769 resultados para Commision paying
Resumo:
Waste management and sustainability are two core underlying philosophies that the construction sector must acknowledge and implement; however, this can prove difficult and time consuming. To this end, the aim of this paper is to examine waste management strategies and the possible benefits, advantages and disadvantages to their introduction and use, while also to examine any inter-relationship with sustainability, particularly at the design stage. The purpose of this paper is to gather, examine and review published works and investigate factors which influence economic decisions at the design phase of a construction project. In addressing this aim, a three tiered sequential research approach is adopted; in-depth literature review, interviews/focus groups and qualitative analysis. The resulting data is analyzed, discussed, with potential conclusions identified; paying particular attention to implications for practice within architectural firms. This research is of importance, particularly to the architectural sector, as it can add to the industry’s understanding of the design process, while also considering the application and integration of waste management into the design procedure. Results indicate that the researched topic had many advantages but also had inherent disadvantages. It was found that the potential advantages outweighed disadvantages, but uptake within industry was still slow and that better promotion and their benefits to; sustainability, the environment, society and the industry were required.
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Political support for renewable energy development, especially offshore renewables, is particularly conspicuous in Scotland and is a centrepiece of SNP policy. However, this is built on something of a paradox because, put simply, without the subsidies paid by electricity consumers in the rest of the UK, the Scottish Government's ambitious targets for renewable energy would be politically unachievable. We argue in this paper that if Scotland does move towards independence, then there could be little reason for the UK to continue paying (much) of the subsidies since the resulting renewable generation would no longer contribute towards UK renewable energy targets. We suggest that the potential scenarios, and their implications, needs to be far better considered in the arguments around the Scottish constitutional position and the broader aims of UK energy policy.
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Objective: To investigate the association between serum 25-hydroxyvitamin D concentrations (25(OH)D) and mortality in a large consortium of cohort studies paying particular attention to potential age, sex, season, and country differences.
Design: Meta-analysis of individual participant data of eight prospective cohort studies from Europe and the US.
Setting: General population.
Participants: 26 018 men and women aged 50-79 years
Main outcome measures: All-cause, cardiovascular, and cancer mortality.
Results: 25(OH)D concentrations varied strongly by season (higher in summer), country (higher in US and northern Europe) and sex (higher in men), but no consistent trend with age was observed. During follow-up, 6695 study participants died, among whom 2624 died of cardiovascular diseases and 2227 died of cancer. For each cohort and analysis, 25(OH)D quintiles were defined with cohort and subgroup specific cut-off values. Comparing bottom versus top quintiles resulted in a pooled risk ratio of 1.57 (95% CI 1.36 to 1.81) for all-cause mortality. Risk ratios for cardiovascular mortality were similar in magnitude to that for all-cause mortality in subjects both with and without a history of cardiovascular disease at baseline. With respect to cancer mortality, an association was only observed among subjects with a history of cancer (risk ratio, 1.70 (1.00 to 2.88)). Analyses using all quintiles suggest curvilinear, inverse, dose-response curves for the aforementioned relationships. No strong age, sex, season, or country specific differences were detected. Heterogeneity was low in most meta-analyses.
Conclusions: Despite levels of 25(OH)D strongly varying with country, sex, and season, the association between 25(OH)D level and all-cause and cause-specific mortality was remarkably consistent. Results from a long term randomised controlled trial addressing longevity are being awaited before vitamin D supplementation can be recommended in most individuals with low 25(OH)D levels.
