111 resultados para Healthcare Professional


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Services are very important to the UK balance of trade; a surplus has been recorded for trade in services every year since 1966. Construction professional services exports (CPS), which cover architecture, engineering and surveying (AES), have also increased, contributing over £3bn to the UK trade balance in 2007. The changing environment of construction professional services exports complicates the validity of the characteristics and definitions of services as described in the research literature and official export statistics. Through semi-structured interviews undertaken with large consulting engineers and a round-table discussion with industry and government representatives, the research found that the impact of globalisation and the changes in the construction business environment, such as increasing foreign ownership and changing forms of procurement, are not fully reflected in the official statistics. There have also been rapid changes in technology, procurement and methods of delivery which have impacted exporting AES firms and a more appropriate set of characteristics is needed to better reflect the project-specific and knowledge-intensive nature of AES firms.

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Globalisation has prompted increasing numbers of construction profes-sional services (CPS) firms to internationalise and export their services. The driver has been twofold; firstly to increase turnover/profits and sec-ondly, to minimise the risk of a reliance on working in a single domestic market which has a fluctuating demand. Secondly, where firms have out-grown their domestic market, and in order to expand, they must export overseas. There has been little research into the way CPS firms operate overseas, yet construction represents approximately 10% of global GDP; this means that understanding CPS firms is important. This paper investigates how CPS firms internationalise and the drivers that impact their decisions and operations overseas. A survey was undertaken and interviews conducted that showed CPS firms are project driven, in-vesting heavily in the process of seeking work/bidding for projects, and are very focused on delivering projects with minimum risk. Increasing foreign ownership, changing procurement approaches and more consolidation of CPS firms in the global marketplace present a changing business land-scape. The research develops a framework of tangible and intangible factors, such as competencies, business organisation culture, leadership and reputation in order to better understand how CPS firms export their ser-vices. Whilst all CPS firms share the same framework of factors, the re-sulting synergies are different not only for each firm but also for each pro-ject. The knowledge-intensive and project-based nature of CPS firms presents a challenge in understanding the way they operate in the global service economy.

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Determination of varicella zoster virus (VZV) immunity in healthcare workers without a history of chickenpox is important for identifying those in need of vOka vaccination. Post immunisation, healthcare workers in the UK who work with high risk patients are tested for seroconversion. To assess the performance of the time-resolved fluorescence immunoassay (TRFIA) for the detection of antibody in vaccinated as well as unvaccinated individuals, a cut-off was first calculated. VZV-IgG specific avidity and titres six weeks after the first dose of vaccine were used to identify subjects with pre-existing immunity among a cohort of 110 healthcare workers. Those with high avidity (≥60%) were considered to have previous immunity to VZV and those with low or equivocal avidity (<60%) were considered naive. The former had antibody levels ≥400mIU/mL and latter had levels <400mIU/mL. Comparison of the baseline values of the naive and immune groups allowed the estimation of a TRFIA cut-off value of >130mIU/mL which best discriminated between the two groups and this was confirmed by ROC analysis. Using this value, the sensitivity and specificity of TRFIA cut-off were 90% (95% CI 79-96), and 78% (95% CI 61-90) respectively in this population. A subset of samples tested by the gold standard Fluorescence Antibody to Membrane Antigen (FAMA) test showed 84% (54/64) agreement with TRFIA.