV exhibits an unprecedented efficiency and their technology is progressing every year. A case study project, TwinFocus®, will be presented in detail.

  7. Prototype Development and Redesign: A Case Study

    Science.gov (United States)

    1990-03-01

    deal with difficult problems of leadership , strategy and management." [Ref. 10:p. 1] Admiral Turner feels that using the case study method "will help...placement officer was a Lieutenant Commander or Commander. Often times they came from leadership positions of executive officer equivalence. They were...ting power. Personnel within the computer organizatin who are used to manual methods and potential users of the system are resisting the change and

  8. Marketing and clinical trials: a case study

    OpenAIRE

    Entwistle Vikki A; Snowdon Claire; Garcia Jo; Knight Rosemary C; Shakur Haleema; Elbourne Diana R; Roberts Ian; Francis David; McDonald Alison M; Grant Adrian M; Campbell Marion K

    2007-01-01

    Abstract Background Publicly funded clinical trials require a substantial commitment of time and money. To ensure that sufficient numbers of patients are recruited it is essential that they address important questions in a rigorous manner and are managed well, adopting effective marketing strategies. Methods Using methods of analysis drawn from management studies, this paper presents a structured assessment framework or reference model, derived from a case analysis of the MRC's CRASH trial, o...

  9. Private power financing: a case study

    International Nuclear Information System (INIS)

    Stocker, Albert

    1991-01-01

    The Public Utility Regulatory Power Act (PURPA) in the USA and the UK's Electricity Act passed in 1989 are discussed and the first UK private power project is considered. A case study is presented, and covers the questions of when to approach the bank; banker versus investment bank; project fundamentals; the sponsor and the management team; the strength of the key project agreements; syndication of the project debt; and bank support during construction and operation. (author)

  10. Shuttle Transportation System Case-Study Development

    Science.gov (United States)

    Ransom, Khadijah

    2012-01-01

    A case-study collection was developed for NASA's Space Shuttle Program. Using lessons learned and documented by NASA KSC engineers, analysts, and contractors, decades of information related to processing and launching the Space Shuttle was gathered into a single database. The goal was to provide educators with an alternative means to teach real-world engineering processes and to enhance critical thinking, decision making, and problem solving skills. Suggested formats were created to assist both external educators and internal NASA employees to develop and contribute their own case-study reports to share with other educators and students. Via group project, class discussion, or open-ended research format, students will be introduced to the unique decision making process related to Shuttle missions and development. Teaching notes, images, and related documents will be made accessible to the public for presentation of Space Shuttle reports. Lessons investigated included the engine cutoff (ECO) sensor anomaly which occurred during mission STS-114. Students will be presented with general mission infom1ation as well as an explanation of ECO sensors. The project will conclude with the design of a website that allows for distribution of information to the public as well as case-study report submissions from other educators online.

  11. Pathologic evidence of pseudoexfoliation in cases of in-the-bag intraocular lens subluxation or dislocation.

    Science.gov (United States)

    Liu, Erica; Cole, Scott; Werner, Liliana; Hengerer, Fritz; Mamalis, Nick; Kohnen, Thomas

    2015-05-01

    To provide complete histopathologic evaluation of explanted capsular bags that spontaneously dislocated in the late postoperative period, with the main objective being to assess the presence of pseudoexfoliation (PXF) material. Goethe-University Frankfurt, Frankfurt, Germany, and John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA. Retrospective case series. Standard gross and light microscopy and complete histopathology were performed on explanted subluxated and dislocated capsular bags containing an intraocular lens (IOL) or a capsular tension ring (CTR) and an IOL. Questionnaires were sent to explanting surgeons, and a patient chart review was performed, when available. The specimens were represented by capsular bags containing an IOL (n = 37) or an IOL-CTR (n = 3). The IOLs included 3-piece hydrophobic acrylic (n = 13), 1-piece hydrophobic acrylic (n = 7), 3-piece silicone (n = 6), 1-piece hydrophilic acrylic (n = 6), 3-piece hydrophilic acrylic (n = 2), and 1-piece poly(methyl methacrylate) (PMMA) (n = 6) designs; all CTRs were PMMA. Soemmering ring formation was mild in 8 specimens, moderate in 18 specimens, and severe in 14 specimens. Excessive contraction of the capsular bag with capsulorhexis phimosis was observed in 24 specimens. Twenty-six specimens had histopathologic evidence of PXF; 13 had a clinical history or evidence of PXF. Pseudoexfoliation might be implicated in a larger proportion of late in-the-bag IOL subluxations and dislocations than previously thought as a result of significant clinical underdiagnosis. This might indicate a need for new considerations during the preoperative and postoperative cataract surgery assessments and follow-up. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  12. The Case for Using Evidence Based Guidelines in Setting Hospital and Public Health Policy

    Directory of Open Access Journals (Sweden)

    Ross Hutchison Francis

    2016-03-01

    Full Text Available Objective: Hospital systems and regulating agencies enforce strict guidelines barring personal items from entering the Operating Room - touting surgical site infections and patient safety as the rationale. We sought to determine whether or not evidence supporting this recommendation exists by reviewing available literature.Background data: Rules and guidelines that are not evidence based may lead to increased hospital expenses and limitations on healthcare provider autonomyMethods: PubMed, Embase, Scopus, Cochrane Library, Web of Science, and CINAHL were searched in order to find articles that correlated personal items in the OR to documented surgical site infections. Articles that satisfied the following criteria were included: (1 studies looking at personal items in the OR such as handbags, purses, badges, pagers, backpacks, jewelry phones, and eyeglasses, etc., but not just operating room equipment; and (2 the primary outcome measure was infection at the surgical site.Results: Seventeen articles met inclusion criteria and were evaluated. Of the 17, the majority did not determine if personal items increased risk for surgical site infection. Only 1 article examined the correlation between a personal item near the operative site and surgical site infection, concluding that wedding rings worn in the OR had no impact on surgical site infections. Most studies examined colonization rates on personal items as potential infection risk; however, no personal items were causally linked to surgical site infection in any of these studies.Conclusion: There is no objective evidence to suggest that personal items in the OR increase risk for surgical site infections.

  13. Ericksonian hypnotherapy for selective mutism: A single-case study.

    Science.gov (United States)

    Cavarra, Mauro; Brizio, Adelina; Gava, Nicoletta

    2017-01-16

    Children affected by selective mutism don't speak in contexts that are unfamiliar to them or in which speaking is expected or required (e.g. school, kindergarten…). Such disorder interferes with the child's normal activities, may have invalidating consequences in the long run if left untreated, is associated to anxious conditions and is considered hard to treat. Contemporary research is still in need of methodologically rigorous outcome studies and the results described in the small number of published randomized controlled trials and retrospective studies indicate cognitive-behavioral interventions lasting 20-24 sessions as the best therapeutic option. This case study, involving a 7-year-old girl, aims at providing preliminary evidence on the effectiveness of Ericksonian hypnosis in the treatment of this condition. A brief review of current evidence is provided. The case was treated by a licensed hypnotherapist, specialized in family therapy, in 5 sessions during the course of 3 months. After 3 months the symptoms of the client were resolved and the diagnosis was no longer applicable. Other improvements regarded her mood, social skills and school performance.  Conclusions: Ericksonian Hypnotherapy lead to the remission of the disorder and to the improvement of the general well being of the client in 5 sessions, a much briefer time span compared to what is reported in current literature. This paper represents the first step in the elaboration of replicable and reliable intervention principles.

  14. Sverdlovsk Anthrax Outbreak: An Educational Case Study

    Science.gov (United States)

    Steele, S. J.; van der Vink, G.

    2002-05-01

    In April and May of 1979 an Anthrax epidemic broke out in the city of Sverdlovsk (now Ekaterinburg) in the former Soviet Union. Sixty-four people were reported to have died from the outbreak, although there is still debate concerning the actual number of victims. While Soviet officials initially attributed this outbreak to contaminated meat, the US Government maintained that the outbreak was due to a leakage from a biological weapons facility. We have created and implemented an undergraduate educational exercise based on the forensic analysis of this event. Students were provided case data of the victims, area satellite images and meteorological data. One goal of the exercise was for students to reconstruct the most probable scenario of events through valid inference based on the limited information and uncertainties associated with the data set. Another goal was to make students sensitive to issues of biological weapons and bioterrorism. The exercise was highly rated by students even before the events of September 11. There is a clear need to educate students, particularly in the sciences, to be aware of the signatures of terrorist activities. Evidence of terrorist activities is more likely to appear from unintended discoveries than from active intelligence gathering. We believe our national security can be enhanced by sensitizing those that monitor the natural environment to the signatures of terrorist activities through the types of educational exercises that we have developed.

  15. [Granulomatous lobular mastitis: a clinicopathologic study of 68 cases].

    Science.gov (United States)

    Cheng, Juan; Du, Yu-tang; Ding, Hua-ye

    2010-10-01

    To study the clinical and pathologic features of granulomatous lobular mastitis (GLM). Sixty-eight cases of GLM were retrieved from the archival file. The clinical data and histologic features were retrospectively reviewed. Sixty-eight patients presented with breast mass. Ulceration in overlying breast skin was seen in 9 cases. Most of the patients had history of breast feeding. None of them had evidence of specific infections involving the breast. The clinical and radiologic features mimicked malignancy. Histologically, GLM was characterized by the presence of non-necrotizing granulomas, usually admixed with neutrophils and associated with benign ductolobular units. The ductolobular architecture was still preserved. The duration of follow up ranged from 6 to 36 months. Four patients suffered from disease recurrence. GLM shows clinical and radiologic features reminiscent of breast cancer. Correct diagnosis requires histologic examination of the biopsy specimens.

