876 resultados para process- outcome relationships


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Non-governmental Organisations (NGOs) have not only gained more and more relevance in the development process of Near Eastern developing societies, but they have also raised an increasing scholarly interest. The traditional civil society in the Middle East, which used to be in charge of the tribe or large families, has been altered by new groups, which are organized around new social structures, interests and goals. The number of NGOs has experienced a swift increase in number and size, and the extent of some renders them important players in the social welfare sector, both at the national and global levels. The expansion and the increasing role of NGOs worldwide since the end of the 1970s as actors in socio-economic development and in the formulation of public policies has had great influence around the globe. However, this new function is not automatically the outcome of independent activity; but rather the result of ramified relationships between the national and international environment.

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Urban environmental depletion has been a critical problem among industrialized-transformed societies, especially at the local level where administrative authorities’ capacity lags behind changes. Derived from governance concept, the idea of civil society inclusion is highlighted. Focusing on an agglomerated case study, Bang Plee Community in Thailand, this research investigates on a non-state sector, 201-Community organization, as an agent for changes to improve urban environments on solid waste collection. Two roles are contested: as an agent for neighborhood internal change and as an intermediary toward governance changes in state-civil society interaction. By employing longitudinal analysis via a project intervention as research experiment, the outcomes of both roles are detected portrayed in three spheres: state, state-civil society interaction, and civil society sphere. It discovers in the research regarding agglomerated context that as an internal changes for environmental betterment, 201-Community organization operation brings on waste reduction at the minimal level. Community-based organization as an agent for changes – despite capacity input it still limited in efficiency and effectiveness – can mobilize fruitfully only at the individual and network level of civil society sectors, while fails managing at the organizational level. The positive outcomes result by economic waste incentive associated with a limited-bonded group rather than the rise of awareness at large. As an intermediary agent for shared governance, the community-based organization cannot bring on mutual dialogue with state as much as cannot change the state’s operation arena of solid waste management. The findings confine the shared governance concept that it does not applicable in agglomerated locality as an effective outcome, both in terms of being instrumental toward civil society inclusion and being provocative of internal change. Shared environmental governance as summarized in this research can last merely a community development action. It distances significantly from civil society inclusion and empowerment. However, the research proposes that community-based environmental management and shared governance toward civil society inclusion in urban environmental improvement are still an expectable option and reachable if their factors and conditions of key success and failure are intersected with a particular context. Further studies demand more precise on scale, scope, and theses factors of environmental management operation operated by civil society sectors.

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This paper describes the relationship between the executive and legislative branches during the first government of Alvaro Uribe Vélez. We will focus on reviewing the legislative output of each branch of power, along with the effectiveness and efficiency they showed as promoters of this production. We will review the impact they had on the legislative agenda setting and on the control of the legislative process  itself, making a diachronic analysis in which each legislature is used as a unit. Thus, we will try to identify the presence (or not) of some kind of pattern interactions,  and we will evaluate, at one hand, the existence of hierarchical and transactional trends, and, on the other, the different types of balances produced  between them.