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The detection and assessment of pain in animals is crucial to improving their welfare in a variety of contexts in which humans are ethically or legally bound to do so. Thus clear standards to judge whether pain is likely to occur in any animal species is vital to inform whether to alleviate pain or to drive the refinement of procedures to reduce invasiveness, thereby minimizing pain. We define two key concepts that can be used to evaluate the potential for pain in both invertebrate and vertebrate taxa. First, responses to noxious, potentially painful events should affect neurobiology, physiology and behaviour in a different manner to innocuous stimuli and subsequent behaviour should be modified including avoidance learning and protective responses. Second, animals should show a change in motivational state after experiencing a painful event such that future behavioural decision making is altered and can be measured as a change in conditioned place preference, self-administration of analgesia, paying a cost to access analgesia or avoidance of painful stimuli and reduced performance in concurrent events. The extent to which vertebrate and selected invertebrate groups fulfil these criteria is discussed in light of the empirical evidence and where there are gaps in our knowledge we propose future studies are vital to improve our assessment of pain. This review highlights arguments regarding animal pain and defines criteria that demonstrate, beyond a reasonable doubt, whether animals of a given species experience pain.
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BACKGROUND AND PURPOSE: Among the pathogenic mechanisms of asthma, a role for oxidative/nitrosative stress has been well documented. Recent evidence suggests that histamine H₄ receptors play a modulatory role in allergic inflammation. Here we report the effects of compound JNJ 7777120 (JNJ), a selective H4 receptor antagonist, on antigen-induced airway inflammation, paying special attention to its effects on lipocortin-1 (LC-1/annexin-A1), a 37 kDA anti-inflammatory protein that plays a key role in the production of inflammatory mediators.
EXPERIMENTAL APPROACH: Ovalbumin (OA)-sensitized guinea pigs placed in a respiratory chamber were challenged with antigen. JNJ (5, 7.5 and 10 mg.kg⁻¹) was given i.p. for 4 days before antigen challenge. Respiratory parameters were recorded. Bronchoalveolar lavage (BAL) fluid was collected and lung specimens taken for further analyses 1 h after antigen challenge. In BAL fluid, levels of LC-1, PGD2 , LTB4 and TNF-α were measured. In lung tissue samples, myeloperoxidase, caspase-3 and Mn-superoxide dismutase activities and 8-hydroxy-2-deoxyguanosine levels were measured.
KEY RESULTS: OA challenge decreased LC-1 levels in BAL fluid, induced cough, dyspnoea and bronchoconstriction and increased PGD2 , LTB4 and TNF-α levels in lung tissue. Treatment with JNJ dose-dependently increased levels of LC-1, reduced respiratory abnormalities and lowered levels of PGD2 , LTB4 and TNF-α in BAL fluid.
CONCLUSIONS AND IMPLICATIONS: Antigen-induced asthma-like reactions in guinea pigs decreased levels of LC-1 and increased TNF-α and eicosanoid production. JNJ pretreatment reduced allergic asthmatic responses and airway inflammation, an effect associated with LC-1 up-regulation.
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Background: Pharmacogenetics is a rapidly growing field that aims to identify the genes that influence drug response. This science can be used as a powerful tool to tailor drug treatment to the genetic makeup of individuals. The present study explores the coverage of the topic of pharmacogenetics and its potential benefit in personalised medicine by the UK newsprint media.
Methods: The LexisNexis database was used to identify and retrieve full text articles from the 10 highest circulation national daily newspapers and their Sunday equivalents in the UK. Content analysis of newspaper articles which referenced pharmacogenetic testing was carried out. A second researcher coded a random sample (21%) of newspaper articles to establish the inter-rater reliability of coding.
Results: Of the 256 articles captured by the search terms, 96 articles (with pharmacogenetics as a major component) met the study inclusion criteria. The majority of articles over-stated the benefits of pharmacogenetic testing while paying less attention to the associated risks. Overall beneficial effects were mentioned 5.3 times more frequently than risks (p < 0.001). The most common illnesses for which pharmacogenetically based personalised medicine was discussed were cancer, cardiovascular disease and CNS diseases. Only 13% of newspaper articles that cited a specific scientific study mentioned this link in the article. There was a positive correlation between the size of the article and both the number of benefits and risks stated (P < 0.01).
Conclusion: More comprehensive coverage of the area of personalised medicine within the print media is needed to inform public debate on the inclusion of pharmacogentic testing in routine practice.
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OBJECTIVE:
To use focus groups to understand barriers to glasses use among children in rural China.
