INTRODUCTION Antioxidant micronutrients may help alleviate oxidative stress in cystic fibrosis (CF) lung disease. To determine treatment effect, systematic reviews (SR) synthesize available evidence. Cochrane SRs are known for being methodologically rigourous, however, may have limited generalizability. OBJECTIVES To assess effectiveness of antioxidant micronutrients in CF lung disease using Cochrane and non-Cochrane SR methodology; to determine whether Cochrane SRs trade relevance for rigour METHODS The first SR followed Cochrane-preferred methods, while the non-Cochrane SR employed a broader search strategy and nclusion criteria. Reviews were contrasted regarding yield of search, treatment effect (efficacy and safety) and risk of bias. RESULTS Neither SR had enough data to support or refute efficacy or safety of antioxidant supplementation in CF lung disease. Compared to the Cochrane SR, the non-Cochrane SR had four more included studies, more precise estimates of efficacy, additional harms data and a similar risk of bias. CONCLUSION Broader search strategies and inclusion criteria may improve relevance of Cochrane SRs without compromising rigour. / Clinical Epidemiology

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(+)-Neopeltolide is a highly potent marine polyketide natural product with activity against multiple cancer cell lines in vitro. The nanomolar range of antifungal and anticancer cytotoxicity in this tetrahydropyran (THP)-containing polyketide, combined with its limited natural supply, has led to several syntheses. In this study, the feasibility of an oxa-Michael conjugate addition route to cis-2,6-THP rings is examined through the efforts toward a total synthesis of the macrocyclic core of (+)-neopeltolide using a highly convergent route. This study is based on the successful preliminary results with a simple 14-member ring model system and the synthesis of the key aldehyde intermediate shown below. The highlighted transformation of this synthesis will be a transannular oxa-conjugate addition to generate the cis-2,6-tetrahydropyran ring system. This route also highlights a highly convergent Wittig coupling to generate the full carbon framework of (+)-neopeltolide. One of the key goals of this project is to compare this synthesis with a chemo-enzymatic total synthesis that relies on chemistry catalyzed by polyketide synthase enzymes in the late stage of the synthesis.

A major challenge facing communities across the Province of Ontario is the provision of educational facilities for students while balancing community-planning objectives. In recent years, it has become clear that Provincial and local policies coupled with demographic and financial pressures are leading to more closures and the loss of the public resources that are local schools. In the last three years, 172 schools have been slated for closure. In addition, public outcry has grown in volume as the Accommodation Review process is cited as an unsatisfying exercise for all those involved. From a planning perspective, schools are an irreplaceable resource in a community, yet current policy structures have left planners with no power to protect public assets while school boards are limited in the ability to find creative alternative solutions to closure. Therefore, to gain a broader understanding of the policies and processes governing Accommodation Reviews, this research was guided by these key questions: • What roles do school board and provincial policies play in school closure process? • How do these policies affect the pedagogical landscape? • What is the impact of school closures on their respective communities? • How do these educational governance methods compare to community planning policies? • Can school board objectives be reconciled with community planning objectives? These questions were addressed through qualitative surveys and interviews with School Board and Municipal officials and staff. The survey was completed with 39 responses across four communities in Southwest Ontario. The survey and interviews discovered a major gap in the knowledge of local officials pertaining to the comprehensive impact of school closures. In addition, responses spurred further investigation into the policies governing school boards including funding formula and public consultation guidelines. When asked, key respondents pointed to the lack of flexibility and the poor structure of the Province’s Education funding formula as the main challenge for providing educational facilities. In addition, the lack of collaboration between local municipalities and school boards in conjunction with the lack of cohesiveness in Provincial policy mandates from the Ministry of Education and the Ministry of Municipal Affairs were found to ultimately compound the problems and the frustrations associated with the Accommodation Review process. Of the School Board officials surveyed and interviewed, very few saw the need for comprehensive collaboration with municipalities and local residents. However, nearly every planner surveyed or interviewed criticized this mindset as shortsighted and myopic. This paper found that for the provision of public goods, such as education policies, there is a need to provide flexibility for the local context. Municipalities must have a role to play in the process and must collaborate with local School Boards. In addition, the Accommodation Review process is limited by outdated funding policies from the Province and lacks the public empowerment that leads to creative decision-making with involvement of the electorate.

