839 resultados para Recommendations to practice
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This report provides updates on the WPAC recommendations to legislature, including actions taken on those recommendations and any follow-up recommendations from WPAC. Recommendations include documentation of activities, and the needs and challenges toward making progress in protecting Iowa’s water resources, identified by WPAC in coordination with all agencies and stakeholders in the management of the state’s water resources in a sustainable, fiscally responsible, and environmentally conscientious manner.
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This report provides updates on the WPAC recommendations to legislature, including actions taken on those recommendations and any follow-up recommendations from WPAC. Recommendations include documentation of activities, and the needs and challenges toward making progress in protecting Iowa’s water resources, identified by WPAC in coordination with all agencies and stakeholders in the management of the state’s water resources in a sustainable, fiscally responsible, and environmentally conscientious manner.
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Background: Drug dosing errors are common in renal-impaired patients. Appropriate dosing adjustment and drug selection is important to ensure patients" safety and to avoid adverse drug effects and poor outcomes. There are few studies on this issue in community pharmacies. The aims of this study were, firstly, to determine the prevalence of dosing inadequacy as a consequence of renal impairment in patients over 65 taking 3 or more drug products who were being attended in community pharmacies and, secondly, to evaluate the effectiveness of the community pharmacist"s intervention in improving dosing inadequacy in these patients when compared with usual care. Methods: The study was carried out in 40 Spanish community pharmacies. The study had two phases: the first, with an observational, multicentre, cross sectional design, served to determine the dosing inadequacy, the drug-related problems per patient and to obtain the control group. The second phase, with a controlled study with historical control group, was the intervention phase. When dosing adjustments were needed, the pharmacists made recommendations to the physicians. A comparison was made between the control and the intervention group regarding the prevalence of drug dosing inadequacy and the mean number of drug-related problems per patient. Results: The mean of the prevalence of drug dosing inadequacy was 17.5% [95% CI 14.6-21.5] in phase 1 and 15.5% [95% CI 14.5-16.6] in phase 2. The mean number of drug-related problems per patient was 0.7 [95% CI 0.5-0.8] in phase 1 and 0.50 [95% CI 0.4-0.6] in phase 2. The difference in the prevalence of dosing inadequacy between the control and intervention group before the pharmacists" intervention was 0.73% [95% CI (−6.0) - 7.5] and after the pharmacists" intervention it was 13.5% [95% CI 8.0 - 19.5] (p < 0.001) while the difference in the mean of drug-related problems per patient before the pharmacists" intervention was 0.05 [95% CI( -0.2) - 0.3] and following the intervention it was 0.5 [95% CI 0.3 - 0.7] (p < 0.001). Conclusion: A drug dosing adjustment service for elderly patients with renal impairment in community pharmacies can increase the proportion of adequate drug dosing, and improve the drug-related problems per patient. Collaborative practice with physicians can improve these results.
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Background: Drug dosing errors are common in renal-impaired patients. Appropriate dosing adjustment and drug selection is important to ensure patients" safety and to avoid adverse drug effects and poor outcomes. There are few studies on this issue in community pharmacies. The aims of this study were, firstly, to determine the prevalence of dosing inadequacy as a consequence of renal impairment in patients over 65 taking 3 or more drug products who were being attended in community pharmacies and, secondly, to evaluate the effectiveness of the community pharmacist"s intervention in improving dosing inadequacy in these patients when compared with usual care. Methods: The study was carried out in 40 Spanish community pharmacies. The study had two phases: the first, with an observational, multicentre, cross sectional design, served to determine the dosing inadequacy, the drug-related problems per patient and to obtain the control group. The second phase, with a controlled study with historical control group, was the intervention phase. When dosing adjustments were needed, the pharmacists made recommendations to the physicians. A comparison was made between the control and the intervention group regarding the prevalence of drug dosing inadequacy and the mean number of drug-related problems per patient. Results: The mean of the prevalence of drug dosing inadequacy was 17.5% [95% CI 14.6-21.5] in phase 1 and 15.5% [95% CI 14.5-16.6] in phase 2. The mean number of drug-related problems per patient was 0.7 [95% CI 0.5-0.8] in phase 1 and 0.50 [95% CI 0.4-0.6] in phase 2. The difference in the prevalence of dosing inadequacy between the control and intervention group before the pharmacists" intervention was 0.73% [95% CI (−6.0) - 7.5] and after the pharmacists" intervention it was 13.5% [95% CI 8.0 - 19.5] (p < 0.001) while the difference in the mean of drug-related problems per patient before the pharmacists" intervention was 0.05 [95% CI( -0.2) - 0.3] and following the intervention it was 0.5 [95% CI 0.3 - 0.7] (p < 0.001). Conclusion: A drug dosing adjustment service for elderly patients with renal impairment in community pharmacies can increase the proportion of adequate drug dosing, and improve the drug-related problems per patient. Collaborative practice with physicians can improve these results.
