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1

Khan, Muhammad Shoaib Arshad. "Scope of BlockChain Technology in Energy Sector." Thesis, Högskolan i Gävle, Avdelningen för byggnadsteknik, energisystem och miljövetenskap, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:hig:diva-30850.

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World energy systems are going through a continuous change. The focus has been shifted from large thermal or hydal power generation to small distributed generation, mainly based upon renewable energy systems. This transition is also backed by some governments. There have also been significant improvements in grid technology, and modern-day smart grid can provide real time bi-directional flow of data i.e. “real time energy deficit and surplus, and also real time prices to both producers and consumers. Smart grid can also accommodate intermittent small suppliers of electricity. This shift in energy generation policy and improvement in grid technology has opened ways for small scale energy producers and consumers to share energy with each other. It has also opened ways to purchase or sale energy to unknown peers over a smart grid. Need has been felt to store these transactions among peers in a secure, non-alterable yet quickly accessible way. Blockchain technology offers to provide this secure, unalterable yet quickly accessible ledger. In this study this transition process and role of blockchain technology for future energy systems has been historically reviewed. It has been found out that on top of keeping record of Peer to Peer transactions, blockchain technology can fill many other purposes. However, technology is still not matured for large scale projects, Research projects are underway to decrease the large time and energy consumption for block building computational processes yet keeping them safe and reliable.
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2

Stojak, Marie-Lucie. "Legally permissible scope of current military activities in space and prospects for their future control." Thesis, McGill University, 1985. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=72779.

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3

Joseph, Abdul Wahid. "Prospects for the reform of District Municipalities: the scope for manoeuvre." Thesis, University of the Western Cape, 2012. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_4515_1370947645.

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4

Joseph, A. W. "Prospects for the reform of district municipalities: the scope for manoeuvre." University of the Western Cape, 2010. http://hdl.handle.net/11394/2940.

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5

Spencer, Jason E. "A comprehensive study of factors impacting the future size and scope of military graduate medical education." Monterey, Calif. : Springfield, Va. : Naval Postgraduate School ; Available from National Technical Information Service, 1997. http://handle.dtic.mil/100.2/ADA342295.

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Thesis (M.S. in Management) Naval Postgraduate School, December 1997.
"December 1997." Thesis advisor(s): Richard B. Doyle, William R. Gates. Includes bibliographical references (p. 115-125). Also available online.
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6

Tao, Yang. "Remedies in WTO dispute settlement mechanism : a study of scope, ambit, effectiveness of the mechanism and the proposals for future reform." Thesis, University of Macau, 2005. http://umaclib3.umac.mo/record=b1637073.

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7

Souza, Isabel Amaral de. "Condições iniciais de saúde e renda futura: uma análise dos impactos da seca no Brasil." Universidade Federal de Juiz de Fora (UFJF), 2017. https://repositorio.ufjf.br/jspui/handle/ufjf/5646.

