864 resultados para Strategic document with primary focus on suicide prevention
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A pesquisa teve como objetivo geral analisar as principais razões pelas quais as empresas públicas paulistas utilizam coaching e mentoring como práticas de compartilhamento de conhecimento. No ano de 2009, foi instituído pelo governador do Estado de São Paulo, o decreto nº 53.963 que instituiu a Política de Gestão do Conhecimento e Inovação para as empresas públicas. Kuniyoshi e Santos (2007) realizaram uma pesquisa, na qual identificaram práticas e iniciativas de gestão do conhecimento adotadas por algumas empresas, dentre elas, coaching e mentoring. As práticas são processos que necessitam de investimento não somente financeiro, mas de tempo e pessoas adequadas, por serem processos mais complexos, instigam a investigação de ações no contexto organizacional de empresas públicas. Este estudo busca contribuir para o desenvolvimento de estudos na área pública. O método utilizado neste estudo de abordagem qualitativa é do tipo exploratória. O objeto desta pesquisa foram as empresas públicas paulistas, que, atualmente, somam 21. Foi realizado estudo de caso, com entrevista e análise documental em duas destas empresas, A Sabesp, empresa do segmento de saneamento de água e esgoto, teve como objetivo analisar a prática de coaching e, o Instituto de Pesquisa Tecnológicas (IPT), referência nacional em metrologia, teve como objetivo analisar a prática de mentoring. Uma vez que não existem práticas exclusivas à Gestão do Conhecimento, e o sucesso de uma prática está relacionado ao contexto na qual está inserida. No caso da Sabesp, a prática de coaching é utilizada como uma das atividades dentro de dois programas, visando desenvolver o capital humano como força competitiva. O IPT teve como objetivo da aplicação do programa de mentoring, especificamente, o compartilhar conhecimento tácito. Foi constatado que as práticas de coaching e mentoring podem ser utilizadas como recurso capaz de tornar a empresa singular perante as demais, mesmo empresas públicas não tendo foco em competitividade, mas utilizam o conhecimento de forma estratégica para melhorar a qualidade de atendimento à sociedade.
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PURPOSE. To assess the level of plasma glutathione in patients with untreated primary open-angle glaucoma. METHODS. Twenty-one patients with newly diagnosed primary open-angle glaucoma and 34 age- and gender-matched control subjects were subjected to a blood analysis to detect the level of circulating glutathione in its reduced and oxidized forms. The effect of age, gender, and systemic blood pressure on circulating glutathione levels was also analyzed. RESULTS. Age had a negative effect on the level of both reduced and total glutathione (P = 0.002, r = -0.52 and P = 0.002, r = -0.52, respectively) in control subjects but not in patients with glaucoma (P > 0.05, r = 0.27, and P > 0.05, r = 0.22, respectively). In the control group, men demonstrated higher levels of both reduced and total glutathione than did women (P = 0.024 and P = 0.032, respectively). After correction for age and gender influences on blood glutathione levels, patients with glaucoma exhibited significantly lower levels of reduced and total glutathione than did control subjects (P = 0.010, F = 7.24 and P = 0.006, F = 8.38, respectively). No differences between study groups were observed in either oxidized glutathione levels or redox index (P > 0.05, F = 0.50; and P > 0.05, F = 0.30, respectively). CONCLUSIONS. Patients with glaucoma exhibit low levels of circulating glutathione, suggesting a general compromise of the antioxidative defense. Copyright © Association for Research in Vision and Ophthalmology.
