General Discussion Sample Clauses

General Discussion. Except in rare instances of 100% participation, each peer nomina- tion study will require a decision regarding the treatment of non- participants. Whether to include or exclude nonparticipants as nominees may seem a minor methodological decision but has not been studied before. Historically, inclusion of nonparticipants has been the default decision and a fundamental requirement for valid peer nomination measures (Xxxxxxxxxxxxxx, 1943; Xxxxxx, 1934). Unfortunately, inclusion of nonparticipants raises ethical concerns (see Mayeux, Underwood, & Xxxxxx, 2007). We investigated two separate datasets, showing that the choice of including or excluding nonparticipants as nominees can affect psychometric properties of peer nominations. The effects varied between studies; differences between inclusion and exclusion were greater for certain types of missingness in Study 1 and greater in one school versus another in Study 2. Study 1 also indicated that, when the inclusion and exclusion conditions differed noticeably, exclusion consistently yielded lower reliability and different corre- lations than inclusion. From a psychometric perspective, our results indicate that non- participants should be included as potential nominees. Although exclusion of nonparticipants did not always detract from data qual- ity, it was likely to do so under conditions that are most probable in real-world situations; that is, when nonparticipants differ in status and peer preference from participants (Xxxx et al., 1997). Excluding nonparticipants as potential nominees removes the ability to test for systematic differences between participants and nonparticipants. Even if nonparticipants can be excluded as nominees without con- sequence when nonparticipation is completely random, the very exclusion of nonparticipants as nominees makes it impossible to demonstrate that nonparticipation is random. If our findings are representative of the research literature more generally, the fact that excluding low-status peers as nominees resulted in the greatest reduction in reliability and change in inter- correlations is concerning. Many peer relationships studies focus on youths who are rejected or unpopular, and they are least likely to participate in school-based research. Our findings highlight the importance of properly representing low-status or marginalized youths and, more generally, in maximizing participation rates with peer nominations. Our study used two large samples and investi- gated relat...

General Discussion. A Local Agency Agreement is an agreement between a local agency and the Washington State Department of Transportation (WSDOT). An agreement is prepared for each federal aid project, and it covers all phases of work involved in the project (preliminary engineering, right of way acquisition, construction). Its purpose is to ensure that the federal funds in the agreed-upon amount are spent in accordance with all applicable state and federal laws and regulations. The agreement also specifies the procedure for payment and reimbursement on the project. If the federal aid participation ratio entered in the agreement is not the maximum rate allowed by the Federal Highway Administration (FHWA), then the participation ratio entered becomes the maximum rate allowed. No costs are eligible for federal aid reimbursement until authorized in writing by WSDOT. This authorization is separate from the agreement. The total cost of a project (including federal, state, agency, and private funds) must be shown on the Local Agency Agreement for each phase of work that includes federal or state funds. At the time of each phase authorization, all funds necessary to complete the scope of work for that phase must be secured.

General Discussion. Colorectal cancer is the cancer with the second highest cancer incidence in Europe.1 Roughly, one out of three patients with a colorectal malignancy has a rectal carcinoma. Surgery is the cornerstone in the curative treatment of rectal cancer. In the 1980s with conventional surgery, the 5-year local recurrence rate was over 20% and the 5-year over- all survival rate around 50%.2,3 In the Swedish Rectal Cancer trial in which 1168 patients were included, preoperative radiotherapy in addition to conventional surgery resulted in a reduction of more than 50% in the 5-year local recurrence rate in comparison to conventional surgery alone (11% versus 27%; P < 0.001).2 Besides, the 5-year overall survival rate improved from 48% to 58% if patients were treated with preoperative radiotherapy in addition to conventional surgery (P = 0.004).2 With the total mesorectal excision (TME), by which the rectum with its mesorectum and visceral fascia are dissect- ed sharply and under direct vision,4 local recurrence rates dropped and overall survival improved.5,6 In the Dutch TME trial, 5 x 5 Gy preoperative radiotherapy in combination with TME surgery was compared to TME surgery alone (1861 patients). In this trial, the 5-year local recurrence rate for patients treated with TME surgery alone was similar to patients treated in the Swedish Rectal Cancer trial with blunt dissection in combination with preoperative 5 x 5 Gy radiotherapy (11%)2,7 If preoperative radiotherapy was added to TME surgery, 5-year local recurrence rate was reduced to 5.6%7 The overall survival rate at 5 year was 64% for both patients treated with TME surgery alone and patients treated with preoperative radiotherapy followed by TME surgery,7 compared to 48% for patients treated with blunt dissection alone in the previously mentioned Swedish trial.2 TME surgery is now considered the standard surgical procedure for rectal cancer.4 However, even if TME surgery is performed, surgical quality varies.8,9 First, these results indicate that improvements in the surgical procedure itself can result in major progress regarding long-term oncological outcome such as decreased local recurrence rates and improved overall survival. Second, it illustrates that variation in surgical quality could lead to large differences in outcome. Recently, it was shown that surgical variation is not only important for patients with rectal cancer, but also plays an important role for the outcome of patients with colon cancer.10,11

