19 resultados para Transition from Care

em Aston University Research Archive


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Supported living and retirement villages are becoming a significant option for older adults with impairments, with independence concerns or for forward planning in older age, but evidence as to psychological benefits for residents is sparse. This study examined the hypothesis that the multi-component advantages of moving into a supported and physically and socially accessible “extra care” independent living environment will impact on psychological and functioning measures. Using an observational longitudinal design, 161 new residents were assessed initially and three months later, in comparison to 33 older adults staying in their original homes. Initial group differences were apparent but some reduced after three months. Residents showed improvement in depression, perceived health, aspects of cognitive function, and reduced functional limitations, while controls showed increased functional limitations (worsening). Ability to recall specific autobiographical memories, known to be related to social-problem solving, depression and functioning in social relationships, predicted change in communication limitations, and cognitive change predicted changes in recreational limitations. Change in anxiety and memory predicted change in depression. Findings suggest that older adults with independent living concerns who move to an independent but supported environment can show significant benefits in psychological outcomes and reduction in perceived impact of health on functional limitations in a short period. Targets for focussed rehabilitation are indicated, but findings also validate development of untargeted general supportive environments.

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Detailed transport studies in plasmas require the solution of the time evolution of many different initial positions of test particles in the phase space of the systems to be investigated. To reduce this amount of numerical work, one would like to replace the integration of the time-continues system with a mapping.

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E-business adoption rates in the agri-food sector are rather low, despite the fact that technical barriers have been mostly overcome during the last years and a large number of sophisticated offers are available. However, concerns about trust seem to impede the development of electronic relationships in the agri-food chains as trust is of particular importance in any exchange of agri-food products along the value chain. Drawing on existing research, characteristics and dimensions of trust are initially identified both in traditional and in electronic B2B relationships and a typology of trust is proposed. The aim of the paper is to provide an overview of the implementation and use of trust elements that e-commerce offers dedicated to agri-food sector. This assessment will show the current situation and discuss gaps for further improvement with the objective to facilitate the uptake of e-commerce in agri-food chains. © 2009 Elsevier B.V. All rights reserved.

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The wear rates of sliding surfaces are significantly reduced if mild oxidational wear can be encouraged. It is hence of prime importance in the interest of component life and material conservation to understand the factors necessary to promote mild, oxidational wear, The present work investigates the fundamental mechanism of the running-in wear of BS EN 31!EN 8 steel couples. under various conditions of load. speed and test duration. Unidirectional sliding experiments were carried out on a pin-on~disc wear machine where frictional force, wear rate, temperature and contact resistance were continuously monitored during each test. Physical methods of analysis (x-ray, scanning electron microscopy etc.) were used to examine the wear debris and worn samples. The wear rate versus load curves revealed mild wear transitions, which under long duration of running, categorized mild wear into four distinct regions.α-Fe20s. Fe304, FeO and an oxide mixture were the predominant oxides in four regions of oxidational wear which were identified above the Welsh T2 transition. The wear curves were strongly effected by the speed and test duration. A surface model was used to calculate the surface parameters, and the results were found to be comparable with the experimentally observed parameters. Oxidation was responsible for the transition from severe to mild wear at a load corresponding to the Welsh T2 transition. In the running-in period sufficient energy input and surface hardness enabled oxide growth rate to increase and eventually exceeded the rate of removal, where mild wear ensued. A model was developed to predict the wear volume up to the transition. Remarkable agreement was found between the theoretical prediction and the experimentally-measured values. The oxidational mechanjsm responsible for transitjon to mild wear under equilibrium conditions was related to the formation of thick homogenous oxide plateaux on subsurface hardened layers, FeO was the oxide formed initially at the onset of mild wear but oxide type changed.during the total running period to give an equilibrium oxide whose nature depended on the loads applied.

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We examined whether inductive reasoning development is better characterized by accounts assuming an early category bias versus an early perceptual bias. We trained 264 children aged 3 to 9 years to categorize novel insects using a rule that directly pitted category membership against appearance. This was followed by an induction task with perceptual distractors at different levels of featural similarity. An additional 52 children were given the same training followed by an induction task with alternative stimuli. Categorization performance was consistently high, however we found a gradual transition from a perceptual bias in our youngest children to a category bias around age 6-7. In addition, children of all ages were equally distracted by higher levels of featural similarity. The transition is unlikely to be due to an increased ability to inhibit perceptual distractors. Instead, we argue that the transition is driven by a fundamental change in children’s understanding of category membership.

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Current British government economic development policy emphasises regional and sub-regional scale, multi-agent initiatives that form part of national frameworks to encourage a 'bottom up' approach to economic development. An emphasis on local multi-agent initiatives was also the mission of Training and Enterprise Councils (TECs). Using new survey evidence this article tracks the progress of a number of initiatives established under the TECs, using the TEC Discretionary Fund as an example. It assesses the ability of successor bodies to be more effective in promoting local economic development. Survey evidence is used to confirm that many projects previously set up by the TECs continue to operate successfully under new partnership arrangements. However as new structures have developed, and policy has become more centralized, it is less likely that similar local initiatives will be developed in future. There is evidence to suggest that with the end of the TECs a gap has emerged in the institutional infrastructure for local economic development, particularly with regard to workforce development. Much will depend in future on how the Regional Development Agencies deploy their growing power and resources.

