Syftet med denna studie var att reliabilitetstesta Alberta Context Tool (ACT) i svensk hälso- och sjukvård och beskriva ortopedsjuksköterskors skattning av kontextuella faktorer såsom ledarskap, arbetskultur, återkoppling, utvecklingsmöjligheter och forskningsanvändning, som kan påverka möjligheten att omsätta forskningsresultat i vårdarbetet. Urvalet bestod av 119 sjuksköterskor som arbetade på ortopediska vårdavdelningar på sex olika sjukhus i mellersta Sverige. ACT är ett frågeformulär framtaget utifrån de senaste årens forskning om vilka faktorer i kontexten som har betydelse för sjuksköterskors forskningsanvändning. Reliabilitetstest gjordes enligt analys med Chronbach`s Alpa och innehållsvaliditet. Resultatet visade att ACT var relevant att användas för sjuksköterskor som arbetar på ortopedisk vårdavdelning i Sverige. Reliabilitetstesten med Chronbach´s Alpa gav värden nära 0,7 för de åtta frågeområden som behandlar kontexten.Sjuksköterskorna rapporterade att det fanns brister i många av de delar av kontexten som enligt forskning visat sig ha betydelse för möjligheten att implementera evidensbaserad vård. Sjuksköterskorna trivdes med sitt arbete och kände att deras kunskaper värderades högt i vårdteamet. Resultatet visade dock att det inte fanns tillräckligt stöd från ledningen för att utveckla vården. De rapporterade att de nästan inte alls fick återkoppling i vårdarbetet. Det saknades stödfunktioner och strategier för att implementering av forskningsresultat skulle vara möjligt att implementera i vårdarbetet. Majoriteten av sjuksköterskorna såg positivt på forskningsanvändning.

Conventional thought dictates that what cannot be measured, cannot be improved. In a quest for improved operational and financial performance, many project-based enterprises have developed numerous methods to measure success. Unfortunately, many of these methods appear to be neither applicable beyond the project boundary nor able to promote effective and proactive decision-making. As a potential remedy, a theoretical framework was developed using principles of Enterprise Engineering to create a performance measurement system for project-based organizations. Known as ARIES (Agile Resource Information and Execution System), the framework builds upon existing project and program management knowledge in order to provide a quantitative methodology for evaluating aspects of enterprise sustainability. By incorporating specific measures, the framework is also able to create a graphical depiction of the enterprises operational performance. To validate the framework, retrospective data were obtained from a successful Architecture and Engineering (A/E) firm that designs and oversees commercial building projects. Analysis of the data provided a picture of the frameworks immediate and long-term benefits for project-based enterprises. From this picture managers can make improved decisions regarding existing and future work, thereby positively impacting the operational performance of the enterprise and enabling it to remain viable over a considerable period of time.

