A Multiattribute Analysis of the Commercial Lending Decision

This paper examines the commercial loan decision process from the perspective of the individual loan officer. An analysis of this process concerns the relative effects of various criteria on the loan application and the degree to which tradeoffs are made among them by the loan officer. A basic theory of the process is first developed. The model is then empirically tested using a set of factorially designed combinations of these variables. This format avoids several of the problems previously encountered when the lending process has been empirically examined. The model not only exhibits a high degree of explanatory power but also permits important insights into this process

The Effects on Agriculture in Utah of Water Transfers to Oil Shale Development

In Part I the institutional factors affecting water distribution in the Upper Colorado River Basin in general and specifically the Uintah Basin are presented. The historical development of the appropriation doctrine of water allocation is outlined and Utah water policy is examined. These institutional factors are analyzed in light of the prototype oil shale development in the Uintah Basin and potential impact on the area\u27s agricultural sector. Oil shale water estimates are compared with Uintah Basin water availability and examined with regard to population projections and municipal water use. Lastly, Utah water policy and the appropriation doctrine are viewed as restraints to efficient water transfers. In Part II irrigation water is treated as a random variable. Its actual quantity is not known ahead of time. If transfers of water to oil shale production affect the variability of water used in agriculture then there will be impacts in agriculture even if the farmers receive the same average quantity of water as originally. These impacts are analyzed in the context of the expected utility maximization hypothesis, i.e., the farmers are hypothesized to maximize expected utility. The measure of an increase in variability is the mean preserving spread. The analyses seek to determine the impact upon expected (average) real income (utility), expected profits (net farm income), purchased inputs, the price of water, and the price of land. The analyses are conducted for both the case where the farmers are risk neutral and the case where they are risk averse

The effectiveness of a multidisciplinary foot care program for children and adolescents with juvenile idiopathic arthritis: an exploratory trial

Objectives: To evaluate the effectiveness of multidisciplinary foot-care, and to evaluate the methodological considerations of a trial of multidisciplinary care in juvenile idiopathic arthritis. Design: Exploratory randomised controlled trial. Subjects/Patients: Children/adolescents with juvenile idiopathic arthritis and inflammatory joint disease affecting the foot/ankle. Methods: Standard medical care was compared with a 12 month program of multidisciplinary foot-care informed by musculoskeletal ultrasound. This program was centred on strict disease control through rigorous examination and interventions delivered by a team comprised of a paediatric rheumatologist, podiatrist, physiotherapist and musculoskeletal ultrasonographer. Patients were assessed on foot impairment and disability scores using the Juvenile Arthritis Foot Disability Index. Results: Forty-four participants, aged 3-17 years were randomly assigned to receive the experimental (n = 21) or usual care (n = 23) interventions. There was an overall improvement in levels of foot related impairments in both groups over 12 months. Between-group differences in change scores for the Juvenile Arthritis Foot Disability Index were not statistically significant at 6 or 12 month follow-ups. Conclusion: The integrated multidisciplinary foot care interventions described in this trial were safe, but did not improve foot impairment levels relative to usual care. This trial identified several methodological challenges including recruitment/retention, difficulties with outcome tools and potential confounders.</p

Visualizing the recovery of patients in Critical Care Units

The authors would like to take this opportunity to sincerely thank the Patient for providing us with access to her data. The aim is to provide software support for the clinicians in critical care units. Testing software on artificial data is limited. Therefore, having access to real patient data has enabled this project to bridge the chasm between theory and practice. Thank you very much! This work was carried out as a collaboration between the University of Plymouth and University Hospitals Plymouth NHS Trust, Plymouth. The authors are grateful to both organizations for their support to carry out this research.Peer reviewe

Foot related impairments and disability in juvenile idiopathic arthritis persist despite modern day treatment paradigms