METHODS:
Separate focus groups were conducted between December 17, 2007, and August 5, 2008, for the following 3 groups at each of 3 schools in rural China: children aged 14 to 18 years with myopia of less than -0.5 diopters in both eyes, those children's parents, and those children's teachers. Participants were also asked to rank their responses to questions about glasses use. The focus group transcripts were coded independently by 2 investigators using qualitative data management software.
RESULTS:
Respondents of all 3 types indicated that glasses purchase and wear should be delayed in children with early myopia and might be harmful to the eyes. Parents and students reported being uncertain about children's actual myopia status and whether glasses should be worn. Parents ranked their most common reason for not buying glasses as being "too busy with work," whereas "too expensive" ranked low. Inconvenience was ranked as an important reason for not wearing glasses among all 3 student groups. "Accuracy of lens power" was the first-ranked requirement for glasses among all student groups, whereas "new and attractive styles" was ranked last by all. All 3 types of respondents believed that wearing glasses or failing to wear them might worsen myopia.
CONCLUSIONS:
Educational programs are needed to address significant knowledge gaps in families and schools about glasses use in rural China. Cost and the need for attractive styles may not be significant barriers to use in this setting, raising the possibility of paying for such programs through cost recovery.
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BACKGROUND: The accuracy and impact on service uptake of early examination after cataract surgery is not known. DESIGN: Prospective cohort study. PARTICIPANTS: Cataract patients in rural Indonesia. METHODS: Visual acuity was measured preoperatively, 1day, 1-3, 4-6 and >12weeks after surgery, and 6-8months postoperatively at an outreach examination. Acceptance of second-eye surgery and spectacles was evaluated. MAIN OUTCOME MEASURE: Presenting visual acuity in the operated eye. RESULTS: Among 241 subjects (extracapsular surgery 84%), examinations at 1day, 1-3, 4-6 and >12weeks and 6-8months were completed for 100% (241), 90.9% (219), 67.6% (163), 22.0% (53) and 80.0% (193), respectively. Among subjects at the final examination (mean age 65.8±10.6years, 51.8% male), 73.6% had bilateral preoperative presenting visual acuity≤6/60. By 4-6weeks, the proportion with good (≥6/18) or poor (≤6/60) visual acuity did not differ significantly from the final examination. Among 49 persons accepting free second-eye surgery, 69.4% (34) and 16.3% (8) returned to clinic at 4-6 and >12weeks, respectively. Among 131 patients (67.9%) paying US$7 for glasses, 94 (71.8%) and 30 (22.9%) attended 4- to 6- and >12-week examinations, respectively. CONCLUSION: Even with large-incision surgery, early assessment of postoperative vision is representative of final vision, and may help deliver postoperative services to more of those needing them. © 2011 The Authors. Clinical and Experimental Ophthalmology © 2011 Royal Australian and New Zealand College of Ophthalmologists.
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Social Cognitive Theory has been used to explain findings derived from focus group discussions (N = 4) held in the United Kingdom with the aim of informing best practice in personalised nutrition. Positive expectancies included weight loss and negative expectancies surrounded on-line security. Monitoring and feedback were crucial to goal setting and progress. Coaching by the service provider, family and friends was deemed important for self-efficacy. Paying for personalised nutrition symbolised commitment to behaviour change. The social context of eating, however, was perceived a problem and should be considered when designing personalised diets. Social Cognitive Theory could provide an effective framework through which to deliver personalised nutrition.