In order to cope with an agricultural economic structure and the development of industrial and commercial use land, the government conducted significant amendment to the Statute for Agricultural Development, adjusting the original ¡§farmland owned by farmers¡¨ and ¡§farmland for agricultural use¡¨ to ¡§releasing farmland owned by farmers¡¨ and ¡§farm building on farmland.¡¨ In addition to loosening the qualifications for the acquisition of farmland, the government also allows for the construction of cluster farm buildings or individual farmhouses. The goal of the policy of cluster farm buildings is established upon the foundation of ¡§production, life, and ecology.¡¨ Regarding production, farmland is not allowed to be segmented, which is beneficial to the promotion of agricultural machinery and rewarding in the expansion of the scale of farmland operation. Regarding everyday life, the construction of well-planned public facilities is able to promote living environment and quality. Regarding ecology, the well-planned management of sewage processing can reduce environmental contamination, protecting the environment. Regarding landscape, the building of farmhouses in a cluster is able to make landscape harmonious. Regarding public investment, the concentration of government funds on a certain area is able to enhance the efficiency of public investment. Although the policy of farm building cluster is made with positive intensions, it is unable to compromise with the current situations of rural areas, rendering problems that affect the growth of rural areas. In fact, these problems have arisen because of the inadequacy of laws and regulations related to rural areas. Therefore, this research examines whether the policy of the construction of farm building cluster can accomplish the three major goals of the sustaining development of rural area and solve the problems of the current problems farm building clusters are facing now and possible solutions. The research employs literature review, secondary source analysis, and on-site investigation as methods. Interviews with various personnel related to the construction of farm buildings, such as administrative, reviewers, scholars, contractor, local farmers, and residents in farm building cluster are conducted with the help of the government. Integrating viewpoints and suggestions from the business, government, and academia, it provides references for the government to promote the amendment of laws and policies related to the construction of farm building cluster in the future. This research discovers that the construction of farm building clusters cannot accomplish its three original goals of ¡§protecting the integrity of farmland, avoiding the loss of excellent farmland, and promoting effective use of farmland¡¨, ¡§enhancing public construction to promote rural area¡¦s additive values, farmers¡¦ living quality, and harmony for the community¡¨, and ¡§avoiding farm buildings in clusters that contaminate farmland, protect ecological environment, and promote harmony in the community.¡¨ In the aspect of production, it suggests the government to 1. Limit the distance between farm buildings and farmland; 2. Prohibit using ¡§forests¡¨ and ¡§reserve areas on slopes¡¨ as farmland; 3. Delimit suitable areas for the construction of farm buildings; 4. Assist utilization of farmland to create production values. In the aspect of everyday life, it suggests 1. Delimit the standard of minimum area for the construction public facilities. In the aspect of ecology, it suggests 1. Build green belts between farm buildings and farmlands; 2. Delimit the standard of sewage discharge testing; 3. Provide funds to assist building ¡§green¡¨ farm buildings; 4. Refurbish old rural areas to make their appearance harmonious with farm building clusters. In the aspect of policy, it suggests 1. Established supervising and monitoring management system; 2. Prohibit the acquisition of farmland for the construction of farm buildings for 2 years to avoid farmland speculation; 3. Publicize laws and policies related to the construction of farm building cluster; 4. Simplify the application procedure of cluster construction; 5. Limit the number of the application of building individual farmhouses; 6. Establish service platform to assist farmers to plan and apply for the construction of farm building clusters by providing instant transparent information.

Research Objectives: Osteoporosis has become a significant public health problem in recent years, especially with the growth of the elderly population. Osteoporotic fractures exact a terrible toll on the population with respect to morbidity, cost, and to a lesser extent mortality. These effects can lead to psychological problems, social consequences, functional limitations, and poor quality of life. Thus, knowledge regarding osteoporotic fractures is needed to evaluate the impact of osteoporotic fractures on society, to identify high-risk populations, and to help policymakers to allocate resources accordingly. This study aims to investigate the influence factors of hospital readmissions among osteoporotic fractures patients in Taiwan, and the study results are expected to increase our understanding of the magnitude of the elderly population suffering from osteoporotic fractures and to urge policymakers to develop effective national prevention strategies. Study Design: Using Taiwan¡¦s National Health Insurance database, we identified elderly patients with a hospitalization for osteoporotic fractures between 2001 and 2007. We divided readmissions into different groups (14-day, 30-day, 180-day and over 180-day) and evaluated each group¡¦s demographic, hospital characteristics, and Charlson Comorbidity Index. The claims data are also used to calculate the health services utilization of osteoporotic fractures among those elderly patients with or without readmission of osteoporotic fractures. The data analyses were carried out by Chi-square test, t test, multiple linear regression and multivariate logistic regression. Population Studied: Patients aged 50 or older with osteoporotic fractures were identified based on the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). Principle Findings: Among 5483 osteoporotic fractures patients, 6.9% of them were readmitted within 14 days, 34.7% were readmitted within 30 days and 13.9% were readmitted within 180 days. The medical resource utilizations were significantly higher in patients with readmissions than those without readmission. Age and Charlson Comorbidity Index were significantly affected the probabilities of readmissions. Conclusion: From the perspective of health policy, the issue of osteoporotic fractures will become increasingly important in the future. This national study will help raise awareness of osteoporotic fractures and hopefully motivate public health policy makers to develop effective national prevention strategies against osteoporosis to prevent osteoporotic fractures.

In the present day, Ad Hoc wireless networks are quite convenient in a local area. But hidden terminal problems and exposed terminal problems exits in Ad Hoc networks. So how to avoid these problems and add channel bandwidth utilization efficiently in MAC (Medium Access Control) layer is a very critical topic. A number of MAC protocols have been presented to overcome these drawbacks, such as RTS / CTS ¡V based and busy tone ¡V based protocol. In this paper, we proposed a dynamic power control scheme, Adjustable Power Control Protocol (APC). APC is based on the concept of power level with broadcasted message. The basic idea is sender should not interfere with other hosts¡¦ going transmissions. Sender would use a suitable power level to send its data so as to overcome above problems. Our simulations show that the channel utilizations of APC is indeed increased in the same time.