  16. Capturing Cultural Glossaries: Case-study II

    Directory of Open Access Journals (Sweden)

    Matete Madiba

    2011-10-01

    Full Text Available

    ABSTRACT: This case-study attempts to present a brief glossary of Northern Sotho medical terms. It is a follow-up of a similar case-study (Madiba, Mphahlele and Kganyago 2003, which was an attempt to capture and present Northern Sotho cooking terms. Case-study I consists of the names for utensils, ingredients and the processes involved in the preparation of cultural dishes. With both these case-studies, the intention has been to use the opportunities availing themselves for the pres-ervation and valorisation of Northern Sotho, including the extension of its corpora to support national dictionary-making processes. The case-study methodology has been very useful for the purposes of this project and the context within which it was undertaken. It aims to provide a model for the collection and presentation of authentic Northern Sotho terminology which otherwise would hardly have been accessible.

    Keywords: CULTURAL GLOSSARY, INDIGENOUS KNOWLEDGE SYSTEMS, CORPUS, OUTCOMES-BASED EDUCATION, ASSESSMENT CRITERIA, TRADITIONAL MEDICAL TERMS, COMMUNICATIVE APPROACH, STRUCTURAL APPROACH, METONYMY, HANDS-ON ACTIVITIES, TASK-BASED LEARNING

    *****

    OPSOMMING: Die totstandbrenging van kulturele woordversamelings: Ge-vallestudie II. Hierdie gevallestudie probeer om 'n beperkte woordelys van Noord-Sotho- mediese terme aan te bied. Dit is 'n voortsetting van 'n soortgelyke gevallestudie (Madiba, Mpha-hlele en Kganyago 2003 wat 'n poging was om Noord-Sothokookterme te versamel en aan te bied. Gevallestudie I bestaan uit die name van gereedskap, bestanddele, en die prosesse betrokke by die voorbereiding van kulturele geregte. Met altwee hierdie gevallestudies was die bedoeling om die geleenthede te gebruik wat hulleself aanbied vir die bewaring en bestendiging van Noord-Sotho, insluitende die uitbreiding van sy korpora om die nasionale woordeboeksamestellingsprosesse te ondersteun. Die gevallestudiemetodologie was baie nuttig vir die doeleindes van

  17. Physics in Industry: A Case Study

    Science.gov (United States)

    Pratt-Ferguson, Ben

    2007-10-01

    Often ignored and sometimes even considered ``black sheep'' by the university & government-lab physicists, many industrial physicists continue making valuable scientific contributions in diverse areas, from computer science to aero and thermo-dynamics, communications, mathematics, engineering, and simulation, to name a few. This talk will focus on what industrial physicists do, what preparations are beneficial to obtaining a first industrial job, and what the business environment is like for physicists. The case study will be that of the author, starting with undergraduate and graduate studies and continuing on to jobs in industry.

  18. Case studies in atomic collision physics

    CERN Document Server

    McDaniel, Earl Wadsworth

    1972-01-01

    Case Studies in Atomic Collision Physics II focuses on studies on the role of atomic collision processes in astrophysical plasmas, including ionic recombination, electron transport, and position scattering. The book first discusses three-body recombination of positive and negative ions, as well as introduction to ionic recombination, calculation of the recombination coefficient, ions recombining in their parent gas, and three-body recombination at moderate and high gas-densities. The manuscript also takes a look at precision measurements of electron transport coefficients and differential cr

  19. Nanomaterial Case Studies: Nanoscale Titanium Dioxide in ...

    Science.gov (United States)

    EPA announced the availability of the final report, Nanomaterial Case Studies: Nanoscale Titanium Dioxide in Water Treatment and in Topical Sunscreen. This report is a starting point to determine what is known and what needs to be known about selected nanomaterials as part of a process to identify and prioritize research to inform future assessments of the potential ecological and health implications of these materials. Two specific applications of nanoscale titanium dioxide (nano-TiO2) are considered: (1) as an agent for removing arsenic from drinking water; and (2) as an active ingredient in topical sunscreen. These case studies are organized around a comprehensive environmental assessment (CEA) framework that combines a product life cycle perspective with the risk assessment paradigm. They are intended to help identify what may need to be known in order to conduct a comprehensive environmental assessment of the potential risks related to nano-TiO2. These “case studies” do not represent completed or even preliminary assessments, nor are they intended to serve as a basis for risk management decisions in the near term on these specific uses of nano TiO2. Rather, the intent is to use this document in developing the scientific and technical information needed for future assessment efforts.

  20. Periodontal disease and spontaneous preterm birth: a case control study

    Directory of Open Access Journals (Sweden)

    Eley Barry

    2006-07-01

    Full Text Available Abstract Background Several studies have suggested an association between periodontal disease and prematurity but this finding has not been consistently observed. Methods Case control study. Cases (n = 50 were women who had delivered after spontaneous preterm labor at Results There was no difference in the proportion of sites with significant attachment loss (≥3 mm: Cases-3.2%, Controls-2.2% p = 0.21. The gingival crevicular fluid concentrations of elastase and gingipain were elevated in cases vs. controls 238.8 uU/ul vs. 159.6 uU/ul p = .007 and 2.70 uU/ul vs. 1.56 uU/ul p = .001. On multivariate analysis, the mean log concentration of elastase, but not of gingipain, remained a significant predictor of preterm labor p = .0.015. Conclusion We found no evidence that clinical periodontal disease is associated with spontaneous preterm birth. Elevated gingival crevicular fluid levels of elastase were associated with preterm birth but further research is needed before this can be assumed to be a causal relationship.

  1. [Burden of proof in medical cases--presumption of fact and prima facie evidence. 1. Burden of proof].

    Science.gov (United States)

    Sliwka, Marcin

    2004-01-01

    The aim of this paper was to present the main rules concerning the burden of proof in polish civil trials, including medical cases. This paper also describes the subject of evidence were presented and explained. The court influence on evidence procedure was also analysed. The effect of the institution of informed consent on burden of proof in polish civil law is also described. This paper includes numerous High Court sentences on evidential and medical issues.

  2. A Case Study in Corporate Social Responsibility

    Directory of Open Access Journals (Sweden)

    Sharon K. Kendrick

    2014-03-01

    Full Text Available This case study promotes analysis through a brief investigation into the role of corporate social responsibility (CSR in the operation of a multinational corporation as evidenced by Google, Inc. The study focuses on a transnational company in order to observe the impact of CSR practice on a global level. The study will present implications of CSR for corporate management, corporate employees, state regulators, shareholders, and customers in general. In addition, the study will discuss consequences of poor CSR compliance for a multinational corporation. Questions for analysis include implications of CSR, employee retention, development of corporate culture, and evaluation of advantages and disadvantages of different CSR approaches. Upon conclusion of the study, suggestions are made for future collaborative efforts in corporate social responsibility as applied to psychological, sociological, and economical motives. Recruiting and training possibilities also present partnership opportunities for best practice sharing in regards to community, civic, and service engagement.

  3. Terahertz applications in cultural heritage: case studies

    Science.gov (United States)

    Giovannacci, D.; Martos-Levif, D.; Walker, G. C.; Menu, M.; Detalle, V.

    2013-11-01

    Terahertz (THz) spectroscopy and imaging is a non-destructive, non-contact, non-invasive technology emerging as a tool for the analysis of cultural heritage. THz Time Domain Spectroscopy (TDS) techniques have the ability to retrieve information from different layers within a stratified sample, that enable the identification of hidden sub-layers in the case of paints and mural paintings. In this paper, we present the THz TDS2 system developed in the European Commission's 7th Framework Program project CHARISMA [grant agreement no. 228330]. Bespoke single processing algorithms; including a deconvolution algorithm can be deployed to increase the resolution and the global performance of the system. The potential and impact of this work is demonstrated through two case studies of mural paintings, where the capability to reveal the stratigraphy of the artworks is demonstrated.

  4. The case study of biomaterials and biominerals

    Science.gov (United States)

    Del Hoyo Martínez, Carmen

    2013-04-01

    The teaching of biomaterials as case study by on-line platform , susceptible to develop both individually and in groups, got different objectives proposed by the European Higher Education System, among which include: participate actively in the teaching-learning process by students, interpreting situations, adapt processes and solutions. It also improves oral and written communication, analytical skills and synthesis and also the ability to think critically. Biomaterials have their origin in biominerals. These are solid inorganic compounds of defined structure, consisting of molecular control mechanisms that operate in biological systems. Its main functions are: structural support, a reservoir of essential elements, sensors, mechanical protection and storage of toxic elements. Following the demand of materials compatible with certain functional systems of our body, developed biomaterials. Always meet the condition of biocompatibility. Should be tolerated by the body and do not provoke rejection. This involves a comprehensive study of physiological conditions and the anatomy of the body where a biomaterial has to be implemented. The possibility of generating new materials from biominerals has a major impact in medicine and other fields could reach as geology, construction, crystallography, etc. While the study of these issues is in its infancy today, can be viewed as an impact on the art and future technology. Planning case study that students would prepare its report for discussion in subgroups. Occurs then the pooling of individual analysis, joint case discussion and adoption by the subgroup of a consensual solution to the problem. The teacher as facilitator and coordinator of the final case analysis, sharing leads to group-wide class and said the unanimous decision reached by the students and gives his opinion on the resolution of the case. REFERENCES D.P. Ausubel. Psicología Educativa. Un punto de vista cognoscitivo. Trillas. Ed. 1983. E.W. Eisner. Procesos

  5. Using Case Studies to Teach About Global Issues, Bali: A Case Study

    Science.gov (United States)

    Oswald, James M.

