48 resultados para ENT examination
Resumo:
Developing and implementing a technology for Facilities Management (FM) can be a complex process. This is particularly the case when a technology impacts on an organisation as a whole. There are often a number of relevant actors, internal and external to FM, who should be engaged. This engagement is guided by the strategy of the organisation which is led by top management decisions. Indeed, it is top management who have the final decision to implement a technology. Actors of top management and other relevant actors will have their own discourses toward the implementation of the technology based on how they foresee the technology befittingly benefitting the organisation. This paper examines actors who play a relevant and necessary part in supporting and implementing a technology to FM. It examines how an actor’s discourse toward the project inhibits or speeds up the implementation of a technology. The methods used for this paper are based on a two year case study in a FM department where a technology development was observed and interviews with key participants were conducted. Critical discourse analysis is used to analyse the data. Prominent discourses that emerge from the data are emphasised during the process of introducing the technology. This research moves beyond focusing purely on project successes but examines the difficulties and the hurdles that must be overcome to reach a successful technology implementation.
Resumo:
Satellite data are used to quantify and examine the bias in the outgoing long-wave (LW) radiation over North Africa during May–July simulated by a range of climate models and the Met Office global numerical weather prediction (NWP) model. Simulations from an ensemble-mean of multiple climate models overestimate outgoing clear-sky long-wave radiation (LWc) by more than 20 W m−2 relative to observations from Clouds and the Earth's Radiant Energy System (CERES) for May–July 2000 over parts of the west Sahara, and by 9 W m−2 for the North Africa region (20°W–30°E, 10–40°N). Experiments with the atmosphere-only version of the High-resolution Hadley Centre Global Environment Model (HiGEM), suggest that including mineral dust radiative effects removes this bias. Furthermore, only by reducing surface temperature and emissivity by unrealistic amounts is it possible to explain the magnitude of the bias. Comparing simulations from the Met Office NWP model with satellite observations from Geostationary Earth Radiation Budget (GERB) instruments suggests that the model overestimates the LW by 20–40 W m−2 during North African summer. The bias declines over the period 2003–2008, although this is likely to relate to improvements in the model and inhomogeneity in the satellite time series. The bias in LWc coincides with high aerosol dust loading estimated from the Ozone Monitoring Instrument (OMI), including during the GERBILS field campaign (18–28 June 2007) where model overestimates in LWc greater than 20 W m−2 and OMI-estimated aerosol optical depth (AOD) greater than 0.8 are concurrent around 20°N, 0–20°W. A model-minus-GERB LW bias of around 30 W m−2 coincides with high AOD during the period 18–21 June 2007, although differences in cloud cover also impact the model–GERB differences. Copyright © Royal Meteorological Society and Crown Copyright, 2010
Resumo:
The volume–volatility relationship during the dissemination stages of information flow is examined by analyzing various theories relating volume and volatility as complementary rather than competing models. The mixture of distributions hypothesis, sequential arrival of information hypothesis, the dispersion of beliefs hypothesis, and the noise trader hypothesis all add to the understanding of how volume and volatility interact for different types of futures traders. An integrated picture of the volume–volatility relationship is provided by investigating the dynamic linear and nonlinear associations between volatility and the volume of informed (institutional) and uninformed (the general public) traders. In particular, the trading behavior explanation for the persistence of futures volatility, the effect of the timing of private information arrival, and the response of institutional traders to excess noise trading risk is examined
Resumo:
Aim: To determine the prevalence and nature of prescribing errors in general practice; to explore the causes, and to identify defences against error. Methods: 1) Systematic reviews; 2) Retrospective review of unique medication items prescribed over a 12 month period to a 2% sample of patients from 15 general practices in England; 3) Interviews with 34 prescribers regarding 70 potential errors; 15 root cause analyses, and six focus groups involving 46 primary health care team members Results: The study involved examination of 6,048 unique prescription items for 1,777 patients. Prescribing or monitoring errors were detected for one in eight patients, involving around one in 20 of all prescription items. The vast majority of the errors were of mild to moderate severity, with one in 550 items being associated with a severe error. The following factors were associated with increased risk of prescribing or monitoring errors: male gender, age less than 15 years or greater than 64 years, number of unique medication items prescribed, and being prescribed preparations in the following therapeutic areas: cardiovascular, infections, malignant disease and immunosuppression, musculoskeletal, eye, ENT and skin. Prescribing or monitoring errors were not associated with the grade of GP or whether prescriptions were issued as acute or repeat items. A wide range of underlying causes of error were identified relating to the prescriber, patient, the team, the working environment, the task, the computer system and the primary/secondary care interface. Many defences against error were also identified, including strategies employed by individual prescribers and primary care teams, and making best use of health information technology. Conclusion: Prescribing errors in general practices are common, although severe errors are unusual. Many factors increase the risk of error. Strategies for reducing the prevalence of error should focus on GP training, continuing professional development for GPs, clinical governance, effective use of clinical computer systems, and improving safety systems within general practices and at the interface with secondary care.
Resumo:
The school subject of Art and the profession of the primary school teacher are gendered female and both are considered low status within the field of Education and other professional areas of society. A number of sociological studies have examined the impact of gendered socialisation and habitus on females’ career choices and various educational initiatives have been put in place over the years to encourage females to select subjects and/or pursue career paths normally associated with males. Yet Art and primary school teaching continue to be a popular choice with middle class girls. Based on a critical ethnographic study of female BAED Art students, who are training to be primary school teachers, this study is an examination of the many factors, historically and contemporaneously that have shaped and continue to shape the subjectivities of females and frame their aspirations and ambitions. Within this discourse significant aspects of the history of Art and Art Education that have contributed to and influenced the construction of the female artist, and their consequent impact on artistically talented females’ personal identity as artists, are also examined.