518 research outputs found

    Research and education in management of large-scale technical programs

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    A research effort is reported which was conducted by NASA in conjunction with Drexel University, and which was aimed at an improved understanding of large scale systems technology and management

    From Composite Indicators to Partial Orders: Evaluating Socio-Economic Phenomena Through Ordinal Data

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    In this paper we present a new methodology for the statistical evaluation of ordinal socio-economic phenomena, with the aim of overcoming the issues of the classical aggregative approach based on composite indicators. The proposed methodology employs a benchmark approach to evaluation and relies on partially ordered set (poset) theory, a branch of discrete mathematics providing tools for dealing with multidimensional systems of ordinal data. Using poset theory and the related Hasse diagram technique, evaluation scores can be computed without performing any variable aggregation into composite indicators. This way, ordinal scores need not be turned into numerical values, as often done in evaluation studies, inconsistently with the real nature of the phenomena at hand. We also face the problem of \u201cweighting\u201d evaluation dimensions, to account for their different relevance, and show how this can be handled in pure ordinal terms. A specific focus is devoted to the binary variable case, where the methodology can be specialized in a very effective way. Although the paper is mainly methodological, all of the basic concepts are illustrated through real examples pertaining to material deprivation

    Chronic Stress, Sense of Belonging, and Depression Among Survivors of Traumatic Brain Injury

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    To test whether chronic stress, interpersonal relatedness, and cognitive burden could explain depression after traumatic brain injury (TBI). Design : A nonprobability sample of 75 mild-to-moderately injured TBI survivors and their significant others, were recruited from five TBI day-rehabilitation programs. All participants were within 2 years of the date of injury and were living in the community. Methods : During face-to-face interviews, demographic information, and estimates of brain injury severity were obtained and participants completed a cognitive battery of tests of directed attention and short-term memory, responses to the Perceived Stress Scale, Interpersonal Relatedness Inventory, Sense of Belonging Instrument, Neurobehavioral Functioning Inventory, and Center for Epidemiological Studies Depression Scale;. Findings : Chronic stress was significantly and positively related to post-TBI depression. Depression and postinjury sense of belonging were negatively related. Social support and results from the cognitive battery did not explain depression. Conclusions : Postinjury chronic stress and sense of belonging were strong predictors of post-injury depression and are variables amenable to interventions by nurses in community health, neurological centers, or rehabilitation clinics. Future studies are needed to examine how these variables change over time during the recovery process.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72593/1/j.1547-5069.2002.00221.x.pd

    Apparent quality-of-life in nations : how long and happy people live

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    Quality-of-life in nations can be measured by how long and happy people live. This is assessed by combining data on life expectancy drawn from civil registration with survey data on subjective enjoyment of life as a whole. This measure of 'apparent' quality-of-life is a good alternative to current indexes of 'assumed' quality-of-life such as the Human Development Index. Data are available for 67 nations in the 1990s. The number of Happy-Life-Years varies considerably across nations. Switzerland is at the top with 63.0 years and Moldavia at the bottom with 20.5 years. China is in the middle with an average of 46.7. Happy lifetime has risen considerably in advanced nations over the last decade. People live longer and happier in nations characterised by economic affluence, freedom and justice. Together these three societal qualities explain 66% of the cross-national variance in Happy-Life-Years. Income equality and generous social security do not appear to be required for a long and happy life

    Life is Getting Better: Societal Evolution and Fit with Human Nature

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    Human society has changed much over the last centuries and this process of ‘modernization’ has profoundly affected the lives of individuals; currently we live quite different lives from those forefathers lived only five generations ago. There is difference of opinion as to whether we live better now than before and consequently there is also disagreement as to whether we should continue modernizing or rather try to slow the process down. Quality-of-life in a society can be measured by how long and happy its inhabitants live. Using these indicators I assess whether societal modernization has made life better or worse. Firstly I examine findings of present day survey research. I start with a cross-sectional analysis of 143 nations in the years 2000–2008 and find that people live longer and happier in today’s most modern societies. Secondly I examine trends in modern nations over the last decade and find that happiness and longevity have increased in most cases. Thirdly I consider the long-term and review findings from historical anthropology, which show that we lived better in the early hunter-gatherer society than in the later agrarian society. Together these data suggest that societal evolution has worked out differently for the quality of human life, first negatively, in the change from a hunter-gatherer existence to agriculture, and next positively, in the more recent transformation from an agrarian to an industrial society. We live now longer and happier than ever before