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Objective To systematically find and synthesise qualitative studies that elicited views and experiences of nurses involved in the delivery of health behaviour change (HBC) interventions in primary care, with a focus on how this can inform enhanced delivery and adherence to a structured approach for HBC interventions. Methods Systematic search of five electronic databases and additional strategies to maximise identification of studies, appraisal of studies and use of meta-synthesis to develop an inductive and interpretative form of knowledge synthesis. Results Nine studies met the inclusion criteria. Synthesis resulted in the development of four inter-linking themes; (a) actively engaging nurses in the process of delivering HBC interventions, (b) clarifying roles and responsibilities of those involved, (c) engaging practice colleagues, (d) communication of aims and potential outcomes of the intervention. Conclusion The synthesis of qualitative evidence resulted in the development of a conceptual framework that remained true to the findings of primary studies. This framework describes factors that should be actively promoted to enhance delivery of and adherence to HBC interventions by nurses working in primary care. Practice implications The findings can be used to inform strategies for researchers, policymakers and healthcare providers to enhance fidelity and support delivery of HBC interventions.
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Purpose – The purpose of this paper is to investigate the effectiveness of quality management training by reviewing commonly used critical success factors and tools rather than the overall methodological approach. Design/methodology/approach – The methodology used a web-based questionnaire. It consisted of 238 questions covering 77 tools and 30 critical success factors selected from leading academic and practitioner sources. The survey had 79 usable responses and the data were analysed using relevant statistical quality management tools. The results were validated in a series of structured workshops with quality management experts. Findings – Findings show that in general most of the critical success factor statements for quality management are agreed with, although not all are implemented well. The findings also show that many quality tools are not known or understood well; and that training has an important role in raising their awareness and making sure they are used correctly. Research limitations/implications – Generalisations are limited by the UK-centric nature of the sample. Practical implications – The practical implications are discussed for organisations implementing quality management initiatives, training organisations revising their quality management syllabi and academic institutions teaching quality management. Originality/value – Most recent surveys have been aimed at methodological levels (i.e. “lean”, “Six Sigma”, “total quality management” etc.); this research proposes that this has limited value as many of the tools and critical success factors are common to most of the methodologies. Therefore, quite uniquely, this research focuses on the tools and critical success factors. Additionally, other recent comparable surveys have been less comprehensive and not focused on training issues.
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Background. Schizophrenia affects up to 1% of the population in the UK. People with schizophrenia use the National Health Service frequently and over a long period of time. However, their views on satisfaction with primary care are rarely sought. Objectives. This study aimed to explore the elements of satisfaction with primary care for people with schizophrenia. Method. A primary care-based study was carried out using semi-structured interviews with 45 patients with schizophrenia receiving shared care with the Northern Birmingham Mental Health Trust between 1999 and 2000. Results. Five major themes that affect satisfaction emerged from the data: the exceptional potential of the consultation itself; the importance of aspects of the organization of primary care; the construction of the user in the doctor-patient relationship; the influence of stereotypes on GP behaviour; and the importance of hope for recovery. Conclusion. Satisfaction with primary care is multiply mediated. It is also rarely expected or achieved by this group of patients. There is a significant gap between the rhetoric and the reality of user involvement in primary care consultations. Acknowledging the tensions between societal and GP views of schizophrenia as an incurable life sentence and the importance to patients of hope for recovery is likely to lead to greater satisfaction with primary health care for people with schizophrenia.
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Tanulmányunk középpontjában a közvetlen külföldi befektetések és a korrupció kapcsolata áll. Feltételezésünk az, hogy a közvetlen külföldi befektetők a kevésbé korrupt országokat kedvelik, mivel a korrupció egy további kockázati tényezőt jelent a befektetők számára, amely növelheti a befektetések költségeit. Megítélésünk szerint ezt kvantitatív módszerekkel lehet a leginkább vizsgálni, így elemzésünk során 79 országot vizsgálunk meg 10 évre vonatkozó átlagokkal a GRETL program és az OLS becslőfüggvény segítségével. Több modell lefuttatása után azt az eredményt kaptuk, hogy a közvetlen külföldi befektetők döntéseiben a korrupció szignifikáns tényező, a két változó között negatív korrelációt figyelhetünk meg. ____ We assume that investors prefer countries where corruption level is lower, as corruption an additional risk factor that might increase the cost of investment. We believe that the best way to prove the previous statement if we use quantitative methods, so we set up a model where 79 countries are tested for 10 years averages, with the help of the GRETL and OLS estimator. After running several models our finding was that corruption is a significant factor in the decisions of foreign investors, and there is a negative correlation between corruption and FDI.
