110 resultados para medication quality and safety


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Online travel reviews are emerging as a powerful source of information affecting tourists' pre-purchase evaluation of a hotel organization. This trend has highlighted the need for a greater understanding of the impact of online reviews on consumer attitudes and behaviors. In view of this need, we investigate the influence of online hotel reviews on consumers' attributions of service quality and firms' ability to control service delivery. An experimental design was used to examine the effects of four independent variables: framing; valence; ratings; and target. The results suggest that in reviews evaluating a hotel, remarks related to core services are more likely to induce positive service quality attributions. Recent reviews affect customers' attributions of controllability for service delivery, with negative reviews exerting an unfavorable influence on consumers' perceptions. The findings highlight the importance of managing the core service and the need for managers to act promptly in addressing customer service problems.

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Objective: To examine the context of occupational health and safety related to blood-borne communicable diseases practice. Methods: A case study approach using qualitative semi-structured interviews with five key informants who represented different sectors of the beauty therapy industry in South Australia. Results: Four main themes were identified: (i) exposure to blood and blood-borne communicable diseases; (ii) prevention in practice; (iii) OH&S problems; and (iv) industry needs. Conclusion: Key OH&S issues in the beauty therapy industry include: power relationships between employers and employees, equipment costs, the need for more continuing education, and monitoring of practitioners. Implications: Economic constraints, continuing education, and government regulation of the beauty therapy industry are highlighted as significant areas for further consideration in addressing the OH&S needs of practitioners and their clients.

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Objective: To examine current knowledge and practice of occupational health and safety (OH&S) regarding hepatitis C in beauty therapy practice. Methods: A questionnaire was sent to all beauty therapy practices identified through the Telstra Yellow Pages and distributed via beauty therapy product agencies. Results: 119 questionnaires were completed by employers and employees in 99 beauty therapy practices in metropolitan Adelaide. Beauty therapists reported carrying out many practices that had exposed them to blood in the past. More than 80% of the procedures carried out by beauty therapists in the previous week were reported to have led to exposure to blood. 39.5% of respondents had not received information about OH&S practices related to blood spills and 77.5% of respondents had received no OH&S information about hepatitis C. Knowledge of hepatitis C and its transmission was poor, with 62% of respondents incorrectly identifying the prevalence of hepatitis C and respondents incorrectly identifying sneezing (28%), kissing (46%) and sharing coffee cups (42%) as a modes of transmission. 80% of beauty therapy practices had no OH&S representative. Conclusion: Beauty therapy practice can expose both operator and client to blood and is therefore a potential site for the transmission of blood-borne diseases including hepatitis C. OH&S information is inadequate in this industry and knowledge of hepatitis C is poor.

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Aim To provide an overview of key governance matters relating to medical device trials and practical advice for nurses wishing to initiate or lead them. Background Medical device trials, which are formal research studies that examine the benefits and risks of therapeutic, non-drug treatment medical devices, have traditionally been the purview of physicians and scientists. The role of nurses in medical device trials historically has been as data collectors or co-ordinators rather than as principal investigators. Nurses more recently play an increasing role in initiating and leading medical device trials. Review Methods A review article of nurse-led trials of medical devices. Discussion Central to the quality and safety of all clinical trials is adherence to the International Conference on Harmonization Guidelines for Good Clinical Practice, which is the internationally-agreed standard for the ethically- and scientifically-sound design, conduct and monitoring of a medical device trial, as well as the analysis, reporting and verification of the data derived from that trial. Key considerations include the class of the medical device, type of medical device trial, regulatory status of the device, implementation of standard operating procedures, obligations of the trial sponsor, indemnity of relevant parties, scrutiny of the trial conduct, trial registration, and reporting and publication of the results. Conclusion Nurse-led trials of medical devices are demanding but rewarding research enterprises. As nursing practice and research increasingly embrace technical interventions, it is vital that nurse researchers contemplating such trials understand and implement the principles of Good Clinical Practice to protect both study participants and the research team.