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Polymer beads have attracted considerable interest for use in catalysis, drug delivery, and photo­nics due to their particular shape and surface morphology. Electrospinning, typically used for producing nanofibers, can also be used to fabricate polymer beads if the solution has a sufficiently low concentration. In this work, a novel approach for producing more uniform, intact beads is presented by electrospinning self-assembled block copolymer (BCP) solutions. This approach allows a relatively high polymer concentration to be used, yet with a low degree of entanglement between polymer chains due to microphase separation of the BCP in a selective solvent system. Herein, to demonstrate the technology, a well-studied polystyrene-poly(ethylene butylene)–polystyrene triblock copolymer is dissolved in a co-solvent system. The effect of solvent composition on the characteristics of the fibers and beads is intensively studied, and the mechanism of this fiber-to-bead is found to be dependent on microphase separation of the BCP.

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Nascent entrepreneurship and new business ownership are subsequent stages in the entrepreneurial process. We illustrate how information from the largest internationally harmonized database on entrepreneurship, the Global Entrepreneurship Monitor project, can be used to approximate the entrepreneurial process. We make a methodological contribution by computing the ratio of new business ownership to nascent entrepreneurship in a way that reflects the transition from nascent to new business ownership and provides cross-nationally comparable information on the efficiency of the entrepreneurial process for 48 countries. We report evidence for the validity of the transition ratio by benchmarking it against transition rates obtained from longitudinal studies and by correlating it with commonly used entrepreneurship indicators and macro-level economic indices. The transition ratio enables future cross-national research on the entrepreneurial process by providing a reliable and valid indicator for one key transition in this process. © 2012 Springer Science+Business Media New York.

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Research Question/Issue - Which forms of state control over corporations have emerged in countries that made a transition from centrally-planned to marked-based economies and what are their implications for corporate governance? We assess the literature on variation and evolution of state control in transition economies, focusing on corporate governance of state-controlled firms. We highlight emerging trends and identify future research avenues. Research Findings/Insights - Based on our analysis of more than 100 articles in leading management, finance, and economics journals since 1989, we demonstrate how research on state control evolved from a polarized approach of public–private equity ownership comparison to studying a variety of constellations of state capitalism. Theoretical/Academic Implications - We identify theoretical perspectives that help us better understand benefits and costs associated with various forms of state control over firms. We encourage future studies to examine how context-specific factors determine the effect of state control on corporate governance. Practitioner/Policy Implications - Investors and policymakers should consider under which conditions investing in state-affiliated firms generates superior returns.

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Aims: To determine the incidence of unintended medication discrepancies in paediatric patients at the time of hospital admission; evaluate the process of medicines reconciliation; assess the benefit of medicines reconciliation in preventing clinical harm. Method: A 5 month prospective multisite study. Pharmacists at four English hospitals conducted admission medicines reconciliation in children using a standardised data collection form. A discrepancy was defined as a difference between the patient's preadmission medication (PAM), compared with the initial admission medication orders written by the hospital doctor. The discrepancies were classified into intentional and unintentional discrepancies. The unintentional discrepancies were assessed for potential clinical harm by a team of healthcare professionals, which included doctors, pharmacists and nurses. Results: Medicines reconciliation was conducted in 244 children admitted to hospital. 45% (109/244) of the children had at least one unintentional medication discrepancy between the PAM and admission medication order. The overall results indicated that 32% (78/244) of patients had at least one clinically significant unintentional medication discrepancy with potential to cause moderate 20% (50/244) or severe 11% (28/244) harm. No single source of information provided all the relevant details of a patient's medication history. Parents/carers provided the most accurate details of a patient's medication history in 81% of cases. Conclusions: This study demonstrates that in the absence of medicines reconciliation, children admitted to hospitals across England are at risk of harm from unintended medication discrepancies at the transition of care from the community to hospital. No single source of information provided a reliable medication history.

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This book challenges the accepted notion that the transition from the command economy to market based systems is complete across the post-Soviet space. While it is noted that different political economies have developed in such states, such as Russia’s ‘managed democracy’, events such as Ukraine gaining ‘market economy status’ by the European Union and acceding to the World Trade Organisation in 2008 are taken as evidence that the reform period is over. Such thinking is based on numerous assumptions; specifically that economic transition has defined start and end points, that the formal economy now has primacy over other forms of economic practices and that national economic growth leads to the ‘trickle down’ of wealth to those marginalised by the transition process. Based on extensive ethnographic and quantitative research, conducted in Ukraine and Russia between 2004 - 2007, this book questions these assumptions by stating that the economies that operate across post-Soviet spaces are far from the textbook idea of a market economy. Through this the whole notion of ‘transition’ is problematised and the importance of informal economies to everyday life is demonstrated. Using case studies of various sectors, such as entrepreneurial behaviour and the higher education system, it is also shown how corruption has invaded almost all sectors of the post-Soviet every day.