The standard IEEE 802.11 MAC protocol assumes that each mobile host uses maximum transmission power for the transmission of each packet. However, energy is very valuable resources for mobile host in ad hoc wireless network. In the past, several researches about power control were proposed. These power control schemes use different power levels and one more separate power control channel in order to save energy, avoid occurrence of collision, and increase network channel utilization. But various power levels lead to each mobile host having different transmission power ranges, and cause the additional hidden terminal problem, namely heterogeneous power terminal problem. Therefore, in this paper, we propose a simple and efficient power control protocol that used dynamic adjustment transmission power ranges to reduce power consumption, avoid collision, increase the network channel utilization, and ease heterogeneous power terminal problem as well.

Due to the separation of Police and Fire Fighting systems, fire control organizations are growing enormously in the recent years, creating heavy workload for the authorities. With the serious shortage of fire fighters in all level of fight control system, the affiliation of military substitute service is a great relief for the fire control societies. Currently, the management of military substitute service and the evaluation of their psychoanalysis still lack of practical methods within the country. This research focuses on the analysis of fire control organizations¡¦ application of military substitute service, management issues, and the psychoanalysis of military substitute service participants. Opinions and background information of participants are collected in large-scale with questionnaires and various methods. Results are evaluated and analyzed to derive logical management patterns, thus develop an ideal scheme to improve the performance of military substitute service participants, as well as maintaining discipline. Defects of existing systems are discussed and improvement strategies are suggested for the fire control authorities to reference for future consideration of military substitute service recruit program.

Recent advances in networking technology have led to a paradigm shift in broadcast media. The entry of the Internet as a form of popular media means that traditional media are now seeking to transform themselves in a bid for survival. Changes in media broadcasting methods have made the spread and acquisition of information faster and easier. Today¡¦s youth of the E-generation live in an economically stable and technologically advanced society. Changes in society, politics and the traditional family structure have made youths an increasingly important market as their buying power and influence on family decisions have increased. The goal of this study is to discover how the subjects of this study utilize various types of media. Media utilization includes their media preferences, utilization frequency and duration as well as where they use it most often. Beyond utilization, the study goes on to examine and categorize the subjects¡¦ lifestyle and media utilization motives. The study then seeks to discover if there are any links between the subjects¡¦ lifestyles and their media utilization motives. Finally, the study examines the question of ¡§Do different lifestyles or media utilization motives lead to differences in media utilization?¡¨ The subjects of this study were E-generation youths (i.e. young people aged between 13 and 22). Taking into consideration the ease of conducting the survey, information availability and cost, Taipei and Kaohsiung (including their counties and cities) were selected as the regions to be sampled. As for the types of media, the five common forms of TV, newspapers, magazines, the Internet and radio were selected for use in this study into media preferences and usage. For this study, the collection of samples was carried out in the form of questionnaire surveys in Taipei and Kaohsiung. After the sample data was acquired, the lifestyles and media utilization motives were categorized and labeled. After factor analysis, lifestyle was divided into four categories: ¡§Community Involvement and Socialization¡¨, ¡§Fashionable and Trendy¡¨, ¡§Pro-Active¡¨ and ¡§Internet Home¡¨; media utilization motives were divided into three types, these being: ¡§Need for Entertainment and Peer Acceptance¡¨, ¡§Need to Increase Knowledge and Skills¡¨ and ¡§Need for Fashion Shopping¡¨. Finally the collected data were subjected to statistical analysis using the SPSS 10.0 software in order to validate the study¡¦s various hypotheses. The results of the study indicated that among youths the media preference was TV first, followed by the Internet. As for frequency of usage, 46.3% of those interviewed used the Internet every day while 41.0% watched TV every day. In terms of duration, those who used the Internet for 5 hours or more made up 24.0% while those who used it for 2 to 4 hours made up 64%. Those who watched TV for 5 hours or more made up 11.6% while those who watched for 2 to 4 hours made up 72.1%. This showed that when it comes to media preferences and utilization, despite youth¡¦s preferences and increasing dependence on the Internet, TV remains an indispensable part of their daily life. By differentiating amongst the sampling locations of this study, it was found that youths in Taipei used the Internet most, followed by TV; the exact reverse was true for youths in Kaohsiung. This showed that their location and environment affected youths¡¦ media preferences. When youths were classified according to their lifestyle, different lifestyles resulted in media utilization motive variances; different media utilization motives also in turn affected how youths utilized media. Based on the above conclusions, the Internet and TV currently remain the types of media that youths are willing to use and devote a great deal of time to. Newspaper, magazine and radio by contrast made up a smaller segment with most youths having significantly less contact with these types of media and spending less time even when they do.