    1974-01-01

    The South Pacific island of Bali is used as a case study of overpopulation and food shortage. A brief description of the resources, the typical lifestyle of the Balinese farmer, and possible teaching techniques are given. (DE)

  6. Describing Case Study Method and Identifying the Factors that Contribute to the Successful Conduct of Case Studies

    OpenAIRE

    Ahmad H. Juma'h; Mustafa Cavus

    2001-01-01

    This article has attempted to describe case study, the limitations and critiques on case study methodology and how the proponents have responded to these. Our special focus have been on the debate on theory building from case study research, and a framework for conducting case study research as well as the factors for a successful case study research. The overall conclusion is that the case study has been inappropriately used to generate theories.

  7. Present status and problems of radionuclide studies in emergency cases

    International Nuclear Information System (INIS)

    Ogawa, Kiyoshi

    1983-01-01

    Scintigraphy is just right for diagnosing emergency cases due to its noninvasive and simple method, but emergency radionuclide studies have not become practical as a result of difficulty problems. Recently, nuclear medical devices have become easier to use in operations. It is become of this, that I have submitted this report regarding the problems of radionuclide studies in emergency cases. There were 101 cases (1.4 %) out of 7,310 cases for the year period Sept. 1981 - Aug. 1982. The studies consisted of 12 brain imaging cases, 9 plumonary imaging cases, 22 cardiac study cases (cardio-angiography cases 8, 99m-Tc-PYP myocardium imaging cases 12, 201-Tl myocardium imaging cases 2), 12 renal study cases, 11 G.I. blood loss cases, 35 peripheral angiography cases. In the near future, we will have to be ready to perform emergency radionuclide studies if the need arises. (author)

  8. Evidence-based policy learning: the case of the research excellence indicat

    Energy Technology Data Exchange (ETDEWEB)

    Hardeman, S.; Vertesy, D.

    2016-07-01

    Excellence is arguably the single most important concept in academia today, especially when it comes to science policy making. At the same time, however, excellence leads to a great amount of discomfort, leading some to plea for an overall rejection of the concept. The discomfort with excellence reaches its heights whenever proposals are made for measuring it. Yet, especially given the period of professionalization science policy making finds itself in, these same metrics are frequently called upon to legitimate policy interventions. Excellence and its measurement, it seems therefore, is something we can neither life with nor without. This paper offers some middle ground in the debate on excellence and its measurement for science policy purposes. Using the case of the European Commission’s Research Excellence Indicator as an example, we show how the development and use of indicators offers an opportunity for learning in science policy making. Ultimately, therefore, we show how and in what ways measuring excellence can contribute to evidence-based science policy learning in practice. (Author)

  9. Putting Words in Their Mouth: Writing Dialogue for Case Studies

    Science.gov (United States)

    Herreid, Clyde Freeman

    2018-01-01

    This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. This issue discusses dialogue writing guidelines most relevant to case writing.

  10. Deep Attack Weapons Mix Study (DAWMS) Case Study

    National Research Council Canada - National Science Library

    Bexfield, James

    2001-01-01

    .... This report describes the process used to conduct the Deep Attack Weapons Mix Study (DAWMS) in 1995-1997. This case study focuses on the weapons being procured by the Services and whether a joint viewpoint would result in a more effective mix...

  11. Case-Control Studies - An Efficient Observational Study Design

    NARCIS (Netherlands)

    van Stralen, Karlijn J.; Dekker, Friedo W.; Zoccali, Carmine; Jager, Kitty J.

    2010-01-01

    Case-control studies are an efficient research method for investigating risk factors of a disease. The method involves the comparison of the odds of exposure in a patient group with that of the odds of exposure in a control group. As only a minority of the population is included in the study, less

  12. A Case Study Application Of Time Study Model In Paint ...

    African Journals Online (AJOL)

    This paper presents a case study in the development and application of a time study model in a paint manufacturing company. The organization specializes in the production of different grades of paint and paint containers. The paint production activities include; weighing of raw materials, drying of raw materials, dissolving ...

  13. Case studies in organic contaminant hydrogeology

    International Nuclear Information System (INIS)

    Baker, J.A.

    1989-01-01

    The effective management of domestic solid waste and hazardous, toxic, and radioactive waste is a major problem in the area of environmental geology and water sciences throughout the world. A series of case studies is presented of organic contaminants from both solid and hazardous waste disposal facilities to provide examples of these problems. The facilities were investigated to determine risks and liabilities before acquisition, to determine the site hydrogeologic conditions for design of appropriate groundwater monitoring plans, and/or to determine the potential for groundwater contamination. The case studies are of disposal facilities located in glacial tills, carbonaceous weathered clay soils, weathered shale, limestone bedrock, dolomite bedrock, and alluvial and sedimentary deposits. The results of these studies and investigations show certain relationships in the distribution of organic pollutants to the different geologic and hydrogeologic characteristics of each facility. In each of the four case studies, all 129 priority pollutants were analyzed in private wells and/or monitoring wells. The 31 volatile organic compounds (VOCs) of the priority pollutant list were the majority of organic compounds detected. When VOCs are found in groundwater impacted by disposal facilities, they are present in groups and tend to be distributed in patterns based on their relative concentrations. It is rare to find only one or two VOCs from facilities where leakage has been detected. The ethylenes and ethanes appear to be more prevalent and mobile than aromatic VOCs. The aromatics are restricted primarily to leachates and wastes and in monitoring wells located adjacent to facilities. 2 refs., 15 figs

  14. Cancer patient experience, hospital performance and case mix: evidence from England.

    Science.gov (United States)

    Abel, Gary A; Saunders, Catherine L; Lyratzopoulos, Georgios

    2014-01-01

      This study aims to explore differences between crude and case mix-adjusted estimates of hospital performance with respect to the experience of cancer patients. This study analyzed the English 2011/2012 Cancer Patient Experience Survey covering all English National Health Service hospitals providing cancer treatment (n = 160). Logistic regression analysis was used to predict hospital performance for each of the 64 evaluative questions, adjusting for age, gender, ethnic group and cancer diagnosis. The degree of reclassification was explored across three categories (bottom 20%, middle 60% and top 20% of hospitals). There was high concordance between crude and adjusted ranks of hospitals (median Kendall's τ = 0.84; interquartile range: 0.82-0.88). Across all questions, a median of 5.0% (eight) of hospitals (interquartile range: 3.8-6.4%; six to ten hospitals) moved out of the extreme performance categories after case mix adjustment. In this context, patient case mix has only a small impact on measured hospital performance for cancer patient experience.

  15. Mathematical modelling a case studies approach

    CERN Document Server

    Illner, Reinhard; McCollum, Samantha; Roode, Thea van

    2004-01-01

    Mathematical modelling is a subject without boundaries. It is the means by which mathematics becomes useful to virtually any subject. Moreover, modelling has been and continues to be a driving force for the development of mathematics itself. This book explains the process of modelling real situations to obtain mathematical problems that can be analyzed, thus solving the original problem. The presentation is in the form of case studies, which are developed much as they would be in true applications. In many cases, an initial model is created, then modified along the way. Some cases are familiar, such as the evaluation of an annuity. Others are unique, such as the fascinating situation in which an engineer, armed only with a slide rule, had 24 hours to compute whether a valve would hold when a temporary rock plug was removed from a water tunnel. Each chapter ends with a set of exercises and some suggestions for class projects. Some projects are extensive, as with the explorations of the predator-prey model; oth...

  16. Prayer Healing: A Case Study Research Protocol.

    Science.gov (United States)

    Kruijthoff, Dirk J; van der Kooi, Cornelis; Glas, Gerrit; Abma, Tineke A

    2017-01-01

    Context • Prayer healing is a common practice in many religious communities around the world. Even in the highly secularized Dutch society, cases of prayer healing are occasionally reported in the media, often generating public attention. There is an ongoing debate regarding whether such miraculous cures do actually occur and how to interpret them. Objective • The aim of the article was to present a research protocol for the investigation of reported cases of remarkable and/or unexplained healing after prayer. Design • The research team developed a method to perform a retrospective, case-based study of prayer healing. Reported prayer healings can be investigated systematically in accordance with a step-by-step methodology. The focus is on understanding the healing by studying it from multiple perspectives, using both medical judgment and patients' narratives collected by qualitative methods Setting • The study occurred at Vrije Universiteit (VU) and VU Medical Center (Amsterdam, Netherlands) as well as the general medical practice of the first author. Participants • Potential participants could be any individuals in the Netherlands or neighboring countries who claim to have been healed through prayer. The reports of healing came from multiple sources, including the research team's medical practices and their direct vicinities, newspaper articles, prayer healers, and medical colleagues. Outcome Measures • Medical data were obtained before and after prayer. Subsequently, a member of a research team and of a medical assessment committee made a standardized judgment that evaluated whether a cure was clinically remarkable or scientifically unexplained. The participants' experiences and insider perspectives were studied, using in-depth interviews in accordance with a qualitative research methodology, to gain insight into the perceptions and explanations of the cures that were offered by participants and by the members of the medical assessment committee. The

  17. Single-Case Design Research: Building the Evidence-Base in the Field of Education of Deaf and Hard of Hearing Students.