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Occupational therapists are equipped to promote wellbeing through occupation and to enable participation and meaningful engagement of people in their social and physical environments (WFOT, 2012). As such, the role of the occupational therapists is profoundly linked to the social, cultural and environmental characteristics of the contexts in which occupations take place. The central role that context plays in occupational performance creates an interesting dichotomy for the occupational therapist: on one hand, a profound understanding of cultural and social factors is required from the Occupational Therapy (OT) in order to develop a meaningful and successful collaboration with the person; on the other hand, the ability of the occupational therapists to recognize and explore the contextual factor of an occupation-person dyad transcends cultural and spatial barriers. As a result, occupational therapists are equipped to engage in international collaboration and practice, and as such face unique and enriching challenges. International fieldwork experiences have become a tool through which occupational therapists in training can develop the critical skills for understanding the impact of cultural and social factors on occupation. An OT student in an international fieldwork experience faces numerous challenges in leading a process that is both relevant and respectful to the characteristics of the local context: language, cultural perceptions of occupation and personhood, religious backgrounds, health care access, etc. These challenges stand out as ethical considerations that must be considered when navigating an international fieldwork experience (AOTA, 2009). For more than five years now, the Faculty of Rehabilitation Medicine (FRM) of the University of Alberta (UoFA) and the School of Medicine and Health Sciences at the Universidad del Rosario (UR), Bogota, Colombia, have sustained a productive and meaningful international collaboration. This collaboration includes a visit by Dr. Albert Cook, professor of the FRM and former dean, to the UR as the main guest speaker in the International Congress of Technologies for Disability Support (IBERDISCAP) in 2008. Furthermore, Dr. Cook was a speaker in the research seminar of the Assistive Technology Research Group of the Universidad del Rosario. Following Dr. Cook’s visit, Professors Liliana Álvarez and Adriana Ríos travelled to Edmonton and initiated collaboration with the FRM, resulting in the signing of an agreement between the FRM and the UR in 2009, agreement that has been maintained to this day. The main goal of this agreement is to increase academic and cultural cooperation between the UR and the UofA. Other activities have included the cooperation between Dr. Kim Adams (who has largely maintained interest and effort in supporting the capacity building of the UR rehabilitation programs in coordinating the provision of research placement opportunities for UR students at the UofA), an Assistive Technology course for clinicians and students led by Dr. Adams, and a research project that researched the use of basic cell phones to provide social interaction and health information access for people with disabilities in a low-income community in Colombia (led by Tim Barlott, OT, MSc, under the supervision of Dr. Adams). Since the beginning, the occupational therapy programs of the Universidad del Rosario and the University of Alberta have promoted this collaboration and have strived to engage in interactions that provide further development opportunities for students and staff. As part of this process, the international placement experience of UofA OT students was born under the leadership of: Claudia Rozo, OT program director at UR, placement and academic leadership of Elvis Castro and Angélica Monsalve, professors of the occupational therapy program at UR; and Dr. Lili Liu, OT department director at UofA, Cori Schmitz, Academic coordinator of clinical education at the UofA; and Tim Barlott and Liliana Álvarez leading the international and cross-cultural aspect of this collaboration.This publication summarizes and illustrates the process of international placement in community settings in Colombia, undertaken by occupational therapy students of the University of Alberta. It is our hope that this document can provide and document the ethical considerations of international fieldwork experience, the special characteristics of communities and the ways in which cultural and social competences are developed and help international students navigate the international setting. We also hope that this document will stimulate discussion among professional and academic communities about the importance and richness of international placement experiences and encourage staff and students to articulate their daily efforts with the global occupational therapy agenda.

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El trasplante de órganos y/o tejidos es considerado como una opción terapéutica viable para el tratamiento tanto de enfermedades crónicas o en estadios terminales, como de afectaciones no vitales, pero que generen una disminución en la calidad de vida percibida por el paciente. Este procedimiento, de carácter multidimensional, está compuesto por 3 actores principales: el donante, el órgano/tejido, y el receptor. Si bien un porcentaje significativo de investigaciones y planes de intervención han girado en torno a la dimensión biológica del trasplante, y a la promoción de la donación; el interés por la experiencia psicosocial y la calidad de vida de los receptores en este proceso ha aumentado durante la última década. En relación con esto, la presente monografía se plantea como objetivo general la exploración de la experiencia y los significados construidos por los pacientes trasplantados, a través de una revisión sistemática de la literatura sobre esta temática. Para ello, se plantearon unos objetivos específicos derivados del general, se seleccionaron términos o palabras claves por cada uno de estos, y se realizó una búsqueda en 5 bases de datos para revistas indexadas: Ebsco Host (Academic Search; y Psychology and Behavioral Sciences Collection); Proquest; Pubmed; y Science Direct. A partir de los resultados, se establece que si bien la vivencia de los receptores ha comenzado a ser investigada, aún es necesaria una mayor exploración sobre la experiencia de estos pacientes; exploración que carecería de objetivo si no se hiciera a través de las narrativas o testimonios de los mismos receptores

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The technique of linear responsibility analysis is used for a retrospective case study of a private industrial development consisting of an extension to existing buildings to provide a warehouse, services block and packing line. The organizational structure adopted on the project is analysed using concepts from systems theory which are included in Walker's theoretical model of the structure of building project organizations (Walker, 1981). This model proposes that the process of building provision can be viewed as systems and subsystems which are differentiated from each other at decision points. Further to this, the subsystems can be viewed as the interaction of managing system and operating system. Using Walker's model, a systematic analysis of the relationships between the contributors gives a quantitative assessment of the efficacy of the organizational structure used. The causes of the client's dissatisfaction with the outcome of the project were lack of integration and complexity of the managing system. However, there was a high level of satisfaction with the completed project and this is reflected by the way in which the organization structure corresponded to the model's propositions.

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The promotion of technologies seen to be aiding in the attainment of agricultural sustainability has been Popular amongst Northern-based development donors for many years. One of these, botanical insecticides (e.g., those based on neem, Pyrethrum and tobacco) have been a particular favorite as they are equated with being 'natural' and hence less damaging to human health and the environment. This paper describes the outcome of interactions between one non-government organisation (NGO), the Diocesan Development Services (DDS), based in Kogi State, Nigeria, and a major development donor based in Europe that led to the establishment of a programme designed to promote the Virtues of a tobacco-based insecticide to small-scale farmers. The Tobacco Insecticide Programme (TIP) began in the late 1980s and ended in 200 1, absorbing significant quantities of resource in the process. TIP began with exploratory investigations of efficacy on the DDS seed multiplication farm followed by stages of researcher-managed and farmer-managed on-farm trials. A survey in 2002 assessed adoption of the technology by farmers. While yield benefits from using the insecticide were nearly always positive and statistically significant relative to an untreated control, they were not as good as commercial insecticides. However, adoption of the tobacco insecticide by local farmers was poor. The paper discusses the reasons for poor adoption, including relative benefits in gross margin, and uses the TIP example to explore the differing power relationships that exist between donors, their field partners and farmers. (C) 2004 by The Haworth Press, Inc. All rights reserved.

