Coordination of Care by Primary Care Practices: Strategies, Lessons and Implications

Documents successful strategies for coordinating care within primary care settings, including family and caregivers; with specialists; with hospital settings; and with community-based services. Discusses challenges, lessons learned, and implications

Arthroscopic Optical Coherence Tomography in Diagnosis of Early Arthritis

Osteoarthritis (OA) is a progressive, debilitating disease that is increasing in prevalence. The pathogenesis of OA is likely multifactorial but ultimately leads to progressive breakdown of collagen matrix and loss of chondrocytes. Current clinical modalities employed to evaluate cartilage health and diagnose osteoarthritis in orthopaedic surgery include, radiography, MRI, and arthroscopy. While these assessment methods can show cartilage fissuring and loss, they are limited in ability to diagnose cartilage injury and degeneration prior breakdown of the articular surface. An improved clinical ability to detect subsurface cartilage pathology is important for development and testing of chondroprotective and chondrorestorative treatments because the pathological changes following surface breakdown are generally considered to be irreversible. Optical Coherence Tomography (OCT), is a novel, non-destructive imaging technology capable of near-real time cross-sectional images of articular cartilage at high resolutions comparable to low power histology. This review discusses a series of bench to bedside studies supporting the potential use of OCT for enhanced clinical diagnosis and staging of early cartilage injury and degeneration. OCT was also found to be useful as a translations research tool to assist in clinical evaluation of novel quantitative MRI technologies for non-invasive evaluation of articular cartilage

Designing and Piloting a Tool for the Measurement of the Use of Pronunciation Learning Strategies

What appears to be indispensable to drive the field forward and ensure that research findings will be comparable across studies and provide a sound basis for feasible pedagogic proposals is to draw up a classification of PLS and design on that basis a valid and reliable data collection tool which could be employed to measure the use of these strategies in different groups of learners, correlate it with individual and contextual variables, and appraise the effects of training programs. In accordance with this rationale, the present paper represents an attempt to propose a tentative categorization of pronunciation learning strategies, adopting as a point of reference the existing taxonomies of strategic devices (i.e. O'Malley and Chamot 1990; Oxford 1990) and the instructional options teachers have at their disposal when dealing with elements of this language subsystem (e.g. Kelly 2000; Goodwin 2001). It also introduces a research instrument designed on the basis of the classification that shares a number of characteristics with Oxford's (1990) Strategy Inventory for Language Learning but, in contrast to it, includes both Likert-scale and open-ended items. The findings of a pilot study which involved 80 English Department students demonstrate that although the tool requires considerable refinement, it provides a useful point of departure for future research into PLS

Marijuana and Youth

This paper contains the first estimates of the price sensitivity of the prevalence of youth marijuana use. Survey data on marijuana use by high school seniors from the Monitoring the Future Project are combined with data on marijuana prices and potency from the Drug Enforcement Administration Office of Intelligence or Intelligence Division. Our estimates of the price elasticity of annual marijuana participation range from 0.06 to 0.47, while those for thirty day participation range from 0.002 to 0.69. These estimates clearly imply that changes in the real, quality adjusted price of marijuana contributed significantly to the trends in youth marijuana use between 1982 and 1998, particularly during the contraction in use from 1982 to 1992. Similarly, changes in youth perceptions of the harms associated with regular marijuana use had a substantial impact on both the contraction in use during the 1982 though 1992 period and the subsequent expansion in use after 1992. These findings underscore the usefulness of considering price in addition to more traditional determinants in any analysis of marijuana consumption decisions made by youths.

In good company: risk, security and choice in young people's drug decisions

This article draws on original empirical research with young people to question the degree to which 'individualisation of risk', as developed in the work of Beck and Giddens, adequately explains the risks young people bear and take. It draws on alternative understandings and critiques of 'risk' not to refute the notion of the reflexive individual upon which 'individualisation of risk' is based but to re-read that reflexivity in a more hermeneutic way. It explores specific risk-laden moments – young people's drug use decisions – in their natural social and cultural context of the friendship group. Studying these decisions in context, it suggests, reveals the meaning of 'risk' to be not given, but constructed through group discussion, disagreement and consensus and decisions taken to be rooted in emotional relations of trust, mutual accountability and common security. The article concludes that 'the individualisation of risk' fails to take adequate account of the significance of intersubjectivity in risk-decisions. It argues also that addressing the theoretical overemphasis on the individual bearer of risk requires not only further empirical testing of the theory but appropriate methodological reflection

Enterprise Accountants, Managerial Status And Gender Salaries

This paper reports on the relationship between salary and a set of explanatory variables for a sample of enterprise (management) accountants. In order to conduct the analysis, a sample was drawn from a large southeastern chapter of the Institute of Management Accountants (IMA). Based upon human capital theory and gender research, different groups of variables are regressed against salary for the 1) sample as a whole; 2) for those enterprise accountants with management status; and 3) for those enterprise accountants without managerial status. Each of the three hypotheses is partially supported. In addition, gender discrimination appears to be limited to non-managers

Scoping studies: towards a methodological framework

This paper focuses on scoping studies, an approach to reviewing the literature which to date has received little attention in the research methods literature. We distinguish between different types of scoping studies and indicate where these stand in relation to full systematic reviews. We outline a framework for conducting a scoping study based on our recent experiences of reviewing the literature on services for carers for people with mental health problems. Where appropriate, our approach to scoping the field is contrasted with the procedures followed in systematic reviews. We emphasize how including a consultation exercise in this sort of study may enhance the results, making them more useful to policy makers, practitioners and service users. Finally, we consider the advantages and limitations of the approach and suggest that a wider debate is called for about the role of the scoping study in relation to other types of literature reviews

A linear programming model for economic planning in New Zealand

A good deal of research into the likely future structure of the New Zealand economy has been carried out in the Agricultural Economics Research Unit. The aim has been to provide realistic quantitative sectoral targets or guidelines to centralised policy making bodies to assist in planning future economic growth in New Zealand. This type of exercise has often been referred to as indicative planning. Until now, the work has entailed the use of an input-output projection model which has come to be known as the Lincoln Model. Briefly, the procedure is to calculate for some future year an economic structure which satisfies the inter-industry relationships and which achieves an exogenously specified increase in the base year consumption level. Economic structure in this context means: the level of output of each sector of the model, the level of exports from each sector, the level of investment by each sector, the level of importing of current and capital goods by each sector. Whenever the Lincoln model has been discussed there has usually been some mention of the optimum economic structure. It has been said that the structure is optimum when resources are so allocated between sectors that the highest level of net national product per head is achieved, consistent with the maintenance of overseas balance of payments equilibrium, full employment and a reasonable growth in incomes per head. While many would question this definition, it is probably a reasonable basis on which to begin investigations into the best future shape of the economy and it is certainly where scrutiny of the projected structure should begin. It has also been suggested that the most efficient method of investigating the nature of an optimum structure is by the use of mathematical programming methods. The purpose of this paper is to demonstrate how the linear programming technique might be used to calculate the optimum economic structure, although it has been found necessary to modify the definition quoted above. Instead of accepting an exogenous target for consumption, programming is used to calculate the maximum level of consumption consistent with the inter-industry relationships and resource availabilities. The need to formulate linear functions has prevented optimisation of consumption per head which would be more acceptable theoretically