7 resultados para Central Supply, Hospital
em CentAUR: Central Archive University of Reading - UK
Resumo:
Many lowland rivers across northwest Europe exhibit broadly similar behavioural responses to glacial-interglacial transitions and landscape development. Difficulties exist in assessing these, largely because the evidence from many rivers remains limited and fragmentary. Here we address this issue in the context of the river Kennet, a tributary of the Thames, since c. 13,000 cal BP. Some similarities with other rivers are present, suggesting that regional climatic shifts are important controls. The Kennet differs from the regional pattern in a number of ways. The rate of response to sudden climatic change, particularly at the start of the Holocene and also mid-Holocene forest clearance, appears very high. This may reflect abrupt shifts between two catchment scale hydrological states arising from contemporary climates, land use change and geology. Stadial hydrology is dominated by nival regimes, with limited winter infiltration and high spring and summer runoff. Under an interglacial climate, infiltration is more significant. The probable absence of permafrost in the catchment means that a lag between the two states due to its gradual decay is unlikely. Palaeoecology, supported by radiocarbon dates, suggests that, at the very start of the Holocene, a dramatic episode of fine sediment deposition across most of the valley floor occurred, lasting 500-1000 years. A phase of peat accumulation followed as mineral sediment supply declined. A further shift led to tufa deposition, initially in small pools, then across the whole floodplain area, with the river flowing through channels cut in tufa and experiencing repeated avulsion. Major floods, leaving large gravel bars that still form positive relief features on the floodplain, followed mid-Holocene floodplain stability. Prehistoric deforestation is likely to be the cause of this flooding, inducing a major environmental shift with significantly increased surface runoff. Since the Bronze Age, predominantly fine sediments were deposited along the valley with apparently stable channels and vertical floodplain accretion associated with soil erosion and less catastrophic flooding. The Kennet demonstrates that, while a general pattern of river behaviour over time, within a region, may be identifiable, individual rivers are likely to diverge from this. Consequently, it is essential to understand catchment controls, particularly the relative significance of surface and subsurface hydrology. (c) 2005 Elsevier B.V. All rights reserved.
Resumo:
Background Pharmacy aseptic units prepare and supply injectables to minimise risks. The UK National Aseptic Error Reporting Scheme has been collecting data on pharmacy compounding errors, including near-misses, since 2003. Objectives The cumulative reports from January 2004 to December 2007, inclusive, were analysed. Methods The different variables of product types, error types, staff making and detecting errors, stage errors detected, perceived contributory factors, and potential or actual outcomes were presented by cross-tabulation of data. Results A total of 4691 reports were submitted against an estimated 958 532 items made, returning 0.49% as the overall error rate. Most of the errors were detected before reaching patients, with only 24 detected during or after administration. The highest number of reports related to adult cytotoxic preparations (40%) and the most frequently recorded error was a labelling error (34.2%). Errors were mostly detected at first check in assembly area (46.6%). Individual staff error contributed most (78.1%) to overall errors, while errors with paediatric parenteral nutrition appeared to be blamed on low staff levels more than other products were. The majority of errors (68.6%) had no potential patient outcomes attached, while it appeared that paediatric cytotoxic products and paediatric parenteral nutrition were associated with greater levels of perceived patient harm. Conclusions The majority of reports were related to near-misses, and this study highlights scope for examining current arrangements for checking and releasing products, certainly for paediatric cytotoxic and paediatric parenteral nutrition preparations within aseptic units, but in the context of resource and capacity constraints.
Resumo:
Over the last two decades, Jordan has suffered a chronic water crisis, and is the tenth most water-scarce nation on Earth. Such water stress has been well illustrated in the case of Greater Amman, the capital, which has grown dramatically from a population of around 2000 in the 1920s, to 2.17 million today. One of the distinctive characteristics of the water supply regime of Greater Amman is that since 1987 it has been based on a system of rationing, with households receiving water once a week for various durations. Amman is highly polarized socio-economically, and by means of household surveys, both quantitative and qualitative, conducted in high- and low-income divisions of the city, a detailed empirical evaluation of the storage and use of water, the strategies used by households to manage water and overall satisfaction with water supply issues is provided in this paper, looking specifically at issues of social equity. The analysis demonstrates the social and economic costs of water rationing and consequent management to be high, as well as emphasizing that issues of water quality are of central importance to all consumers regardless of their socio-economic status within the city.