    Science.gov (United States)

    Cannon, Joanna E; Guardino, Caroline; Antia, Shirin D; Luckner, John L

    2016-01-01

    The field of education of deaf and hard of hearing (DHH) students has a paucity of evidence-based practices (EBPs) to guide instruction. The authors discussed how the research methodology of single-case design (SCD) can be used to build EBPs through direct and systematic replication of studies. An overview of SCD research methods is presented, including an explanation of how internal and external validity issues are addressed, and why SCD is appropriate for intervention research with DHH children. The authors then examine the SCD research in the field according to quality indicators (QIs; at the individual level and as a body of evidence) to determine the existing evidence base. Finally, future replication areas are recommended to fill the gaps in SCD research with students who are DHH in order to add to the evidence base in the field.

  18. Identification case of evidence in timber tracing of Pinus radiate, using high-resolution melting (HRM) analysis.

    Science.gov (United States)

    Solano, Jaime; Anabalón, Leonardo; Encina, Francisco

    2016-03-01

    Fast, accurate detection of plant species and their hybrids using molecular tools will facilitate assessment and monitoring of timber tracing evidence. In this study the origin of unknown pine samples is determined for a case of timber theft in the region of Araucania southern Chile. We evaluate the utility of the trnL marker region for species identification applied to pine wood based on High Resolution Melting. This efficient tracing methods can be incorporated into forestry applications such as certification of origin. The object of this work was genotype identification using high-resolution melting (HRM) and trnL approaches for Pinus radiata (Don) in timber tracing evidence. Our results indicate that trnL is a very sensitive marker for delimiting species and HRM analysis was used successfully for genotyping Pinus samples for timber tracing purposes. Genotyping samples by HRM analysis with the trnL1 approach allowed us to differentiate two wood samples from the Pinaceae family: Pinus radiata (Don) and Pseudotsuga menziesii (Mirb.) Franco. The same approach with Pinus trnL wood was not able to discriminate between samples of Pinus radiata, indicating that the samples were genetically indistinguishable, possibly because they have the same genotype at this locus. Timber tracing with HRM analysis is expected to contribute to future forest certification schemes, control of illegal trading, and molecular traceability of Pinus spp. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  19. Wind to Hydrogen in California: Case Study

    Energy Technology Data Exchange (ETDEWEB)

    Antonia, O.; Saur, G.

    2012-08-01

    This analysis presents a case study in California for a large scale, standalone wind electrolysis site. This is a techno-economic analysis of the 40,000 kg/day renewable production of hydrogen and subsequent delivery by truck to a fueling station in the Los Angeles area. This quantity of hydrogen represents about 1% vehicle market penetration for a city such as Los Angeles (assuming 0.62 kg/day/vehicle and 0.69 vehicles/person) [8]. A wind site near the Mojave Desert was selected for proximity to the LA area where hydrogen refueling stations are already built.

  20. Case study: Bioremediation in the Aleutian Islands

    International Nuclear Information System (INIS)

    Steward, K.J.; Laford, H.D.

    1995-01-01

    This case study describes the design, construction, and operation of a bioremediation pile on Adak Island, which is located in the Aleutian Island chain. Approximately 1,900 m 3 of petroleum-contaminated soil were placed in the bioremediation pile. The natural bioremediation process was enhanced by an oxygen and nutrient addition system to stimulate microbial activity. Despite the harsh weather on the island, after the first 6 months of operation, laboratory analyses of soil samples indicated a significant (80%) reduction in diesel concentrations

  1. Reinforcement learning: Solving two case studies

    Science.gov (United States)

    Duarte, Ana Filipa; Silva, Pedro; dos Santos, Cristina Peixoto

    2012-09-01

    Reinforcement Learning algorithms offer interesting features for the control of autonomous systems, such as the ability to learn from direct interaction with the environment, and the use of a simple reward signalas opposed to the input-outputs pairsused in classic supervised learning. The reward signal indicates the success of failure of the actions executed by the agent in the environment. In this work, are described RL algorithmsapplied to two case studies: the Crawler robot and the widely known inverted pendulum. We explore RL capabilities to autonomously learn a basic locomotion pattern in the Crawler, andapproach the balancing problem of biped locomotion using the inverted pendulum.

  2. Case study of nuclear power planning

    International Nuclear Information System (INIS)

    Covarrubias, A.J.; Lane, J.A.

    1976-01-01

    An improved version of the computer programme WASP (Wien Automatic System Planning) is described by the example of a case study. The aim of an optimal power plant development within the economic development is reached over several steps the most important parameters of which are explained in detail. To use the method it is necessary to know and to describe the energy and electricity supply situation of the country referred to. The programme development described has proved to be good in use in an international frame. The IAEA offers its help to all prospected customers in their initial period with the programme WASP. (UA) [de

  3. Makerspaces in Engineering Education: A Case Study

    DEFF Research Database (Denmark)

    Jensen, Lasse Skovgaard; Özkil, Ali Gürcan; Mougaard, Krestine

    2016-01-01

    it by opening makerspaces and adopting elements of the Maker Movement in their offerings. This paper investigates how university driven makerspaces can affect engineering design and product development education trough a case study. We provide our findings based on interviews and data collected from educators......, students the administrative and workshop staff of the makerspace. The findings are used to outline the challenges in incorporating the offerings of makerspaces. By discussing these challenges we identify opportunities for turning university makerspaces into innovation hubs and platforms that can support...

  4. Russian Media Educators: Case Studies Portraits

    Directory of Open Access Journals (Sweden)

    Alexander Fedorov

    2013-01-01

    Full Text Available This article is devoted to case studies of the media education works of some well knowns Russian media educators. The analysis of media educational work of the famous Russian media educators leads us to the conclusion that media education in Russia is developing, building on the synthesis of the aesthetic, socio-cultural, and practical concepts, with a focus on the development of media competence of the audience, mainly school and youth. The enthusiasts of media education, even devoid of substantial public support for its innovative projects, achieve significant and meaningful results.

  5. Metrology in Pharmaceutical Industry - A Case Study

    International Nuclear Information System (INIS)

    Yuvamoto, Priscila D.; Fermam, Ricardo K. S.; Nascimento, Elizabeth S.

    2016-01-01

    Metrology is recognized by improving production process, increasing the productivity, giving more reliability to the measurements and consequently, it impacts in the economy of a country. Pharmaceutical area developed GMP (Good Manufacture Practice) requeriments, with no introduction of metrological concepts. However, due to Nanomedicines, it is expected this approach and the consequent positive results. The aim of this work is to verify the level of metrology implementation in a Brazilian pharmaceutical industry, using a case study. The purpose is a better mutual comprehension by both areas, acting together and governmental support to robustness of Brazilian pharmaceutical area. (paper)

  6. Myonecrosis in Sickle Cell Anemia: Case Study.

    Science.gov (United States)

    Turaga, Lalita Prabha; Boddu, Prajwal; Kipferl, Steve; Basu, Anupam; Yorath, Martin

    2017-01-30

    BACKGROUND Myonecrosis is one of the more poorly studied, painful manifestations of sickle cell crisis. Medical literature is sparse detailing the manifestations and management of such symptoms. In myonecrosis, red cells containing sickle hemoglobin become rigid, resulting in reduced blood flow and myonecrosis. CASE REPORT We present a case study of a patient in sickle cell crisis with an episode of acute pain and swelling to the intrinsic muscles of the foot as a prominent feature of the crises. Although muscle biopsy is considered the gold standard for the diagnosis of myositis or myonecrosis, a low intensity signal on T1 and high intensity signal on T2 at the affected muscle belly can be as conclusive as imaging studies. In an actively sickling patient any invasive intervention should be avoided as it can result in ischemic necrosis of the tissues, due to interruption of capillary flow in end-arteries. CONCLUSIONS Early recognition is critical in sickle cell disease management, allowing for prompt and aggressive fluid resuscitation which remains a cornerstone in the management of most sickle cell vaso-occlusive crises. In this instance, off loading the extremity and early fluid resuscitation resolved the pain and swelling and prevented myonecrosis.