General Discussion. Our results for British and American collective agreement suggest that lexically controlled features are responsible for the differences in plural agreement between the varieties. In spontaneous speaking, specifications of plurality for particular collectives and not dynamic variations in underlying conceptualization create the differences. This is consistent with the third of the three hypotheses we tested, the one that attributes the differences between the dialects to differences in lexically specified number among collective nouns. The lexicons of individual speakers of a dialect may differ as to which collectives are specified as plural, for reasons that may be tracedto differences in linguistic experience but in any case are typical of most types of lexical variation. Across speakers, there will be variability in which collectives are treated as plurals, but lexical rather than notional variability drives the patterns of usage that we found in both experimental elicitation and corpus distribution.

General Discussion. The results of the second study were in accordance with our predictions, and consistent with the results of our first study. Participants who had received high or average respect for their behavioral descriptions, perceived themselves as respected and showed higher feelings of affective commitment in comparison with participants who perceived themselves as disrespected (see also Branscombe et al., 2002; Xx Xxxxxx, 2002, 2003; Xx Xxxxxx & Xxxxx, 2003; Ellemers et al., 2004; Xxxx & Xxxxx, 1988; Xxxxx and Xxxxxxx, 2003; Xxxxx & Xxxx, 1992; Xxxxx & Xxxxxx, 2000, 2003). Additionally, in contrast with the respected participants, those who were disrespected showed higher levels of situational group attachment an>iety and indicated more psychological disengagement as e>pressed in intentions to leave the group. When focusing on the motivational basis of the engagement participants displayed on the discretionary group efforts measure, we found that the e>tra behavioral efforts that contribute to the group are indeed activated by two different motives. This confirms the validity of our argument that different underlying motives can evoke outwardly similar behavioral displays: Whereas respected participants were stimulated to e>ert more discretionary group efforts to the e>tent that they e>perienced more feelings of affective commitment with the task-group (the carrot), disrespected people showed enhanced behavioral engagement in discretionary group efforts when they felt more situational group attachment an>iety (the stick; see also Xxxxxxx & Xxxxxxxx, 2000). Thus, in E>periment 4, we successfully replicated the effect on actual discretionary group efforts. As predicted, and similar to E>periment 3, compared to average respected group members both high and low respected participants showed enhanced effort e>ertion on discretionary group efforts, but only when they perceived the respect received as diagnostic and related to their position within the group (cf. De Cremer, 2002; Xxxxxx et al., 2002, 2003; Xxxx et al., 1995). In the non-diagnostic condition, where it was made clear to participants that the respect received was not predictive of their ingroup position and could be regarded as occasional feedback, the effect on e>tra effort did not appear as predicted. The results of the present contribution uncover new directions in research on intra-group dynamics. Specifically, by e>amining the operation of a collective motive, enhanced by higher levels of affective com...

General Discussion. In the current research we examined how the prominence of family ties in politics shapes people’s perceptions of nepotism, as well as the impact of these perceptions on political attitudes and behaviors. Four studies consistently showed that: (1) The prominence of family ties in politics increases people’s belief that nepotism plays an intricate part in their nation’s politics, (2) the perception of nepotism makes people more politically cynical, (3) political cynicism due to nepotism shapes

General Discussion. The effectiveness of eRehabilitation is not only influenced by the intervention itself, but also by the implementation strategy and the context in which the intervention is implemented. These latter two aspects often vary from one intervention, organisation or country to the other [1,2]. This complex interplay between the effectiveness, the implementation and the context of an eRehabilitation intervention in stroke care constitutes the focus of the present thesis. The Fit After Stroke @Home (Xxxx@xxxx) project is the central study in this thesis. It consisted of the following phases (Figure 1): 1. a thorough and structured investigation of the anticipated barriers/facilitators in the context of the specialised rehabilitation facility. With this information, an eRehabilitation intervention and a tailored implementation strategy were developed, simultaneously with the control period of the effect study. After this, 2. the effectiveness; and 3. the implementation strategy of the eRehabilitation intervention was evaluated. Studying these three different phases in the same clinical setting enabled us to interpret the effect of the intervention in the context in which it was used and evaluated the extent to which the implementation and context influenced the effects. Considering the results of the studies, this thesis leads to a deeper understanding of how and why eRehabilitation works, compared to merely studying the effectiveness of an eRehabilitation intervention as independent tool. Apart from the relevance of the results for patients and healthcare professionals, the outcomes can be used to inform other stakeholders, including directors, managers and policymakers regarding the future implementation and upscaling of eRehabilitation [3]. This chapter discusses the interplay between the multiple phases of the research projects (the effectiveness, the implementation and the context). Besides, recommendations for future research and clinical practice are given. Executing and evaluating the implementation strategy (15 months) 7