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Where either the seller or buyer of landed property fails to complete a contract to sell land the non-breaching party has a right to seek specific performance of the contract. This remedy would compel the party in default to perform the contract on pain of being held in contempt of court if the court's order is not obeyed. The defaulting party would not be able to satisfy its obligations under the law by paying a sum of money as damages for breach of contract. This paper considers the impecuniosity defence to specific performance as recognised by courts in Northern Ireland, the Republic of Ireland, Australia and New Zealand. Where the buyer demonstrates that he or she simply cannot raise the funds to buy the property specific performance will not be decreed and the court will make an award of damages for breach of contract measured by the difference between the contract price and the market price of the property at the time of default. The paper considers the nature and parameters of this defence and how it differs (if at all) from the alternative defence of extreme hardship. The paper addresses the question of whether it might be better to move to a position where sellers of land in all cases no longer enjoy a presumption of specific performance but have to demonstrate that the alternative remedy of damages is clearly inadequate. If this should be so the paper goes on to consider whether abolition of the presumption in favour of specific performance for sellers should lead to abolition of the presumption of specific performance for buyers, as is the position in Canada following the Supreme Court's decision in Semelhago v Paramadevan [1996] 2 SCR 415.
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Mindfulness has been described as “paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally.” (Kabat-Zinn, 1994, p. 4). It is a technique where one focuses on the present, gradually letting go of thoughts about the past or the future. Mindfulness is becoming more popular as a technique to help people manage stress. Research suggests, for example, that individuals who have higher levels of mindfulness have increased performance in attention and cognitive flexibility (Moore & Malinowski, 2009); report higher levels of relationship satisfaction (Kozlowski, 2013), and lower levels of perceived stress (Roeser et al., 2013). As a therapeutic technique mindfulness has been shown to be effective through, for example, Mindfulness Based Cognitive Therapy and Mindfulness-Based Stress Reduction (Nevanper, 2012). Aims of Research The argument offered here is that mindfulness is likely to act in the same way as other types of coping i.e. that it is not a ‘silver bullet’ and that it is likely to be a preferred strategy used by some and not others. The aim of this research therefore is to compare the impact of mindfulness compared to other types of coping on well-being - operationalised as happiness, selfcompassion and stress.
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Com o objetivo de sublinhar a habilidade e o direito à criação do indivíduo com necessidades especiais este projeto deriva da beleza do território da arte e dos paradigmas de interação e imersão, hoje potencializados pelo feedback multimodal e multissensorial dos ambientes multimédia responsivos. Enfatizando o atual contexto da escola inclusiva, este estudo teve lugar num estabelecimento de ensino, em Portugal, envolvendo um grupo de alunos com Necessidades Educativas Especiais — NEE — de Currículo Específico Individual — CEI. Num contexto real, intentámos avaliar que tipo de impacto poderão ter os ambientes artísticos interativos nestes alunos, enquanto meio de autoexpressão e de inclusão. O estudo realizado assumiu um carácter exploratório. Special INPUT foi o conceito proposto por diferentes ambientes e abordagens de interação, implementados em sessões individuais com os participantes, que permitiu observar e promover, sob um contexto artístico, as habilidades intelectual, emocional, de personalidade, interpessoal, intrapessoal, psicomotora e, artística. Conceptualizámos, prototipámos e implementámos oito ambientes interativos, artísticos e lúdicos, que enfatizaram de formas diversas a experiência imersiva mediada pela técnica. Daí emergiram três grupos de ambientes – Special SOUND, Special MOVEMENT e Special ME – que intentaram promover nestes alunos a descoberta de si mesmos através do input de som, movimento e/ou vídeo processados em tempo real. O feedback visual e/ou sonoro visou o “engajamento lúdico” e a “ressonância estética” enquanto meios de descoberta e desenvolvimento da habilidade e valor pessoais. Numa perspetiva de diferenciação e individualização curricular, reconhecemos as vantagens dos ambientes artísticos interativos na inclusão de alunos com NEE, tendo-se observado um impacto positivo derivado da autoria e do controlo propiciados aos participantes nestes contextos. Hoje, a possibilidade de recorrer ao multimédia e a toda uma panóplia de interfaces não invasivas, explorando a poética de som e imagem interativos, em contexto artístico, inspira abordagens originais, centradas na pessoa, atentando às potencialidades e plasticidades das vigentes ferramentas de autor para a programação de interação, promovendo a dignificação da diferença, a autoexpressão e sensibilidade individuais, e os processos de autoobservação, autodescoberta e autoconsciência da capacidade expressiva que promovem a ideia positiva do “self” e o desenvolvimento de diferentes aptidões pessoais.