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Matkapuhelimet ovat uusia markkinointikanavia, joiden avulla ihmiset voidaan tavoittaa melkein missä ja milloin vain. Mobiilimarkkinoinnin avulla on mahdollista lähettää henkilökohtaisia mainosviestejä tai tarjota kullekin parhaiten sopivia palveluja. Viraalimarkkinointia voidaan käyttää apuna viestien levittämisessä, aivan kuten internetmainonnassa. Tässä tutkimuksessa on keskitytty matkapuhelimiin lähetettäviin musiikkisuosituksiin sekä siihen miten ihmiset suhtautuvat niihin ja olisivatko he valmiita lähettämään viestejä edelleen kavereilleen. Mobiilimusiikkikysely tehtiin, jotta saataisiin selville asiakkaiden halukkuutta vastaanottaa musiikkisuosituksia matkapuhelimiin, sekä heidän halukkuuttaan viraalimarkkinointia kohtaan. Kyselyyn vastasi kaiken kaikkiaan lähes1300 opiskelijaa. Kyselyn tulokset osoittavat, että lisätutkimusta tulisi tehdä alle 18-vuotiaiden matkapuhelimenkäyttäjien joukossa. Tutkimuksen perusteella löydettiin tekijöitä, jotka vaikuttavat opiskelijoiden halukkuuteen vastaanottaa musiikkisuosituksia matkapuhelimiinsa sekä heidän halukkuuttaan viraalimarkkinointiin.
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Exercising in the heat induces thermoregulatory and other physiological strain that can lead to impairments in endurance exercise capacity. The purpose of this consensus statement is to provide up-to-date recommendations to optimize performance during sporting activities undertaken in hot ambient conditions. The most important intervention one can adopt to reduce physiological strain and optimize performance is to heat acclimatize. Heat acclimatization should comprise repeated exercise-heat exposures over 1-2 weeks. In addition, athletes should initiate competition and training in a euhydrated state and minimize dehydration during exercise. Following the development of commercial cooling systems (e.g., cooling vest), athletes can implement cooling strategies to facilitate heat loss or increase heat storage capacity before training or competing in the heat. Moreover, event organizers should plan for large shaded areas, along with cooling and rehydration facilities, and schedule events in accordance with minimizing the health risks of athletes, especially in mass participation events and during the first hot days of the year. Following the recent examples of the 2008 Olympics and the 2014 FIFA World Cup, sport governing bodies should consider allowing additional (or longer) recovery periods between and during events for hydration and body cooling opportunities when competitions are held in the heat.
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Exercising in the heat induces thermoregulatory and other physiological strain that can lead to impairments in endurance exercise capacity. The purpose of this consensus statement is to provide up-to-date recommendations to optimise performance during sporting activities undertaken in hot ambient conditions. The most important intervention one can adopt to reduce physiological strain and optimise performance is to heat acclimatise. Heat acclimatisation should comprise repeated exercise-heat exposures over 1-2 weeks. In addition, athletes should initiate competition and training in a euhydrated state and minimise dehydration during exercise. Following the development of commercial cooling systems (eg, cooling-vest), athletes can implement cooling strategies to facilitate heat loss or increase heat storage capacity before training or competing in the heat. Moreover, event organisers should plan for large shaded areas, along with cooling and rehydration facilities, and schedule events in accordance with minimising the health risks of athletes, especially in mass participation events and during the first hot days of the year. Following the recent examples of the 2008 Olympics and the 2014 FIFA World Cup, sport governing bodies should consider allowing additional (or longer) recovery periods between and during events, for hydration and body cooling opportunities, when competitions are held in the heat.
