23 resultados para appropriate contracts
Resumo:
No-bid contracting is a highly prevalent practice in public procurement of technology services. Alt-hough no-bid contracting is a substantial problem since it reduces competition and welfare, the litera-ture lacks theoretical explanations and empirical tests for why public organizations award no-bid con-tracts. In this paper, we propose three theoretical explanations for no-bid contracting, drawing on transaction cost economics, organizational learning, and institutional theory. We also present how we test these explanations using a comprehensive sample of public procurement transactions. We expect to contribute theoretical explanations for no-bid contracting and practical implications for policy-makers.
Resumo:
OBJECTIVES To improve malnutrition awareness and management in our department of general internal medicine; to assess patients' nutritional risk; and to evaluate whether an online educational program leads to an increase in basic knowledge and more frequent nutritional therapies. METHODS A prospective pre-post intervention study at a university department of general internal medicine was conducted. Nutritional screening using Nutritional Risk Score 2002 (NRS 2002) was performed, and prescriptions of nutritional therapies were assessed. The intervention included an online learning program and a pocket card for all residents, who had to fill in a multiple-choice questions (MCQ) test about basic nutritional knowledge before and after the intervention. RESULTS A total of 342 patients were included in the preintervention phase, and 300 were in the postintervention phase. In the preintervention phase, 54.1% were at nutritional risk (NRS 2002 ≥3) compared with 61.7% in the postintervention phase. There was no increase in the prescription of nutritional therapies (18.7% versus 17.0%). Forty-nine and 41 residents (response rate 58% and 48%) filled in the MCQ test before and after the intervention, respectively. The mean percentage of correct answers was 55.6% and 59.43%, respectively (which was not significant). Fifty of 84 residents completed the online program. The residents who participated in the whole program scored higher on the second MCQ test (63% versus 55% correct answers, P = 0.031). CONCLUSIONS Despite a high ratio of malnourished patients, the nutritional intervention, as assessed by nutritional prescriptions, is insufficient. However, the simple educational program via Internet and usage of NRS 2002 pocket cards did not improve either malnutrition awareness or nutritional treatment. More sophisticated educational systems to fight malnutrition are necessary.
Resumo:
Workshop Overview The use of special effects (moulage) is a way to augment the authenticity of a scenario in simulation. This workshop will introduce different techniques of moulage (oil based cream colors, watercolors, transfer tattoos and 3D Prosthetics). The participants will have the opportunity to explore these techniques by applying various moulages. They will compare the techniques and discuss their advantages and disadvantages. Moreover, strategies for standardization and quality assurance will be discussed. Workshop Rationale Moulage supports the sensory perception in an scenario (1). It can provide evaluation clues (2) and help learners (and SPs) to engage in the simulation. However, it is of crucial importance that the simulated physical pathologies are represented accurate and reliable. Accuracy is achieved by using the appropriate technique, which requires knowledge and practice . With information about different moulage techniques, we hope to increases the knowledge of moulage during the workshop. By applying moulages in various techniques we will practice together. As standardization is critical for simulation scenarios in assessment (3, 4) strategies for standardization of moulage will be introduced and discussed. Workshop Objectives During the workshop participants will: - gain knowledge about different techniques of moulages - practice moulages in various techniques - discuss the advantages and disadvantages of moulage techniques - describe strategies for standardization and quality assurance of moulage Planned Format 5 min Introduction 15 min Overview – Background & Theory (presentation) 15 min Application of moulage for ankle sprain in 4 different techniques (oil based cream color, water color, temporary tatoo, 3D prosthetic) in small groups 5 min Comparing the results by interactive viewing of prepared moulages 15 min Application of moulages for burn in different techniques in small groups 5 min Comparing results the results by interactive viewing of prepared moulages 5 min Sharing experiences with different techniques in small groups 20 min Discussion of the techniques including standardization and quality assurance strategies (plenary discussion) 5 min Summary / Take home points