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O estudo do comportamento do consumidor turista é a chave para descodificar todas as atividades de marketing, usadas para desenvolver, comunicar e vender um produto turístico. A maximização destas atividades depende da compreensão da forma como os consumidores tomam as decisões para comprar ou utilizar os produtos turísticos (Swarbrooke e Horner, 1999). Deste modo, torna-se fundamental conhecer e compreender este tipo de turista, identificando as suas necessidades e, desta forma, criar novos pacotes de produtos, escolher os melhores canais de comunicação, estabelecer contactos com os operadores certos, de modo a adequar a oferta à procura. Assim, de forma a dar resposta às questões anteriormente definidas, foi elaborado o presente estudo, o qual tinha como objetivo principal identificar o perfil dos enoturistas, bem como as dimensões das motivações (push e pull) que estão relacionadas com a satisfação e, por conseguinte, com a sua lealdade. Deste modo foi realizada uma extensa revisão da literatura de referência nas áreas da motivação, satisfação, lealdade e dos modelos de decisão de compra, tendo especial atenção à tipologia do turista em causa. Resultante da revisão da literatura, e nela apoiada, foi construído um modelo de investigação que estabelece que as motivações (push e pull) influenciam positivamente a satisfação e, consequentemente, a lealdade ao destino e aos produtos do destino. Com o intuito de validar o modelo de investigação, foi realizado um estudo empírico que incluiu a recolha de dados primários, a partir de um questionário administrado com o apoio de algumas unidades de Turismo do Douro. Assim, a partir de uma amostra de 519 turistas, o estudo chama a atenção para a importância das motivações internas e externas na lealdade ao destino e aos produtos do destino. Deste modo, este estudo indica que os responsáveis das diferentes organizações do destino devem dar especial atenção aos fatores motivacionais internos, Reencontro com a Natureza (REN), Novidade e Conhecimento (NC), Relaxamento (REL) e Socialização (SOC) dado que estes fatores influenciam positivamente as motivações pull, as quais foram medidas através da Oferta de Atividades Enoturísticas (OAE), da Diversidade e Qualidade Gastronómica (DQG) e da Reputação da Região (RR), o que segundo o modelo testado faz aumentar a lealdade aos produtos da região. Por outro lado, os resultados fornecem evidências de que as Motivações Externas deste tipo de turista estão intimamente associadas com a vantagem competitiva da região. Por último, apresentam-se algumas das limitações inerentes ao estudo e sugerem-se pistas para a investigação futura que prossigam e complementem o presente trabalho.
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Aim There is growing interest in the contribution of public-private partnerships (PPPs) bridging the shortage of financial resources and management expertise in developing public healthcare infrastructure. However, few studies have evidenced PPPs’ ability in increasing efficiency in public procurement of primary healthcare infrastructure. The aim of this study was to assess to what extent PPPs would increase efficiency in public procurement of primary healthcare facilities. Subject and Methods A qualitative analysis, adopting a realistic research evaluation method, used data collected from a purposive sample of public (n=23) and private sector staff (n=2) directly involved in the UK National Health Service Local Improvement Finance Trust (LIFT). Results We find a positive association of LIFT helping to bridge public sector capital shortages for developing primary care surgeries. LIFT is negatively associated with inefficient procurement because it borrows finance from private banks, leaving public agencies paying high interest rates. The study shows that some contextual factors and mechanisms in LIFT play a major part in obstructing public staff from increasing procurement efficiency. Conclusion PPP’s ability to increase efficiency may be determined by contextual factors and mechanisms that restrict discretion over critical decisions by frontline public sector staff. Developing their capacity in monitoring PPP activities may make partnerships more efficient.
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This sheet written in Spanish answers the questions: why does my child need vaccines now?, what vaccines does my child need?, when should my child be vaccinated?, what else should I know about these vaccines?, how can I get help paying for these vaccines? and where can I learn more?