887 resultados para Conditionalities in the health sector
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The purpose of this paper is to analyze innovations and the innovation system and its dynamics in the ethanol sector in the State of Sao Paulo. More specifically, this paper focuses on the development process in the sector, the public policies taken to promote the sector, and the organizations and key players involved in these policies and their responses to unforeseeable changes in economic, social and technological environments. To this end, this paper takes an historical perspective and reviews data on the cultivation of sugar cane, the production of ethanol, and on sugar cane yields as indicators of the innovations achieved in the sector. The geographical distribution of these indicators is also examined. Next, several cases in Piracicaba and Campinas in the State of Sao Paulo are presented; these give us a more concrete idea of the processes involved in innovation and technology transfer. Based on these observations, the ethanol cluster and the innovation system of the State of Sao Paulo are discussed from the viewpoint of the flowchart approach to industrial cluster policy.
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This paper explores the extent and forms of black economic empowerment (BEE) in the South African agricultural sector through a case study of the wine industry in the Western Cape. Compared to the mining and fisheries sectors, the progress of BEE in the agricultural sector is still in the early stage. However, various forms of black entry into the wine industry, not limited to BEE deals by large corporations, began to emerge, especially since the enactment of the Broad-based Black Economic Empowerment Act (BBBEE Act), Act 53 of 2003. This paper identifies two types of BEE wineries as unique forms of black entry into the wine industry and investigates in detail their features, backgrounds and challenges by referring to several prominent examples of each type of BEE winery.
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We present time series of export productivity proxy data including 230Thex-normalized deposition rates (rain rates) of 10Be, dissolution-corrected biogenic Ba, and biogenic opal as well as authigenic U concentrations which are complemented by rain rates of total (detrital) Fe and sea ice indicating diatom abundances from five sediment cores across the Atlantic sector of the Southern Ocean covering the past 150,000 years. The results suggest that 10Be rain rates and authigenic U concentration cannot serve as quantitative paleoproductivity proxies because they have also been influenced by detrital particle fluxes in the case of 10Be and bulk sedimentation rates (sediment focussing) and deep water oxygenation in the case of U. The combined results of the remaining productivity proxies of this study (rain rates of biogenic opal and biogenic Ba in those sections without authigenic U) and other previously published proxy data from the Southern Ocean (231Pa/230Th and nitrogen isotopes) suggest that a combination of sea ice cover, shallow remineralization depth, and stratification of the glacial water column south of the present position of the Antarctic Polar Front and possibly Fe fertilization north of it have been the main controlling factors of export paleoproductivity in the Southern Ocean over the last 150,000 years. An overall glacial increase of export paleoproductivity is not supported by the data, implying that bioproductivity variations in the Southern Ocean are unlikely to have contributed to the major glacial atmospheric CO2 drawdown observed in ice cores.
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We identify geochemical features of sedimentary organic matter in various morphostructural zones of the Antarctic sector of the Atlantic. We present background geochemical organic parameters for shelf and deep-sea sediments from the Weddell and Scotia Seas and the Bransfield Strait. Geochemical organic parameters are good indicators of environmental and facial variations in sediments and could be used for environmental monitoring of the World Ocean.
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A new radiolarian-based transfer function for sea surface temperature (SST) estimations has been developed from 23 taxa and taxa groups in 53 surface sediment samples recovered between 35° and 72°S in the Atlantic sector of the Southern Ocean. For the selection of taxa and taxa groups ecological information from water column studies was considered. The transfer function allows the estimation of austral summer SST (December-March) ranging between -1 and 18°C with a standard error of estimate of 1.2°C. SST estimates from selected late Pleistocene squences were sucessfully compared with independend paleotemperature estimates derived from a diatom transfer function. This shows that radiolarians provide an excellent tool for paleotemperature reconstructions in Pleistocene sediments of the Southern Ocean.
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"December 2005."
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Reliable, comparable information about the main causes of disease and injury in populations, and how these are changing, is a critical input for debates about priorities in the health sector. Traditional sources of information about the descriptive epidemiology of diseases, injuries and risk factors are generally incomplete, fragmented and of uncertain reliability and comparability. Lack of a standardized measurement framework to permit comparisons across diseases and injuries, as well as risk factors, and failure to systematically evaluate data quality have impeded comparative analyses of the true public health importance of various conditions and risk factors. As a consequence the impact of major conditions and hazards on population health has been poorly appreciated, often leading to a lack of public health investment. Global disease and risk factor quantification improved dramatically in the early 1990s with the completion of the first Global Burden of Disease Study. For the first time, the comparative importance of over 100 diseases and injuries, and ten major risk factors, for global and regional health status could be assessed using a common metric (Disability-Adjusted Life Years) which simultaneously accounted for both premature mortality and the prevalence, duration and severity of the non-fatal consequences of disease and injury. As a consequence, mental health conditions and injuries, for which non-fatal outcomes are of particular significance, were identified as being among the leading causes of disease/injury burden worldwide, with clear implications for policy, particularly prevention. A major achievement of the Study was the complete global descriptive epidemiology, including incidence, prevalence and mortality, by age, sex and Region, of over 100 diseases and injuries. National applications, further methodological research and an increase in data availability have led to improved national, regional and global estimates for 2000, but substantial uncertainty around the disease burden caused by major conditions, including, HIV, remains. The rapid implementation of cost-effective data collection systems in developing countries is a key priority if global public policy to promote health is to be more effectively informed.
