48 resultados para Hospital in the Home


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The Seille Valley in eastern France was home to one of Europe’s largest Iron Age salt industries. Sedimentology, palynology and geochronology have been integrated within ongoing archaeological investigations to reconstruct the Holocene palaeoenvironmental history of the Seille Valley and to elucidate the human–environment relationship of salt production. A sedimentary model of the valley has been constructed from a borehole survey of the floodplain and pollen analyses have been undertaken to reconstruct the vegetation history. Alluvial records have been successfully dated using optically stimulated luminescence and radiocarbon techniques, thereby providing a robust chronological framework. The results have provided an insight into the development of favourable conditions for salt production and there is evidence in the sedimentary record to suggest that salt production may have taken place during the mid-to-late Bronze Age. The latter has yet to be identified in the archaeological record and targeted excavation is therefore underway to test this finding. The development of the Iron Age industry had a major impact on the hydrological regime of the valley and its sedimentological history, with evidence for accelerated alluviation arising from floodplain erosion at salt production sites and modification of the local fluvial regime due to briquetage accumulation on the floodplain. This research provides an important insight into the environmental implications of early industrial activities, in addition to advancing knowledge about the Holocene palaeoenvironmental and social history of this previously poorly studied region of France.

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This paper presents the findings of the study that examines how income multiples for mortgage loan associates with home repossession using the data of the Council of Mortgage Lenders (CML). It employs a statistical measure for improving regression efficiency with conditioning information in the form of lagged instrument to unravel the pattern of association evident from the data. Based on the data, the study investigates what level of income multiples is optimum – that is the income multiple that minimises home repossession. A sensitivity analysis was undertaken to show how home repossession responds to changes in income multiples. For each of the analytical tasks, the study compares the aggregate market, first-time-buyers, and home movers.

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This paper examines the phenomenon of cross-border property lending and examines a number of issues regarding lending procedures and decision making processes in the context of the relationship between lender and professional advisor. It commences by placing these procedures and processes in the context of the development of cross border European property investment and finance. The UK has been a popular destination for overseas investors and lenders over the last decade and is therefore used as a case study to examine the additional institutional risk that overseas lenders may face when operating outside of their own country and obtaining advice from home professionals. The UK market was the subject of a boom period during the late 1980s, followed by a recession in the early 1990s. The losses triggered a number of professional negligence actions by lenders against valuers. These include a number of overseas lenders mainly from Europe and these cases have been examined for any particular features which, coupled with other data gained from overseas lenders as part of an interview survey, could be used to isolate any significant problems for European lenders in overseas markets. The research identified a lack of clarity in roles and relationships between lender and advisor, difficulties in communications both internally and between overseas branches and headquarters and failures in provision and interpretation of advice. The paper concludes by identifying the issues which may need to be addressed generally by lenders and their advisors, when the lenders are operating in overseas markets.

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Much of the literature in international business analysing the multinational enterprise uses the country as the relevant environmental parameter. This paper presents both theoretical and empirical evidence to demonstrate that country-level analysis now needs to be augmented by analysis at the ‘regional’ level of the broad triad markets of Europe, North America and the Asia Pacific. The great majority of the world's 500 largest firms concentrate their activities within their home region of the triad. This study uses variance component analysis and finds that this home region effect outperforms the country effect. Together, the regional and industry effects explain most of the geographic expansion of multinational enterprises (MNEs), whereas country, firm and year effects are very minor. The new data and variance component analysis on the activities of large MNEs reported here suggest that new thinking is required about the importance of large regions of the triad as the relevant unit of analysis for business strategy to supplement the conventional focus on the country.

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This article examines the ways that technological objects inside the home are viewed and productively used by a group of older people to extend their access to environments beyond the home. Beginning with a discussion of types of domestic object, we highlight appliances and gadgets, and focus our attentions on the latter. The changes in life brought on by ageing, in particular a reduction in mobility, provide the context for our study, in which access to the outside world becomes increasingly difficult. Recognising their changing circumstances led our participants to actively and selectively engage with these objects, mitigating the shrinking of their accessible environment by using them as a gateway to the many virtual worlds now available. We coin the term ‘portal objects’ to describe the potential that this type of technological object provides, and suggest that the investigation of interiors can be enriched by recognising and including the worlds outside that become integral to occupation inside.

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This paper examines the implementation of brownfield regeneration policies in the UK within the context of complex systems of multi-level governance. Using the regeneration of the Thames Gateway as an example, it explores how the Government's centrally driven institutional arrangements have undermined leadership in this key development project. The Government's approach to brownfield governance is characterised as one of constant intervention in the Thames Gateway in an ad hoc and incoherent fashion. Congested and fragmented governance structures are the result. These, this paper argues, have diffused the focus and undermined the leadership of policy and implementation. It is suggested that the adoption of the principles of policy mapping and weaving would bring more clarity and coherence to the governance of the Thames Gateway.

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This paper examines the relationship between embodied individuals and the home that they inhabit. Although there has been some work on both the embodied practices in the home and on the material nature of the home itself, this has not been integrated with the majority of research on home which has focused on meaning. It is argued that there is a lack of a unifying framework that can incorporate both use and meaning elements of home. A way of incorporating these elements through adoption of the concept of affordances is put forward. However, the affordance approach needs to be developed to achieve this. The paper does this first by incorporating the concept of intentionality of actions and then through the use of the concept of well‐being. Debates about housing for people with a physical disability and the practical help provided to this group of people are used to illustrate how the approach could work.