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Partnerships are complex, diverse and subtle relationships, the nature of which changes with time, but they are vital for the functioning of the development chain. This paper reviews the meaning of partnership between development institutions as well as some of the main approaches taken to analyse the relationships. The latter typically revolve around analyses based on power, discourse, interdependence and functionality. The paper makes the case for taking a multianalytical approach to understanding partnership but points out three problem areas: identifying acceptable/unacceptable trade-offs between characteristics of partnership, the analysis of multicomponent partnerships (where one partner has a number of other partners) and the analysis of long-term partnership. The latter is especially problematic for long-term partnerships between donors and field agencies that share an underlying commitment based on religious beliefs. These problems with current methods of analysing partnership are highlighted by focusing upon the Catholic Church-based development chain, linking donors in the North (Europe) and their field partners in the South (Abuja Ecclesiastical Province, Nigeria). It explores a narrated history of a relationship with a single donor spanning 35 years from the perspective of one partner (the field agency).

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Perfectionism is a risk and maintaining factor for eating disorders, anxiety disorders and depression. The objective of this paper is to review the four bodies of evidence supporting the notion that perfectionism is a transdiagnostic process. First, a review of the literature was conducted that demonstrates the elevation of perfectionism across numerous anxiety disorders, depression, and eating disorders compared to healthy controls. Data is presented that shows perfectionism increases vulnerability for eating disorders, and that it maintains obsessive–compulsive disorder, social anxiety and depression as it predicts treatment outcome in these disorders. Second, evidence is examined showing that elevated perfectionism is associated with co-occurrence of psychopathology. Third, the different conceptualisations of perfectionism are reviewed, including a cognitive-behavioural conceptualisation of clinical perfectionism that can be utilised to understand this transdiagnostic process. Fourth, evidence that treatment of perfectionism results in reductions in anxiety, depression and eating pathology is reviewed. Finally,the importance of clinicians considering the routine assessment and treatment of perfectionism is outlined.

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Reanalysis data provide an excellent test bed for impacts prediction systems. because they represent an upper limit on the skill of climate models. Indian groundnut (Arachis hypogaea L.) yields have been simulated using the General Large-Area Model (GLAM) for annual crops and the European Centre for Medium-Range Weather Forecasts (ECMWF) 40-yr reanalysis (ERA-40). The ability of ERA-40 to represent the Indian summer monsoon has been examined. The ability of GLAM. when driven with daily ERA-40 data, to model both observed yields and observed relationships between subseasonal weather and yield has been assessed. Mean yields "were simulated well across much of India. Correlations between observed and modeled yields, where these are significant. are comparable to correlations between observed yields and ERA-40 rainfall. Uncertainties due to the input planting window, crop duration, and weather data have been examined. A reduction in the root-mean-square error of simulated yields was achieved by applying bias correction techniques to the precipitation. The stability of the relationship between weather and yield over time has been examined. Weather-yield correlations vary on decadal time scales. and this has direct implications for the accuracy of yield simulations. Analysis of the skewness of both detrended yields and precipitation suggest that nonclimatic factors are partly responsible for this nonstationarity. Evidence from other studies, including data on cereal and pulse yields, indicates that this result is not particular to groundnut yield. The detection and modeling of nonstationary weather-yield relationships emerges from this study as an important part of the process of understanding and predicting the impacts of climate variability and change on crop yields.

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Objectives: To assess the potential source of variation that surgeon may add to patient outcome in a clinical trial of surgical procedures. Methods: Two large (n = 1380) parallel multicentre randomized surgical trials were undertaken to compare laparoscopically assisted hysterectomy with conventional methods of abdominal and vaginal hysterectomy; involving 43 surgeons. The primary end point of the trial was the occurrence of at least one major complication. Patients were nested within surgeons giving the data set a hierarchical structure. A total of 10% of patients had at least one major complication, that is, a sparse binary outcome variable. A linear mixed logistic regression model (with logit link function) was used to model the probability of a major complication, with surgeon fitted as a random effect. Models were fitted using the method of maximum likelihood in SAS((R)). Results: There were many convergence problems. These were resolved using a variety of approaches including; treating all effects as fixed for the initial model building; modelling the variance of a parameter on a logarithmic scale and centring of continuous covariates. The initial model building process indicated no significant 'type of operation' across surgeon interaction effect in either trial, the 'type of operation' term was highly significant in the abdominal trial, and the 'surgeon' term was not significant in either trial. Conclusions: The analysis did not find a surgeon effect but it is difficult to conclude that there was not a difference between surgeons. The statistical test may have lacked sufficient power, the variance estimates were small with large standard errors, indicating that the precision of the variance estimates may be questionable.

