Formal Stage Research Articles

The Effect which Nagging has on Fast Food Purchase Intent by Tweens in Pietermaritzburg Area, South Africa

Tweens, are defined by Lindstrom (2004, 175) as pre-pubescent consumers who fit into the age category of 8 – 14 years old. Tweens are regarded as the richest generation of children to date, with an estimated personal expenditure of $28 billion in the United States in 2000 (Gunter, Oats, Blades, 2005: 2). However, it is the influence which tweens exert on parental consumption which potentially makes tweens a profitable niche market. Data collected by Gunter, et al. (2005) stated that tweens were responsible for an estimated $250 billion worth of parental expenditure due to the influence which they exert during the purchase decision making process. The research for this paper was based on a formulated questionnaire which was administered at 4 schools in the Pietermaritzburg area. The objectives of the research was: to determine how advertising appeals affect the consumption of fast food by children in the Pietermaritzburg area; to determine if any preconceived perceptions of fast food brands exist in the mindset of children; to determine the effect that age has on cognition of advertisements; and to determine the effect which the ‘Nag Factor’ has on consumption. Data was analysed utilising SPSS (Statistics Package for Social Sciences) and key findings were graphically represented. These findings are discussed and compared to literature. The findings of the study showed that the effects of nagging do not have a strong correlation with consumption frequency; Even though the majority of tweens (86%) were aware of adverts, respondents who were unaware of what an advert was requested fast food at a similar frequency; During the concrete operations phase age does not have a strong correlation with nagging, but in the formal operations stage as age increases the frequency of nagging decreases. DOI: 10.5901/mjss.2014.v5n20p141

Peculiarities of the cascade cleavage of the polarized C≡C-fragment in α-ketoacetylenes on reaction with ethylene diamine

The reaction of diarylketoacetylenes with ethylenediamine (EDA) leads to arylmethylketones and 2-substituted imidazoline derivatives. This transformation involves complete cleavage of the triple bond via initial intermolecular Michael-addition with subsequent intramolecular Michaeladdition. Final fragmentation can be presented as a retro-Mannich reaction, accompanied by three formal reductive stages (formation of three C-H bonds), while the other carbon undergoes a formal oxidation, in which three C-N bonds (C-N and C=N) are formed.

Case study on initial allocation of Shanghai carbon emission trading based on Shapley value

Carbon emission trading is an effective measure to reduce greenhouse gas emissions worldwide. China has publicized plans to initiate the demonstration of carbon emission trading in seven regions as of 2013. Initial allocation is fundamental, but it proposes difficulty in the mechanism design of the carbon emission trading system. Benchmark, grandfathering and the Shapley value have been employed to simulate a specific case, which consists of the initial allocation of carbon emission allowances of three power plants in Shanghai, China. The results of the Shapley value are regarded as a theoretical equitable reference. The results of benchmark are similar to those of the Shapley value. However, it is apparent that the allocation regarding grandfathering is inequitable. Considering other factors, we proposed the following: At the introduction of experimental stage, free allocation pertaining to grandfathering can be adopted; meanwhile, benchmark should be prepared and adopted at the appropriate time. Furthermore, a portion of the initial allowances can be reserved for auction, and this portion for auction will escalate to the extent of 100% upon entering the formal stage. In addition, the tiered price mechanism and the subsidy policy are also suggested.

Fio Condutor Microgenético: uma metodologia para a mediação metacognitiva em jogos computacionais

This study aims to present the Microgenetic Conductor Wire, a tool for metacognitive mediation in computational games. We present the preliminary results of application of this method taking two games provided with educational content belonging to the mathematical sciences and developed onto concrete material, in children between 9 and 10 years. The data generated showed cognitive improvements identified by the emergence of Innovative Schemes (Inhelder [ 6 ]) for the resolution of problems in games. We present evidence that learning is disconnected from predefined chronological stages as Piaget argued. Our results verified that content requiring complex mathematical reasoning and that are expected with over 12 years in the formal operations stage of abstract reasoning (Piaget [17]), can be learned and consolidated by younger children in the range between 9 and 10 years.