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Este trabalho tem por objetivo investigar os efeitos da exposição a adversidades nutricionais durante a primeira infância sobre os rendimentos futuros. Com base nas informações contidas no Censo Demográfico de 2010 e nas informações da Secretaria de Defesa Civil do Ministério da Integração Nacional, foram selecionados indivíduos expostos a seca de 1979 a 1984, durante a primeira infância, para verificar se seus rendimentos foram afetados, quando em idade adulta. A adoção de exposição à seca deveu-se aos efeitos gerados por esta sobre a nutrição e a exogeneidade de fenômenos climáticos. Utilizou-se uma abordagem por Propensity Score Matching (PSM) para estimar o efeito médio da seca para indivíduos expostos a ela. Foram selecionadas duas amostras, a primeira contendo indivíduos nascidos em igual localidade, mas em períodos distintos, e outra com indivíduos nascidos em diferentes localidades, mas em mesmo período. Para a primeira amostra, os resultados indicaram que indivíduos expostos à seca apresentaram rendimentos médios do trabalho inferiores na ordem de 40%, em relação a rendimentos individuais, e em torno de 60%, para rendimentos domiciliares, em relação ao grupo controle. Para a segunda amostra, porém, os resultados indicaram rendimentos médios superiores para os tratados, em torno de 2%, para rendimentos individuais, e 4% para rendimentos domiciliares.
This work aimed to investigate the effects of exposure to nutritional adversities during early childhood on future work returns. Based on the information contained in the 2010 Demographic Census and information from the Secretariat of Civil Defense of the Ministry of National Integration, individuals exposed to the drought that lasted from 1979 to 1984 during early childhood were selected to verify whether their work income was affected, when in adulthood. The adoption of exposure to drought was due to the effects generated by it on nutrition and the exogeneity of climatic phenomena. A Propensity Score Matching (PSM) approach was used to estimate the mean effect of drought among individuals exposed to it. Two samples were selected, the first containing individuals born in the same locality, but at different periods, and another with individuals born in different localities, but in the same period. For the first sample, the results indicated that individuals exposed to drought presented lower average incomes in the order of 40%, in relation to individual income, and around 60%, for household income, in relation to the control group. For the second sample, however, the results indicated higher mean incomes for treated, around 2%, for individual income, and 4% for household income.
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8

Berglund, Anita. "On associations between different factors and whiplash injury : epidemiological studies on risk of initial and future complaints /." Stockholm, 2002. http://diss.kib.ki.se/2002/91-7349-121-7/.

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9

Trenti, Enrico <1983&gt. "Le società pubbliche a partecipazione regionale e locale operanti nei settori dei servizi pubblici locali e dei servizi “strumentali” e quelle con scopo lucrativo: la recente evoluzione legislativa, gli ambiti di attività ed i relativi limiti, le prospettive future." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2012. http://amsdottorato.unibo.it/4687/5/Trenti_Enrico_tesi.pdf.

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Анотація:
Con la prima parte, si intende fornire un quadro pressoché esaustivo delle principali disposizioni in materia di società a partecipazione pubblica regionale e locale operanti nel campo dei servizi pubblici locali e della loro interpretazione giurisprudenziale e dottrinale, prendendo le mosse dagli ultimi interventi legislativo. Nella seconda parte, si affronta, invece, il tema dei limiti legislativi alla capacità di azione delle società a partecipazione pubblica e dei connessi dubbi interpretativi, anche alla luce degli orientamenti giurisprudenziali e dottrinali. In particolare, l’analisi riguarda l’art. 13 del decreto”Bersani” e il comma 9 dell’art. 23 bis (ora pedissequamente trasfuso nel comma 33 dell’art. 4 del d.l. n. 138/2011), ossia le principali disposizioni che definiscono, rispettivamente, la capacità di azione delle società (a partecipazione pubblica) strumentali e di quelle operanti nel campo dei servizi pubblici locali titolari di affidamenti diretti (assentiti con modalità diverse dall’evidenza pubblica). Vengono forniti cenni di inquadramento in relazione al cd. procedimento di riordino delle partecipazioni societarie pubbliche previsto dalla legge finanziaria del 2008 (art. 3, commi 27 – 32). Dal combinato disposto delle suddette norme, così come interpretate dalla giurisprudenza costituzionale ed amministrativa, si ricavano, poi, utili indicazioni in ordine alla possibilità, per gli enti pubblici territoriali, di costituire società con scopo meramente lucrativo (ossia, soggetti societari privi del rapporto di strumentalità con gli enti costituenti o partecipanti, chiamati ad operare, in regime di concorrenza, in settori completamente liberalizzati) e società cd. multiutilities (aventi oggetto sociale complesso, la cui attività si estrinseca tanto nel campo dei servizi strumentali, quanto in quello dei servizi pubblici locali), nonché in relazione alla disciplina applicabile all’attività di detti soggetti societari. La finalità ultima del contributo consiste nell'individuazione delle linee guida finalizzate alla classificazione delle società pubbliche in funzione della loro attività.
In the first part, it aims to provide a nearly exhaustive list of the main provisions of public companies of regional and local level operating in the field of local public services and their legal and doctrinal interpretation, building on the recent legislative actions. In the second part , is faced, however, the issue of legislative limits the capacity for action of public companies and related questions of interpretation, in light of the jurisprudential and doctrinal. In particular, the analysis is for the art. Decree 13 of the "Bersani" and paragraph 9 of article. 23 bis (now slavishly transfused in the paragraph of Article 33. 4 of Decree Law 138/2011), ie the main provisions that define, respectively, the capacity of action of society (public participation) equipment and those working in the field of services Local public holders of direct loans (assentiti public in different ways by the evidence). Provides an outline of classification in relation to the cd. process of reorganization of the public company shares provided by the Finance Act of 2008 (Article 3, paragraphs 27 to 32). The combined effect of these rules, as interpreted by the Constitutional and administrative jurisprudential, are obtained, then, useful information regarding the extent to which local governments can set up companies with lucrative purposes only (ie, corporate entities with no relationship instrumentality or participants with local constituents, called to work in a competitive, in sectors fully liberalized ) and company cd. multi-utilities (whose corporate purpose complex, whose activity is manifested both in the field of instrumental services as in the interest of local public services), and in relation to the regime applicable to the activity of these corporate entities. The ultimate purpose of the contribution consists in identifying guidelines for the classification of public companies according to their activities.
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Trenti, Enrico <1983&gt. "Le società pubbliche a partecipazione regionale e locale operanti nei settori dei servizi pubblici locali e dei servizi “strumentali” e quelle con scopo lucrativo: la recente evoluzione legislativa, gli ambiti di attività ed i relativi limiti, le prospettive future." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2012. http://amsdottorato.unibo.it/4687/.