Resumo:
Milk supply from Mexican dairy farms does not meet demand and small-scale farms can contribute toward closing the gap. Two multi-criteria programming techniques, goal programming and compromise programming, were used in a study of small-scale dairy farms in central Mexico. To build the goal and compromise programming models, 4 ordinary linear programming models were also developed, which had objective functions to maximize metabolizable energy for milk production, to maximize margin of income over feed costs, to maximize metabolizable protein for milk production, and to minimize purchased feedstuffs. Neither multicriteria approach was significantly better than the other; however, by applying both models it was possible to perform a more comprehensive analysis of these small-scale dairy systems. The multi-criteria programming models affirm findings from previous work and suggest that a forage strategy based on alfalfa, rye-grass, and corn silage would meet nutrient requirements of the herd. Both models suggested that there is an economic advantage in rescheduling the calving season to the second and third calendar quarters to better synchronize higher demand for nutrients with the period of high forage availability.
Resumo:
Small-scale dairy systems play an important role in the Mexican dairy sector and farm planning activities related to resource allocation have a significant impact on the profitability of such enterprises. Linear programming is a technique widely used for planning and ration formulation, and partial budgeting is a technique for assessing the impact of changes on the profitability of an enterprise. This study used both methods to optimise land use for forage production and nutrient availability, and to evaluate the economic impact of such changes in small-scale Mexican dairy systems. The model showed satisfactory performance when optimal solutions were compared with the traditional strategy. The strategy using fresh ryegrass, maize silage and oat hay, and the strategy using a combination of alfalfa hay, maize silage, fresh ryegrass and oat hay appeared attractive options for providing a better nutrient supply and maintaining a higher stocking rate throughout the year than the traditional strategy.
Resumo:
The real estate market in Poland is a relatively immature market, but one that has been experiencing substantial transformation. The development of the market has been encouraged by a number of factors, including changes arising as a result of new legislation and the migration of capital between capital markets. The progress of the real estate sector towards a western style competitive market has taken place within the gradual transformation of the Polish economy into a free market economy. As investment grade property is in relatively short supply in Poland, investors consider opportunities within the wider CEE block. An analysis of the risk-return characteristics of the three largest CEE real estate markets namely, Poland, Hungary and Czech Republic, shows that the returns in these markets have been negatively correlated with the UK. As these economies and markets evolve, and being part of the wider EU trading block, their economic performance will slowly converge and become more synchronized with their western counterparts. However, the catch-up of the CEE markets to western European performance cycles will be protracted and consequently there are likely to be significant ongoing portfolio risk reduction opportunities
Resumo:
Objectives A pharmacy Central Intravenous Additives Service (CIVAS) provides ready to use injectable medicines. However, manipulation of a licensed injectable medicine may significantly alter the stability of drug(s) in the final product. The aim of this study was to develop a stability indicating assay for CIVAS produced dobutamine 500 mg in 50 ml dextrose 1% (w/v) prefilled syringes, and to allocate a suitable shelf life. Methods A stability indicating high performance liquid chromatography (HPLC) assay was established for dobutamine. The stability of dobutamine prefilled syringes was evaluated under storage conditions of 4°C (protected from light), room temperature (protected from light), room temperature (exposed to light) and 40°C (protected from light) at various time points (up to 42 days). Results An HPLC method employing a Hypersil column, mobile phase (pH=4.0) consisting of 82:12:6 (v/v/v) 0.05 M KH2PO4:acetonitrile:methanol plus 0.3% (v/v) triethylamine with UV detection at λ=280 nm was specific for dobutamine. Under different storage conditions only samples stored at 40°C showed greater than 5% degradation (5.08%) at 42 days and had the shortest T95% based on this criterion (44.6 days compared with 111.4 days for 4°C). Exposure to light also reduced dobutamine stability. Discolouration on storage was the limiting factor in shelf life allocation, even when dobutamine remained within 5% of the initial concentration. Conclusions A stability indicating HPLC assay for dobutamine was developed. The shelf life recommended for the CIVAS product was 42 days at 4°C and 35 days at room temperature when protected from light.