Thermokinetic investigation of binary Cu/Zn hydroxycarbonates as precursors for Cu/ZnO catalysts

A combination of thermogravimetric analysis (TG) and differential scanning calorimetry (DSC) coupled to mass spectrometry has been applied to study the thermal decomposition of Cu/Zn hydroxycarbonates, which are used as a precursor for the active methanol synthesis catalyst. Original TG and DSC profiles and results of a formal kinetic analysis of the calcination process are compared with transformations occurring in the solid phase, which has been studied by means of in situ XRD. A series of hydroxycarbonate precursors with different Cu/Zn molar ratios (40/60, 70/30, 80/20) were synthesized under conditions reported as optimum for catalytic performance. The samples contain primarily two crystalline phases, aurichalcite (Cu,Zn)5(CO3)2(OH)6 and zincian malachite (Cu,Zn)2CO3(OH)2. At least four formal decomposition stages of CO2 and H2O evolution cause the major mass loss in the TG experiments. The best-fit quality for all the studied samples was obtained for a four-step competitive reaction model. The experimental TG dependences are adequately described by the n-th order equation and 3D Jander diffusion equation. The effects of the gas flow, sample mass, and water transfer conditions on the reaction pathway were studied. The presence of H2O vapor in the reaction feed accelerates the decomposition and dramatically changes the reaction TG profile. The decomposition enthalpy of mixed Cu/Zn (80/20) hydroxycarbonate was determined, and the formation enthalpy of the decomposition intermediate, a carbonate-modified oxide, was calculated to be ΔHf° = −633.7 ± 5.6 kJ/mol.

Modeling Social Opposition to Infrastructure Development

Social and political dynamics increasingly determine the fate of infrastructure development around the world. Decision makers involved with projects such as the Keystone XL pipeline in North America, the Belo Monte Dam in Brazil, and the Bujagali Dam in Uganda have been forced to substantially change their plans as a result of opposition. This study looks at such emergent dynamics to provide a quantitative assessment of risks associated with social sustainability in infrastructure development. An interactional model is proposed to analyze emergent risks in a complex system of systems and it is applied to emergent risks in infrastructure development. The analysis is based on the game-theoretic equilibria for an interaction between two actors, namely, the developer and the opposition. Using simulation the structural and contextual variations were investigated in the context of the project along with consequent emergent patterns of outcomes and associated risk profiles. The model comprises informal and formal interactional stages to investigate the impact of alternative mitigation strategies on project risk. The application of the proposed methodology is showcased in an analysis of informal and formal strategies to deliver socially sustainable projects.

A review of prognostic factors in thymic malignancies

Prognosis is a central piece of information we would like to know when someone is diagnosed with a disease. Prognosis is affected by many factors. For a cancer, one important aspect is the anatomic extent of the tumor, typically described by a stage classification. Nevertheless, a stage classification system should not be confused with a system to predict prognosis—tumor stage is only one aspect. Prognosis is affected by the treatment given, by patient-specific factors (i.e., comorbidities), tumor-related factors, and others, collectively known as prognostic factors. The International Thymic Malignancy Interest Group (ITMIG) is currently engaged in the development of a validated formal stage classification system for thymic malignancies, together with the International Association for the Study of Lung Cancer and under the auspices of the Union International Contre le Cancer (UICC) and American Joint Commission on Cancer (AJCC). Assessment of prognostic factors is an important corollary to development of an anatomic stage classification system. A review of the current literature identifying prognostic factors is an important baseline to have for this initiative. The study and classification of prognostic factors, in general, is very rudimentary. Often there is confusion because people are not clear about the outcome in question: a factor may be prognostic relative to overall survival, to cure from the disease, to response to treatment, etc. Prognostic factors are often specific to a subgroup of patients and a particular setting: factors associated with prognosis for a patient with thymoma undergoing surgery may be different from that of a patient with thymic carcinoma undergoing chemotherapy and radiation. Prognostic factors can be divided into “domains” of tumor-related factors, host factors (i.e., that would be present in the patient even if there was no tumor), and environmental factors (including things such as access to optimal care). Furthermore, once we identify a prognostic factor, we immediately begin trying to change the outcome to be what we want to see (i.e., to undermine the predictive value of the prognostic factor). Finally, there are many statistical pitfalls and errors in the definition of prognostic factors, as discussed in another article in this issue.1 Despite deficiencies in our level of sophistication about the science of prognostic factors, the need to estimate future outcomes for patients is great. This article sets out to provide a review of the current state of affairs in the area of thymic malignancies.