General Discussion. Chapters 2 to 5 assess the detection of OTC in lymph nodes and its clinical relevance. OTC in lymph nodes from gastric cancer patients (chapter 2) are of clinical value if they are present in at least 20% of the lymph nodes whereas in CRC (chapter 5), MM and not ITC are found to be of clinical relevance. The difference between these studies in OTC relevance might be explained by the higher number of harvested lymph nodes in gastric cancer compared to CRC (median 15 with a range of one to 92 vs median 6 with a range of one to 26). Besides being a staging tool, lymphadenectomy has also been reported to have therapeutic value.39-41 In CRC and bladder cancer, improved survival was shown in both node-negative and node-positive patients when an increased number of lymph nodes was examined.39;40 The results of our study in gastric cancer patients (chapter 2) support the therapeutic value of a higher number of dissected lymph nodes as a significantly higher number of harvested lymph nodes was seen in less than 20% OTC-positive group (n = 27) compared to the greater or equal than 20% OTC-positive group (n = 10) (Xxxx-Xxxxxxx test, median 18 (range 6 to 92) vs median 8.5 (range one to 35); P = 0.021). This again corresponds to the survival benefit of patients with N2 disease42 who underwent a D2 dissection as previously reported.43 We do not expect the number of levels examined to be a factor for the difference between chapter 2 and 5 as the percentage of OTC-positive lymph nodes after analysis of the first level in CRC also did not differ between cases and controls. Furthermore, the anticytokeratin antibodies CAM5.2 and AE1/AE3 had been compared and no difference in staining pattern was observed (data not published). In chapter 4, we do not differentiate between ITC and MM. More patients are seen with OTC detected by multilevel sectioning and immunohistochemical staining in patients who have developed disease recurrence than in patients without recurrence, but it does not reach significance (P = 0.055). When disregarding single tumor cells as relevant, the sensitivity of the test remaines 100% and the specificity rises from 43% to 64% in predicting disease recurrence. Nevertheless, the specificity of the RT-PCR test is still higher (79%). This may relate to the fact that RT-PCR detects RNA which represents active cells whereas immunohistochemistry detects proteins which might also be in apoptotic tumor cells. An additional finding in the study presented in chapter ...

General Discussion. The findings of the five studies included in this thesis show that rehabilitation greatly influences the lives of individuals with HL concerning their speech understanding, language development, social wellbeing, and school career. We would like to further delve into the perspective of patients with HL who are confronted with obstacles and future possibilities in the following sections.

General Discussion. The results of the three studies confirmed the vital role of time perspective in explaining why and how motives of entrepreneurship relate to the pursuit of business growth. Across three studies, opportunity-based entrepreneurship was found to be positively associated with the pursuit of business growth (i.e., business growth intentions and engagement in growth-pursuit behaviors) via future time perspective. It supports the idea that opportunity-based small-business owners pay a lot of attention to the long-term viability and future of their businesses, which makes it more likely for them to understand and foresee the benefits of business growth. In other words, future time perspective in the context of entrepreneurship is a variable that may facilitate opportunity-based small-business owners’ intentions to pursue business growth as well as engagement in growth-pursuit behaviors. In terms of necessity-based entrepreneurship, the results were mixed. Study 3.3 indicated that necessity-based entrepreneurship was negatively associated with both business growth intentions and current engagement in growth-pursuit behaviors via lower levels of future time perspective. However, Studies 3.1 and 3.2 did not find a negative link between necessity-based entrepreneurship and growth intentions nor a negative link between necessity-based entrepreneurship and future time perspective. There are two possible explanations for this inconsistency. First, it is possible that participants in Studies 3.1 and 3.2 were strongly present-oriented, but not necessarily less future-oriented. Given that present time perspective and future time perspective are two different constructs (Xxxxxx et al., 1999), being strongly present-oriented does not automatically cause one to be less future-oriented.