Effects Of Specific Design Features Research Articles

Hemodynamics in Idealized Stented Coronary Arteries: Important Stent Design Considerations.

Stent induced hemodynamic changes in the coronary arteries are associated with higher risk of adverse clinical outcome. The purpose of this study was to evaluate the impact of stent design on wall shear stress (WSS), time average WSS, and WSS gradient (WSSG), in idealized stent geometries using computational fluid dynamics. Strut spacing, thickness, luminal protrusion, and malapposition were systematically investigated and a comparison made between two commercially available stents (Omega and Biomatrix). Narrower strut spacing led to larger areas of adverse low WSS and high WSSG but these effects were mitigated when strut size was reduced, particularly for WSSG. Local hemodynamics worsened with luminal protrusion of the stent and with stent malapposition, adverse high WSS and WSSG were identified around peak flow and throughout the cardiac cycle respectively. For the Biomatrix stent, the adverse effect of thicker struts was mitigated by greater strut spacing, radial cell offset and flow-aligned struts. In conclusion, adverse hemodynamic effects of specific design features (such as strut size and narrow spacing) can be mitigated when combined with other hemodynamically beneficial design features but increased luminal protrusion can worsen the stent’s hemodynamic profile significantly.

Moderators of the effect of weight on job‐related outcomes: a meta‐analysis of experimental studies

AbstractThis study provides the first meta‐analytic testing of (1) several proposed moderators of the relationship between employee weight and job‐related outcomes (e.g., target gender, target qualifications, and rater gender); and (2) the effect of specific design features on the variation in results obtained across relevant experimental studies (e.g., weight manipulation and amount of job‐relevant information). The results indicate that there are important moderators of the relationship between people's weight and job‐related outcomes. However, design feature may significantly influence the obtained results. In particular, inconsistent experimental findings regarding the hypothesized moderating role of target sex appear to be explained by limitations in the way in which target weight was manipulated in some studies. Directions for future research are identified.

What Design Features Are Used in Effective e-Health Interventions? A Review Using Techniques from Critical Interpretive Synthesis

The effectiveness of e-health interventions varies greatly. Despite this, there has been relatively little formal consideration of how differences in the design of an intervention (i.e., how the content is delivered) may explain why some interventions are more effective than others. This review primarily examines the use of the Internet to provide educational and self-management interventions to promote health. The article develops hypotheses about how the design of these interventions may be associated with outcomes. In total, 52 published reports from both a diversity sample and a representative sample were reviewed using techniques from Critical Interpretive Synthesis. Four core interactive design features were identified that may mediate the effects of intervention design on outcomes: Social context and support, contacts with intervention, tailoring, and self-management. A conceptual framework to summarize the design of e-health interventions delivered using the Internet is proposed. The framework provides a guide for systematic research to identify the effects of specific design features on intervention outcomes and to identify the mechanisms underlying any effects. To optimize the design of e-health interventions more work is needed to understand how and why these design features may affect intervention outcomes and to investigate the optimal implementation and dosage of each design feature.

Weighing the Evidence

The optimal of existing research evidence to guide design decisions is referred to as evidence-based design. Sackett, Rosenberg, Gray, Haynes, and Richardson's (1996) well-known definition of evidence- based practice for any discipline is conscientious, explicit, and of current best evidence in making decisions... (p. 71). This definition emphasizes the importance of using evidence, and the judicious use also implies the importance of respecting other factors in design decision making, such as a client's preferences, the project budget, the culture of an organization, and even the community context of the project's location.Evidence-based design is a relatively new science, and we have far more need for evidence than we have available research findings. In fact, there are far more urban myths (accepted truths with no evidence) about the effects of specific design features on outcomes than there is real research evidence. So who and what should we believe when making the million- and sometimes billion-dollar decisions that can affect healthcare delivery for many years to come? We are obligated to build the evidence depository with credible and replicable findings from formal research done using our current projects, disseminating these findings in journals such as HERD and at national professional conferences, diffusing the evidence in design meetings and team discussions, and then adopting the evidence rather than our traditional routines and practices to guide decisions in future projects.Research implementation or utilization is the heart of evidence-based nursing (van Achterberg, Schoonhoven, & Grol, 2008). Everett Rogers' theory for the diffusion of innovation (Rogers, 2003) explains the implementation of research evidence or findings and the rate of adoption of new findings. It indicates that the adoption of new evidence is affected by (1) how credible the evidence seems; (2) the users of the evidence with all of their biases and perceived barriers to implementation; (3) how widely communicated the findings are; and (4) the social system in which the evidence will be used. Thus, while the research findings may be clearly known, some will be early adopters of the new findings, whereas others may be late adopters who wait to see how others implement the new ideas into their building designs. Most important to early adoption is the availability of credible, reliable, and valid research findings.Weighing the EvidenceLet's face it: not all evidence is created equal. Some of the evidence regarding the effect of specific design features on patient outcomes or organizational performance is weightier than other evidence, meaning that we can be fairly sure that the findings can be used to guide decisions in other design projects. What is it that makes some evidence more reliable? How do we analyze or appraise research findings to determine that they are worthy of implementation? These are critical questions, considering that design decisions have costs associated with them. We want to make these decisions based on the best possible evidence available, not on someone's opinion or an urban myth.Hierarchies or Levels of EvidenceHierarchies provide a guide to the strength of available evidence regarding the research methodology used to measure the effect of design features on specific outcomes and the quality of the research in its elimination of inherent biases. Evans (2002) states, Hierarchies aim to provide a simple way to communicate a complex array of evidence generated by a variety of research methods... and they provide a level of trust that can be placed on the recommendations, or alert the user when caution is required (p. 79). Medicine and nursing have developed hierarchies that rank the systematic review of multi-site studies at the highest level of reliability and expert opinion, case studies, and descriptive studies at the lowest level. When making decisions to treat or not to treat, we want to evidence gained from the systematic review of multiple studies conducted at multiple sites with rigorous research to minimize the possibility that the findings occurred by chance. …