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The history of planning and creating strategies has a past of over half a century. Throughout this lifetime period we have witnessed both the evolution of theory and practice. The MBA study books in the last-third of the 20th century have with predilection exhibited this very process as a complex of monetary centered budget planning, forecast-based planning, strategic planning and strategic management. There might be a controversy existing about the naming, characteristics and timing of these different sections but there is an accordance that the changes that we have taken place in the last decade as a whole without a doubt can be derived from these very changes in the business environment or in some outstanding cases (like 9/11) they can be acknowledged as the ability of corporate foreseeing and the ability to adapt to the vision of the future. The main purposes of the research is to provide a summarized picture about the changing process of this procedure during last decades as far as the planning and creating strategies are concerned and also their milestones and periods. Try to explore and systemize the very aspects of these changes. The happenings of the first decade of the new millennium are outstandingly interesting if we consider their real effect on the theory and practice of strategic management. Let us remember the euphoria around the year 2000, the predictions of „new technologies”, „new economy”, „new organization” and „new leadership”. We have implied before on the destruction of the twin towers of the World Trade Center which meant a new era, a new quality of international terrorism and its consequences (Afghanistan, Iraq). But the „product” of this decade is the strategic aim that companies focus on, which is the social responsibility regarding the unavoidance of the effects of climate change on the long run. During the research the big question has risen concerning how did the science of strategic management do as far as the predictions of the global monetary and economic crisis are concerned? And also its solutions this very science has to offer in order to handle and get over the crisis. Does it conclude from the answers given to the questions that a change in paradigms are necessary, a new quality is needed or may be we have come to a new crossroad of the development process that will take over strategic management? (...)
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The effects of lead exposure may endure through one's lifetime and can negatively effect educational performance. While the link between the cause and effects of lead poisoning has been identified, the application of lead health education as the mechanism of disease prevention has not. The purpose of this study was to examine whether caregiver participation in a family-based educational intervention can result in decreased lead exposure in low socioeconomic children. ^ Participants (n = 50) were caregivers of children 12 to 36 months of age. They were randomly selected from an urban clinic and randomly assigned to either a treatment or control group. The experimental design of this study involved two clinic visits. Parents in the treatment group were given the educational intervention during the first clinic visit while those in the control group were given the intervention during the second clinic visit. The intervention was reinforced with a lead education brochure coupled with a video on childhood lead poisoning. One instrument was used to test parental knowledge of lead poisoning both pre- and post-intervention. Blood lead levels in pediatric participants were tested using two blood lead screens approximately three to four months apart determined by well-child check-up schedules. ^ Findings from the analysis of variance showed the interaction between the change in blood lead level between the children's first and second clinic visits and the treatment level. This demonstrated a significant interaction between the differences of first and second clinic visits blood lead levels and the presence or absence of the educational intervention. ^ The findings from an analysis of covariance support that caregivers in the treatment group have significantly higher scores on the second clinic visit scores on the CLKT than the caregivers in the control group. These data suggest that the educational treatment is effective in increasing the knowledge of caregivers about the dangers of lead poisoning and the strategies for lead poisoning prevention. ^ Conclusions indicate that the education of adult caregivers can affect blood lead levels of children, the educational treatment increased the knowledge of caregivers, caregivers were able to carry out procedures taught, and caregivers retained knowledge over time. ^
