68 resultados para best practice


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The incretin hormones glucagon-like peptide-I (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) are physiological gut peptides with insulin-releasing and extrapancreatic glucoregulatory actions. Incretin analogues/mimetics activate GLP-I or GIP receptors whilst avoiding physiological inactivation by dipeptidyl peptidase 4 (DPP-4), and they represent one of the newest classes of antidiabetic drug. The first clinically approved GLP-1 mimetic for the treatment of type-2 diabetes is exenatide (Byetta/exendin) which is administered subcutaneously twice daily. Clinical trials of liraglutide, a GLP-1 analogue suitable for once-daily administration, are ongoing. A number of other incretin molecules are at earlier stages of development. This review discusses the various attributes of GLP-1 and GIP for diabetes treatment and summarises current clinical data. Additionally, it explores the therapeutic possibilities offered by preclinical agents, such as non-peptide GLP-1 mimetics, GLP-1/glucagon hybrid peptides, and specific GIP receptor antagonists.

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This paper engages with contemporary discussions in relation to the commodification of policing and security. It suggests that the existing literature regarding these trends has been geared primarily towards commercial security providers and has failed to address the processes by which public policing models are commodified and marketed both within, and through, the transnational policing community. Drawing upon evidence from the police change process in Northern Ireland, we argue that a Northern Irish Policing Model (NIPM) has emerged in the aftermath of the Independent Commission on Policing (ICP) reforms. This is increasingly branded and promoted on the global stage. Furthermore, we suggest that the NIPM is not monolithic, but segmented, and targeted towards a number of different 'consumers' both domestically and transnationally. Reflecting these diverse markets, the NIPM draws upon two seemingly incongruous constituent elements: the 'best practice' lessons of policing transition, as embodied in the ICP reforms; and, the legacy of counter-terrorism expertise drawn from the preceding decades of conflict. The discussion concludes by querying as to which of these components of the NIPM is in the ascendancy.

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In the aftermath of recent natural disasters, NGOs have become increasingly involved in the permanent reconstruction of affected communities. These organizations, often operating well outside their expertise, encounter significant barriers as they implement reconstruction programmes. This paper presents the theoretical bedrock of a current research project, the overall goal of which is to design a competency-based framework model that can be used by NGOs in post-disaster reconstruction projects. Drawing on established theories of management, a unique perspective has been developed from which a competency-based reconstruction theory emerges. This theoretical framework brings together three distinct fields; Disaster Management, Strategic Management and Project Management, each vital to the success of the model. This theoretical study will incorporate a critical review of literature within each field. It is imperative that NGOs involved in post-disaster reconstruction familiarize themselves with concepts and strategies. It is hoped that the competence-based frame-work model that is produced on the basis of this theory will help define the standard of best practice to which future NGO projects might align themselves.

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In this paper, the results of an empirical analysis of a set of 416 descriptive case studies published by corporate members of the UN Global Compact are presented. Although these cases cannot be viewed as representative of the Compact itself or of corporate social responsibility (CSR) and development in general, they can illustrate which kinds of projects are deemed appropriate as best practice examples among Compact members, and therefore indicate the direction, in which predominantly voluntary and business-led CSR might at best be evolving. To help contextualize the analysis, the paper starts with a brief overview of recent academic work on the strengths and limitations of CSR in the light of international development, followed by the empirical analysis of Compact case studies. The results raise doubts regarding the general suitability of contemporary CSR initiatives to tackle some of the most pressing developmental challenges. Instead, only certain topics are commonly addressed, while a number of issues such as anti-corruption measures or labour rights are underrepresented in the case study sample. Regarding the target regions of the best practice examples, the majority is reported on activities based in OECD countries and a small number of emerging markets such as South Africa, India or China, while neglecting other regions such as sub-Saharan Africa (excluding South Africa). From a European Union policy perspective, these results indicate that there is a role to play for the state in order to create a better fit between CSR agendas and the actual developmental needs in the South.

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Ground-penetrating radar (GPR) is a rapid geophysical technique that we have used to assess four illegally buried waste locations in Northern Ireland. GPR allowed informed positioning of the less-rapid, if more accurate use of electrical resistivity imaging (ERI). In conductive waste, GPR signal loss can be used to map the areal extent of waste, allowing ERI survey lines to be positioned. In less conductive waste the geometry of the burial can be ascertained from GPR alone, allowing rapid assessment. In both circumstances, the conjunctive use of GPR and ERI is considered best practice for cross-validation of results and enhancing data interpretation.