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In this research fluidization behavior of cubical Bovine intestine samples was studied. Bovine intestine samples were heat pump dried at atmospheric pressure and at emperatures below and above the material freezing points. Experiments were conducted to study fluidization characteristics and drying kinetics at different drying conditions. Bovine particles were characterized according to Geldart classification and minimum fluidization velocity was calculated using Ergun Equation and generalized equation for all drying conditions at the beginning of the trials and end of the trials. Walli’s model was used to categorize stability of the fluidization at the beginning and end of the drying for each trial. Walli’s values determined were positive at the beginning and end of all trials indicating stable fluidisation at the beginning and end for each drying condition.

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This research investigated airborne particle characteristics and their dynamics inside and around the envelope of mechanically ventilated office buildings, together with building thermal conditions and energy consumption. Based on these, a comprehensive model was developed to facilitate the optimisation of building heating, ventilation and air conditioning systems, in order to protect the health of their occupants and minimise the energy requirements of these buildings.

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Purpose: This randomized, multicenter trial compared first-line trastuzumab plus docetaxel versus docetaxel alone in patients with human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer (MBC). Patients and Methods: Patients were randomly assigned to six cycles of docetaxel 100 mg/m 2 every 3 weeks, with or without trastuzumab 4 mg/kg loading dose followed by 2 mg/kg weekly until disease progression. Results: A total of 186 patients received at least one dose of the study drug. Trastuzumab plus docetaxel was significantly superior to docetaxel alone in terms of overall response rate (61% v 34%; P = .0002), overall survival (median, 31.2 v 22.7 months; P = .0325), time to disease progression (median, 11.7 v 6.1 months; P = .0001), time to treatment failure (median, 9.8 v 5.3 months; P = .0001), and duration of response (median, 11.7 v 5.7 months; P = .009). There was little difference in the number and severity of adverse events between the arms. Grade 3 to 4 neutropenia was seen more commonly with the combination (32%) than with docetaxel alone (22%), and there was a slightly higher incidence of febrile neutropenia in the combination arm (23% v 17%). One patient in the combination arm experienced symptomatic heart failure (1%). Another patient experienced symptomatic heart failure 5 months after discontinuation of trastuzumab because of disease progression, while being treated with an investigational anthracycline for 4 months. Conclusion: Trastuzumab combined with docetaxel is superior to docetaxel alone as first-line treatment of patients with HER2-positive MBC in terms of overall survival, response rate, response duration, time to progression, and time to treatment failure, with little additional toxicity. © 2005 by American Society of Clinical Oncology.

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This paper will identify and discuss the major occupational health and safety (OHS) hazards and risks for clean-up and recovery workers. The lessons learned from previous disasters including; the Exxon Valdez oil spill, World Trade Centre (WTC) terrorist attack, Hurricane Katrina and the Deepwater Horizon Gulf of Mexico oil spill will be discussed. The case for an increased level of preparation and planning to mitigate the health risks for clean-up and recovery workers will be presented, based on recurring themes identified in the peer reviewed literature. There are a number of important issues pertaining to the occupational health and safety of workers who are engaged in clean-up and recovery operations following natural and technological disasters. These workers are often exposed to a wide range of occupational health and safety hazards, some of which may be unknown at the time. It is well established that clean-up and recovery operations involve risks of physical injury, for example, from manual handling, mechanical equipment, extreme temperatures, slips, trips and falls. In addition to these well established physical injury risks there are now an increasing number of studies which highlight the risks of longer term or chronic health effects arising from clean-up and recovery work. In particular, follow up studies from the Exxon Valdez oil spill, Hurricane Katrina and the World Trade Centre (WTC) terrorism attack have documented the longer term health consequences of these events. These health effects include respiratory symptoms and musculoskeletal disorders, as well as post traumatic stress disorder (PTSD). In large scale operations many of those workers and supervisors involved have not had any specific occupational health and safety (OHS) training and may not have access to the necessary instruction, personal protective equipment or other appropriate equipment, this is especially true when volunteers are used to form part of the clean-up and recovery workforce. In general, first responders are better equipped and trained than clean-up and recovery workers and some of the training approaches used for the traditional first responders would be relevant for clean-up and recovery workers.