Bakgrund: Cancer som är en livshotande sjukdom orsakar inte bara fysiska symptom utan även psykiska. Sjukdomen medför ovisshet som rör många olika aspekter, så som sjukdomsutveckling, behandling och framtid. Syfte: Syftet med studien är att belysa upplevelser av ovisshet hos personer med cancer. Metod: Studien genomfördes som en litteraturstudie baserad på vetenskapliga artiklar. Sammanlagt användes nio artiklar till resultatet som alla handlade om ovisshet vid cancer. Resultat: Resultatet presenteras i tre huvudkategorier med tillhörande subkategorier. Huvudkategorin Vad är orsaken till sjukdomen? andlar om sjukdomens uppkomst och varför just individen har drabbats. Hur är det att leva med cancer? handlar om personers bristande kunskap om sjukdomen och ovisshet angående behandlingen samt tilliten till vården. Hur ser framtiden ut? handlar om sjukdomens utveckling, behandlingsbiverkningar och omgivningen. Diskussion: I metoddiskussionen granskas studiens metod med hjälp av begreppen överförbarhet, giltighet och trovärdighet. I resultatdiskussionen diskuteras studiens viktigaste fynd. Det som belyses är vikten av information, problematiken till att ta ett beslut om behandling, vikten av tillit till vården och en diskussion angående varför just den enskilde individen har blivit drabbad. / Background: Cancer is a life threatening disease; it causes not only physical symptoms but also psychological. The disease leads to uncertainty in many aspects, such as disease progression, the treatment and the future. Purpose: The aim of this study is to highlight the experiences of uncertainty in people with cancer. Method: The study was conducted as a literature study based on scientific articles. Altogether nine articles where assembled to the results. The articles focused on the experiences of uncertainty in people with cancer. Results: The results are presented in three main categories and related subcategories. What’s the cause of the disease? which includes information about the origin of the disease.  What’s it like to live with cancer? which includes information about people's lack of knowledge, uncertainty about the treatment and trust in health care. What does the future hold? deals with the development of the disease, treatment side effects and surroundings. Discussion:  The method is discussed from the terms transferability, validity and credibility. The results most important findings are discussed: importance of information, the issues about making a treatment decision, the importance of trusting in health care and a discussion about why the individual have become a victim of cancer.

Syfte med detta arbete var attbelysa den aktuella situationen i läkemedelsanvändningen på fyra äldreboende i mellersta Sverige. Studien utvisade, med hjälp av en enkät innehållande 27 frågor, skillnader i åtta sjuksköterskors kunskaper om läkemedel och prioritering av läkemedelsgenomgångar på arbetsplatserna. Granskningen visade även hur många läkemedel som användes genomsnittligt per boendeenhet, hur många fallolyckor som inträffade samt hur ofta och länge sjukhusvård behövdes under den sexmånader långa undersökningsperioden. Dessutom undersöktes om antalet läkemedel och antalet fallolyckor var relaterade till den omvårdnadsansvariga sjuksköterskans kunskaper om läkemedel. Antalet förskrivna läkemedel fanns tillgängliga med hjälp av Apotekens e-dos system. Omvård-nadsansvariga sjuksköterskor tillhandahöll sammanlagt 134 läkemedelslistor. Resultatet visade på basen av läkemedelslistorna på de fyra äldreboende att dessa låg på signifikant olika nivåer beträffande antalet genomsnittligt förskrivna läkemedel per enhet. Vidare skiljde sig sjuksköterskornas kunskaper om läkemedel för äldre åt och kunskaperna relaterade till prioriteringar av läkemedelsgenomgångar, användning av professionella hjälpmedel samt till vilja till utbildning på egen tid. Vidare hade äldreboenden olika antal fallolyckor och utnyttjade i olika grad sjukhusvård. Antal fallolyckor förklarades av antalet förskrivna läkemedel per boende per dag till 95,2 % och följaktligen antal sjukhusdagar förklarades med antal läkemedel per person per dag till 86,5 % men hjälp av linjär regression, modell Enter. Resultatet diskuterades utgående från Dorothea Orems omvårdnadsteori att den äldre har egenvårdsbehov i egen farmakologisk terapi men saknar egenvårdskapacitet i densamma, vilket innebär att sjuksköterskan har största ansvaret att tolka och förmedla patientens läkemedelsbehov.

