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Higher caseloads are associated with better outcomes for many conditions treated in secondary and tertiary care settings, including colorectal cancer (CRC). There is little known whether such volume-outcome relationship exist in primary care settings. The purpose of this paper is to examine general practitioner (GP) CRC-specific caseload for possible associations with referral pathways, disease stage and CRC patients’ overall survival.

The paper retrospectively analyses a prospectively maintained CRC database for 2009-2014 in a single district hospital providing bowel cancer screening and tertiary rectal cancer services.

Of 1,145 CRC patients, 937 (81.8 per cent) were diagnosed as symptomatic cancers. In total, 210 GPs from 44 practices were stratified according to their CRC caseload over the study period into low volume (LV, 1-4); medium volume (MV, 5-7); and high volume (HV, 8-21 cases). Emergency presentation (LV: 49/287 (17.1 per cent); MV: 75/264 (28.4 per cent); HV: 105/386 (27.2 per cent); p=0.007) and advanced disease at presentation (LV: 84/287 (29.3 per cent); MV: 94/264 (35.6 per cent); HV: 144/386 (37.3 per cent); p=0.034) was more common amongst HV GPs. Three-year mortality risk was significantly higher for HV GPs (MV: (hazard ratio) HR 1.185 (confidence interval=0.897-1.566), p=0.231, and HV: HR 1.366 (CI=1.061-1.759), p=0.016), but adjustment for emergency presentation and advanced disease largely accounted for this difference. There was some evidence that HV GPs used elective cancer pathways less frequently (LV: 166/287 (57.8 per cent); MV: 130/264 (49.2 per cent); HV: 182/386 (47.2 per cent); p=0.007) and more selectively (CRC/referrals: LV: 166/2,743 (6.1 per cent); MV: 130/2,321 (5.6 per cent); HV: 182/2,508 (7.3 per cent); p=0.048).

Higher GP CRC caseload in primary care may be associated with advanced disease and poorer survival; more work is required to determine the reasons and to develop targeted intervention at local level to improve elective referral rates.

The purpose of this paper is to suggest an approach to data value considerations that is related to the generalized notion of authenticity and can be applied to the design of preservation policies. There has been considerable progress in the scalable architectures for policy-driven digital collection preservation as well as in modeling preservation costs. However, modeling the value of both digital artifacts and collections seems a more elusive topic that has yet to find a proper methodology and means of expression.

A top-down conceptual analysis was developed and the principles of information technology service management and quality management were applied to the domain of digital preservation. Then, in a bottom-up analysis, the various notions of authenticity in digital preservation projects, reference models and conceptual papers were reviewed.

The top-down and bottom-up analyses have a meeting point, establishing a close relation between the concepts of data authenticity and data value.

The generalized understanding of authenticity can support the design of sensible preservation policies and their application to the formation and long-term maintenance of digital collections.

The purpose of this paper is to study the effect of slurry erosion at different parameters on plasma sprayed Cr₃C₂ coated 13Cr4Ni turbine steel and compare the results of coated steel with bare steel.

Cr₃C₂ + 25NiCr coating was successfully developed on 13Cr4Ni turbine steel using plasma spraying method. The slurry erosion test was performed using a simulated erosion testing rig. The commercially available silica sand was used as abrasive media and the effect of concentration (ppm), average particle sizes and rotational speed on the slurry erosion behavior were studied at 300 and 900 impact angles. Developed coatings were characterized by scanning electron microscope, XRD, EDS and micro hardness tests and study of erosion wear.

Results revealed that three times higher hardness of coatings was obtained because of the hard phases of chromium carbide and nickel carbide, which restricted the abrasive wear in comparison to uncoated steel. Lower abrasive wear was observed at 900 impact angle coupled with lower levels of slurry concentration and rotational speed. Further, it was observed that initially cumulative mass loss rate was high which gets stabilized after the surface become smooth and on exposing for higher periods. Overall results indicated that erosive wear was reduced significantly by the application of developed coating.

The developed plasma sprayed coating is very useful to enhance the service life of turbine steel by lowering the effect of slurry erosion.

This article reports on the intrapersonal, interpersonal and ecological factors that shaped the professional identity (PI) construction of five ESL Malaysian pre-service teachers (PSTs) during microteaching classes and teaching practicum.

The study is qualitative in nature aiming to give voice to ESL PSTs and allow them share their personal experience while constructing their professional identity. The semi-interview data were supported by observation data to validate what PSTs report in their interview. The researchers chose junctural points in the PI construction journey to follow the developmental line of PI growth and to live the experience with the participant. The project was a co-construction of knowledge and enabled a more comprehensive understanding of the phenomenon.

This inquiry revealed that PI is dynamic and changing constantly as one reinterprets and reevaluates self and interact and react to the various intrapersonal, interpersonal and ecological factors in their context. At the intrapersonal level, lack of practical experience and intrinsic motivation and sense of low self-efficacy created a perception of low PI in the beginning of the simulated practice. The findings also show that supportive interpersonal relationships developed within a facilitating context such as the simulated teaching class smoothed the emergence of high PI. However, when the interpersonal relationships and ecological context in the practicum settings were challenging, they hindered PI development and led to a PI crisis.

The article offers recommendations to enhance the pivotal role of teaching practice during PSTs' journey of becoming.