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The relationships between wheat protein quality and baking properties of 20 flour samples were studied for two breadmaking processes; a hearth bread test and the Chorleywood Bread Process (CBP). The strain hardening index obtained from dough inflation measurements, the proportion of unextractable polymeric protein, and mixing properties were among the variables found to be good indicators of protein quality and suitable for predicting potential baking quality of wheat flours. By partial least squares regression, flour and dough test variables were able to account for 71-93% of the variation in crumb texture, form ratio and volume of hearth loaves made using optimal mixing and fixed proving times. These protein quality variables were, however, not related to the volume of loaves produced by the CBP using mixing to constant work input and proving to constant height. On the other hand, variation in crumb texture of CBP loaves (54-55%) could be explained by protein quality. The results underline that the choice of baking procedure and loaf characteristics is vital in assessing the protein quality of flours. (C) 2003 Elsevier Ltd. All rights reserved.

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The applications of rheology to the main processes encountered during breadmaking (mixing, sheeting, fermentation and baking) are reviewed. The most commonly used rheological test methods and their relationships to product functionality are reviewed. It is shown that the most commonly used method for rheological testing of doughs, shear oscillation dynamic rheology, is generally used under deformation conditions inappropriate for breadmaking and shows little relationship with end-use performance. The frequency range used in conventional shear oscillation tests is limited to the plateau region, which is insensitive to changes in the HMW glutenin polymers thought to be responsible for variations in baking quality. The appropriate deformation conditions can be accessed either by long-time creep or relaxation measurements, or by large deformation extensional measurements at low strain rates and elevated temperatures. Molecular size and structure of the gluten polymers that make up the major structural components of wheat are related to their rheological properties via modern polymer rheology concepts. Interactions between polymer chain entanglements and branching are seen to be the key mechanisms determining the rheology of HMW polymers. Recent work confirms the observation that the dynamic shear plateau modulus is essentially independent of variations in MW of glutens amongst wheat varieties of varying baking performance and also that it is not the size of the soluble glutenin polymers, but the secondary structural and rheological properties of the insoluble polymer fraction that are mainly responsible for variations in baking performance. Extensional strain hardening has been shown to be a sensitive indicator of entanglements and long-chain branching in HMW polymers, and is well related to baking performance of bread doughs. The Considere failure criterion for instability in extension of polymers defines a region below which bubble walls become unstable, and predicts that when strain hardening falls below a value of around 1, bubble walls are no longer stable and coalesce rapidly, resulting in loss of gas retention and lower volume and texture. Strain hardening in doughs has been shown to reach this value at increasingly higher temperatures for better breadmaking varieties and is directly related to bubble stability and baking performance. (C) 2003 Elsevier Ltd. All rights reserved.

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Analysis of the oil-absorption process in deep-fat fried potato cylinders (frying temperatures of 155degreesC, 170degreesC, and 185degreesC) allowed to distinguish 3 oil fractions: structural oil (absorbed during frying), penetrated surface oil (suctioned during cooling), and surface oil. Results showed that a small amount of oil penetrates during frying because most of the oil was picked up at the end of the process, suggesting that oil uptake and water removal are not synchronous phenomena. After cooling, oil was located either on the surface of the chip or suctioned into the porous crust microstructure, with an inverse relationship between them for increasing frying times.

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Aim: To describe how quantitative data obtained from applying a series of indicators for preventable drug related morbidity (PDRM) in the electronic patient record in English general practice can be used to facilitate changes aimed at helping to improve medicines management. Design: A multidisciplinary discussion forum held at each practice facilitated by a clinical researcher. Subjects and setting: Eight English general practices. Outcome measures: Issues discussed at the multidisciplinary discussion forum and ideas generated by practices for tackling these issues. Progress made by practices after 1, 3, and 6 months. Results: A number of clinical issues were raised by the practices and ideas for moving them forward were discussed. The issues that were easiest and most straightforward to deal with (for example, reviewing specific patient groups) were quickly addressed in most instances. Practices were less likely to have taken steps towards addressing issues at a systems level. Conclusions: Data generated from applying PDRM indicators can be used to facilitate practice-wide discussion on medicines management. Different practices place different priority levels on the issues they wish to pursue. Individual practice "ownership'' of these, together with having a central committed figure at the practice, is key to the success of the process.