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Анотація:
Con la prima parte, si intende fornire un quadro pressoché esaustivo delle principali disposizioni in materia di società a partecipazione pubblica regionale e locale operanti nel campo dei servizi pubblici locali e della loro interpretazione giurisprudenziale e dottrinale, prendendo le mosse dagli ultimi interventi legislativo. Nella seconda parte, si affronta, invece, il tema dei limiti legislativi alla capacità di azione delle società a partecipazione pubblica e dei connessi dubbi interpretativi, anche alla luce degli orientamenti giurisprudenziali e dottrinali. In particolare, l’analisi riguarda l’art. 13 del decreto”Bersani” e il comma 9 dell’art. 23 bis (ora pedissequamente trasfuso nel comma 33 dell’art. 4 del d.l. n. 138/2011), ossia le principali disposizioni che definiscono, rispettivamente, la capacità di azione delle società (a partecipazione pubblica) strumentali e di quelle operanti nel campo dei servizi pubblici locali titolari di affidamenti diretti (assentiti con modalità diverse dall’evidenza pubblica). Vengono forniti cenni di inquadramento in relazione al cd. procedimento di riordino delle partecipazioni societarie pubbliche previsto dalla legge finanziaria del 2008 (art. 3, commi 27 – 32). Dal combinato disposto delle suddette norme, così come interpretate dalla giurisprudenza costituzionale ed amministrativa, si ricavano, poi, utili indicazioni in ordine alla possibilità, per gli enti pubblici territoriali, di costituire società con scopo meramente lucrativo (ossia, soggetti societari privi del rapporto di strumentalità con gli enti costituenti o partecipanti, chiamati ad operare, in regime di concorrenza, in settori completamente liberalizzati) e società cd. multiutilities (aventi oggetto sociale complesso, la cui attività si estrinseca tanto nel campo dei servizi strumentali, quanto in quello dei servizi pubblici locali), nonché in relazione alla disciplina applicabile all’attività di detti soggetti societari. La finalità ultima del contributo consiste nell'individuazione delle linee guida finalizzate alla classificazione delle società pubbliche in funzione della loro attività.
In the first part, it aims to provide a nearly exhaustive list of the main provisions of public companies of regional and local level operating in the field of local public services and their legal and doctrinal interpretation, building on the recent legislative actions. In the second part , is faced, however, the issue of legislative limits the capacity for action of public companies and related questions of interpretation, in light of the jurisprudential and doctrinal. In particular, the analysis is for the art. Decree 13 of the "Bersani" and paragraph 9 of article. 23 bis (now slavishly transfused in the paragraph of Article 33. 4 of Decree Law 138/2011), ie the main provisions that define, respectively, the capacity of action of society (public participation) equipment and those working in the field of services Local public holders of direct loans (assentiti public in different ways by the evidence). Provides an outline of classification in relation to the cd. process of reorganization of the public company shares provided by the Finance Act of 2008 (Article 3, paragraphs 27 to 32). The combined effect of these rules, as interpreted by the Constitutional and administrative jurisprudential, are obtained, then, useful information regarding the extent to which local governments can set up companies with lucrative purposes only (ie, corporate entities with no relationship instrumentality or participants with local constituents, called to work in a competitive, in sectors fully liberalized ) and company cd. multi-utilities (whose corporate purpose complex, whose activity is manifested both in the field of instrumental services as in the interest of local public services), and in relation to the regime applicable to the activity of these corporate entities. The ultimate purpose of the contribution consists in identifying guidelines for the classification of public companies according to their activities.
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11