  7. The Misconception of Case-Control Studies in the Plastic Surgery Literature: A Literature Audit.

    Science.gov (United States)

    Hatchell, Alexandra C; Farrokhyar, Forough; Choi, Matthew

    2017-06-01

    Case-control study designs are commonly used. However, many published case-control studies are not true case-controls and are in fact mislabeled. The purpose of this study was to identify all case-control studies published in the top three plastic surgery journals over the past 10 years, assess which were truly case-control studies, clarify the actual design of the articles, and address common misconceptions. MEDLINE, Embase, and Web of Science databases were searched for case-control studies in the three highest-impact factor plastic surgery journals (2005 to 2015). Two independent reviewers screened the resulting titles, abstracts, and methods, if applicable, to identify articles labeled as case-control studies. These articles were appraised and classified as true case-control studies or non-case-control studies. The authors found 28 articles labeled as case-control studies. However, only six of these articles (21 percent) were truly case-control designs. Of the 22 incorrectly labeled studies, one (5 percent) was a randomized controlled trial, three (14 percent) were nonrandomized trials, two (9 percent) were prospective comparative cohort designs, 14 (64 percent) were retrospective comparative cohort designs, and two (9 percent) were cross-sectional designs. The mislabeling was worse in recent years, despite increases in evidence-based medicine awareness. The majority of published case-control studies are not in fact case-control studies. This misunderstanding is worsening with time. Most of these studies are actually comparative cohort designs. However, some studies are truly clinical trials and thus a higher level of evidence than originally proposed.

  8. Field evidence of social influence in the expression of political preferences: the case of secessionists flags in Barcelona.

    Science.gov (United States)

    Parravano, Antonio; Noguera, José A; Hermida, Paula; Tena-Sánchez, Jordi

    2015-01-01

    Models of social influence have explored the dynamics of social contagion, imitation, and diffusion of different types of traits, opinions, and conducts. However, few behavioral data indicating social influence dynamics have been obtained from direct observation in "natural" social contexts. The present research provides that kind of evidence in the case of the public expression of political preferences in the city of Barcelona, where thousands of citizens supporting the secession of Catalonia from Spain have placed a Catalan flag in their balconies and windows. Here we present two different studies. 1) During July 2013 we registered the number of flags in 26% of the electoral districts in the city of Barcelona. We find that there is a large dispersion in the density of flags in districts with similar density of pro-independence voters. However, by comparing the moving average to the global mean we find that the density of flags tends to be fostered in electoral districts where there is a clear majority of pro-independence vote, while it is inhibited in the opposite cases. We also show that the distribution of flags in the observed districts deviates significantly from that of an equivalent random distribution. 2) During 17 days around Catalonia's 2013 national holiday we observed the position at balcony resolution of the flags displayed in the facades of a sub-sample of 82 blocks. We compare the 'clustering index' of flags on the facades observed each day to thousands of equivalent random distributions. Again we provide evidence that successive hangings of flags are not independent events but that a local influence mechanism is favoring their clustering. We also find that except for the national holiday day the density of flags tends to be fostered in facades located in electoral districts where there is a clear majority of pro-independence vote.

  9. Energy management study: A proposed case of government building

    International Nuclear Information System (INIS)

    Tahir, Mohamad Zamhari; Nawi, Mohd Nasrun Mohd; Baharum, Mohd Faizal

    2015-01-01

    Align with the current needs of the sustainable and green technology in Malaysian construction industry, this research is conducted to seek and identify opportunities to better manage energy use including the process of understand when, where, and how energy is used in a building. The purpose of this research is to provide a best practice guideline as a practical tool to assist construction industry in Malaysia to improve the energy efficiency of the office building during the post-production by reviewing the current practice of the building operation and maintenance in order to optimum the usage and reduce the amount of energy input into the building. Therefore, this paper will review the concept of maintenance management, current issue in energy management, and on how the research process will be conducted. There are several process involves and focuses on technical and management techniques such as energy metering, tracing, harvesting, and auditing based on the case study that will be accomplish soon. Accordingly, a case study is appropriate to be selected as a strategic research approach in which involves an empirical investigation of a particular contemporary phenomenon within its real life context using multiple sources of evidence for the data collection process. A Government office building will be selected as an appropriate case study for this research. In the end of this research, it will recommend a strategic approach or model in a specific guideline for enabling energy-efficient operation and maintenance in the office building

  10. Energy management study: A proposed case of government building

    Science.gov (United States)

    Tahir, Mohamad Zamhari; Nawi, Mohd Nasrun Mohd; Baharum, Mohd Faizal

    2015-05-01

    Align with the current needs of the sustainable and green technology in Malaysian construction industry, this research is conducted to seek and identify opportunities to better manage energy use including the process of understand when, where, and how energy is used in a building. The purpose of this research is to provide a best practice guideline as a practical tool to assist construction industry in Malaysia to improve the energy efficiency of the office building during the post-production by reviewing the current practice of the building operation and maintenance in order to optimum the usage and reduce the amount of energy input into the building. Therefore, this paper will review the concept of maintenance management, current issue in energy management, and on how the research process will be conducted. There are several process involves and focuses on technical and management techniques such as energy metering, tracing, harvesting, and auditing based on the case study that will be accomplish soon. Accordingly, a case study is appropriate to be selected as a strategic research approach in which involves an empirical investigation of a particular contemporary phenomenon within its real life context using multiple sources of evidence for the data collection process. A Government office building will be selected as an appropriate case study for this research. In the end of this research, it will recommend a strategic approach or model in a specific guideline for enabling energy-efficient operation and maintenance in the office building.

  11. Energy management study: A proposed case of government building

    Energy Technology Data Exchange (ETDEWEB)

    Tahir, Mohamad Zamhari; Nawi, Mohd Nasrun Mohd [School of Technology Management and Logistics, Universiti Utara Malaysia, 06010 Sintok, Kedah (Malaysia); Baharum, Mohd Faizal [School of Building, Housing and Planning, Universiti Sains Malaysia, 11800 Penang (Malaysia)

    2015-05-15

    Align with the current needs of the sustainable and green technology in Malaysian construction industry, this research is conducted to seek and identify opportunities to better manage energy use including the process of understand when, where, and how energy is used in a building. The purpose of this research is to provide a best practice guideline as a practical tool to assist construction industry in Malaysia to improve the energy efficiency of the office building during the post-production by reviewing the current practice of the building operation and maintenance in order to optimum the usage and reduce the amount of energy input into the building. Therefore, this paper will review the concept of maintenance management, current issue in energy management, and on how the research process will be conducted. There are several process involves and focuses on technical and management techniques such as energy metering, tracing, harvesting, and auditing based on the case study that will be accomplish soon. Accordingly, a case study is appropriate to be selected as a strategic research approach in which involves an empirical investigation of a particular contemporary phenomenon within its real life context using multiple sources of evidence for the data collection process. A Government office building will be selected as an appropriate case study for this research. In the end of this research, it will recommend a strategic approach or model in a specific guideline for enabling energy-efficient operation and maintenance in the office building.

  12. Case Study: Puttin' on the Ritz: How to Put Science into Cases

    Science.gov (United States)

    Herreid, Clyde Freeman

    2017-01-01

    There are multiple ways to put science into a case. This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. This month's issue discusses different ways of presenting science in case studies.

  13. The information needs of occupational therapy students: a case study.

    Science.gov (United States)

    Morgan-Daniel, Jane; Preston, Hugh

    2017-06-01

    This article summarises a case study on the information needs of Masters level Occupational Therapy 5 (OT) students at one English university. A mixed methods questionnaire was used to explore motivators for information-seeking, preferred information resources and barriers inhibiting the satisfaction of information needs. Thirteen recommendations for practice were formulated, focusing on how information professionals can best facilitate OT students' learning and evidence-based research skills in preparation for clinical practice. The study was completed by Jane Morgan-Daniel, who received a Distinction for her work from Aberystwyth University, where she graduated with an MSC in Information and Library Studies in December 2016. She has written this article together with her dissertation supervisor, Hugh Preston. A. M. © 2017 Health Libraries Group.

  14. Collagenous sprue: a clinicopathologic study of 12 cases.

    LENUS (Irish Health Repository)

    Maguire, Aoife A

    2012-02-01

    Collagenous sprue is a rare form of small bowel enteropathy characterized by chronic diarrhea and progressive malabsorption with little data available on its natural history. The pathologic lesion consists of subepithelial collagen deposition associated with variable alterations in villous architecture. The small bowel biopsies of 12 cases were reviewed. Clinical details, celiac serology, and T-cell receptor gene rearrangement study results, when available, were collated. There were 8 females and 4 males (age ranged from 41 to 84 y) who presented with chronic diarrhea and weight loss. Small intestinal biopsies showed subepithelial collagen deposition with varying degrees of villous atrophy and varying numbers of intraepithelial lymphocytes. Four patients had previous biopsies showing enteropathic changes without collagen deposition. Seven cases were associated with collagenous colitis and 1 also had features of lymphocytic colitis. Three patients also had collagen deposition in gastric biopsies. One case was associated with lymphocytic gastritis. Celiac disease (CD, gluten-sensitive enteropathy) was documented in 4 patients. Five patients made a clinical improvement with combinations of a gluten-free diet and immunosuppressive therapy. Two patients died of complications of malnutrition and 1 of another illness. Clonal T-cell populations were identified in 5 of 6 cases tested. Four of these patients improved clinically after treatment but 1 has died. Collagenous sprue evolved on a background of CD in 4 cases. There was no history of CD in others and these cases may be the result of a biologic insult other than gluten sensitivity. None has developed clinical evidence of lymphoma to date.

