Thesis (doctoral)--University of Helsinki.

Dissertation (Ph.D.)--The University of North Carolina at Greensboro, 2009. / Directed by Gerald Duffy; submitted to the Dept. of Curriculum and Instruction. Title from PDF t.p. (viewed May 10, 2010). Includes bibliographical references (p. 173-180).

Thesis (Ph. D.)--Drexel University, 2005. / Includes abstract and vita. Includes bibliographical references (leaves 120-134).

Abstract Imaging of the head and spine with CT and/or MRI was performed on 125 Northern Finnish NF1 patients to evaluate the CNS lesions in patients of different ages and their role in diagnosis and follow-up. Manifestations of NF1 in the head were more common in children than in adults. 77% of the children and 33% of the adults had T2 hyperintense brain lesions. Optic gliomas were present in 29% of the patients, in 44% of the children and 10 % of the adults. 8% of the patients had other intracranial tumours . Spinal lesions were seen in 75% of the patients. Hyperintense T2 lesions were most common in the age group of 5 to 9 years. During follow-up of the children, the lesions diminished in 25%, remained unchanged in 36%, showed mixed behaviour in 20% and disappeared in 10%. In 15% they increased in size and number. In one patient a malignant tumour developed at the site of a T2 lesion. Optic gliomas were located intraorbitally and/or prechiasmally in 94%, chiasmally and/or at the hypothalamus in 58% and in other optic areas in 14% of the patients. 52 % of the intraorbital gliomas were bilateral. The gliomas remained unchanged in 68% of the children and 50% of the adults. Other lesions included plexiform neurofibromas, sphenoid bone dysplasias and hydrops of the optic sheath. Optic glioma was more common in children with T 2 hyperintense brain lesions than without them. The other brain tumours included six astrocytomas, including an affected mother and her son. In one patient the astrocytoma regressed spontaneously. Hydrocephalus was seen in 5% of the patients. T2 hyperintense brain lesions were more common and numerous in macrocephaly; all macrocephalic children, but only 59% of the normocephalic children were affected. All children without T2 lesions were normocephalic. The brain measurements did not reveal any specific area to be responsible for macrocephaly. Spinal postural changes and dural ectasias were more common in adults. The spinal cord was affected in two patients. Spinal neurofibromas were seen in 19% of the children and 55% of the adults. Even young children may have severe manifestations. In one family a rare familial type of spinal neurofibromatosis (FSNF) was observed in four adults with bilateral spinal neurofibromas at all levels of the spine. Although both CT and MRI were valuable in CNS imaging, MRI proved to be the method of choice in detecting T2 hyperintense brain lesions, in evaluating the intracranial extent of optic gliomas and hydrops of the optic sheath and lesions of the spinal cord and nerves. MR imaging proved necessary for evaluating the extent of NF1 manifestations and helpful in the diagnosis, screening and follow-up of NF1 patients.

No description available.

Follow-up is a natural component of both project management and projects which, curiously enough, the research community has not previously addressed. The purpose of this paper is to investigate the role of the follow-up process in project management. The follow-up process is defined as a process where execution and implementation is improved through the exertion of continuous control. The method used was a multiple-case study, building on data from four organizations actively implementing follow-up processes. The data comprised interviews with project managers from the case organizations, company documentation, annual reports, publicly available information and presentations. The sectors the case organizations operated in were IT services, manufacturing, event organization, and a governmental administrative authority. Five themes emerged from an analysis of the empirical data which were found to influence the follow-up process in projects. The five themes are Documentation, Standardization, Accountability, Learning and Risk Assessment. With insights from the five themes, the research community and project managers can gain a strong understanding of what the follow-up process looks like and its role in project management. The implications for project managers include a better appreciation of the follow-up process and knowledge of the aspects to consider when setting up a new project process. With this paper the authors hope to contribute to the improvement of project management research and practice through a heightened awareness and understanding of the follow-up process.

No description available.

No description available.

抽樣調查是統計學很重要的一部份，抽樣方法恰當與否關係著調查結果的成敗，然而無反應卻是一個很棘手的問題。基於成本考量，一般都會假設其對估計結果不會造成太大的影響，然而事實證明，在很多時候無反應的確會影響到估計結果的準確度，準確度的高低必需與真實母體參數值做比較，我們較難取得真實母體的資訊，所以我們使用模擬的方式在不同情況下來證實使用二次訪問(也就是追蹤調查)其估計結果的準確度較一般訪問(不進行二次訪問)的準確度高出許多。這個結果在某些情況下是特別明顯的，當有反應者與無反應其所包含的資訊差異很大且無反應的比重較高時，一般訪問的估計結果偏誤情況會比二次訪問的估計結果偏誤嚴重。 針對無反應問題，許多學者提出一些補救的方法，例如加權法、插補法等等，然而至今沒有一個較明確且通用的方法可以有效改善無反應的偏誤問題，造成無反應的原因很多，我們只能針對這些可知的原因加以修正調查方式或內容；我們也不能假設有反應者與無反應者所代表的資訊會很相近，進而宣稱“可以只用有反應的樣本來估計母體參數並不會造成太大的偏誤”，我們只能從反應率方面著手來降低偏誤情況，提高反應率是我們可以努力的方向，從開始設計問卷到最後實施調查，中間很多環節都會直接或間接影響到反應率，我們只要針對這些環節多加考慮、規劃，盡可能免除會造成無反應的因素，相信對最後的反應率提高是很有幫助的。另一方面，追蹤訪問也是一個提高反應率的有效方法，針對第一次無反應的有效樣本再次進行重新訪問，如此也可以使偏誤降低，本研究著重在不同情況下進行二次訪問的效率探討及比較。

Background: While the provision of adequate nutrition support in critically ill patients has been shown to have an impact on short-term clinical outcomes, relatively little is known about subsequent long-term outcomes. We aimed to examine the association between nutritional adequacy and long-term outcomes including survival and health-related quality of life (HRQoL) in critically ill patients requiring prolonged mechanical ventilation. Methods: The study was conducted as a retrospective cohort study on data collected prospectively in the context of a multicenter randomized controlled trial (RCT) in critically ill patients. Randomized patients who stayed in the intensive care unit (ICU) and were mechanically ventilated for >8 days were eligible for the study, but only six-month survivors were considered for the assessment of HRQoL. Nutritional adequacy was obtained from the average proportion of prescribed calories received during the first eight days of mechanical ventilation in the ICU. Survival status and HRQoL as assessed using Short-Form 36 Health Survey (SF-36) were obtained prospectively as part of the RCT protocol at three-months and six-months post ICU admission. Results: Of the 1223 patients enrolled in the randomized controlled trial, 475 met the inclusion criteria for this study. At six-month follow-up, 302 of the 475 patients were alive. Among critically ill patients with >8 days of mechanical ventilation in the ICU, survival time in those who received low nutritional adequacy was significantly shorter than for those who received high nutritional adequacy after adjusting for important covariates. Among six-month survivors, clinically meaningful and statistical significant associations between increase in scores of Physical Functioning (PF) and Role Physical domains (RP) of the SF-36 and 25% increase in nutritional adequacy were observed at three-months follow-up. No significant associations were observed at six-months. Conclusions: Our findings suggest that nutritional adequacy received as early as the first week in the ICU seems beneficial to longer survival time and faster physical recovery post ICU discharge in critically ill patients requiring prolonged mechanical ventilation in the ICU. Well-designed randomized controlled trials are needed to provide stronger assessment of the causal impact of nutrition therapy on long-term outcomes. / Thesis (Master, Community Health & Epidemiology) -- Queen's University, 2013-09-28 21:31:40.064