RINKUSH. "ASSESSING THE AUTOMOBILE SECTOR AND ITS FUTURE SCOPE." Thesis, 2022. http://dspace.dtu.ac.in:8080/jspui/handle/repository/19260.

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This report outlines the technical potential that the Indian auto sector faces, with a focus on passenger vehicles (cars). It strives to explain the decisions that Indian automakers will make by attempting to comprehend the factors that will impact acceptance of upcoming new technology. Connectivity, electric powertrains, autonomous vehicles, and industry 4.0 are all possibilities. Clearly, the most crucial elements that will push vehicle OEMs (Original Equipment Manufacturers) to depart from their established business structures are government rules and market pull. In interviews with industry leaders, it was revealed that they will be obliged to gradually electrify their fleet in order to stay up with the changing market environment. Despite existing product and eco-system problems, OEMs will face a difficulty in developing the requisite market pull for electric vehicles. Once the problem of BS VI adoption is overcome, the attention will shift to electrification. Other technologies such as connection, autonomy, shared mobility, and so on will acquire prominence, but they will be supplemental product qualities that will assist attract customers rather than the main offer in and of themselves. The government must likewise use extreme caution when guiding the industry in a particular direction. It must resist the urge to make judgments on behalf of the sector and instead allow market forces to choose which technology or opportunity should be adopted. Finally, we propose a government policy direction that applies a weighted average-based emission standard for all manufacturers. In this study, we will focus on the future scope of the automobile industry in India, and what is the scope of Electric vehicles or FCEV’s will diminish the scope for EV’s or any other new technology will disrupt the market. Also, if autonomous cars and Industry 4.0 will work in the Indian environment, running autonomous cars as a public transport can give relief in accidents and traffic jams caused by human errors.
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12

Joseph, AW. "Prospects for the reform of district municipalities: the scope for manoeuvre." Thesis, 2010. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_6611_1363012277.

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13

Long, Feinan. "The Water Transfer System in Southern Alberta: Scope and Implications for a Future Provincial Water Market." Thesis, 2013. http://hdl.handle.net/10214/5333.

