923 resultados para other issues


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For detailed contents, cf. Martin & Walter.

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Other issues have translation statement: Traduit de l'Anglois, par F. Soulés.

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Objective: To identify factors influencing the prescribing of medicines by general practitioners in rural and remote Australia. Design: A qualitative study using a questionnaire to determine attitudes about prescribing, specific prescribing habits and comments on prescribing in ‘rural practice’. Setting: General practice in rural and remote Queensland. Subjects: General practitioners practising in rural and remote settings in Queensland (n = 258). Main outcome measures: The factors perceived to influence the prescribing of medicines by medical practitioners in rural environments. Results: A 58% response rate (n = 142) was achieved. Most respondents agreed that they prescribe differently in rural compared with city practice. The majority of respondents agreed that their prescribing was influenced by practice location, isolation of patient home location, limited diagnostic testing and increased drug monitoring. Location issues and other issues were more likely to be identified as ‘influential’ by the more isolated practitioners. Factors such as access to continuing medical education and specialists were confirmed as having an influence on prescribing. The prescribing of recently marketed drugs was more likely by doctors practising in less remote rural areas. Conclusion: Practising in rural and remote locations is perceived to have an effect on prescribing. These influences need to be considered when developing quality use of medicines policies and initiatives for these locations. What is already known: Anecdotal and audit based studies have shown that rural general practice differs to urban-based practice in Australia, including some limited data showing some variations in prescribing patterns. No substantiated explanations for these variations have been offered. It is known that interventions to change prescribing behaviour are more likely to be effective if they are perceived as relevant and hence increasing our knowledge of rural doctors’ perceptions of differences in rural practice prescribing is required. What this study adds: Rural doctors believed that they prescribe differently in rural compared with city practice and they described a range of influences. The more remotely located doctors were more likely to report the ‘rural’ influences on prescribing, however, most results failed to reach statistical significance when compared to the less remotely located doctors. These perceptions should be considered when developing medicines policy and education for rural medical practitioners to ensure it is perceived rurally relevant.

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We examined the feasibility of a low-cost, store-and-forward teledermatology service for general practitioners (GPs) in regional Queensland. Digital pictures and a brief case history were transmitted by email. A service coordinator carried out quality control checks and then forwarded these email messages to a consultant dermatologist. On receiving a clinical response from the dermatologist, the service coordinator returned the message to the referring GP. The aim was to provide advice to rural Gps within one working day. Over six months, 63 referrals were processed by the teledermatology service, covering a wide range of dermatological conditions. In the majority of cases the referring doctors were able to treat the condition after receipt of email advice from the dermatologist; however, in 10 cases (16%) additional images or biopsy results were requested because image quality was inadequate. The average time between a referral being received and clinical advice being provided to the referring GPs was 46 hours. The number of referrals in the present study, 1.05 per month per site, was similar to that reported in other primary care studies. While the use of low-cost digital cameras and public email is feasible, there may be other issues, for example remuneration, which will militate against the widespread introduction of primary care teledermatology in Australia.

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In this paper, numerical simulations are used in an attempt to find optimal Source profiles for high frequency radiofrequency (RF) volume coils. Biologically loaded, shielded/unshielded circular and elliptical birdcage coils operating at 170 MHz, 300 MHz and 470 MHz are modelled using the FDTD method for both 2D and 3D cases. Taking advantage of the fact that some aspects of the electromagnetic system are linear, two approaches have been proposed for the determination of the drives for individual elements in the RF resonator. The first method is an iterative optimization technique with a kernel for the evaluation of RF fields inside an imaging plane of a human head model using pre-characterized sensitivity profiles of the individual rungs of a resonator; the second method is a regularization-based technique. In the second approach, a sensitivity matrix is explicitly constructed and a regularization procedure is employed to solve the ill-posed problem. Test simulations show that both methods can improve the B-1-field homogeneity in both focused and non-focused scenarios. While the regularization-based method is more efficient, the first optimization method is more flexible as it can take into account other issues such as controlling SAR or reshaping the resonator structures. It is hoped that these schemes and their extensions will be useful for the determination of multi-element RF drives in a variety of applications.