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This dissertation focused on an increasingly prevalent phenomenon in today's global business environment—strategic alliance portfolio. Building on resource-based view, resource dependency theory and real options theory, this dissertation adopted a multi-dimensional perspective to examine the performance implications, strategic antecedents of alliance portfolio configuration, and its strategic effects on firms' decision-making on their continuing foreign expansion. The dissertation consisted of three interrelated essays, each of which dealt with a specific research question. In the first essay I applied a two-dimensional construct that embraces both alliance relations' and alliance partners' attributes to illustrate alliance portfolio configuration. Based on this framework, a longitudinal study was conducted attempting to explore the performance properties of alliance portfolio configuration. The results revealed that alliance diversity and partner diversity have different relative contributions to firms' economic performance. The relationship between alliance portfolio configuration and firm performance was shaped by degree of multinationality in a curvilinear pattern. The second essay attempted to identify the firm level driving forces of alliance portfolio configuration and how these forces interacting with firms' internationalization influence firms' strategic choices on alliance portfolio configuration. The empirical results indicated that past alliance experience, slack resource and firms' brand images are three critical determinants shaping alliance portfolios, but those shaping relationships are conditioned by firms' multinationality. The third essay primarily employed real options theory to build a conceptual framework, revealing how country-, alliance portfolio-, firm-, and industry level factors and their interactions influence firms' strategic decision-making on post-entry continuing expansion in foreign markets. The two empirical studies were resided in global hospitality and travel industries and use panel data to test the relevant theoretical models. Overall, the dissertation advanced and enriched the theoretical domain of alliance portfolio. It particularly shed valuable insights on three fundamental questions in the domain of alliance portfolio research, namely "if and how alliance portfolios contribute to firms' economic performance"; "what determines the appearance of alliance portfolios”; and "how alliance portfolios affect firms' strategic decision-making". This dissertation also extended the international business and strategic management research on service multinationals' foreign expansion and performance.
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This study on China’s relations with Brazil and Argentina, as well as its implications for U.S. concerns examines two main questions: Why China’s increasing influence on Brazil and Argentina may be considered a cause for U.S. security concerns? And if this is the case, how do China’s strategic alliances with the two countries has impacted U.S. leadership? In an effort to look at China’s influence from multidimensional angles and beyond China’s visible economic influence in these two countries, this paper argues that China’s interest in the Latin American region, with a focus on brazil and Argentina, responds to a more crafted, pragmatic and tailored vision with long-term strategic and political goals. The results of this study reveal that China – avoiding intra-regional competition through a strategic diversification of sectors – has been able to secure critical resources for its population as well as promote enduring alliances in the region that could represent a plausible cause of concern for U.S. interests. In this regard, China’s avoidance of a direct challenge to traditional partners’ influence has responded to the gaps left by a gradual, but steady lack of U.S. involvement.
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A circumpolar representative and consistent wetland map is required for a range of applications ranging from upscaling of carbon fluxes and pools to climate modelling and wildlife habitat assessment. Currently available data sets lack sufficient accuracy and/or thematic detail in many regions of the Arctic. Synthetic aperture radar (SAR) data from satellites have already been shown to be suitable for wetland mapping. Envisat Advanced SAR (ASAR) provides global medium-resolution data which are examined with particular focus on spatial wetness patterns in this study. It was found that winter minimum backscatter values as well as their differences to summer minimum values reflect vegetation physiognomy units of certain wetness regimes. Low winter backscatter values are mostly found in areas vegetated by plant communities typically for wet regions in the tundra biome, due to low roughness and low volume scattering caused by the predominant vegetation. Summer to winter difference backscatter values, which in contrast to the winter values depend almost solely on soil moisture content, show expected higher values for wet regions. While the approach using difference values would seem more reasonable in order to delineate wetness patterns considering its direct link to soil moisture, it was found that a classification of winter minimum backscatter values is more applicable in tundra regions due to its better separability into wetness classes. Previous approaches for wetland detection have investigated the impact of liquid water in the soil on backscatter conditions. In this study the absence of liquid water is utilized. Owing to a lack of comparable regional to circumpolar data with respect to thematic detail, a potential wetland map cannot directly be validated; however, one might claim the validity of such a product by comparison with vegetation maps, which hold some information on the wetness status of certain classes. It was shown that the Envisat ASAR-derived classes are related to wetland classes of conventional vegetation maps, indicating its applicability; 30% of the land area north of the treeline was identified as wetland while conventional maps recorded 1-7%.