Endoscopically identified well-differentiated rectal carcinoid tumors: impact of tumor size on the natural history and outcomes

There is a paucity of data pertaining to the natural history and outcomes of patients with well-differentiated rectal carcinoids. To correlate endoscopic size with the natural history and outcome. Retrospective study. Single tertiary referral center. Eighty-seven patients with endoscopically identified well-differentiated rectal carcinoid tumors. Colonoscopy. Prevalence of metastasis at diagnosis, disease progression, and survival. Metastasis was present at diagnosis in 3%, 66%, and 73% of tumors measuring ≤10 mm, 11 to 19 mm, and ≥20 mm, respectively. Metastasis was predicted with 100% sensitivity and 87% specificity using an endoscopic lesion size ≥9 mm. In patients without identified metastasis, 64% were identified during screening colonoscopy. Within this select cohort, subsequent metastasis was discovered only at distant extra pelvic sites, in 1.6%, 50%, and 100% of patients with tumors initially measuring ≤10 mm, 11 to 19 mm, and ≥20 mm, respectively. The carcinoid related 5- and 10-year survival rates for locally confined disease were 96%. The corresponding survival rates for local and advanced metastatic disease were 60% and 35%, respectively. Subjective estimation of tumor size, mitotic index or Ki-67 labeling index not reported, and lack of formal and standardized baseline staging algorithm and surveillance program. The clinical behavior of 11- to 19-mm tumors appears to mimic that of larger (>20 mm) lesions with respect to the presence of metastasis at diagnosis and disease progression. Therefore, if local therapy is contemplated, we propose to make a distinction between ≤10-mm and 11- to 19-mm tumors, favoring an aggressive staging and management protocol for 11- to 19-mm carcinoid tumors.

Sınıf Öğretmenlerinin 12 Yıllık (4+4+4) Zorunlu Eğitime İlişkin Görüşleri

The aim of this research is to analyze the views and the predictions of the classroom teachers towards the changes in the educational system before the application of the 12–year–compulsory education (4+4+4), the problems that they have encountered after the application, their admirations on the applications and the changes in their opinions. The study was designed according to the scanning model in order to take the opinions of the classroom teachers towards the 12–year–compulsory education both before the application and one year after the application and to compare their opinions. The study group of the research consisted of 23 classroom teachers (7 males and 16 females) that work in Kadikoy, Uskudar, Umraniye, Pendik and Sultanbeyli districts in Istanbul. The interview form developed by the researchers was used to collect data. It includes 4 open–ended questions. These questions have the dimensions like the age to start formal education, staging, teaching job and student improvement. According to the results of the study, the classroom teachers indicated regards the 12 –year-compulsory education that (1) the students who start school at the age of 60–66 months are academically less successful than the others and this age gap isn’t appropriate to teach reading and writing since the children at this age aren’t mature enough for attending school; (2) the necessary piloting hasn’t been realized for the application and the substructure isn’t sufficient and a lot of classroom teachers have encountered the norm surplus problem since the fifth grade was taken into the middle school grades; (3) the problem created by the fact that especially younger students and older students are in the same campus will be hindered with this change; (4) the application has caused teachers to deal with the other cases except from teaching and the application has made classroom management difficult; (5) the fact that students meet their branch teachers in the fifth grade will be beneficial in terms of revealing their interest and skills and; (6) the children at the age of 60–66 months have suffered from failure fear, so increasing the progressive differences inside a classroom affect the students’ abilities to express themselves negatively.

The International Thymic Malignancy Interest Group Thymic Initiative: A State-of-the-Art Study of Thymic Malignancies

Thymic malignancies are relatively rare tumors. A general lack of knowledge, misconceptions about benignancy, confusion about the definition of terms, and variability in reporting of outcomes have further hampered progress in these diseases. The International Thymic Malignancy Interest Group has emerged to counter these challenges and has brought together a worldwide multidisciplinary community determined to improve outcomes for these patients. Although the organization is young (initiated in 2010), major early accomplishments have created a foundation and infrastructure for scientific research. These include consensus definitions of terms, an unprecedented global database, development of practical clinical resources and, together with the International Association for the Study of Lung Cancer, development of proposals for the first formal stage classification of these malignant tumors. Many articles have been published or are under way, and a second phase of projects building on the early success is proceeding. The greatest accomplishment of the International Thymic Malignancy Interest Group lies in the establishment of an open culture of collaboration and the engagement of a broad group of individuals united by a common mission. It is a testament to what can be achieved, despite ongoing and inherent challenges, by determination and a collective effort.