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In the past decade the South Saskatchewan River Basin (SSRB), the most water scarce watershed in southern Alberta, has attracted strong criticisms for implementing a water license transfer system. National advocacy organizations have raised the concern that it may set precedent for a larger liberalized water market. This study aims to assess this concern through 21 unstructured in-depth interviews with governmental, non-governmental, and the local irrigation stakeholders. The theories of policy paradigms and Ostrom’s collective action model were used to assess the findings. It was found that a community-based policy paradigm, based on collective action to managing scarce water resources, was historically key in SSRB. Furthermore, the decline in both community-based and state-based paradigms over Alberta’s water policy within the past two decades have allowed the market-based paradigm to become more influential. Hence this study predicts that a liberalized water market will likely develop in the near future in Alberta.
The Arthur D. Latornell Graduate Research Travel Grants
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14

Kussmaul, Carolyn. "Global expansion of the Physician Assistant profession: healthcare system needs, scope of practice and future directions." Thesis, 2017. https://hdl.handle.net/2144/26727.

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BACKGROUND: The World Health Organization predicts that by 2030 there will be a shortage of more than 14 million healthcare workers. Fifty years ago, to help address the growing demand for medical providers, the United States created a new medical profession, the Physician Assistant. Since 2000, several other countries including Australia, Canada, Germany, Great Britain, India, Israel, Ireland, New Zealand, Saudi Arabia, Scotland, South Africa, and The Netherlands have developed or are developing their own PA-like profession. LITERATURE REVIEW FINDINGS: This thesis contains a comprehensive literature review, composed largely of small pilot and qualitative studies, which summarizes the introduction and expansion of the PA profession in each country. The literature review highlights that around the globe the PA profession is unified by similar condensed medical education and training. However, there is presently a lack of literature on the current roles and tasks of PAs in each country. PROPOSED PROJECT: This thesis proposes a qualitative study to identify each country’s motivation for PA professional development, current scope of practice of PAs and future directions for the PA profession. CONCLUSIONS: The results will be analyzed to reveal correlations, as well as unifying themes and characteristics that are shared among all PAs globally. SIGNIFICANCE: The compiled data will illuminate an emerging profession that is helping to alleviate the healthcare workforce shortage.
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15

Lee, Kun Liang, and 李坤良. "The Business Model and Future Development Research of Joint Insurance Company in Mainland China –The Business Scope." Thesis, 2013. http://ndltd.ncl.edu.tw/handle/adjy5n.

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碩士
國立中興大學
高階經理人碩士在職專班
101
In recent years, cross-strait trade is booming and financial interactions are frequent. Insurance companies of Taiwan anticipate sharing the insurance market of China so they seek to develop in China. The trend of establishing joint insurance company is inevitable. However, because of the cross-strait political relationship and the different cultural background and ethics perception, joint insurance companies still remain in deficit after long operation. This research aims to explore the problems that the joint insurance venture in China in the business scope and strategies and propose an answer to the difficulties that joint insurance venture developing in China. The insurance companies of Taiwan can operate well in the long run is due to the sound healthcare system, the clear conception of insuring, and the down-to-earth operation of the insurance venture, the highly valued service of compensation, the high level of the sales’ professional skills and other factors. However, the above-mentioned features in China are still in the lower level so that the joint insurance venture is still in debt. In view of this, before entering the market of the China, the problems that the joint companies might face in the future have to be investigated and research. Those who have entered the market of China should pay attention to the opinions of the sales and adjust the operational strategies in order to develop sustainably and make profit.
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16

Twiname, S. "Mechanistic understanding of climate-driven range shifts: using thermal tolerances of rock lobster to predict future change." Thesis, 2019. https://eprints.utas.edu.au/31467/1/Twiname_whole_thesis.pdf.