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Molecular testing for the BCR-ABL1 fusion gene by real time quantitative polymerase chain reaction (RT-qPCR) is the most sensitive routine approach for monitoring the response to therapy of patients with chronic myeloid leukaemia. In the context of tyrosine kinase inhibitor (TKI) therapy, the technique is most appropriate for patients who have achieved complete cytogenetic remission and can be used to define specific therapeutic milestones. To achieve this effectively, standardization of the laboratory procedures and the interpretation of results are essential. We present here consensus best practice guidelines for RT-qPCR testing, data interpretation and reporting that have been drawn up and agreed by a consortium of 21 testing laboratories in the United Kingdom and Ireland in accordance with the procedures of the UK Clinical Molecular Genetics Society.

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There are 424 credit unions in Ireland with assets under their control of €14.3bn and a membership of 2.5m which equates to about 66% of the economically active population, the highest penetration level of any country. That said, the Irish movement sits at a critical development stage, well behind mature markets such as Canada and the US in terms of product provision, technological sophistication, fragmentation of trade bodies and regulatory environment. This study analyses relative cost efficiency or performance of Irish credit unions using the popular frontier approach which measures an entity’s efficiency relative to a frontier of best practice. Parametric techniques are utilised, with variation in inefficiency being attributed to credit union-specific factors. The stochastic cost frontier parameters and the credit-union specific parameters are simultaneously estimated to produce valid statistical inferences. The study finds that the majority of Irish credit unions are not operating at optimal levels. It further highlights the factors which drive efficiency variation across credit unions and they include technological sophistication, ‘sponsor donated’ resources, interest rate differentials and the levels of bad debt written off

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The National Student Survey (NSS) in the UK has since 2005 questioned final year
undergraduate students on a broad range of issues relating to their university experience.
Across disciplines and universities students have expressed least satisfaction in the areas of
assessment and feedback. In response to these results many educational practitioners have
reviewed and revised their procedures and the UK Higher Education Academy (HEA) has
produced guidelines of best practice to assist academics in improving these specific areas.
The Product Design and Development (PDD) degree at Queen’s University Belfast is
structured with an integrated curriculum with group Design Build Test (DBT) projects as the
core of each year of the undergraduate programme. Based on the CDIO syllabus and
standards the overall learning outcomes for the programme are defined and developed in a
staged manner, guided by Bloom’s taxonomy of learning domains.
Feedback in group DBT projects, especially in relation to the development of personal and
professional skills, represents a different challenge to that of individual assignment feedback.
A review of best practice was carried out to establish techniques which could be applied to
the particular context of the PDD degree without modification and also to identify areas
where a different approach would need to be applied.
A revised procedure was then developed which utilised the structure of the PDD degree to
provide a mechanism for enhanced feedback in group project work, while at the same time
increasing student development of self and peer evaluation skills. Key to this improvement
was the separation of peer ratings from assessment in the perception of the students and the
introduction of more frequent face to face feedback interviews.
This paper details the new procedures developed and additional issues which have been
raised and addressed, with reference to the published literature, during 3 years of operation.

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The international introduction of electric vehicles (EVs) will see a change in private passenger car usage, operation and management. There are many stakeholders, but currently it appears that the automotive industry is focused on EV manufacture, governments and policy makers have highlighted the potential environmental and job creation opportunities while the electricity sector is preparing for an additional electrical load on the grid system. If the deployment of EVs is to be successful the introduction of international EV standards, universal charging hardware infrastructure, associated universal peripherals and user-friendly software on public and private property is necessary. The focus of this paper is to establish the state-of-the-art in EV charging infrastructure, which includes a review of existing and proposed international standards, best practice and guidelines under consideration or recommendation.

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Rotational molding is a process used to manufacture hollow plastic products, and has been heralded as a molding method with great potential. Reduction of cycle times is an important issue for the rotational molding industry, addressing a significant disadvantage of the process. Previous attempts to reduce cycle times have addressed surface enhanced molds, internal pressure, internal cooling, water spray cooling, and higher oven air flow rates within the existing process. This article explores the potential benefits of these cycle time reduction techniques, and combinations of them. Recommendations on a best practice combination are made, based on experimental observations and resulting product quality. Applying the proposed molding conditions (i.e., a combination of surface-enhanced molds, higher oven flow rates, internal mold pressure, and water spray cooling), cycle time reductions of up to 70% were achieved. Such savings are very significant, inviting the rotomolding community to incorporate these techniques efficiently in an industrial setting. POLYM. ENG. SCI., 49:1846-1854, 2009. (C) 2009 Society of Plastics Engineers