Lower extremities peripheral arterial disease among patients admitted to cardiac rehabilitation: The THINKPAD registry

Background/objectivesLower extremities peripheral arterial disease (LE-PAD) across the wide range of conditions for Cardiac Rehabilitation (CR) is poorly understood. The “ATHerosclerosis of the lower extremIties as a liNKed comorbidity in Patients Admitted for carDiac rehabilitation” (THINKPAD) registry explored LE-PAD in CR patients in terms of prevalence and interventions delivered. MethodsMulticenter, consecutive case series of 1506 patients discharged from 16 CR Units in Italy from May 1 to June 30, 2012. ResultsLE-PAD constituted a primary indication for CR and a comorbidity on admission in 2.6% and 9.3% of patients respectively. LE-PAD patients were significantly older (72±9 vs. 67±12years, p<0.001) and displayed a worse cardiovascular risk profile (diabetes 38% vs. 23%, hypertension 86% vs. 63%, hypercholesterolemia 74% vs. 52%, smoking 72% vs. 50%, low level of physical activity 84% vs. 69%, impaired diet habits 69% vs. 55%, p<0.01 for all). COPD (17% vs. 11%, p<0.05), CKD (20% vs. 10%, p<0.01), and past history of coronary revascularization (29% vs. 14%, p<0.001) were also more represented in the LE-PAD group. Half of LE-PAD patients received a formal staging, with low provision of ABI (18%) and color Doppler (48%) investigation. Secondary prevention targets at the end of CR for blood pressure and lipid control were accomplished in 83% and 46% of patients respectively (strongly correlated with the presence of CAD), while other guideline-recommended drugs for LE-PAD were prescribed in less than 4% of cases. ConclusionLE-PAD represents an uncommon referral indication for CR. Our data confirm its systematic underassessment and undertreatment.

Evaluating Client Selection and Selection Fidelity

The effectiveness of specialized interventions depends in part on the target population and whether those selected for admission to interventions (i.e., specialized programs) and recruited to participate in research evaluations are representative of the target population. This article describes the process by which clients were selected to participate in a specialized mental health caseload (SMHC). The study focuses on the referral and selection process at the program level and the factors influencing acceptance and rejection. Using a mixed methods approach, we found that selection was guided by a three-stage process: The first was a general education phase, followed by an informal pre-screening stage, and finally a formal screening stage. Once clients were referred, client selection was informed principally by the program’s formal criteria. Informal processes appeared consistent with the formal selection criteria. Further research is necessary to assess potential bias prior to the formal referral process.

'과학1' 중학교 교과서의 물질의 상태 변화와 분자 운동 내용이 요구하는 인지 수준 분석(제III보)