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Climate change and ocean warming are driving changes in marine ecosystems globally. One of the most observed alterations are species’ geographical re-distributions, or range shifts. Many of these shifts have been poleward extensions of species’ ranges, however there is high variation in many aspects of these shifts. What causes these differences in species responses is likely complex and we currently do not have a strong understanding of the cause of this variation. Therefore, there is a pressing need to understand the mechanisms behind species’ range shifts to be able to better predict future changes. One way to begin to understand what may cause a species to shift their range is to investigate their physiological and behavioural thermal tolerances. Here, the thermal tolerances of a range of performance measures of a local and a range-shifting species of spiny lobster in south-east Australia were explored, and potential responses of both species to future ocean warming in the region were modelled. Eastern rock lobster, Sagmariasus verreauxi, are a large species of spiny lobster found along the east coast of Australia and are suspected of undergoing a range shift further into Tasmanian waters, currently occupied by the resident species, southern rock lobster, Jasus edwardsii. The effect of this range-shifting species and its potential interaction with the local species has implications for the valuable local commercial J. edwardsii fishery, as well as for the marine ecosystem in Tasmania. Understanding potential mechanisms behind species’ range shifts is key to being able to predict future changes and proactively manage resources sustainably. Thermal performance curves allow exploration and visualisation of how a species’ measure of performance changes with temperature. Thermal performance curves of multiple measures of performance for the two species of lobster, J. edwardsii and S. verreauxi, at two different life stages, puerulus (final larval stage) and juvenile, were investigated. Using intermittent-flow respirometry, the effects of temperature on aerobic metabolism and aerobic scope across the temperature gradient were developed into thermal performance curves. The effect of temperatures on escape speed, an important survival performance measure, was also measured. It was found that the two species have different thermal tolerances between multiple measures of performance as well as between life stages. This suggests that a single measure of performance may not accurately be able to predict whole-organism changes under ocean warming scenarios. To further determine whether individual species’ thermal tolerances can be used to predict changes to species’ interactions under ocean warming scenarios, competitive trials for food resources between the two lobster species over a range of temperatures were conducted. Single adult individuals of both species were placed in a tank with a single food item and the resulting interaction filmed for analysis. Jasus edwardsii was successful in obtaining the food item before S. verreauxi in the majority of trials. Jasus edwardsii also exhibited significantly more aggressive behaviours than S. verreauxi, who exhibited significantly more submissive behaviours over the temperatures range tested. These results indicate that Jasus edwardsii is competitive at and above temperatures determined optimal for other performance measures in previous studies. It also suggests that while individual thermal tolerances are valuable measures for individual performance under changing climate conditions, they may not be sufficient in predicting changes to the outcomes of interactions due to unforeseen indirect effects in terms of organism behaviour. To gain a more comprehensive understanding of how populations may react to changing ocean conditions, modelling approaches can be used to investigate aspects of species performance not readily obvious from experimental results. Models of Intermediate Complexity for Ecosystem assessments (MICE) are flexible, targeted models that can be used to answer specific questions such as; how will a range shifting lobster affect a resident species in Tasmania? The two-part model first explores how individual physiological thermal tolerances affect projected biomass under a range of scenarios, and secondly incorporates competitive interactions into the framework to project changes as a result of indirect effects of ocean warming. From part one of the model, population trajectories that incorporated physiological data into the model greatly changed the projected biomass. Jasus edwardsii projected biomass remained stable or increased slightly over the 50-year projection, while S. verreauxi biomass is projected to greatly increase, a result consistent with their thermal tolerances and future projected ocean warming in the region. Incorporating competitive interactions in the second part of the model changes the dynamics due to the two populations sharing resources. In these projections, J. edwardsii projected biomass decreased, while S. verreauxi projected biomass increased. Here, it is assumed that the effects of thermal tolerances of the two species outweighs the increased competitive ability of J. edwardsii over S. verreauxi. These results show that incorporating thermal tolerance data into models can greatly affect the outcome of the projections, and that indirect effects of climate changes such as those to species interactions may have considerable effects on populations with potential knock on effects for marine ecosystems. These results all indicate that the mechanisms facilitating or hindering species range shifts are complex and not always easily apparent. While predictions about individual species performance under climate change may be relatively simple to develop, the ability to predict changes to marine communities or ecosystems is much more complicated. Here it is shown that a wide range of techniques can be used to aid in our pursuit for greater understanding of species’ range shifts and their potential effects on marine communities. Ultimately, a comprehensive framework is required that incorporates both experimental and modelling techniques to best grasp current and future changes to both individual species and marine ecosystems.
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Mashiane, Linkie Sheila. "Exploring stories of registered counsellors about their relevance and future in South Africa." Diss., 2019. http://hdl.handle.net/10500/25468.