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This paper describes the experimental evaluation of a novel Autonomous Surface Vehicle capable of navigating complex inland water reservoirs and measuring a range of water quality properties and greenhouse gas emissions. The 16 ft long solar powered catamaran is capable of collecting water column profiles whilst in motion. It is also directly integrated with a reservoir scale floating sensor network to allow remote mission uploads, data download and adaptive sampling strategies. This paper describes the onboard vehicle navigation and control algorithms as well as obstacle avoidance strategies. Experimental results are shown demonstrating its ability to maintain track and avoid obstacles on a variety of large-scale missions and under differing weather conditions, as well as its ability to continuously collect various water quality parameters complimenting traditional manual monitoring campaigns.

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This paper presents the blast response, damage mechanism and evaluation of residual load capacity of a concrete–steel composite (CSC) column using dynamic computer simulation techniques. This study is an integral part of a comprehensive research program which investigated the vulnerability of structural framing systems to catastrophic and progressive collapse under blast loading and is intended to provide design information on blast mitigation and safety evaluation of load bearing vulnerable columns that are key elements in a building. The performance of the CSC column is compared with that of a reinforced concrete (RC) column with the same dimensions and steel ratio. Results demonstrate the superior performance of the CSC column, compared to the RC column in terms of residual load carrying capacity, and its potential for use as a key element in structural systems. The procedure and results presented herein can be used in the design and safety evaluation of key elements of multi-storey buildings for mitigating the impact of blast loads.

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While data quality has been identified as a critical factor associated with enterprise resource planning (ERP) failure, the relationship between ERP stakeholders, the information they require and its relationship to ERP outcomes continues to be poorly understood. Applying stakeholder theory to the problem of ERP performance, we put forward a framework articulating the fundamental differences in the way users differentiate between ERP data quality and utility. We argue that the failure of ERPs to produce significant organisational outcomes can be attributed to conflict between stakeholder groups over whether the data contained within an ERP is of adequate ‘quality’. The framework provides guidance as how to manage data flows between stakeholders, offering insight into each of their specific data requirements. The framework provides support for the idea that stakeholder affiliation dictates the assumptions and core values held by individuals, driving their data needs and their perceptions of data quality and utility.

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In recent times significant change has occurred to the Australian health and safety regulatory context. In this paper we consider the potential response of smaller firms in general, and ethnic owned and/or operated smaller firms in particular. We draw on literature examining smaller firms' responses to regulation and apply this to what little we know about smaller ethnic firms in Australia in the context of the regulatory change. We highlight the challenges to owner managers and what could be done to engage and support smaller ethnic firms to realise the opportunities resulting from this regulatory change.

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Small firms are popularly viewed as resistant to complying with regulation. Harmonisation of Australia’s state-based work health and safety regimes is a significant regulatory change. In this article, we consider the likely responses of small firms to work health and safety harmonisation and argue that a range of choices are open to small firm owner-managers. These choices are shaped by individuals’ world views and are influenced by elements in the firms’ context. A significant element is the public narrative of work health and safety harmonisation, which can be understood by using discourse and sense-making concepts. Our analysis of small firm owner-manager choices takes into account small firms’ embeddedness in their regulatory context and the influence on organisational decision-making of the narrative of work health and safety harmonisation. The dominant narrative is arguably silent on the benefits of the work health and safety regulatory change and therefore the response of small firms is likely to be avoidance or minimalism. Non-compliance could be the result due to poor awareness of opportunities arising from this regulatory change.

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The conventional measures of benchmarking focus mainly on the water produced or water delivered, and ignore the service quality, and as a result the 'low-cost and low-quality' utilities are rated as efficient units. Benchmarking must credit utilities for improvements in service delivery. This study measures the performance of 20 urban water utilities using data from an Asian Development Bank survey of Indian water utilities in 2005. It applies data envelopment analysis to measure the performance of utilities. The results reveal that incorporation of a quality dimension into the analysis significantly increases the average performance of utilities. The difference between conventional quantity-based measures and quality-adjusted estimates implies that there are significant opportunity costs of maintaining the quality of services in water delivery.