우리나라 중학교 '과학1'에 실려 있는 '물질의 상태 변화'와 '분자의 운동'에 대한 서술 내용이 요구하는 인지 요구도를 분석하였다. '분자의 운동'에는 '확산과 증발', '기체의 압력과 부피', '기체의 온도와 부피', 그리고 '상태 변화와 열에너지' 개념이 포함된다. 인지 요구도 분석에 활용한 분석 준거는 영국에서 개발된 과학 교과 내용 분류틀에 있는 3종류 분석틀이다. 분석 대상인 6종 교과서 내용들이 요구하는 인지 수준들은 구체적 조작 수준과 형식적 조각 수준들이 다양하였다. 해당 내용에는 여러 인지 수준들이 있으나 그 중에서도 높은 인지 수준을 요구하는 내용들을 보면 다음과 같다. 첫째, 단원 초기에 물질의 세 가지 상태를 설명할 때에는 그 서술 내용이 요구하는 높은 인지 수준이 6종 모두 후기 구체적 조작 수준이다. 그러나 단원의 초기 이후부터는 이에 대한 설명이 모두 초기 형식적 수준이다. 분자 배열과 분자 모형에 관한 내용이 요구하는 높은 인지 수준은 모든 6종 교과서가 분자 운동으로 서술하고 있기 때문에 초기 형식적 조작 수준이다. 둘째, 확산과 증발 개념에 대한 내용이 요구하는 높은 인지 수준은 6종 교과서 모두 초기 형식적 조작 수준이다. 왜냐하면 상태 변화를 분자 운동론으로 서술하고 있어서 초기 형식적 조작 수준이다. 셋째, 기체의 압력과 부피, 기체의 온도와 부피 개념에 대한 내용이 요구하는 높은 인지 수준은 교과서 6종 모두 초기 형식적 조작 수준이다. 분자 운동을 이용한 형식적 모델을 이해해야 하고 그리고 그래프를 통해 보일 법칙과 샤를 법칙을 이해해야 하기 때문에 학생들은 고차식의 그래프를 해석해야 하며, 두 독립변수 사이의 관계를 발견해야 하므로 초기 형식적 조작 수준이다. 넷째, 상태 변화와 열에너지 개념에 대한 내용이 요구하는 높은 인지 수준은 교과서 6종 모두 초기 형식적 조작 수준이다. 물질의 끓는점과 어는점을 설명하는 고차식 그래프의 해석 능력을 요구하고 있기 때문에 초기 형식적 조작 수준이다. 물질의 상태 변화와 온도의 관계도 분자 운동론을 이용하여 서술하고 있기 때문에 초기 형식적 조작 수준이다. The purpose of this study is to analyze the cognitive demands level of the description about 'changes of state' and 'kinetic theory' on the 'science 1' textbooks by the 2007 revised curriculum. The three types of curriculum analysis taxonomy have been used to analyze the cognitive demands level of those contents on the 6 kinds of 'science 1' textbooks. The most higher level of cognitive demands about the concepts have been discussed here due to the focus of the concepts. The first, the cognitive demand level about 'three states of substances' depending on the motion of their particles in 6 textbooks is a early formal operational stage because of using by the application of kinetic theory. The second, the cognitive demand level about 'diffusion' and 'evaporation' is a early formal operational stage, because the particles move around faster so they can change their position. The third, the cognitive level of the pressure and volume in a gas is a early formal operational stage because of explaining only phenomena in simple correspondence with formal model of kinetic theory. And simple functional relationships beyond linear on the graph of the volume and pressure of gas, the volume and temperature of gas is also a early formal operational stage. The fourth, the cognitive level of the energy of heat by a change of the state is also a early formal operational stage because kinetic theory picture accepted as providing explanation by the change of the state. And functional relationships beyond linear on the graph of the explanation of boiling point of water in water is also a early formal operational stage.

Predictors of Implantable Pulse Generator Placement After Sacral Neuromodulation: Who Does Better?

Numerous studies have documented a relationship between provider variables, including surgeon volume and specialty, and outcomes for surgical procedures. In this study we analyzed claims data from a Medicare database to analyze outcomes of sacral neuromodulation (SNM) with respect to both provider and patient factors. A 5% random sample of Medicare beneficiaries from 1997 to 2007 was the data source. Data retrieved included demographic information, ICD-9 diagnosis codes, and CPT procedure codes. Multivariate analysis was performed to identify predictors of progression to implantable pulse generator (IPG) implantation. After stage I testing, urologists were more likely than gynecologists to proceed to IPG placement (Center for Medicare and Medicaid Services: 49% vs. 43%, p < 0.0001). After percutaneous testing, gynecologists were more likely than urologists to proceed to battery placement (63% vs.44%, p = 0.005). Among the patient variables analyzed, women were more likely than men to progress to battery placement. Patients treated by high-volume providers had higher rates of IPG placement after formal stage I trials (71% vs. 33%, p < 0.0001). The rate of IPG implantation after SNM was greater among high-volume providers. Women had better outcomes than men. Further research may better define the relationship between outcomes of sacral neuromodulation and specific etiology of voiding dysfunction.