    Cross-cultural adaptation and patients' judgments of a Question Prompt List for Italian-speaking cancer patients

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    <p>Abstract</p> <p>Background</p> <p>Question Prompt Lists (QPLs) have proven very effective in encouraging cancer patients to ask questions, allowing them to take up a more active role during visits with the oncologist. As no such tool has yet been validated for Italian-speaking users, we carried out the cross-cultural adaptation and evaluation of an existing Australian Question Prompt List.</p> <p>Methods</p> <p>Cross-cultural adaptation was performed in accordance with the five steps described by Guillemin and Beaton. Forward and back translations of the original tool were carried out, and the products discussed by an Expert Committee who agreed on a prefinal version of the Italian QPL, which was submitted to 30 volunteer patients for evaluation. They rated each question's adequacy of content, clarity of wording, usefulness, and generated anxiety, on a 3-point Likert scale. Based on the analysis of patient ratings, the final version of the Italian QPL was produced.</p> <p>Results</p> <p>Few discrepancies between the two back translations and the original version of the instrument were noted, indicating that the Italian translation (synthesis of the 2 forward translations) was substantially accurate. Most volunteer patients felt that the questionnaire was adequate, easy to understand and useful. Only a few minor criticisms were expressed. Certain questions on diagnosis and prognosis generated the highest level of anxiety. Patient comments and ratings on clarity highlighted the need to clarify common health care terms which are not widely used by the public (i.e. guideline, multidisciplinary team and clinical trial)</p> <p>Conclusions</p> <p>This cross-cultural adaptation has produced an Italian Question Prompt List that is now available for multi-center international studies and can be safely used with Italian-speaking cancer patients.</p

    Upregulation of the Oct3/4 network in basal breast cancer is associated with its metastatic potential and shows tissue dependent variability

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    Adaptive plasticity of Breast Cancer stem cells (BCSCs) is strongly correlated with cancer progression and resistance, leading to a poor prognosis. In this study, we report the expression profile of several pioneer transcription factors of th

    The challenges of communicating research evidence in practice: perspectives from UK health visitors and practice nurses

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    &lt;p&gt;Background: Health practitioners play a pivotal role in providing patients with up-to-date evidence and health information. Evidence-based practice and patient-centred care are transforming the delivery of healthcare in the UK. Health practitioners are increasingly balancing the need to provide evidence-based information against that of facilitating patient choice, which may not always concur with the evidence base. There is limited research exploring how health practitioners working in the UK, and particularly those more autonomous practitioners such as health visitors and practice nurses working in community practice settings, negotiate this challenge. This research provides a descriptive account of how health visitors and practice nurses negotiate the challenges of communicating health information and research evidence in practice.&lt;/p&gt; &lt;p&gt;Methods: A total of eighteen in-depth telephone interviews were conducted in the UK between September 2008 and May 2009. The participants comprised nine health visitors and nine practice nurses, recruited via adverts on a nursing website, posters at a practitioner conference and through recommendation. Thematic analysis, with a focus on constant comparative method, was used to analyse the data.&lt;/p&gt; &lt;p&gt;Results: The data were grouped into three main themes: communicating evidence to the critically-minded patient; confidence in communicating evidence; and maintaining the integrity of the patient-practitioner relationship. These findings highlight some of the daily challenges that health visitors and practice nurses face with regard to the complex and dynamic nature of evidence and the changing attitudes and expectations of patients. The findings also highlight the tensions that exist between differing philosophies of evidence-based practice and patient-centred care, which can make communicating about evidence a daunting task.&lt;/p&gt; &lt;p&gt;Conclusions: If health practitioners are to be effective at communicating research evidence, we suggest that more research and resources need to be focused on contextual factors, such as how research evidence is negotiated, appraised and communicated within the dynamic patient-practitioner relationship.&lt;/p&gt
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