  15. A postural `stressed` cerebral HMPAO case study

    Energy Technology Data Exchange (ETDEWEB)

    Williams, R.C.; Jost, G.M.; Bolitho, L.; Grantham, M. [Wangaratta District Hospital, VIC (Australia)

    1998-03-01

    Full text: This case study represents an example of the utility of postural hypoperfusion stressed HMPAO SPECT. An elderly woman of 78 with a long history of giddiness was referred to our laboratory for examination of possible cerebral ischaemia. She had recurrent dizzy episodes, sometimes posture related, over the past few years and had suffered several falls. Cerebral DSA revealed minimal disease. CT scans were reported as normal. Carotid duplex Doppler studies revealed bilateral plaque disease in the carotid bulbs extending to the origins of the ICAs which were not significant stenoses. Postural symptoms were induced by standing the patient up rapidly and HMPAO was administered at the same time. A SPECT scan of the brain was performed. Quantitative analysis showed a left to right decrease of 10.8% in the temporo-occipital area, 5.6% in the temporo-parietal area and 2.5% in the cerebellar and parietal areas. Images revealed moderately reduced tracer concentration in the left half of the cerebellum and the left occipital region extending as far forward as the temporo-parietal region A repeat HMPAO SPECT scan without stress was normal. This would appear to indicate reversible ischaemia in the left posterior region, and is consistent with the reported symptoms. This case illustrates the usefulness of HMPAO in the diagnosis of reversible cerebral ischaemia.

  16. Sacroiliac joint dysfunction: a case study.

    Science.gov (United States)

    Murray, William

    2011-01-01

    Pain is a widespread issue in the United States. Nine of 10 Americans regularly suffer from pain, and nearly every person will experience low back pain at one point in their lives. Undertreated or unrelieved pain costs more than $60 billion a year from decreased productivity, lost income, and medical expenses. The ability to diagnose and provide appropriate medical treatment is imperative. This case study examines a 23-year-old Active Duty woman who is preparing to be involuntarily released from military duty for an easily correctable medical condition. She has complained of chronic low back pain that radiates into her hip and down her leg since experiencing a work-related injury. She has been seen by numerous providers for the previous 11 months before being referred to the chronic pain clinic. Upon the first appointment to the chronic pain clinic, she has been diagnosed with sacroiliac joint dysfunction. This case study will demonstrate the importance of a quality lower back pain assessment.

  17. Delivering Online Examinations: A Case Study

    Directory of Open Access Journals (Sweden)

    John MESSING

    2004-07-01

    Full Text Available Delivering Online Examinations: A Case Study Jason HOWARTH John MESSING Irfan ALTAS Charles Sturt University Wagga Wagga-AUSTRALIA ABSTRACT This paper represents a brief case study of delivering online examinations to a worldwide audience. These examinations are delivered in partnership with a commercial online testing company as part of the Industry Master’s degree at Charles Sturt University (CSU. The Industry Master’s degree is an academic program for students currently employed in the IT industry. Using Internet Based Testing (IBT, these students are examined in test centres throughout the world. This offers many benefits. For example, students have the freedom of sitting exams at any time during a designated interval. Computer-based testing also provides instructors with valuable feedback through test statistics and student comments. In this paper, we document CSU’s use of the IBT system, including how tests are built and delivered, and how both human and statistical feedback is used to evaluate and enhance the testing process.

  18. Organisational culture and learning: a case study.

    Science.gov (United States)

    Bell, Elaine

    2013-11-01

    To explore the impact organisational cultures have on the learning experience of student nurses and identify the influencing factors. A case study approach was used. The single case being a Defence School of Health Care Studies (DSHCS) and the multiple units of analysis: student nurses, the lecturers and Student Standing Orders. An in depth three dimensional picture was achieved using multiple data collection methods: interview, survey, observation and document analysis. The findings suggest that the DSHCS is perceived to be a sub-culture within a dominant civilian learning culture. Generally, the students and staff believed that the DSHCS is an excellent learning environment and that the defence students overall are high achievers. The common themes that appeared from the data were image, ethos, environment, discipline, support, welfare and a civilian versus military way of thinking. The learning experience of defence student nurses is very positive and enhanced by the positive learning culture of the civilian Higher Educational Institution. The factors influencing a positive learning experience that can be impacted by the overarching culture are discipline, image, ethos of adult learning, support and welfare. Copyright © 2013 Elsevier Ltd. All rights reserved.

  19. A postural 'stressed' cerebral HMPAO case study

    International Nuclear Information System (INIS)

    Williams, R.C.; Jost, G.M.; Bolitho, L.; Grantham, M.

    1998-01-01

    Full text: This case study represents an example of the utility of postural hypoperfusion stressed HMPAO SPECT. An elderly woman of 78 with a long history of giddiness was referred to our laboratory for examination of possible cerebral ischaemia. She had recurrent dizzy episodes, sometimes posture related, over the past few years and had suffered several falls. Cerebral DSA revealed minimal disease. CT scans were reported as normal. Carotid duplex Doppler studies revealed bilateral plaque disease in the carotid bulbs extending to the origins of the ICAs which were not significant stenoses. Postural symptoms were induced by standing the patient up rapidly and HMPAO was administered at the same time. A SPECT scan of the brain was performed. Quantitative analysis showed a left to right decrease of 10.8% in the temporo-occipital area, 5.6% in the temporo-parietal area and 2.5% in the cerebellar and parietal areas. Images revealed moderately reduced tracer concentration in the left half of the cerebellum and the left occipital region extending as far forward as the temporo-parietal region A repeat HMPAO SPECT scan without stress was normal. This would appear to indicate reversible ischaemia in the left posterior region, and is consistent with the reported symptoms. This case illustrates the usefulness of HMPAO in the diagnosis of reversible cerebral ischaemia

  20. 27 CFR 53.182 - Supporting evidence required in case of tax-paid articles used for further manufacture.

    Science.gov (United States)

    2010-04-01

    ... required in case of tax-paid articles used for further manufacture. 53.182 Section 53.182 Alcohol, Tobacco... articles used for further manufacture. (a) Evidence to be submitted by claimant. No claim for credit or... material in the manufacture or production of, or as a component part of, a second article manufactured or...

  1. Preliminary Evidence for the Off-Label Treatment of Bulimia Nervosa With Psychostimulants: Six Case Reports.

    Science.gov (United States)

    Keshen, Aaron; Helson, Thomas

    2017-07-01

    Psychostimulants have been assessed in bulimia nervosa patients with comorbid attention deficit/hyperactivity disorder (ADHD), but few studies have examined the impact of psychostimulants on bulimia nervosa patients without comorbid ADHD. The aim of this study was to examine psychostimulants as a potential treatment for bulimia nervosa and to assess the concern of weight loss, given the medication's appetite-suppressing effects. This retrospective study describes 6 case reports of outpatients who were prescribed a psychostimulant specifically for their bulimia nervosa. The number of binge/purge days per months and body mass index were assessed. All patients demonstrated reductions in the number of binge/purge days per month, and 1 patient experienced total remission of bulimic symptoms. Minor fluctuations in weight were observed, but no clinically significant reductions in weight were noted. These findings support the need for clinical trials to examine the efficacy and safety of this potential treatment. © 2017, The American College of Clinical Pharmacology.

  2. Scheduling job shop - A case study

    Science.gov (United States)

    Abas, M.; Abbas, A.; Khan, W. A.

    2016-08-01

    The scheduling in job shop is important for efficient utilization of machines in the manufacturing industry. There are number of algorithms available for scheduling of jobs which depend on machines tools, indirect consumables and jobs which are to be processed. In this paper a case study is presented for scheduling of jobs when parts are treated on available machines. Through time and motion study setup time and operation time are measured as total processing time for variety of products having different manufacturing processes. Based on due dates different level of priority are assigned to the jobs and the jobs are scheduled on the basis of priority. In view of the measured processing time, the times for processing of some new jobs are estimated and for efficient utilization of the machines available an algorithm is proposed and validated.

  3. Location of existing Case Studies on Open Education

    OpenAIRE

    Burke, Siobhan

    2014-01-01

    Members of the Open Education Special Interest Group have collected a selection of short case studies on Open Education. View all of the case studies at http://repository.alt.ac.uk/view/divisions/CaseStudies/ Location of existing Case Studies on Open Education: The following lists aims to capture and amalgamate the various different case study sources which have been created and developed within the UK around experiences of Open Educational Resources.

  4. Once more unto the breech: the firearms evidence in the Sacco and Vanzetti case revisited: Part I.

    Science.gov (United States)

    Starrs, J E

    1986-04-01

    The Sacco and Vanzetti case has a timeless appeal. It raises trenchant issues of the fairness of a criminal trial in the face of the public's hue and cry. It is a sorry reminder that physical evidence must be closeted with care and punctiliously marked for later courtroom uses. Claims of unfairness at the trial of Sacco and Vanzetti have evoked doubts of their guilt. On this issue, a Select Committee of firearms experts in 1983 reevaluated the existing firearms evidence from the Sacco and Vanzetti trial. Its conclusions, a number of which point unerringly to the guilt of Sacco and none of which add a scintilla to the case against Vanzetti, are analyzed in this paper, which is in two parts. Part I sets the stage by focussing on the facts of the crime in South Braintree, MA and the prosecutorial strategies in the use of the firearms evidence at the trial in Dedham, MA. The firearms evidence against Vanzetti is analyzed separately from that marshalled against Sacco. Part II will address the rampant charges of governmental misconduct in the handling of the firearms evidence. A concluding section of Part II reveals startling new evidence relevant to the guilt of Nicola Sacco.