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Landslide processes can have direct and indirect consequences affecting human lives and activities. In order to improve landslide risk management procedures, this PhD thesis aims to investigate capabilities of active LiDAR and RaDAR sensors for landslides detection and characterization at regional scales, spatial risk assessment over large areas and slope instabilities monitoring and modelling at site-specific scales. At regional scales, we first demonstrated recent boat-based mobile LiDAR capabilities to model topography of the Normand coastal cliffs. By comparing annual acquisitions, we validated as well our approach to detect surface changes and thus map rock collapses, landslides and toe erosions affecting the shoreline at a county scale. Then, we applied a spaceborne InSAR approach to detect large slope instabilities in Argentina. Based on both phase and amplitude RaDAR signals, we extracted decisive information to detect, characterize and monitor two unknown extremely slow landslides, and to quantify water level variations of an involved close dam reservoir. Finally, advanced investigations on fragmental rockfall risk assessment were conducted along roads of the Val de Bagnes, by improving approaches of the Slope Angle Distribution and the FlowR software. Therefore, both rock-mass-failure susceptibilities and relative frequencies of block propagations were assessed and rockfall hazard and risk maps could be established at the valley scale. At slope-specific scales, in the Swiss Alps, we first integrated ground-based InSAR and terrestrial LiDAR acquisitions to map, monitor and model the Perraire rock slope deformation. By interpreting both methods individually and originally integrated as well, we therefore delimited the rockslide borders, computed volumes and highlighted non-uniform translational displacements along a wedge failure surface. Finally, we studied specific requirements and practical issues experimented on early warning systems of some of the most studied landslides worldwide. As a result, we highlighted valuable key recommendations to design new reliable systems; in addition, we also underlined conceptual issues that must be solved to improve current procedures. To sum up, the diversity of experimented situations brought an extensive experience that revealed the potential and limitations of both methods and highlighted as well the necessity of their complementary and integrated uses.
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Implementering av ett informationssystem ur en organisatorisk synvinkel initieras av en idé om ett system och avslutas då användningen av det inte längre kräver en medveten ansträngning. Ifall tolkningen av implementering är denna, är det fråga om en långsam och komplicerad process, som berör organisationens alla parter. Ny informationsteknologi anses påverka flertalet arbetsprocesser och organiseringen av det dagliga arbetet. Möjligheterna att ta i bruk systemet och utnyttja det är många. I avhandlingen undersöks implementering av ett system för att administrera hemvårdsbesök där hemvårdare använde handdatorer för att registrera information om besökens längd och innehåll. I avhandlingen observeras vilka förändringar som sker i arbetets praxis p.g.a. det nya systemet och hur dessa förändringar påverkar vårdarbetet. Forskningen inleds med att strukturera teorier om arbetspraxis för kommande analys. Arbetspraxis är inarbetade och rutinmässiga arbetssätt i arbetets sociomateriella omgivning. Arbetspraxis i avhandlingen innebär hemvårdarens praxis och upplevd erfarenhet, där verksamheten informeras av gemensamma arbetssätt, projekt, identiteter och intressen. Organisationens auktoritet kommer även fram i den förverkligade arbetspraxisen. Forskningen genomfördes som en etnografisk longitudinell studie under åren 2001-2004. I studien observerades hur nyttjandet av handdatorerna framskred ur ett organisatoriskt perspektiv. Hemvårdares arbete och verksamhet (arbetspraxis) observerades både under vårdsbesök och under pauser. Därtill intervjuades hemvårdarna för att erhålla en bättre förståelse för de rationaliteter som styr arbetet och hur systemet togs i bruk. Dokument relaterade till projektet att införa ett nytt system och administrativa dokument har utnyttjats som källmaterial. Analysen av källmaterialet styrdes av det teoretiska tillvägagångssättet att undersöka arbetspraxis. Problem som identifierades i samband med införandet av systemet och de förändringar som det medförde analyserades i detalj. Parallellt analyserades organisatorisk makt, kontroll och arbetsidentitet. Undersökningen beskriver hur det nya systemet gradvis anpassades till hemvården efter ett initialt motstånd. Under själva implementering av systemet ifrågasattes tidigare arbetspraxis och inställningen till den eftersom arbetspraxisens materiella omgivning förändrades. Det teoretiska tillvägagångssättet i att undersöka arbetspraxis framhäver vårdarens agerande i förändringsprocessen. Resultatet av forskningen visar vikten av realistiska målsättningar, givande av gruppstöd med återkoppling samt förmåga att anpassa sig till det oväntade vid införande av informationssystem.
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Due to the different dynamics required for organizations to serve the emerging market which contains billions of people at the bottom of the pyramid (BOP) coupled with the increasing desire for organizations to grow and be more multinational, organizations need to continually innovate. However, the tendency for large and established companies to ignore the BOP market and rather focus on existing markets, gives an indication of the existence of a vulnerability that potentially disruptive innovations from the BOP will not be recognized in good time for a counter measure. This can be deduced from the fact that good management practice advocates that managers should learn and listen to their customers. Therefore majority of the large existing companies continually focus on their main customer/market with sustaining innovations which leaves aspiring new entrants with an underserved BOP market to experiment with. With the aid of research interviews and an agent-based model (ABM) simulation, this thesis examines the attributes of BOP innovations that can qualify them as disruptive and the possibilities of tangible disruptive innovations arising from the bottom of the pyramid and their underlying drivers. The thesis Furthermore, examines the associated impact of such innovations on the future sustainability of established large companies that are operating in the developed world, particularly those with a primary focus which is targeted towards the market at the top of the pyramid (TOP). Additionally, with the use of a scenario planning model, the research provides an evaluation of the possible evolution and potential sustainability impacts that could emerge, from the interplay of innovations at the two pyramidal market levels and the chosen market focus of organizations – TOP or BOP. Using four scenario quadrants, the thesis demonstrates the resulting possibilities from the interaction between the rate of innovations and the segment focused on by organizations with disruptive era characterizing the paradigm shift quadrant. Furthermore, a mathematical model and two theoretical propositions are developed for further research. As recommendations, the thesis also extends the ambidextrous organizational theory, business model innovation and portfolio diversification as plausible recommendations to limit a catastrophic impact, resulting from disruptive innovations.