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The growing problem of drug resistance has greatly complicated the treatment for falciparum malaria. Whereaschloroquine and sulfadoxine/ pyrimethamine could once cure most infections, this is no longer true and requiresexamination of alternative regimens. Not all treatment failures are drug resistant and other issues such asexpired antimalarials and patient compliance need to be considered. Continuation of a failing treatment policyafter drug resistance is established suppresses infections rather than curing them, leading to increasedtransmission of malaria, promotion of epidemics and loss of public confidence in malaria control programs.Antifolate drug resistance (i.e. pyrimethamine) means that new combinations are urgently needed particularlybecause addition of a single drug to an already failing regimen is rarely effective for very long. Atovaquone/proguanil and mefloquine have been used against multiple drug resistant falciparum malaria with resistance toeach having been documented soon after drug introduction. Drug combinations delay further transmission ofresistant parasites by increasing cure rates and inhibiting formation of gametocytes. Most currentlyrecommended drug combinations for falciparum malaria are variants of artemisinin combination therapy wherea rapidly acting artemisinin compound is combined with a longer half-life drug of a different class. Artemisininsused include dihydroartemisinin, artesunate, artemether and companion drugs include mefloquine, amodiaquine,sulfadoxine/ pyrimethamine, lumefantrine, piperaquine, pyronaridine, chlorproguanil/dapsone. The standard ofcare must be to cure malaria by killing the last parasite. Combination antimalarial treatment is vital not only tothe successful treatment of individual patients but also for public health control of malaria.

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Tang sancai is one of the most important types of Chinese ceramics. To determine the provenance of Tang sancai is important to study ancient trade and other issues. In this paper we compare ICP-MS trace elements and TIMS Sr-Nd isotopes of visibly similar Tang sancai from two major production centres Gongxian and Yaozhou. The variation in contents/ratios of many of > 40 trace elements is small for samples from Gongxian, yet is considerably bigger for that from Yaozhou. However, the variation in Sr-87/Sr-86 and Nd-143/Nd-144 isotopic ratios is very small for samples from both places. Gongxian and Yaozhou samples have distinctive Sr-Nd isotopic and trace element features despite their similarity in major elements, and these analysis data can be interpreted with geochemistry, indicating that Sr and Nd isotopes have great potential in ceramic provenance studies. The distinct characterisation of these samples provides valuable criteria for identifying provenance of Tang sancai of uncertain origin. Two modern fakes are also analysed, and they can as well be distinguished from antique Tang sancai using above criteria. (c) 2005 Published by Elsevier Ltd.

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No mundo dos negócios as organizações colocam-se numa procura contínua por diferenciações estratégicas e buscam o talento humano em profissionais cada vez mais competentes. A competência está relacionada ao desempenho e pode ser treinada e desenvolvida de acordo com as atividades e o trabalho prestado. A educação para o trabalho adquire maior importância à medida que aumenta seu papel na dinâmica da sociedade moderna que exige atualização contínua dos saberes e busca reduzir a evasão dos cursos como um de seus desafios. Esta pesquisa procura compreender a evasão escolar a partir da diferença salarial entre grupos de estudantes que abandonaram e finalizaram o curso, entre outras análises. Os dados foram coletados entre alunos ingressantes em dez cursos técnicos de nível médio de uma escola técnica estadual na cidade de São Paulo entre os anos 2009 e 2011. A pesquisa permite concluir que os alunos formados conseguem melhores salários que os evadidos, sendo a média dos salários dos que conseguiram se formar superior em 16,6% à média salarial dos evadidos. A maioria dos alunos evadidos aponta o trabalho como principal causa da evasão escolar. Evidencia-se a presença das políticas públicas para o crédito educacional entre os respondentes, já que 34,8% da amostra possuem bolsas de estudo, do PROUNI ou do crédito educativo do FIES.

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As cartas são uma das formas de comunicação a distância mais antigas de que se tem notícia. Além disso, há séculos são feitos tratados e estudos de como as cartas são e de como devem ser escritas. Este estudo enfoca as cartas enviadas ao programa televisivo Globo Rural, da TV Globo no ano de 2005, data de seu 25º aniversário. Em um primeiro momento, através de um banco de dados, composto por 418 cartas, delineou-se a identidade e as demandas dos telespectadores que escreveram ao programa. Percebeu-se, entre outras questões, que além das pessoas residentes em áreas rurais e que mantêm relação com o campo, muitos telespectadores de áreas urbanas e profissionais de áreas de conhecimento não-rurais também entram em contato com o programa através de cartas. Em um segundo momento, através de escolhas intencionais, com uma abordagem qualitativa, sem intenção de generalização, discutiu-se algumas características atuais da maneira de se escrever cartas. Ao comparar com antigos tratados datados da Era Antiga pode-se concluir que as cartas analisadas ainda mantêm muitos traços discursivos definidos desde então.(AU)