  5. Evidence for gene-environment interaction in a genome wide study of nonsyndromic cleft palate

    DEFF Research Database (Denmark)

    Beaty, Terri H; Ruczinski, Ingo; Murray, Jeffrey C

    2011-01-01

    Nonsyndromic cleft palate (CP) is a common birth defect with a complex and heterogeneous etiology involving both genetic and environmental risk factors. We conducted a genome-wide association study (GWAS) using 550 case-parent trios, ascertained through a CP case collected in an international...... consortium. Family-based association tests of single nucleotide polymorphisms (SNP) and three common maternal exposures (maternal smoking, alcohol consumption, and multivitamin supplementation) were used in a combined 2 df test for gene (G) and gene-environment (G × E) interaction simultaneously, plus...... multiple SNPs associated with higher risk of CP in the presence of maternal smoking. Additional evidence of reduced risk due to G × E interaction in the presence of multivitamin supplementation was observed for SNPs in BAALC on chr. 8. These results emphasize the need to consider G × E interaction when...

  6. Forensic Polygraph in Crime Investigation: A Case Study

    Directory of Open Access Journals (Sweden)

    Aabad Ayoub

    2016-06-01

    Full Text Available A polygraph is an instrument that measures and records physiological changes inside the body. In the absence of a valid physical evidence, polygraphy may be a useful technique to verify truthfulness or detect deception. The present study was conducted to determine the truthfulness of a suspect in a murder case that was referred to PFSA for a polygraph examination. The stomach contents of the examinee and the hyoid bone of the vicvtim were submitted to the department of toxicology and forensic pathology at the PFSA, respectively. In the present study, integrated zone comparison technique (IZCT and forensic assessment interview technique (FAINT designed for specific and multi issue testing were used to examine the suspect. Computerized Academy for Scientific Investigative training (ASIT Algorithm and weighted scoring were applied in IZCT and FAINT scoring, respectively. The suspect of this murder case was brought to PFSA for polygraph examination. During the initial interview, the suspect denied any involvement in the said case. However, after complete polygraph examination, the suspect was proven to have been deceptive and later on confessed to police officials. The polygraph examination of the suspect proved him deceptive which was later confirmed by his confession. His stomach did not contain any toxic/ sedative material.

  7. Where Does Evidence from New Trials for Schizophrenia Fit with the Existing Evidence: A Case of the Emperor's New Clothes?

    Directory of Open Access Journals (Sweden)

    Mahesh Jayaram

    2012-01-01

    Full Text Available Advent of “atypical” antipsychotics has spawned new trials in the recent years and the number of such trial reports has been increasing exponentially. As clinicians we have been led to believe that “atypicals” are better than “typicals” despite the odd dissenting voice in academic and clinical circles. This has been largely ignored until the publication of two landmark, independent, pragmatic trials, Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE and Cost Utility of the Latest Antipsychotic Drugs in Schizophrenia Study (CUtLASS, which proved that thoughtfully chosen “typical” antipsychotics were as good as the newer “atypicals.” We pooled “leaving the study early data” from Cochrane Reviews that existed before CATIE and CUtLASS and added data from CATIE and CUtLASS to the pool for a “before and after” comparison. Addition of CATIE and CUtLASS data only led to narrowing of the already existing confidence intervals, merely increasing precision, and decreasing the risk of Type II error. Perhaps surprisingly, CATIE and CUtLASS when pooled with the already existing data showed us that we had chosen to turn a blind eye to findings that already existed. This leads clinicians to question as to whether, in future, we need to feel less guilty about crying out early on that the emperor has no clothes on.

  8. The Effect of Using Case Studies in Business Statistics

    Science.gov (United States)

    Pariseau, Susan E.; Kezim, Boualem

    2007-01-01

    The authors evaluated the effect on learning of using case studies in business statistics courses. The authors divided students into 3 groups: a control group, a group that completed 1 case study, and a group that completed 3 case studies. Results evidenced that, on average, students whom the authors required to complete a case analysis received…

  9. On misunderstandings in connection with case-studies

    DEFF Research Database (Denmark)

    Flyvbjerg, Bent

    2005-01-01

    This article examines five common misunderstandings about case-study research: (1) Theoretical knowledge is more valuable than practical knowledge; (2) One cannot generalize from a single case, therefore the single case study cannot contribute to scientific development; (3) The case study is most...

  10. Stakeholders and Apart Hotels: Multiple Case Study

    Directory of Open Access Journals (Sweden)

    Elizabeth Kyoko Wada

    2012-09-01

    Full Text Available Means of accommodation involve a wide range of social actors and agents, as well as different business models. Management strategies in this sector have been increasingly important for long-term sustainability and competitiveness of business organizations. This study aims to analyze the interactions between apart-hotels and their stakeholders to foster an improvement of services provided, aligning the interface of strategic management from the point of view of managers and their key stakeholders. It is an exploratory study, with qualitative chacter, along with multiple case studies of the following establishments: Travel Inn, Hotels Slaviero and Etoile george v. Brazilian enterprises, which manage lodging facilities with apart-hotel concepts, combining features that enable comparative analysis of the study. For conceptual understanding, this study was based on literature about stakeholders, taking the work of Freeman (1984 and Freeman et al (2010 as main references. The research was conducted through semi-structured interviews with managers of lodging facilities and their key stakeholders and through direct observation and documentation. We found that not all groups of influence are considered in the planning of service flats. However, the organizations surveyed indicated that the market has realized the importance of the groups that exert influence and are influenced by their goals, and are therefore increasingly alert for integration of such groups in their strategic planning.

  11. Embodiment of the Spirit: A Case Study

    Directory of Open Access Journals (Sweden)

    Jan Grimell

    2017-02-01

    Full Text Available Adopting a longitudinal approach to exploring the psychology of the transition from military to civilian life, one case study is presented that adds a spiritual perspective to the transition process. This case study serves as an example representative from a group of participants who have been followed through a research project on identity reconstruction during the transition to civilian life. This individual, not unlike many others within the group, undergoes an unexpected progression of the military I-position of the self throughout the process of becoming a civilian. This study utilizes a dialogical approach to the identity work to further the understanding of longitudinal adjustments to the self. An analysis of the narrative developments and interactions among pre-existing and new I-positions of the self over time has been made based upon three annually conducted interviews spanning from 2014 to 2016. The results lead to the suggestion that if a military I-position of the self grows more salient and voiced throughout the process of transitioning into civilian life, then this vocalization may be related to the spirit of a person embodied in a specific I-position of the self. Such growth of a military I-position after leaving active service may gravitate around a deep sense of “who I am” with a profound sense of meaning attached to this position. Instead of perceiving as an unwanted development the growth of a military sense of “who I am,” one should acknowledge it as a deeper dimension of self and life. It is important to find an outlet for such a progression of the self so as to sustain balance and dialogue. Future research is encouraged to further examine these qualitative findings.

  12. Betel quid, chewing habits and difficult intubation: A case report and critical appraisal of evidence for practice.

    Science.gov (United States)

    Narendra, P L; Hegde, Harihar V; Vijaykumar, T K; Nallamilli, Samson

    2015-01-01

    Betel quid is used by 10-20% of world of population. Oral submucus fibrosis (OSF) is a chronic premalignant disease common in South Asian countries where betel quid is chewed. It is characterized by juxtaepithelial fibrosis of oral cavity and limited mouth opening, which can cause difficult intubation. A recent study in Taiwan has revealed long-term betel nut chewing is not predictor of difficult intubation. We describe two cases of OSF and critically analyze this study and its implications for clinical practice. OSF is now seen in Saudi Arabia and western countries with use of commercial betel quid substitutes. Although betel quid without tobacco is used in Taiwan, available evidence suggests rapid and early development of OSF where commercial chewing products like Pan Masala are used in India. Effects of betel quid may vary depending on the composition of quid and chewing habits. Studies where personal habits are involved must be analyzed carefully for external validity. Even though, Taiwan study is controlled, its validity outside Taiwan is highly questionable. Since OSF can cause unanticipated difficult intubation, thus during preanesthetic assessment, history of betel quid chewing, more importantly use of commercial chewing products is more likely to give clues to severity of OSF and possible difficult intubation. Further controlled trails in populations where commercial chewing products are used is necessary to detect association of chewing habits and difficult intubation.

  13. Assessing the Value of Educational Competencies of Healthcare Leaders and Organizational Factors: A Case Study Analysis

    Science.gov (United States)

    Munz, James A.