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While substance use problems are considered to be common in medical settings, they are not systematically assessed and diagnosed for treatment management. Research data suggest that the majority of individuals with a substance use disorder either do not use treatment or delay treatment-seeking for over a decade. The separation of substance abuse services from mainstream medical care and a lack of preventive services for substance abuse in primary care can contribute to under-detection of substance use problems. When fully enacted in 2014, the Patient Protection and Affordable Care Act 2010 will address these barriers by supporting preventive services for substance abuse (screening, counseling) and integration of substance abuse care with primary care. One key factor that can help to achieve this goal is to incorporate the standardized screeners or common data elements for substance use and related disorders into the electronic health records (EHR) system in the health care setting. Incentives for care providers to adopt an EHR system for meaningful use are part of the Health Information Technology for Economic and Clinical Health Act 2009. This commentary focuses on recent evidence about routine screening and intervention for alcohol/drug use and related disorders in primary care. Federal efforts in developing common data elements for use as screeners for substance use and related disorders are described. A pressing need for empirical data on screening, brief intervention, and referral to treatment (SBIRT) for drug-related disorders to inform SBIRT and related EHR efforts is highlighted.
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The United Nations Office of Drug Control (UNODC) published ‘International Standards on Drug Use Prevention’ in 2013. The Standards were developed through a systematic assessment of the international evidence on prevention and they provide a summary of the available scientific evidence. The briefing provides a summary of the UNODC prevention standards and gives corresponding examples of relevant UK guidelines,programmes and interventions currently available in England. Its aim is to help people who commission, develop and implement prevention strategies and interventions to translate the standards into the English operating landscape. It also aims to support local authority commissioners to develop their prevention strategies and implement them in line with evidence.
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International research informs us that any economic downturn leads to an increase in suicides. In one recent article in the Lancet it was stated that a 1.0% increase in unemployment led to 0.7% increase in suicides. Such analysis is startling and in Ireland more than relevant as our suicide numbers rose dramatically in 2009 and 2010. Provisional figures for 2009 indicated a record number of 527 recorded suicides and even though there was a slight fall in 2010 the figure remains unacceptably high. It is likely that when the year of occurrence figures for these years are published the numbers will be even higher This year we have included a section in Chapter 5 on the year on year difference between ‘provisional’ (year of registration) data and ‘official’ (year of occurrence) data which highlights the reason why these two data sets cannot be directly compared. We also acknowledge that some undetermined deaths can also be classified as suicides. Ongoing analysis of this data is therefore important. What is particularly worrying and perhaps not unexpected is the rise in suicides in the middle age groups, both men and women. Such a dramatic increase can largely be attributed to the fracturing and resulting stress and pressure on individuals which has occurred in our society due to the economic downturn. .
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Progressive multifocal leukoencephalopathy (PML) caused by reactivation of the JC virus (JCV), a human polyomavirus, occurs in autoimmune disorders, most frequently in systemic lupus erythematosus (SLE). We describe a HIV-negative 34-year-old female with SLE who had been treated with immunosuppressant therapy (IST; steroids and azathioprine) since 2004. In 2011, she developed decreased sensation and weakness of the right hand, followed by vertigo and gait instability. The diagnosis of PML was made on the basis of brain MRI findings (posterior fossa lesions) and JCV isolation from the cerebrospinal fluid (700 copies/ml). IST was immediately discontinued. Cidofovir, mirtazapine, mefloquine and cycles of cytarabine were sequentially added, but there was progressive deterioration with a fatal outcome 1 year after disease onset. This report discusses current therapeutic choices for PML and the importance of early infection screening when SLE patients present with neurological symptoms. In the light of recent reports of PML in SLE patients treated with rituximab or belimumab, we highlight that other IST may just as well be implicated. We conclude that severe lymphopenia was most likely responsible for JCV reactivation in this patient and discuss how effective management of lymphopenia in SLE and PML therapy remains an unmet need.