STRUCTURAL DEVELOPMENTS IN THE U.S. GRAINS SUBSECTOR

Industrial Organization,

Clinical Reasoning and Causal Attribution in Medical Diagnosis

Forming a medical diagnosis is a complicated reasoning process undertaken by physicians. Although there has been much research focusing on clinical reasoning approaches, there is limited empirical evidence in relation to causal attribution in medical diagnosis. The research on which this thesis is based explored and examined the social process of medical diagnosis and provides an explanation of the clinical reasoning and causal attribution used by physicians. The research was undertaken in an Emergency Department within an acute hospital, the data were collected using mixed method approach including one to one semi-structured interviews with individual physicians; observation of their medical assessments of patients and secondary data analysis of the subsequent recorded medical notes. The study involved 202 patients and 26 physicians. The analysis of the physicians’ semi-structured interviews, shows how physicians describe the diagnostic step process and how they blend their clinical reasoning skills and professional judgment with evidence-based medicine. Physicians apply prior learning of taught biomedical and pathophysiological knowledge to question patients using pattern recognition of common signs and symptoms of disease. These findings are portrayed through taped narratives of the physician/patient interaction during the medical diagnostic process, which shows how physicians control the medical encounter. The analysis/interpretation of documentary evidence (recorded medical notes) provides an insight into the way in which physicians used the information gathered during the diagnostic step process. By using SPSS it was possible to cluster the cases (individual patients) into groups. This stage-ordered classification procedure demonstrated commonality amongst individual cases whilst highlighting the uniqueness of any cases. A pattern emerged of two groups of cases: Group 1 - comprised of patients with the presenting complaints of chest pain, shortness of breath, collapse, abdominal pain, per rectal bleed, nausea, vascular and neurological problems and Group 2 - comprised of patients presenting with trauma, mechanical falls, miscarriage/gynaecological problems, allergies/rashes and dental problems. Findings show that the clinical reasoning approaches used varied according to the complexity of the patient’s presenting complaint. The recorded medical notes for the patients in Group 1, were comprehensive and demonstrated a combined approach of hypothetic-deductive and probabilistic reasoning which enabled the physicians to deal with the degree of uncertainty that is inherent in medicine. The recorded process in the medical notes was shortened for the majority of patients in Group 2, and here the clinical reasoning approach used was found to deterministic. It is acknowledged, that this is not always the case. By using crisp set QCA it was possible to explore causal conditions consistent with Group 1. Further analysis led to examination of the link of causal conditions presented in the medical notes with the individual impression/working diagnosis made by physicians.Plymouth Universit

King Lear: A Textual and Bibliographic Study

This thesis project examines the printing history of William Shakespeare’s King Lear. The discussion includes the various arguments concerning the authoritative nature of the Quarto 1 and First Folio texts versus those that followed. The study explores the idea that since Q1 and First Folio are considered original or authoritative texts that all others are editions taken from them. While Q1 and First Folio appear to possess marked differences in their text, they must be considered as representing a draft and revision even as neither should be understood as inferior to the other, for each holds authoritative value for Shakespearean scholars. The project also offers a close reading, though not exhaustive, of many areas of the play text, stage directions, and the story’s through line. Through comparison and discussion the project includes a focus on detailed differences found between the various editions of the play to support the thesis of Q1 and First Folio as authoritative in nature

A Comparative Analysis of Cognitive Differences Among Female Elite and Nonelite High School Field Hockey Players and High School Physical Education Class Nonathletes

The Empire State Games Western Scholastic Field Hockey Team (n = 14), a high school field hockey team (n = 15), and nonathletes in a high school physical education class (n = 9) were given a battery of tests and inventories to compare mental aspects such as abstract visual reasoning, concentration, sport-confidence, psychological skills relevant to exceptional performance, and competitive anxiety. Analyses included multivariate analysis of variance for each cognitive category, one way univariate analysis of variance for each subtest within a cognitive category, and a stepwise multiple regression technique to determine which tests made the greatest contribution to predicting group membership. Multiple analysis revealed that the elite group displayed significantly higher sport-confidence and selected psychological skills. Results of a stepwise multiple regression technique indicated that motivation, mental preparation, and team motivation accounted for 67% of the behavioral variance. A subsequent multivariate analysis within just the two field hockey groups revealed that the top half of the elite group displayed significantly higher trait sport-confidence and motivation than the bottom half of the nonelite group. A stepwise multiple regression analysis found that motivation, trait sport-confidence, state sport-confidence, and sequencing of information accounted for 99% of the behavioral variance. The results of this investigation indicated that there are cognitive differences already significant at the high school level, and that these factors influence the development of perceived competence

Strengthening the vitality of New Hope Free Methodist Church through the natural church development approach

https://place.asburyseminary.edu/ecommonsatsdissertations/1162/thumbnail.jp

The 'You're Going to Die!' Joke as a Means of Expressing Homophobia

Notes and Querie