Background: Foot problems such as synovitis, growth disturbance and deformity are considered common in juvenile idiopathic arthritis (JIA) and have been previously reported in over 90% of cases. The medical management of JIA appears to have improved recently however little is known about the impact of new regimes on localised joints such as in the foot. This pilot study aimed to investigate the prevalence of foot related impairments and disability, and survey the medical and podiatric management of patients in a cohort of UK children with JIA. Methods: This study was a tertiary care based cross-sectional survey. Thirty consecutive JIA patients with a history of foot and ankle arthritis completed the juvenile arthritis foot disability index questionnaire (JAFI) (0-4 for each domain), child health assessment questionnaire (CHAQ) (0-3), and pain visual analogue scale (VAS) (0-100mm). Foot deformity score (0-38), active and limited joint counts (0-77) and walking speed (m/s) were measured also recorded. Foot care provision over the previous 12 months was determined from the medical records in 23/ 30 participants. Results were analysed using simple descriptive statistics and expressed as median (range). Results: Children received biologic agents in 35%, DMARDs in 65%, and 90% of participants had received multiple intra-articular cortico-steroid injections. Median (range) values for foot disease outcomes were JAFI impairment = 1 (0-3), JAFI activity limitation = 1 (0-4) JAFI participation restriction 1 (0-3), CHAQ = 0.38 (0-2), VAS pain = 22 (0-79), foot deformity = 6 (0-20), active joints = 0 (0-7), limited joints (0-31), walking speed = 1.09 (0.84- 1.38). The JAFI scores represent mild foot related impairment and disability. Gait defects, deformity or abnormal foot posture, and/or active foot disease were the main reasons for referral. 43% of children received specialist podiatry care comprising footwear advice, orthotic therapy, and silicone digital appliances together with intrinsic muscle strengthening exercises. Conclusions: Despite DMARD/biologic regimes and specialist podiatry, foot related impairment and disability persists in JIA children. Foot care appears to be in line with current recommendations. Further study is required to determine the long-term consequences of these changes found during childhood in the foot

Pamela: development of the RF system for a non-relativistic non-scaling FFAG

The PAMELA project(Particle Accelerator For MEdical Applications) currently consists of the design of a particle therapy facility. The project, which is in the design phase, contains Non-Scaling FFAG, particle accelerator capable of rapid beam acceleration, giving a pulse repetition rate of 1kHz, far beyond that of a conventional synchrotron. To realise the repetition rate, a key component of the accelerator is the rf accelerating system. The combination of a high energy gain per turn and a high repetition rate is a significant challenge. In this paper, options for the rf system of the proton ring and the status of development are presented

Challenging practice traditions to embed education for sustainable development within the engineering curriculum

There has never been a more pressing time than now for Engineering Education for Sustainable Development (EESD). However, Education for Sustainable Development (ESD) remains invisible in most Australian engineering curricula. A common narrative from engineering academics is that ESD is covered by someone else, elsewhere in the curriculum. A similar narrative prevails among 20 interviewed engineers working on an infrastructure project in regional Australia - it’s someone else’s responsibility. This paper builds on the authors’ previous work, which identified a striking resemblance between engineering perceptions of sustainability in an Australian university and on an infrastructure project. The Theory of Practice Architectures (TPA) is used as a conceptual framework to examine the sayings, doings and relatings of 20 engineers and 10 engineering academics interviewed as part of this study. The study found that practice traditions, including masculinity, hierarchical workplaces, and an emphasis on technical competence, constrain sustainability integration in engineering curriculum and in engineering practice. These practice traditions also enable the continuation of narrowly defined engineering work practices, which resist the incorporation of a more holistic approach. Changing practice traditions is not an easy task; however, it is a necessary first step to incorporating ESD within the engineering curriculum

Biexponential diffusion decay in formalin-fixed prostate tissue: Preliminary findings

Magnetic resonance microimaging was used to measure diffusion decay over an extended b-factor range in a formalin-fixed normal prostate sample and a Gleason pattern 3+4 cancer tissue sample. The coefficients of biexponential fits to diffusion decay data from 1600 voxels of dimension 160 x 160 x 160 mu m3 in each sample were correlated with underlying epithelial and stromal compartment partial volumes estimated from high-resolution apparent diffusion coefficient (ADC) data (40 x 40 x 40 mu m3 voxels) from the same tissue. In the normal tissue sample, the signal fractions of the low and high ADC components of the biexponential fits correlated linearly with partial volumes of epithelial tissue (R2 = 0.6) and stromal tissue (R2 = 0.5), respectively. Similar but weaker correlations were observed in the cancer sample. Epithelium-containing high spatial resolution voxels appeared to be composed of similar to 60% low ADC and similar to 40% high ADC component. Stromal voxels appeared to be composed of similar to 20% low ADC and similar to 80% high ADC component. This preliminary report suggests that distinctly different diffusion properties in microscopically adjacent cell types contribute to the multiexponential diffusion decay phenomenon in prostate tissue. Magn Reson Med, 2012. (c) 2011 Wiley Periodicals, Inc