    2017-01-01

    This qualitative research study addressed the problem that the healthcare industry has no clear evidence of the academic competencies that influence the attainment of organizational success. The study was based on one case study at a Commission on Accreditation of Healthcare Management Education (CAHME) accredited Masters of Health Administration…

  14. Calcium, snails, and birds: a case study

    Directory of Open Access Journals (Sweden)

    R. Mänd

    2000-10-01

    Full Text Available Recent studies have shown that wild birds breeding in acidified areas have difficulties with obtaining sufficient calcium for their eggshells, and that the cause of it is the shortage of land snails. Many birds have to search for Ca-rich snail shells on a daily basis during egg production. Molluscs depend on litter calcium, which has decreased due to acidification of the environment. Calcium limitation may be a widespread phenomenon also in non-acidified, naturally Ca-poor areas. The problem is that while in the latter areas the time for development of specific adaptations may have been sufficient, then in acidified areas, on the contrary, calcium shortage is a recent phenomenon. Therefore, since the extent of calcium limitation in non-acidified areas is hard to derive from observational data, experimental approach is needed. We provide experimental evidence that specific calcium deficit does affect reproductive traits also in the birds breeding in naturally base-poor habitats. Our study was conducted in a heterogeneous woodland area in Estonia containing deciduous forest patches as well as base-poor pine forest with low snail abundance. Ca supplementation, using snail shell and chicken eggshell fragments, was carried out for pied flycatchers and great tits. Extra calcium affected positively several reproductive traits like egg volume and eggshell thickness, start of breeding, and fledglings’ parameters. The negative relationship between calcium availability and lay-date suggests that birds adjust their breeding tactics to conditions of Ca deficiency, for example, by postponing laying.

  15. Relationship Between Salted Fish Consumption and Nasopharyngeal Carcinoma: An Evidence-based Case Report

    Directory of Open Access Journals (Sweden)

    Ikhwanuliman Putera

    2015-03-01

    Full Text Available Aim: to know the relationship between salted fish consumption and nasopharyngeal carcinoma (NPC. Methods: we searched for the articles from PubMed® and ScienceDirect® based on our clinical question. After filtered with our in- and exclusion criteria, we had six articles about this topic, all of them were case-control studies. All articles were then critically appraised for their validity, importance, and applicability. Results: there was no consistent relationship between salted fish consumption and NPC. Worth to note that those studies wo showed the firm relationship were conducted in Southern China, where the incidence of NPC was extremely high and related to specific Chineese-style salted fish consumption. Conclusion: there was an inconsistent relationship between salted fish consumption and NPC. Key words: salted fish, risk factor, nasopharyngeal carcinoma.

  16. Quantifying Relevance of Mobile Digital Evidence As They Relate to Case Types: A Survey and a Guide for Best Practices

    Directory of Open Access Journals (Sweden)

    Shahzad Saleem

    2014-09-01

    Full Text Available In this work, a survey was conducted to help quantify the relevance of nineteen types of evidence (such as SMS to seven types of digital investigations associated with mobile devices (MD (such as child pornography. 97 % of the respondents agreed that every type of digital evidence has a different level of relevance to further or solve a particular investigation. From 55 serious participants, a data set of 5,772 responses regarding the relevance of nineteen types of digital evidence for all the seven types of digital investigations was obtained. The results showed that (i SMS belongs to the most relevant type of digital evidence for all the seven types of investigations, (ii MMS belongs to the most relevant type of digital evidence for all the types of digital investigations except espionage and eavesdropping where it is the second most relevant type of digital evidence, (iii Phonebook and Contacts is the most relevant type of digital evidence for all types of digital investigations except child pornography, (iv Audio Calls is the most relevant type of digital evidence for all types of digital investigations except credit card fraud and child pornography and (v Standalone Files are the least relevant type of digital evidence for most of the digital investigations. The size of the response data set was fairly reasonable to analyze and then define; by generalization, relevance based best practices for mobile device forensics, which can supplement any forensics process model, including digital triage. For the reliability of these best practices, the impact of responses from the participants with more than five years of experience was analyzed by using one hundred and thirty three (133 instances of One-Way ANOVA tests. The results of this research can help investigators concentrate on the relevant types of digital evidence when investigating a specific case, consequently saving time and effort.

  17. Quality improvement initiatives in a case management service: case study.

    Science.gov (United States)

    Davies, Deborah J

    2015-01-01

    This article explores the importance of quality practices in underpinning the person-centred approach at a Community Options Program (COP) case management service in northern NSW. The NSW community care sector does not have a statutory excellence body to identify, promote and support improved practices and quality and safety across community services, and therefore the COP provider decided to establish a dedicated role to focus on the quality improvement of its service. The subsequent quality improvement initiatives have included mapping the clients' journey through the service, identifying areas to standardise practice, and creating service pathways. The clients' journey was used as the framework to identify where standardised practice was required, and a robust process was implemented to develop over 25 good practice guidelines and tools that addressed the variations in practice and enabled the service pathways to be developed. Prior to trialling the guidelines and tools, staff received education sessions on the anticipated changes to practice, and the practicality and applicability of the guidelines were evaluated at the end of the trials. This information was reviewed and the guidelines were amended accordingly before being rolled out. The guidelines have been in use for over 12 months and have provided the benchmark against which to audit practice, and have resulted in key performance improvements such as an increase in client review rates and a rise in the feedback response rate from clients, with a noticeable shift in the comments about the brokered support worker to acknowledging the role of their case manager. Formalising informal supports for those clients that lived alone also increased, which means these people are less reliant on services and there is a reduced risk of social isolation.

  18. Case Study: Neglected Health Issues in Niger

    Directory of Open Access Journals (Sweden)

    Cameron Neylon

    2017-10-01

    Full Text Available The project “Problemes négligés du système de santé au Niger” focusses on a core set of often-neglected issues that nevertheless have an overall negative impact on health system effectiveness in Niger. For example, poor quality maternal health services result from challenges related to the midwifery profession and from pressures from addressing the effects of illegal termination of pregnancy. Overall health system governance is undermined by weak management of human resources and health information systems as well as problems related to decentralisation of health care provision and dependence on external funding for health projects. LASDEL applies a rapid assessment and qualitative research approach to working with patients and health care professionals to identify the scale and characteristics of these problems. The project goal is to develop an evidence base to support tackling these neglected issues. Développer des recherches sur les « problèmes négligés » dans la gouvernance de la santé, et sur cette base contribuer à des réformes des systèmes de santé permettant une meilleure qualité des soins pour les populations vulnérables. "Develop research on "neglected problems" in the provision of health systems, and through this work, contribute to health system reforms, that provide better quality of care for vulnerable populations." As can be seen above, many of these issues relate to reproductive health and more generally to health issues of disadvantaged groups. Some issues are neglected for political or social reasons meaning that they are not recognised or acknowledged and in some cases are criminalised. Therefore there are profound issues of participant privacy, protection and even safety for this project. Data sharing therefore requires thoughtful anonymisation and selection. The project group is Francophone with limited English language knowledge and the researchers and the context is largely in French. In common with

  19. Visualization studies on evidence-based medicine domain knowledge (series 3): visualization for dissemination of evidence based medicine information.

    Science.gov (United States)

    Shen, Jiantong; Yao, Leye; Li, Youping; Clarke, Mike; Gan, Qi; Li, Yifei; Fan, Yi; Gou, Yongchao; Wang, Li

    2011-05-01

    To identify patterns in information sharing between a series of Chinese evidence based medicine (EBM) journals and the Cochrane Database of Systematic Reviews, to determine key evidence dissemination areas for EBM and to provide a scientific basis for improving the dissemination of EBM research. Data were collected on citing and cited from the Chinese Journal of Evidence-Based Medicine (CJEBM), Journal of Evidence-Based Medicine (JEBMc), Chinese Journal of Evidence Based Pediatrics (CJEBP), and the Cochrane Database of Systematic Reviews (CDSR). Relationships between citations were visualized. High-frequency key words from these sources were identified, to build a word co-occurrence matrix and to map research subjects. CDSR contains a large collection of information of relevance to EBM and its contents are widely cited across many journals, suggesting a well-developed citation environment. The content and citation of the Chinese journals have been increasing in recent years. However, their citation environments are much less developed, and there is a wide variation in the breadth and strength of their knowledge communication, with the ranking from highest to lowest being CJEBM, JEBMc and CJEBP. The content of CDSR is almost exclusively Cochrane intervention reviews examining the effects of healthcare interventions, so it's contribution to EBM is mostly in disease control and treatment. On the other hand, the Chinese journals on evidence-based medicine and practice focused more on areas such as education and research, design and quality of clinical trials, evidence based policymaking, evidence based clinical practice, tumor treatment, and pediatrics. Knowledge and findings of EBM are widely communicated and disseminated. However, citation environments and range of knowledge communication differ greatly between the journals examined in this study. This finds that Chinese EBM has focused mainly on clinical medicine, Traditional Chinese Medicine, pediatrics, tumor

  20. Logistics opportunity costs: A mining case study

    Directory of Open Access Journals (Sweden)

    Leani van Jaarsveld

    2013-11-01

    Full Text Available This study highlighted the importance of determining the impact that an ineffective mode of transport has on a firm’s transportation model and costs. The main focus of this study was to determine the logistics opportunity costs of using road transport within a mining firm. A case study approach was followed, as the investigation aimed to analyse a complex problem experienced by one company and present it in an easily understandable format. From the results of this study, it was apparent that the logistics opportunity costs associated with the mode of transport was substantial. This highlighted the need for firms to revise their choice of transport mode on a regular basis, as it has a major impact not only on their transportation costs, but also on their inventory holding and carbon emissions. The results also have implications for South Africa’s only freight railway, Transnet Freight Rail, which should not only focus on expanding its existing capacity, but also on improving its customer service delivery whilst containing tariff increases.