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The category of Registered Counsellors was created to provide psychological service at primary level to previously disadvantaged communities, yet there is lack of public and professional knowledge concerning this category. This study aimed at finding reasons why people choose to become registered counsellors and what their relevance and future is in South Africa. Social constructionism is the epistemological framework for this qualitative investigation. Three registered counsellors aged between 27 and 31 were chosen for this study using a combination of purposive and snowball sample technique. Rich data were collected through open ended interviews. This approach was chosen as the most relevant because it helped in giving a voice to the three ‘registered counsellors’ which in turn helped in getting a holistic understanding of the participants’ point of view. Thematic analysis technique was used to identify key themes. The main themes identified in comparative analysis were the following: the need to help, feeling of fulfillment, working in a multidisciplinary team, registered counsellors as first point of entry, experiencing barriers in terms of lack of recognition, confusion between registered counsellors and other healthcare professionals; and the role of HPCSA. The results showed that the participants became registered counsellors because of the need to help others. The results also showed that registered counsellors are relevant in South Africa because their services are needed for the well-being of society. There is a future for registered counsellors in South Africa to close the gap in terms of mental health workforce shortage.
Psychology
M.A. (Psychology)
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18

HSU, CHUN-YUAN, and 許春元. "A Study of Scale and Scope Economies of Futures Commission Merchants in Taiwan." Thesis, 2004. http://ndltd.ncl.edu.tw/handle/27468837856098990899.

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19

"Re-Conceptualizing Genetic Influence in GxE Studies: Does Inherited Sensitivity to Environmental Influence Moderate the Indirect Effect of Parent Knowledge on Future Drinking?" Doctoral diss., 2020. http://hdl.handle.net/2286/R.I.64295.

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abstract: Excessive drinking in adolescence is a public health issue with major consequences on both an individual and societal level. Elucidating genetic and environmental influences could be particularly informative for prevention efforts. One potential source of genetic influence is sensitivity to environmental influences. It was hypothesized that parent knowledge would interact with genetic sensitivity to the environment to indirectly reduce risk for alcohol problems through less adolescent rule breaking behavior. Participants (N=316) provided genetic data and reported their rule breaking behavior and past year frequency of heavy drinking, and participants’ custodial parents reported their perceived knowledge of their child’s activities. A novel index of genetic sensitivity to environmental influence was created using published methylation quantitative trait locus data from the frontal lobe. Study hypotheses were mostly not supported. The study results likely reflect the poor distribution of study variables and the limitations of the current study’s sensitivity gene score. The current study underscored the importance of adhering to methodological rigor and explored alternate conceptualizations and methods that future research could use to elucidate the role of inherited to sensitivity to environmental influences in adolescent drinking.
Dissertation/Thesis
Doctoral Dissertation Psychology 2020
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20

BAGNATO, GIANLUCA. "The PREdictor of MAlnutrition in Systemic Sclerosis (PREMASS) score: the first validated combined index predictive of future weight loss in systemic sclerosis." Doctoral thesis, 2017. http://hdl.handle.net/11570/3116752.