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Purpose – This paper aims to contribute to the debate on the drivers of the productivity gap that exists between the UK and its major international competitors. Design/methodology/approach – From the macro perspective the paper explores the quantitative evidence on the productivity differentials and how they are measured. From the micro perspective, the article explores the quantitative evidence on the role of management practices claimed to be a key determinant in promoting firm competitiveness and in bridging the UK gap. Findings – This study suggests that management practices are an ambiguous driver of firm productivity and higher firm performance. On the methodological side, qualitative and subjective measures of either management practices or firm performance are often used. This makes the results not comparable across studies, across firms or even within firms over time. Productivity and profitability are often and erroneously interchangeably used while productivity is only one element of firm performance. On the other hand, management practices are multi-dimensional constructs that generally do not demonstrate a straightforward relationship with productivity variables. To assume that they are the only driver of higher productivity may be misleading. Moreover, there is evidence of an inverse causal relationship between management practices and firm performance. This calls into question most empirical results of the extant literature based on the unidirectional assumption of direct causality between management practices and firm performance. Research limitations/implications – These and other issues suggest that more research is needed to deepen the understanding of the UK productivity gap and more quantitative evidence should be provided on the way in which management practices contribute to the UK competitiveness. Their impact is not easily measurable due to their complexity and their complementary nature and this is a fertile ground for further research. Originality/value – This paper brings together the evidence on the UK productivity gap and its main drivers, provided by the economics, management and performance measurement literature. This issue scores very highly in the agenda of policy makers and academics and has important implications for practitioners interested in evaluating the impact of managerial best practices.

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This dissertation investigates the very important and current problem of modelling human expertise. This is an apparent issue in any computer system emulating human decision making. It is prominent in Clinical Decision Support Systems (CDSS) due to the complexity of the induction process and the vast number of parameters in most cases. Other issues such as human error and missing or incomplete data present further challenges. In this thesis, the Galatean Risk Screening Tool (GRiST) is used as an example of modelling clinical expertise and parameter elicitation. The tool is a mental health clinical record management system with a top layer of decision support capabilities. It is currently being deployed by several NHS mental health trusts across the UK. The aim of the research is to investigate the problem of parameter elicitation by inducing them from real clinical data rather than from the human experts who provided the decision model. The induced parameters provide an insight into both the data relationships and how experts make decisions themselves. The outcomes help further understand human decision making and, in particular, help GRiST provide more accurate emulations of risk judgements. Although the algorithms and methods presented in this dissertation are applied to GRiST, they can be adopted for other human knowledge engineering domains.

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The prominent position given to academic writing across contemporary academia is reflected in the substantive literature and debate devoted to the subject over the past 30 years. However, the massification of higher education, manifested by a shift from elite to mass education, has brought the issue into the public arena, with much debate focusing on the need for ‘modern-day' students to be taught how to write academically (Bjork et al., 2003; Ganobcsik-Williams, 2006). Indeed, Russell (2003) argued that academic writing has become a global ‘problem' in Higher Education because it sits between two contradictory pressures (p.V). On one end of the university ‘experience' increasing numbers of students, many from non-traditional backgrounds, enter higher education bringing with them a range of communication abilities. At the other end, many graduates leave university to work in specialised industries where employers expect them to have high level writing skills (Ashton, 2007; Russell, 2003; Torrence et al., 1999). By drawing attention to the issues around peer mentoring within an academic writing setting in three different higher education Institutions, this paper makes an important contribution to current debates. Based upon a critical analysis of the emergent findings of an empirical study into the role of peer writing mentors in promoting student transition to higher education, the paper adopts an academic literacies approach to discuss the role of writing mentoring in promoting transition and retention by developing students' academic writing. Attention is drawn to the manner in which student expectations of writing mentoring actually align with mentoring practices - particularly in terms of the writing process and critical thinking. Other issues such as the approachability of writing mentors, the practicalities of accessing writing mentoring and the wider learning environment are also discussed.

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The traditional methods of graduate recruitment do not adequately meet the needs of the changing profile of students and graduates. As industry becomes internationalized, the needs of employers are also changing. Graduate recruitment is in response to short term needs and varying levels of experience are required. A case study method was used in Dublin Institute of Technology to evaluate effectiveness of a virtual careers fair in providing greater access to job opportunities for students and graduates. Access by employers to potential employees was also measured. Findings showed that while access improved, other issues requiring attention emerged.

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The paper informs about the history of manuscript digitization in the National Library of the Czech Republic as well as about other issues concerning processing of manuscripts. The main consequence of the massive digitization and record and/or full text processing is a paradigm shift leading to the digital history.