Before making a purchase, more and more consumers in recent years are consulting other consumers¡¦ product reviews online, to assist them in making a purchasing decision. However, due to the massive amount of online reviews, consumers can hardly get useful information effectively. Hence, information overload has become a problem. Query functions in search engines like Yahoo and Google can help users find some of the reviews that they need for specific information. Nevertheless, the returned pages from these search engines are still beyond the visual capacity of humans. Therefore, this study aims to develop a new concept of personalized recommendation based on consumer product reviews to solve the afore-mentioned problem. A series of laboratory experiment examines the effectiveness of the proposed approach and compares this approach with other traditional approaches on precision of recommendation. Meanwhile, the meaning of the recommendation behind each approach is explained. Lastly, the prototype of recommendation system based on the proposed approach is illustrated. Our system can display the trend of the gathered consumer reviews in a graphical way, such as a product satisfaction run chart. The development of recommendation systems is not only beneficial to consumers, but also advantageous to sellers.

Post-Project Review On Outsourcing Management -- The Case Of National Tax Due to the decreased budget in recent years, our government is pushing forward for outsourcing of the whole process on IT (IT,Information Itecnology) Systems. To cut cost in the developmental stage, to facilitate the integration and sharing of the resources on IT Systems, and to assist the IT Systems industries are the reasons for the outsourcing. The outsourcing is not limited to the application software on IT Systems, but also includes hardware, network equipments and personnel support. In Taiwan, although there was some existing cases in the past, but seldom involved outsourcing of the whole system . ¡§Post-Project Review On Outsourcing Management - The Case Of National Tax.¡¨ is a very good example for the outsourcing of the whole system from the government. In that project, it covered great areas and involved the integration of different groups and units. So, there are many topics worthy of exploring and studying in that project. For the research of the whole system outsourcing, some scholar key in on the successful outcomes, others focus on the project management point of view. The studies from the angle of post-project review process are scarce. The information gathered from the post-project review process are very important, it could serve as reference for government¡¦s future outsourcing projects. Therefore, the subject of this research is focused on the post-project review process. In order to adjust themselves to meet the trend in government projects outsourcing, the companies doing business in the field of Information Technology System Integration in Taiwan are investing heavily, regardless of costs, in offering every possible resources to create the best business opportunities in the future for themselves, and further winning the bid for the outsourcing projects. However, the inexperienced project management in this field and also the lack of prior experience to learn from has created a difficult environment for companies to take on the tasks. While executing the projects, they often act like a rookie on the field or walking on thin ice, one step at a time. Because the lack of precedent to follow, quite often one will encounter unexpected incidents while executing the projects, and this will lead to a huge jump in costs, therefore losing the grip on cost-control mechanism severely. Also in the case of information system outsourcing, the listed products, equipments and services from the vendors can be only considered as references; one must measures the invisible demands from customers on ¡§service satisfaction¡¨. So, one cannot make decision just based on vendors opinions, otherwise, it will just increase the negotiation costs, equipments or miscellaneous expenditures. Using this research as an example, the case involved an outsourcing bid for ¡§Tax information System Outsourcing Plan ¡V National Tax Outsourcing Service¡¨ project from the Bureau of National Tax, Department of Treasury in 1999. The Mitac Inc. won the bid for $1,830,000,000 New Taiwan dollars as a five years integrated outsourcing project. But in the company¡¦s 2001 financial report, they listed a loss of $480,000,000 New Taiwan dollars due to the project. This example made clear that one can no longer compare nowadays outsourcing projects with the old integrated projects. Through the author¡¦s first-hand knowledge of many companies, it was found that due to the complexity of tasks and deadline pressure during the executing of the outsourcing projects, no one could effectively put together in a systematic way of task flowcharts and experiences for future references. The Mitac case is in the finishing stage, so this research is focused on the post-project review, re-examine various task flowcharts, organize and structure them into a systematic way. By doing so, it provides reference information that would benefit corporate managers for their pre-project evaluation in the future. It also provides a track that people can follow when they carry out future outsourcing projects.