Policy Transfer and Accession: A Comparison of Three International Governmental Organisations

This article compares the extent of policy transfer related to the accession processes of three international governmental organisations (IGOs), the European Union (EU), the Organisation for Economic Cooperation and Development (OECD) and the World Trade Organisation (WTO). It is argued that this is necessary as there is a tendency for studies of IGOs as agents of transfer to focus primarily upon the transfer that occurs after a state has acceded to membership, neglecting the extent of transfer that can take place during the accession process. The key findings are: one, policy transfer occurs during the accession process in all three organisations and, to varying extents, in all three stages of the accession process; two, the extent of transfer varies by accession stage and over time for all three organisations; three, the greatest extent of transfer occurs in the pre-accession and formal accession stages; four, the greater the degree of isomorphism between an applicant’s policies and institutions and those of the IGO, the less the extent of policy transfer in the accession process.

The Impact of Front‐End Innovation Activities on Product Performance

This paper describes and tests a model of the impact of front‐end innovation activities on product performance. Data were collected from 272 companies to test the hypothesis that front‐end performance impacts new product performance in the marketplace while controlling for new product development (NPD) processes and strategy. The data support the hypothesis that front‐end performance favorably and independently impacts overall product success, time to market, market penetration, and financial performance.Front‐end performance is predicted by a set of activities, including: the actual amount of front‐end work done in various areas, specifically marketing, R&amp;D, and concept development; the existence of a front‐end process; the existence of a champion; and agreement on the order of developmental steps in the front end. Front‐end activities are related to front‐end performance, and front‐end performance is related to NPD performance. This relationship highlights the distinction between front‐end activities and standard product development practices and the importance of building competency in the front end.This is the first study that quantifies both the nature and amount of work done in the front end and relates that work to commercial performance. This research empirically demonstrates the distinction between the front‐end and formal stages and gates types of systems. This suggests that the concept of the front end needs it own set of theoretical constructs to adequately describe and predict this categorically different set of activities. While this study demonstrates the difference between front‐end and stage‐gate systems, it does not establish the limits of those activities.From a managerial point of view recognizing that formal development and front‐end activities are different mandates that these activities must be managed differently. In particular, the skills, structures, processes, governance, leadership, performance metrics, and resources must be assessed separately and differently. These findings suggest that firms should actively manage the flow of ideas from the front end into the more formal development programs.

The Journey of Primary Care Practices to Meaningful Use: A Colorado Beacon Consortium Study

The Health Information Technology for Economic and Clinical Health Act of 2009 provides for incentive payments through Medicare and Medicaid for clinicians who implement electronic health records (EHRs) and use this technology meaningfully to improve patient care. There are few comprehensive descriptions of how primary care practices achieve the meaningful use of clinical data, including the formal stage 1 meaningful use requirements. Evaluation of the Colorado Beacon Consortium project included iterative qualitative analysis of practice narratives, provider and staff interviews, and separate focus groups with quality improvement (QI) advisors and staff from the regional health information exchange (HIE). Most practices described significant realignment of practice priorities and aims, which often required substantial education and training of physicians and staff. Re-engineering office processes, data collection protocols, EHRs, staff roles, and practice culture comprised the primary effort and commitment to attest to stage 1 meaningful use and subsequent meaningful use of clinical data. While realizing important benefits, practices bore a significant burden in learning the true capabilities of their EHRs with little effective support from vendors. Attestation was an important initial milestone in the process, but practices faced substantial ongoing work to use their data meaningfully for patient care and QI. Key resources were instrumental to these practices: local technical EHR expertise; collaborative learning mechanisms; and regular contact and support from QI advisors. Meeting the stage 1 requirements for incentives under Medicare and Medicaid meaningful use criteria is the first waypoint in a longer journey by primary care practices to the meaningful use of electronic data to continuously improve the care and health of their patients. The intensive re-engineering effort for stage 1 yielded practice changes consistent with larger practice aims and goals. While many of these practices are now poised to use data meaningfully, faster progress will likely come with continued local QI and technical support and planned community-wide learning.