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This research aims to investigate knowledge acquisition and concept formation in the domain of economics and business studies through a foreign language, English, from the very initial to the very final stage of development in the context of Higher Education in Turkey. It traces both the processes as well as the product of acquisition in order to provide a detailed picture of how knowledge acquisition occurs. It aims to explore ways in which the acquisition process can be facilitated and promoted while prospective students of the Department of Economics and Business Administration receive a language training programme, following the completion of which they will join their academic community which offers part of its courses through the English language. The study draws upon (some) theories of mental representation of knowledge, such as schema, frame and script. The concept of discourse community with its characteristics is investigated, enculturation of prospective students to acquire knowledge of their domain through L2 is explored, and the crucial role of the constructivist theory in relation to knowledge acquisition is highlighted. The present study was conducted through a process of enculturation taking place partly at the language centre of Çukurova University and partly at the target discourse community. The data utilised for initiating knowledge acquisition was obtained by establishing a corpus of economics and business texts, which the learners are expected to read during their academic courses utilising computerised technology. The method of think aloud protocols was used to analyse processes taking place in knowledge acquisition, while the product of what was acquired was investigated by means of written recall protocols. It has been discovered that knowledge acquisition operates on the basis of analogical and to a certain extent metaphorical reasoning. The evidence obtained from the think aloud protocols showed that neophytes were able to acquire fundamental concepts of their future domain by reaching the level of shared understanding with the members of their target community of the faculty. Diaries and questionnaire analyses demonstrated that enculturation facilitated learners' transition from the language centre into the target community. Analyses of the written recall protocols and examinations from the post-enculturation stage of the research showed that neophytes' academic performances in their target community were much higher than those of their non-enculturated counterparts. Processes learners go through and strategies they spontaneously make use of, especially while acquiring knowledge of a specific domain through L2 have so far remained unexplored research areas. The present research makes a potential contribution to the language and knowledge acquisition theories by examining closely and systematically the language and the strategies they employ in acquiring such knowledge. The research findings offer useful implications to English language teaching at language schools. Language teachers are provided with useful guidelines as to how they can provide prospective students of a particular academic community with an experience of acquiring fundamental concepts of their discipline before they become members of their target community.

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This paper conceptualises the enhancement of technological capability by firms, following international technology transfer, as an evolutionary process. During this process, the existing technological, managerial and other complementary resources may require restructuring. Since China is in transition from central planning to market orientation, the organisational and managerial practices of Chinese firms are different from those of international technology suppliers. Resourcebased and evolutionary theories of the firm, which provide insights into the evolution of structures, mechanisms, skills, experiences and technical know-how, have been applied to outline the processes of acquiring technological capability. Selected case studies have been used to illustrate the issues and the framework provides guide for further empirical work.

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Studying the transition from a linearly stable coherent laminar state to a highly disordered state of turbulence is conceptually and technically challenging, and of great interest because all pipe and channel flows are of that type. In optics, understanding how a system loses coherence, as spatial size or the strength of excitation increases, is a fundamental problem of practical importance. Here, we report our studies of a fibre laser that operates in both laminar and turbulent regimes. We show that the laminar phase is analogous to a one-dimensional coherent condensate and the onset of turbulence is due to the loss of spatial coherence. Our investigations suggest that the laminar-turbulent transition in the laser is due to condensate destruction by clustering dark and grey solitons. This finding could prove valuable for the design of coherent optical devices as well as systems operating far from thermodynamic equilibrium. © 2013 Macmillan Publishers Limited.

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Background - It is well recognised that errors are more likely to occur during transitions of care, especially medicines errors. Clinic letters are used as a communication tool during a transition from hospital (outpatient clinics) to primary care (general practitioners). Little is known about medicines errors in clinic letters, as previous studies in this area have focused on medicines errors in inpatient or outpatient prescriptions. Published studies concerning clinic letters largely focus on perceptions of patients or general practitioners in respect to overall quality. Purpose - To investigate medicines errors contained in outpatient clinic letters generated by prescribers within the Neurology Department of a specialist paediatric hospital in the UK.Materials and methods - Single site, retrospective, cross-sectional review of 100 clinic letters generated during March–July 2013 in response to an outpatient consultation. Clinic letters were conveniently selected from the most recent visit of each patient. An evaluation tool with a 10-point scale, where 10 was no error and 0 was significant error, was developed and refined throughout the study to facilitate identification and characterisation of medicines errors. The tool was tested for a relationship between scores and number of medicines errors using a regression analysis.Results - Of 315 items related to neurology mentioned within the letters, 212 items were associated with 602 errors. Common missing information was allergy (97%, n = 97), formulation (60.3%, n = 190), strength/concentration (59%, n = 186) and weight (53%, n = 53). Ninety-nine letters were associated with at least one error. Scores were in range of 4–10 with 42% of letters scored as 7. Statistically significant relationships were observed between scores and number of medicines errors (R2 = 0.4168, p < 0.05) as well as between number of medicines and number of drug-related errors (R2 = 0.9719, p < 0.05). Conclusions - Nearly all clinic letters were associated with medicines errors. The 10-point evaluation tool may be a useful device to categorise clinic letter errors.