According to the empirical study, it is confirmed that physician satisfaction has great influence on patient satisfaction, and the physician¡Vpatient relationship could also affect health quality. The agreeableness and satisfaction of the healthcare providers (especially the physicians) to reimbursement system therefore should be emphasized especially with the intervention of health insurance. The objective of the study is to investigate the agreeableness and satisfaction of dentists to global budgets and their contributing factors. We survey dentists practiced within the Southern Branch and the Kao-Ping Branch regions of the National health insurance bureau with questionnaire. The primary result is as following: 1. The satisfaction of dentists to global budget after implementation: Male dentists are more satisfied than female detests. Dentists over 40 years old or with more than 15 years of practice experience are more satisfied. Solo practitioners are more satisfied than those who are employed or in partnership. Dentists practiced at Kaohsiung city have better stultification within the Kao-Ping Branch region; while the dentists, work in Jia-yi county are more satisfied than those at Tainan city within the Southern Branch region. Dentists with greater patient volume per day or longer business hours per week are less satisfied. Lastly, dentists whose service points claimed per month didn¡¦t decrease after the implementation of global budget are more satisfied with the system. 2. The agreeableness of dentists to global budget after implementation: Male, older dentists agree more with the reimbursement system. Dentists with more or equal service points claimed per month after implementation agree more with the global budget system. But those increase service hours per week are less agreeable to the system. Within the Kao-Ping Branch region, the dentists practice in Pun-hu county, are more agreeable than those at Kaohsiung city; those work in Jia-yi are more in agreement than those at Tainan within the Southern Branch region. Opened questionnaire indicated that surveyed dentists showed negative feedback on t the appropriateness, equity, and standardization of peer review. They further suggested the operation of dental association should be transparent, and the names of the dental clinics should be made known to the public if there¡¦s fraud. Besides, they also made some constructive suggestions such as the establishment of the public record of the oral cavity examination, periodic oral examination, and improvement of professional medical technology. Theses suggestions should be useful to the dental association for professional and quality improvement, standard protocol development and to the Bureau of the National Health Insurance for policy evaluation.

In recent years, upon the urgent request of increasing administrative efficiency by all circles, how to maximize the effect from the limitative resource shall be the goal that every unit of Armed Forces has to labour on. Internal control, internal review and internal auditing can be the unlackable roles In these process. Every unit can reach more outcomes in promoting effect and performing financial resource if use them perfectly. Loopholes that influence the order of financial affairs still occur from time to time. Researcher wants to probe into the roles of supervising in military organization. How can they establish a system which promote what is beneficial and abolish what is harmful to reach the goal of reorganization. This study probes into role performing of accountants by questionnaire method under internal control, internal review and internal auditing system, also referring to related documents as researching tools of this study. The object of the questionnaire will be members of Naval Command and it¡¦s subunits. The result of this study is as follows: 1.There are highly identifications but no differences by point of view from (non)accounts in institution, execution and outcome of internal control, internal review and internal auditing system. 2.In the internal control system, there are no remarkable differences in execution and outcome from gender, age, education, seniority, rank and position of accountants. There are differences in institution from positions of supervisor or non-supervisor. 3.In the internal review system, there are no remarkable differences in institution, execution and outcome from gender, age, education, seniority, rank and position of accountants, which leads a result that the accountants have a highly identification in the internal review roles. 4.In the internal audit system, there are differences in outcome from age and rank of accountants, as well in institution and execution from seniority. Suggestion on the follow-up researcher: 1.Review the limitation and deficient of this study. 2.State to relevant topics which this research institute derive, in order to offer to a follow-up researcher and consult.