The relationships between characteristics of milking sheds and the attitudes to dairy cows, working conditions, and quality of life of dairy farmers

This study consisted of a survey of dairy farmers and their milking sheds at 198 Victorian dairy farms to examine the relationships between physical features in the milking shed and a number of job-related characteristics of the farmer, such as attitudes to handling cows and job satisfaction. Furthermore, farmers’ opinions of the effects of specific design features of the milking shed on cow behaviour were sought. A further objective of this survey was to use the relationships between shed characteristics and job-related characteristics of the farmer to identify, for future research, possible features of the milking shed that may affect cow behaviour. There was substantial variation in both the behavioural beliefs of farmers about cow behaviour in the milking shed and reports by farmers on comfort and working conditions in the dairy, indicating that considerable opportunities exist to improve these key job-related characteristics. A principal component analysis (PCA) of the responses to the questions on job-related characteristics of the farmer identified 6 factors: 2 of the factors identified were related to behavioural beliefs by farmers about cow behaviour (labelled ‘Cow Movement’ and ‘Cow Behaviour’); one of the factors related to comfort of the farmer in the shed (labelled ‘Operator Comfort’); and 3 of the factors related to aspects of the quality of life of the farmer (labelled ‘Workload’, ‘Farmer Mood’, and ‘Job Characteristics’). Positive beliefs about both cow movement (factor called Cow Movement) and cow behaviour (factor called Cow Behaviour) were correlated with farmers being more positive about working in the dairy (factor called Operator Comfort; P < 0.05 and P < 0.01, respectively) and the characteristics of the job (factor called Job Characteristics; P < 0.01). These relationships suggest that improvements in cow behaviour may lead to improvements in both job satisfaction and the quality of life of the farmer. Furthermore, regression analysis revealed that a number of the shed features, such as height of the breast rail, presence of stall gates, length and width of the platform and solid side on first milking bail, were significant predictors of one or more of these 6 PCA factors. Although these results may not reflect causal relationships, these relationships between shed characteristics and a number of job-related characteristics of the farmer highlight the potential importance of shed design to both the cow and the farmer and provide a valuable guide in identifying features of milking sheds that require future examination as to their effects on cow behaviour.

Bankruptcy around the World: Explanations of Its Relative Use

The law and finance literature highlights the role of investor rights in financial development, firm corporate governance, and financing patterns. For a panel of 35 countries, we investigate how bankruptcy use relates to countries’ creditor rights and judicial efficiency. Bankruptcies are higher in countries with more creditor rights, except for a “no automatic stay on assets” provision. Higher judicial efficiency is associated with more bankruptcies and appears as a substitute with more creditor rights. Although only a first step, our findings suggest creditor rights are complex, balancing prioritization of claims, ex ante risk-taking incentives, and an efficient resolution of distressed firms.

The effects of design and configuration on the biomechanical response of an internal spinal fixator.

This study examines the biomechanical performance of an internal spinal fixator and the effects of specific design features under a range of loading modes. The commercial device was mounted on plastic vertebrae in a corpectomy injury model and attached by a series of experimental jigs to an appropriate material testing machine and tested under axial compression, torsion and flexion and extension moments. Results from the torsional tests indicated that increasing the clamp tightening torque from 5 to 15 N m significantly increased the rigidity of the fixation system. The inclusion of the transverse elements resulted in a significant increase in the torsional stiffness, with the increase largely overriding the effect of clamp tightening torque. By contrast, under compressive and both flexion and extension loads, neither of the design features of the fixator had a marked effect on the overall measured stiffness of the system. However, under extension loads, there were specific interactions between the two design parameters. The present study clearly indicates the need for the optimization of the design of the clamps and for alternative configurations of the transverse elements to enhance their performance under sagittal loads.