This study was conducted in one of the understudied contexts in regards of PI construction. It captured a holistic view of the PI construction. It showed that the interplay of interpersonal and intrapersonal factors, in addition to ecological factors, is not isolated from each other. On the contrary, they were like a cycle circumscribing the PSTs and impact their PI construction. Hence, the authors believe that the study contributed with a comprehensive understanding of pre-service PI construction.

Organizational wicked problems are ill-defined phenomena arising in complex environments with intertwined and evolving interests. This paper aims to use a nonlinear epistemological approach to explore how multiple management decision tools work together to form configurational paths to deal with organizational wicked problems and to propose some heuristic toolkits for tackling them.

Based on interviews with 53 senior executives dealing with 62 organizational wicked problems, this paper uses grounded theory to construct an antecedent theoretical framework and then uses qualitative comparative analysis (QCA) to conduct configuration analysis on the strategy portfolios that can tackle organizational wicked problems.

This paper used grounded theory to identify six theoretical dimensions as management decision tools for dealing with organizational wicked problems: change adaptation, goal performing, administration, mechanical integration, organic integration and entrepreneuring. In addition, this paper used QCA to explore and propose three heuristic toolkits – synergy oriented, institution oriented and innovation oriented – as multiple equivalent paths to help deal with organizational wicked problems.

This paper uses configuration analysis instead of the net effect analysis of the traditional econometric method and captures multiple antecedent conditions for decision-makers to deal with organizational wicked problems from a holistic perspective. This paper constructs three heuristic toolkits and matches each of them with the most suitable type of organizational wicked problem, constructing a complete research chain of “identifying–tackling” the organizational wicked problem and providing a reference for organizations facing similar situations in future practice.

Lactose intolerance (LI) is a disturbing gastrointestinal disorder with a high prevalence in all parts of the world, especially in Asian countries. The purpose of this study is to investigate the prevalence of LI in students from Zabol, Iran.

Based on cluster random sampling method, 887 subjects were selected for the study. Of all, 54.7 per cent of the students were boys. The mean (±SD) of age, weight and body mass index (BMI) for participants were 13.27 ± 1.14 years, 42.12 ± 10.25 kg and 18.7 ± 3.9 kg/m², respectively. LI was assessed using a validated self-administered questionnaire. After measuring the anthropometric indices, students were asked to ingest 200cc of milk. The questionnaires were completed 2 h after the ingestion of milk.

In total, 25.8 per cent of the adolescents had LI. Of all, 1, 4.6, 11, 30.2 and 53.2 per cent of affected students had severe, relatively severe, moderate, relatively mild and mild LI, respectively. The association between LI and gender, and BMI was not significant (p > 0.05 for both); however, the association between LI and the history of LI in parents (OR = 2.06; 95 per cent CI: 1.47-2.88; p < 0.001), and breakfast consumption was significant (OR = 1.49; 95 per cent CI: 1.04-2.14; p = 0.028).

Although the prevalence of LI is noticeable, majority of adolescents had mild and relatively mild LI. Parents’ history and breakfast consumption are related to the rate of LI prevalence. Appropriate strategies should be considered to prevent breakfast skipping.

This study explores the interplay among climate change, economic growth and energy consumption in G20 countries by considering the role of green energy.

This study uses various empirical tools to determine the association between carbon emissions, economic growth, renewables, non-renewables, population and urbanization for a panel of G20 countries between 1990 and 2014.

Empirical outcomes from various empirical tools reveal a positive and significant impact of economic growth, non-renewable energy consumption and urbanization on carbon emissions, and their increase will further lead to the deterioration of environmental quality. The elasticity coefficient of renewable energy coefficient is negative and significant implying an increase in its consumption will improve environmental quality. Panel causality test results reveal the existence of both short-run and long-run causality among the variables. Therefore, results infer that a reduction in the consumption of non-renewable and substitution with renewables will have a significant impact on carbon emission mitigation.

Through this study, the authors suggest the sustainable use of renewables as they are sustainable, secure, efficient, environmentally justifiable and economically viable sources of energy. Therefore, replacing traditional non-renewables with modern renewables has the potential in avoiding the dangerous impacts of greenhouse gases (GHGs) particularly in the G20 countries. This paper intends to guide policymakers regarding the environmental quality and renewable energy consumption required to hold back the fossil fuel dependence for a cleaner and greener planet.

To rescue at-risk historical scientific data stored at the McGill Observatory, the objectives of the Data Rescue Archive Weather (DRAW) project are: to build a repository; to develop a protocol to preserve the data in weather registers; and to make the data available to research communities and the public. The paper aims to discuss these issues.

The DRAW project adopts an open archive information system compliant model as a conceptual framework for building a digital repository. The model consists of data collection, conversion, data capture, transcription, arrangement, description, data extraction, database design and repository setup.

A climate data repository, as the final product, is set up for digital images of registers and a database is designed for data storage. The repository provides dissemination of and access to the data for researchers, information professionals and the public.

Doing a quality check is the most important aspect of rescuing historical scientific data to ensure the accuracy, reliability and consistency of data.

The DRAW project shows how the use of historical scientific data has become a key element in research analysis on scientific fields, such as climatology and environmental protection.

The historical climate data set of the McGill Observatory is by nature unique and complex for preservation and research purposes. The management of historical scientific data is a challenge to rescue and describe as a result of its heterogeneous and non-standardized form.