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Urban domestic cat (Felis catus) populations can attain exceedingly high densities and are not limited by natural prey availability. This has generated concerns that they may negatively affect prey populations, leading to calls for management. We enlisted cat-owners to record prey returned home to estimate patterns of predation by free-roaming pets in different localities within the town of Reading, UK and questionnaire surveys were used to quantify attitudes to different possible management strategies. Prey return rates were highly variable: only 20% of cats returned ≥4 dead prey annually. Consequently, approximately 65% of owners received no prey in a given season, but this declined to 22% after eight seasons. The estimated mean predation rate was 18.3 prey cat−1 year−1 but this varied markedly both spatially and temporally: per capita predation rates declined with increasing cat density. Comparisons with estimates of the density of six common bird prey species indicated that cats killed numbers equivalent to adult density on c. 39% of occasions. Population modeling studies suggest that such predation rates could significantly reduce the size of local bird populations for common urban species. Conversely, most urban residents did not consider cat predation to be a significant problem. Collar-mounted anti-predation devices were the only management action acceptable to the majority of urban residents (65%), but were less acceptable to cat-owners because of perceived risks to their pets; only 24% of cats were fitted with such devices. Overall, cat predation did appear to be of sufficient magnitude to affect some prey populations, although further investigation of some key aspects of cat predation is warranted. Management of the predation behavior of urban cat populations in the UK is likely to be challenging and achieving this would require considerable engagement with cat owners.

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This paper presents an account of the literacy activities engaged in by the parents of 29 children around the time that the children were about to start school at Key Stage 1. Fifteen of the children were reading fluently before they began school and the remaining fourteen were matched for age, sex, receptive vocabulary scores, preschool group attended and socio-economic family status, but not reading fluently. In order to ascertain that the fluent readers were not simply coming from homes where literacy activities were more in evidence, parents were asked to report on their own literacy activities. The data obtained indicated that there were no systematic differences in the activities of the two sets of parents. They also showed that there was a considerable amount of literacy activity evidence in the homes. It is argues that, whilst the home environment is highly instrumental in nurturing literacy development, it is not enough to account for precocious reading ability.

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In the UK alone there are more than 2500 museums of interest to international and home audiences. Despite their prevalence and a strong museological culture in the UK and beyond, the geographic study of museums is relatively under-developed. To date there has been no systematic overview of this field either in the UK or internationally. This review article is intended as a contribution towards an emerging ‘museum geography’. Beginning with an exploration of research on museums, collections and museum practice, the author then considers the recent ‘spatial turn’ in museum studies and discusses how geographers have variously encountered museums, collections and museum practice to date. The article then reviews the potential for the future study of museums by geographers. In so doing, the author suggests that the study of museums offers some exciting opportunities for geographical research and teaching.

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Accident and Emergency (A&E) units provide a route for patients requiring urgent admission to acute hospitals. Public concern over long waiting times for admissions motivated this study, whose aim is to explore the factors which contribute to such delays. The paper discusses the formulation and calibration of a system dynamics model of the interaction of demand pattern, A&E resource deployment, other hospital processes and bed numbers; and the outputs of policy analysis runs of the model which vary a number of the key parameters. Two significant findings have policy implications. One is that while some delays to patients are unavoidable, reductions can be achieved by selective augmentation of resources within, and relating to, the A&E unit. The second is that reductions in bed numbers do not increase waiting times for emergency admissions, their effect instead being to increase sharply the number of cancellations of admissions for elective surgery. This suggests that basing A&E policy solely on any single criterion will merely succeed in transferring the effects of a resource deficit to a different patient group.

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Speaking of the public response to the deaths of children at the Bristol Royal Infirmary before 2001, the BMJ commented that the NHS would be 'all changed, changed utterly'. Today, two inquiries into the Mid Staffordshire Foundation Trust suggest nothing changed at all. Many patients died as a result of their care and the stories of indifference and neglect there are harrowing. Yet Bristol and Mid Staffordshire are not isolated reports. In 2011, the Health Services Ombudsman reported on the care of elderly and frail patients in the NHS and found a failure to recognise their humanity and individuality and to respond to them with sensitivity, compassion and professionalism. Likewise, the Care Quality Commission and Healthcare Commission received complaints from patients and relatives about the quality of nursing care. These included patients not being fed, patients left in soiled bedding, poor hygiene practices, and general disregard for privacy and dignity. Why is there such tolerance of poor clinical standards? We need a better understanding of the circumstances that can lead to these outcomes and how best to respond to them. We discuss the findings of these and other reports and consider whether attention should be devoted to managing individual behaviour, or focus on the systemic influences which predispose hospital staff to behave in this way. Lastly, we consider whether we should look further afield to cognitive psychology to better understand how clinicians and managers make decisions?

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This paper presents a novel mobile sink area allocation scheme for consumer based mobile robotic devices with a proven application to robotic vacuum cleaners. In the home or office environment, rooms are physically separated by walls and an automated robotic cleaner cannot make a decision about which room to move to and perform the cleaning task. Likewise, state of the art cleaning robots do not move to other rooms without direct human interference. In a smart home monitoring system, sensor nodes may be deployed to monitor each separate room. In this work, a quad tree based data gathering scheme is proposed whereby the mobile sink physically moves through every room and logically links all separated sub-networks together. The proposed scheme sequentially collects data from the monitoring environment and transmits the information back to a base station. According to the sensor nodes information, the base station can command a cleaning robot to move to a specific location in the home environment. The quad tree based data gathering scheme minimizes the data gathering tour length and time through the efficient allocation of data gathering areas. A calculated shortest path data gathering tour can efficiently be allocated to the robotic cleaner to complete the cleaning task within a minimum time period. Simulation results show that the proposed scheme can effectively allocate and control the cleaning area to the robot vacuum cleaner without any direct interference from the consumer. The performance of the proposed scheme is then validated with a set of practical sequential data gathering tours in a typical office/home environment.