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Background/Purpose: Malnutrition and severe gastrointestinal dysfunction are the cause of mortality in 4-15% of systemic sclerosis (SSc) patients whereas overall gastrointestinal involvement is observed in 75-90% of cases. There is currently no disease modifying treatment for severe GI involvement and malnutrition in SSc, and their implementation in clinical trials is halted by our current inability to stratify patients with SSc for the risk of progression. Here we set out to identify a combined index predictive of significant weight loss at 12 months employing Malnutrition Universal Screening Tool (MUST) and serum adiponectin to leptin ratio (A/L) both with known value in other conditions. Methods: This was an international, multicentre, longitudinal study employing 180 SSc patients in two independent cohorts: a study cohort (110 consecutive SSc patients) enrolled from University of Messina (60) and University of Padova (50), and a validation cohort (70) at the University of Leeds. Serum A/L ratio was measured by ELISA. MUST score, which includes BMI and weight loss reported by the patient in the last 3-6 months, was calculated as described: 0=no, 1=mild, >2=moderate/severe risk of malnutrition. End point of the study was weight loss ≥10% of baseline weight at 12 months. Results: The two cohorts showed no significant differences in demographic and clinical features. Overall, median BMI decreased over time in both study and validation cohorts (23.5 vs 22.35 and 23.44 vs 22.49, respectively; p<0.0001). A/L ratio correlated significantly with BMI in both cohorts (r2=0.19 for study cohort, r2=0.25 for validation cohort; p<0.0001). MUST score had only low value in predicting weight loss in the study cohort (AUC 0.7; 95% CI: 0.58-0.82). Specifically, 46.5% of SSc patients with “no” or 3 “mild” MUST risk lost ≥10% weight at 12 months. Logistic regression analysis identified the combination of BMI and A/L as the best PREdictor of MAlnutrition in Systemic Sclerosis (PREMASS). The formula 12.18-(0.63*BMI) + (1.51*A/L) predicted the 10% weight loss at 12 months with an AUC=0.91( 95% CI:0.77-0.84). A PREMASS score >0.23 showed 91.3% sensitivity (95% CI:79.79-100) and 80.46% specificity (95% CI:72.13-88.79) for ≥10% weight loss with an overall 55.26% positive predictive value (PPV) (95% CI:39.45-71.07) and 97.22% negative predictive value (NPV) (95% CI:93.43-100) and a relative risk (RR) of 19.90 (95% CI:4.93-80.37). In the validation cohort, PREMASS showed 76.47% sensitivity (95% CI:56.31-96.63) and 75.47% specificity (95% CI:63.89-87.06) with an overall 50% PPV (95% CI:30.78-69.22), 90.91% NPV (95% CI:82.41-99.4) and a RR of 5.5 (95% CI: 2-15.10). Conclusion: Here we propose PREMASS as the first independently validated index for stratification of risk for severe weight loss in the following 12 months in SSc. Prediction of future weight loss in SSc could aid both in clinical management and stratification/enrichment in clinical trials.
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21

Babooa, Sanjiv Kumar. "Public health service delivery at the Sir Seewoosagur Ramgoolam National Hospital." Diss., 2004. http://hdl.handle.net/10500/2044.

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This dissertation analyses public health service delivery at the Sir Seewoosagur Ramgoolam National Hospital (S.S.R.N.H.) in Mauritius. Particular emphasis is laid on the historical development of public health service delivery at S.S.R.N.H. Public health service delivery has been approached from the view points of its nature and scope. The core components of the research survey have been on some major obstacles and flaws in effective public health service delivery at S.S.R.N.H. The measuring instrument used for the research survey was a self­ administered questionnaire. The main findings were discussed especially absenteeism, personnel turnover, stress, burnout, morale, sexual harassment, lethargy and disobedience, nepotism, shirking responsibility, alcohol and drug abuse, active political interference, bribery and corruption, dishonesty and retaliation and neglect of duty. Attention was also devoted on the current national health policy for improving public health service delivery at S.S.R.N.H., inter-alia, the National Policy for Public Heath Act 17 of 2000 and the White Paper on Health Sector Development and Reform of December 2003. The public health environment is constantly altering. Therefore, it is essential to adjust to the changing health environment. This dissertation has addressed the future challenges in the micro health environment and macro health environment of S.S.R.N.H. Ultimately, a holistic instead of a parochial approach to addressing shortcomings identified in public health service delivery at S.S.R.N.H. has been advocated in this dissertation.
Public Administration
M.Admin. (Public Admin)
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