An empirical study on the implementation and evaluation of a goal-driven software development risk management model

ContextBuilding a quality software product in the shortest possible time to satisfy the global market demand gives an enterprise a competitive advantage. However, uncertainties and risks exist at every stage of a software development project. These can have an extremely high influence on the success of the final software product. Early risk management practice is effective to manage such risks and contributes effectively towards the project success. ObjectiveDespite risk management approaches, a detailed guideline that explains where to integrate risk management activities into the project is still missing. Little effort has been directed towards the evaluation of the overall impact of a risk management method. We present a Goal-driven Software Development Risk Management Model (GSRM) and its explicit integration into the requirements engineering phase and an empirical investigation result of applying GSRM into a project. MethodWe combine the case study method with action research so that the results from the case study directly contribute to manage the studied project risks and to identify ways to improve the proposed methodology. The data is collected from multiple sources and analysed both in a qualitative and quantitative way. ResultsWhen risk factors are beyond the control of the project manager and project environment, it is difficult to control these risks. The project scope affects all the dimensions of risk. GSRM is a reasonable risk management method that can be employed in an industrial context. The study results have been compared against other study results in order to generalise findings and identify contextual factors. ConclusionA formal early stage risk management practice provides early warning related to the problems that exists in a project, and it contributes to the overall project success. It is not necessary to always consider budget and schedule constraints as top priority. There exist issues such as requirements, change management, and user satisfaction which can influence these constraints.

Impact of sociodemographic factors on cognitive function in school-aged HIV-infected Nigerian children

BackgroundIn this study, we sought to evaluate the influence of sociodemographic factors, ie, age, sex, socioeconomic status, maternal education, and human immunodeficiency virus (HIV) status, on cognitive performance in school-aged HIV-infected Nigerian children.MethodsSixty-nine HIV-positive children aged 6–15 years were matched with 69 HIV-negative control children for age and sex. The children were subdivided for the purpose of analysis into two cognitive developmental stages using Piaget’s staging, ie, the concrete operational stage (6–11 years) and the formal operational stage (12–15 years). All participants underwent cognitive assessment using Raven’s Standard Progressive Matrices (RPM). Sociodemographic data for the study participants, ie, age, sex, socioeconomic status, and level of maternal education, were obtained using a study proforma. Logistic regression analyses were used to determine associations of HIV status and sociodemographic characteristics with RPM cognitive scores.ResultsThe overall mean RPM score for the HIV-positive children was 18.2 ± 9.8 (range 8.0–47.0) which was significantly lower than the score of 27.2 ± 13.8 (range 8.0–52.0) for the HIV-negative children (P < 0.001). On RPM grading, 56.5% of the HIV-positive children had cognitive performance at below average to intellectually defective range. Below average RPM scores were found to be significantly associated with younger age (6–11 years), positive HIV status, lower socioeconomic status, and low level of maternal education.ConclusionYounger age, poor socioeconomic status, and low level of maternal education were factors apart from HIV infection that were significantly associated with low cognitive function in school-aged HIV-infected Nigerian children.

Importance of Idiopathic Pulmonary Fibrosis Staging for Clinical Trial Endpoints

We welcome the Pulmonary Perspective on the evaluation of clinically meaningful primary endpoints for idiopathic pulmonary fibrosis (IPF) (1). However, the logic of this discussion is weakened by the failure to acknowledge that the disease progression is influenced by the burden of disease at presentation. The burden of disease is normally described by a staging system, which is currently absent for IPF. One specific endpoint will clearly be insufficient if applied to “all comers with IPF.” Therefore, the definition of endpoints is heavily dependent on the staging of the disease (2). Regrettably, we have not seen a formal staging system emerge from the American Thoracic Society/European Respiratory Society/Japanese Respiratory Society/Latin American Thoracic Association guideline publication (3). We have learned from randomized controlled studies that change in FVC is a very pragmatic endpoint to be applied in patients with “mild to moderate disease,” which equates with a limited burden of disease. In patients with limited disease, defined as a gas transfer of greater than 40% predicted (2), mortality as an endpoint has a very low frequency. In contrast, mortality as an endpoint is more common in patients with advanced disease, defined as a gas transfer less than 40%. Therefore the relative endpoints are dependent on the stage of the disease. This burden/stage of disease can be defined on the basis of simple lung function testing. We would encourage the debate to consider that the appropriate endpoints should be defined on the basis of the burden or stage of disease, and that the discussions highlight the need for a simple reproducible staging system for IPF in a manner comparable to the Global Initiative for Chronic Obstructive Lung Disease classification for chronic obstructive pulmonary disease.