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Reproductive performance in the high-yielding dairy cow has severely decreased in the last 40 yr. The aim of this study was to compare the effectiveness of 4 nutritional strategies in improving the reproductive performance of high-yielding dairy cows. It was hypothesized that offering cows a high-starch ration in early lactation would enhance the onset of luteal activity, and that decreasing the severity of negative energy balance in the early postcalving period would improve reproductive parameters. Nutritional regimens aimed at improving fertility were applied to 96 Holstein-Friesian dairy animals. Upon calving, animals were allocated in a balanced manner to one of 4 dietary treatments. Primiparous animals were balanced according to live weight, body condition score and calving date. Multiparous animals were balanced according to parity, previous lactation milk yield, liveweight, body condition score and calving date. Treatment 1 was based on an industry best practice diet (control) to contain 170 g of crude protein/kg of dry matter. Treatment 2 was an individual cow feeding strategy, whereby the energy balance (EB) of individual animals was managed so as to achieve a predetermined target daily EB profile (+/- 10 MJ/d). Treatment 3 was a high-starch/high-fat combination treatment, whereby an insulinogenic (high-starch) diet was offered in early lactation to encourage cyclicity and followed by a lipogenic (low-starch, high-fat) diet to promote embryo development. Treatment 4 was a low-protein diet, containing 140 g of crude protein/kg of dry matter, supplemented with protected methionine at an inclusion level of 40 g per animal per day. The nutritional strategies implemented in this study had no statistically significant effects on cow fertility measures, which included the onset of luteal activity, conception rate, in-calf rate, and the incidence of atypical cycles. The individual cow feeding strategy improved EB in early lactation but had no benefit on conception rate to first insemination. However, conception rate to second insemination, 100-d pregnancy rate (from the commencement of breeding), and overall pregnancy rate tended to be higher in this group. The high-starch/high-fat treatment tended to decrease the proportion of delayed ovulations and increase the proportion of animals cycling by d 50 postcalving. Animals that failed to conceive to first insemination had a significantly longer luteal phase in the first cycle postpartum and a longer inter-ovulatory interval in the second cycle postpartum. With regards to estrous behavior, results indicate that as the size of the sexually active group increased, the intensity of estrus and the expression of mounting or attempting to mount another cow also increased. Furthermore, cows that became pregnant displayed more intense estrous behavior than cows that failed to become pregnant.

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Purpose
The increasing impact and costs of long term sickness absence have been well documented. However, the diversity and complexity of interventions and of the contexts in which these take place makes a traditional review problematic. Therefore, we undertook a systematic realist review to identify the dominant programme theories underlying best practice, to assess the evidence for these theories, and to throw light on important enabling or disabling contextual factors.

Method
A search of the scholarly literature from 1950 to 2011 identified 5,576 articles, of which 269 formed the basis of the review.

Results
We found that the dominant programme theories in relation to effective management related to: early intervention or referral by employers; having proactive organisational procedures; good communication and cooperation between stakeholders; and workplace-based occupational rehabilitation. Significant contextual factors were identified as the level of support for interventions from top management, the size and structure of the organisation, the level of financial and organisational investment in the management of long-term sickness absence, and the quality of relationships between managers and staff.

Conclusions
Consequently, those with responsibility for managing absence should bear in mind the contextual factors that are likely to have an impact on interventions, and do what they can to ensure stakeholders have at least a mutual understanding (if not a common purpose) in relation to their perceptions of interventions, goals, culture and practice in the management of long term sickness absence.

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As alternate care levels are transferred from hospital to community settings, health care workers in long term care are caring for individuals where conditions are more medically complex. In response to this situation decision makers in long term care are pursuing the goal of practice based on the best evidence. Identifying the information needs of health care workers in this environment represents the first step towards cultivating a best practice culture in long term care. The purpose of this study was to identify what information resources staff need to improve clinical and managerial decision making. The perceptions of health care workers at two long term care organizations were investigated through quantitative and qualitative methods, using a questionnaire and focus groups. In each of the settings there were gaps in the availability of resources and perceived needs for education. The findings from both settings revealed the need for more information resources to assist staff to improve individual care of residents and develop better approaches to health problems.

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There are major concerns about the level of personal borrowing, particularly sourced from credit cards. This paper charts the progress of an initiative to create a Responsible Lending Index (RLI) for the credit industry. The RLI proposed to voluntarily benchmark lending standards and promote best practice within the credit industry by involving suppliers of credit, customer representatives and regulators. However, despite initial support from some banks, consumer bodies and the Chair of the Treasury Select Committee, it failed to gain sufficient support from financial institutions in its original format. The primary reasons for this were related to the complexity of building such a robust index and the banks trade body’s fear of exposing its members to public scrutiny. A revised alternative, the Responsible Lending Initiative, was proposed which took into account these concerns. However, the Association of Payment Clearing Service (APACS), the trade body of the credit industry, then effectively destroyed the proposal. This article describes an attempt to address the challenges in the credit card industry with the initiation of the RLI, reflected in stakeholder discourse and in the context of a wider concern expressed by the involved stakeholders in terms of the need for greater responsibility in the banking industry’s lending practices.