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This thesis presents different IPR risk mitigation actions as well as enforcement practices and evaluates their usability in different situations. The focus is on pending patent applications, where the right is not officially recognized or established yet, but some references are made to granted patents as well. The thesis presents the different aspects when assessing the risk level created by patents and pending applications. At all times it compares the patent law of the United States and European Patent Convention. Occasionally some references are made to national law, when the European Patent Convention cannot be applied. The thesis presents two case examples, which bring the risk mitigation actions and enforcement practices closer to practice.
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Poster at Open Repositories 2014, Helsinki, Finland, June 9-13, 2014
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Both educators and politicians appear to be quite concerned about a dropout rate in Ontario's public schools of some 30 percent. With the basic understanding that a high dropout rate is costly both in economic terms and in human terms, something quite obviously needs to be done to reduce the dropout rate in Ontario schools and, in doing so, ensuring Ontario and its graduates an active role in a growing global economy. This study is an exploratory pilot study in that it examined mentoring and the role that mentoring can play in assisting a student in staying in school and graduating from secondary school. Also incorporated in this is co-operative education and the role it can play, through mentoring, in making students aware of lifestyle level of employment, and of the skills necessary to obtain gainful, meaningful employment. In order to gain information on student attitudes, needs and expectations of a mentoring situation, a series of three questionnaires was used. Also, a questionnaire was distributed to the various co-operative education employers. The intent of this questionnaire was to probe the attitudes, needs and expectations of a mentoring situation from the perspective of an employer. The findings of this study indicated that co-operative education and mentoring are a very valuable and useful component in education. There exist certain factors in a co-operative education setting that serve to enhance and to augment the traditional or "theoretical" setting of the classroom. In addition, a mentoring situation tends to add a sense of relevance to education that students seem to require. Also, an opportunity is offered that allows a student to practice and further refine the skills that have been taught over the course of the student's academic life. Results from this study suggested that a mentoring situation, occurring through a co-operative education situation, adds relevance and a sense of "application" to the traditional or classroom schooling situation. The whole idea of mentoring bodes well for the future of education and of the student. Many advantages are identified in a mentoring situation. One of the advantages is that the schools are able to work quite closely with the community and business in order to stay current and informed on the needs and expected needs of the business community. Co-operative education has now gone beyond being an "experimental" mode of education. All students can benefit from being involved in the program. Certainly at-risk students are aided with staying in school. Those students who are said to be not at-risk can also benefit from being enrolled in the program by gaining hands-on work experience and some of the necessary skills to ensure a place in a growing world economy.
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Educators continually look for strategies to enhance and improve the reading practices of their students. This is an especially challenging task for secondary level teachers as high school students often lack intrinsic motivation to read for pleasure (Bucher & Manning, 2004; Horton, 2005; Wooicott, Research Pty. Ltd. 2001). The purpose of this study was to detennine the effects of the Drop Everything and Read (D.E.A.R.) program on writing, on reading, and on grades, from the perspective of eight Grade 9 students. Of particular interest were the students' perceptions of the effect that participation in the program had on their grades, their writing, their motivation to reading, and their concept of themselves as readers. The eight participants were tracked over the course of a semester. Using qualitative research techniques, data were collected from four sources: two student surveys, researcher's daily field observations, students' weekly reading logs, and three open-ended one-on-one interviews. In order to gain an understanding of the impact of the D.E.A.R program, the data were corroborated, and analyzed with NVivo: N7 (2006). From the data analysis, five themes emerged as a function of the Grade 9 students' experiences in the D.E.A.R. program: Reading Preferences, Time Spent Reading, Making Associations with Reading for Pleasure, Perceptions of Self-as-Reader, and Evaluations of the D.E.A.R Program. In the interest of supporting students' positive reading habits and for the future implementation, these five themes are presented as a series of findings together with recommendations for practice.