The development and the utility of high-tech medical equipments are increasing relative to the health expenditure growth. These high-tech equipments do not necessary benefit the quality of patient care but increase the service utilization for hospitals. This study aims to describe the difference of equipments distribution between academic medical centers and metropolitan hospitals and to examine the association between the change of the kinds, number, and utility of high-tech medical equipments and the health service utilization. Two databases were used in this study. First, a secondary data from the annual hospital survey published in 2003 and 2004 by Taiwan Hospital Association was used. The data contained information on 8 health service volumes, kinds, number and utility of 17 kinds of high-tech medical equipments, 4 hospital characteristics, and 3 kinds of staff ratio. Second, Statistical Yearbook of Department of Social Affairs, Ministry of Interior provided data on Tthe percentage of 65+ years old population in every location. The 8 kinds of health service volumes varience were designed as dependent variables and the 3 independent variables were separately change of kinds, number and utility of high-tech medical equipments. There were 59 samples, 8 academic medical centers and 51 metropolitan hospitals, included. The t-test showed differences between academic medical centers and metropolitan hospitals in change of kinds, number, utility of high-tech medical equipments and health service volumes varience. Person correlation presented how these variables correlated to each other. Regression analyses predicted the health service utilization from those variables. Generally speaking, the academic medical centers only had significant higher varience of average daily emergency roomvisits¡]t = 3.59, p = 0.01¡^than metropolitan hospitals did but there was no significant difference in 3 independent variables. Besides, correlation among medical equipments, health service utilization and themselves shows that the change of total high-tech medical equipment kinds was significant positive correlated with the change of total number of high-tech medical equipments¡]r = 0.44¡^; the change of total number of high-tech medical equipment was significant positive correlated with average daily emergency roomvisits varience¡]r = 0.28¡^and average daily physical examination of outpatient department visits variance¡]r = 0.30¡^; the average utility of high-tech medical equipment was significant positive correlated with average daily outpatient department visits varience¡]r = 0.27¡^. However, the 3 independent variables have no overall significant effect on change of health service utilization. Based on the above findings, although literature indicated that the kinds and number of high-tech medical equipments somehow might stimulate the demand for health service, we did not find the same results. It could be concluded that hospitals¡¦ purchasing of equipment do not impose a significant impact on raising the medical service utilization. Thus, acquisition of high-tech medical equipment might make a hospital a technological leader or give the public a more professional image whether it can help a hospital raise the service quantity is still left to its management.

Fly ashes generated from fluidized bed combustion of low calorific value, high ash content Turkish lignites are characterized by high content of acidic oxides, such as SiO2, Al2O3 and Fe2O3, varying in the range 50-70%. However, there exists no study for the investigation of the possibility of using these ashes as concrete admixture. Therefore, in this study, characterization of fly ashes from fluidized bed combustion of a Turkish lignite and evaluation of these fly ashes as a substitute for Portland cement in production of pastes and mortars were carried out. The samples were subjected to chemical, physical, mineralogical and morphological analyses. Results of chemical and physical analyses of three fly ash samples show that they satisfy the requirements of EN 197-1, EN 450 and ASTM C 618, except for CaO and SO3, owing to high content of acidic oxides of these ashes contrary to majority of FBC fly ashes reported in the literature. In addition to characterization studies, water requirement, compressive strength, setting time and soundness tests were also performed for 10%, 20% and 30% fly ash-cement blends and the reference cement. Results of these tests reveal that the blends meet compressive strength, setting time and soundness requirements of ASTM C 595 without any pre-hydration treatment, and that fly ashes from fluidized bed combustion of Turkish lignites have significant potential for utilization as an admixture in manufacture of blended cements.