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The associations of volumetric (vBMD) and areal (aBMD) bone mineral density measures with prevalent cardiovascular disease (CVD) and subclinical peripheral arterial disease (PAD) were investigated in a cohort of older men and women enrolled in the Health, Aging, and Body Composition Study. Participants were 3,075 well-functioning white and black men and women (42% black, 51% women), aged 68-80 years. Total hip, femoral neck, and trochanter aBMD were measured using dual-energy X-ray absorptiometry. Quantitative computed tomography was used to evaluate spine trabecular, integral, and cortical vBMD measures in a subgroup (n = 1,489). Logistic regression was performed to examine associations of BMD measures with CVD and PAD. The prevalence of CVD (defined by coronary heart disease, PAD, cerebrovascular disease, or congestive heart failure) was 29.8%. Among participants without CVD, 10% had subclinical PAD (defined as ankle-arm index < 0.9). Spine vBMD measures were inversely associated with CVD in men (odds ratio of integral [ORintegral] = 1.34, 95% confidence interval [CI] 1.10-1.63; ORtrabecular = 1.25, 95% CI 1.02-1.53; ORcortical = 1.36, 95% CI 1.11-1.65). In women, for each standard deviation decrease in integral vBMD, cortical vBMD, or trochanter aBMD, the odds of CVD were significantly increased by 28%, 27%, and 22%, respectively. Total hip aBMD was associated with subclinical PAD in men (OR = 1.39, 95% CI 1.03-1.84) but not in women. All associations were independent of age and shared risk factors between BMD and CVD and were not influenced by inflammatory cytokines (interleukin-6 and tumor necrosis factors-alpha). In conclusion, our results provide further evidence for an inverse association between BMD and CVD in men and women. Future research should investigate common pathophysiological links for osteoporosis and CVD.
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The aim of this research is to assess the acquisition and absorption technology capabilities of the public sector in developing countries, with specific focus on the State of Kuwait. The assessment process of these two capabilities was conducted using a model originally designed for the private sector. In addition, the research aims to propose a framework to enhance the technological capability of developing countries, as well as the performance of the public sector. To achieve these aims, an investigation of the technology process to three public ministries in Kuwait was conducted. The prime interest of this investigation was to evaluate the role of the transferred technology in enhancing the indigenous technological capability of the public sector. The research is based on a case study approach, comprising a main case study (Ministry of Electricity and Water) and three minor case studies. Based on the outcomes from an extensive literature review and the preliminary sectoral visits, the research question and four hypotheses were formulated. These hypotheses were then tested using interview-based survey and documentation. The findings of the research revealed the weakness of the acquisition and absorption technological capabilities of the public sector. Consequently, the public sector relies extensively on foreign contractors and expatriates to compensate for this weakness. Also, it was found that Kuwait Government has not taken the necessary measures to develop its technological capability. This research has proposed a framework which could lead, if properly managed, to the enhancement of indigenous capability. It has also proposed how to improve performance and productivity in the public sector. Finally, the findings suggest that the assessment model, with minor adjustment, is applicable to the public sector.
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Corporate Governance - which is concerned with the management and direction of organizations at the very highest level - has grown in importance in the private sector, from where the concept largely derives, as a result mainly of malpractice. As a consequence, interest in the topic has grown steadily, largely on the part of Governments, regulators and academics. Managerial reforms of the NHS introduced refashioned District Health Authorities (DHAs) which mimic the role and structure of the Company board. The research reported in this thesis is an assessment of corporate governance in post reform English DHAs. The research examines the characteristics of directors, the extent to which corporate governance can be empirically demonstrated, the extent to which it is consistent with the Working for Patients reforms, and, the consequences of such changes for the development of directors and of DHAs. The research also considers the relevance of the findings to other parts of the NHS and public sector. The work draws upon the conceptual framework established by Tricker (1984; also Hilmer & Tricker 1991) with detailed survey and case study findings concerned with issues of direction, executive management, supervision and accountability. The findings from this new research make an important contribution to the policy debate and to the literature(s) concerned.
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The Government has established essential principles in order to make significant improvements in the health of the people and has placed an emphasis on shifting care to the primary sening. This research has explored the potential role of the community pharmacist in health promotion in the pharmacy, and at general medical practices. The feasibility of monitoring patients' health status in the community was evaluated by intervention to assess and alter cardiovascular risk factors.68, hypertensive patients, monitored at one surgery, had a change in mean systolic blood pressure from 158.28 to 146.55 mmHg, a reduction of 7.4%, and a change in mean diastolic bood pressure from 90.91 to 84.85 mmHg, a reduction of 6.7%.120 patients, from a cohort of 449 at the major practice, with an initial serum total cholesterol of 6.0+mmol/L, experienced a change in mean value from 6.79 to 6.05 mmol/L, equivalent to a reduction of 10.9%. 86% of this patient cohort showed a decrease in cholesterol concentration. Patients, placed in a high risk category according to their coronary rank score, assessed at the first health screening, showed a consistent and significant improvement in coronary score throughout the study period of two years. High risk and intermediate risk patients showed improvements in coronary score of 52% and 14% respectively. Patients in the low risk group maintained their good coronary score. In some cases, a patient's improvement was effected in liaison with the GP, after a change or addition of medication and/or dosage.Pharmacist intervention consisted of advice on diet and lifestyle and adherence to medication regimes. It was concluded that a pharmacist can facilitate a health screening programme in the primary care setting, and provide enhanced continuity of care for the patient.
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The purpose of this paper is to deal with the outcomes of a so-called “employability management needs analysis” that is meant to provide more insight into current employability management activities and its possible benefits for Information and Communication Technology (ICT) professionals working in Small- and Medium-sized enterprises (SMEs) throughout Europe. A considerable series of interviews (N=107) were conducted with managers in SMEs in seven European countries, including Germany, Greece, Italy, the Netherlands, Norway, Poland, and the UK. A semi-structured interview protocol was used during the interviews to cover three issues: employability (13 items), ageing (8 items), and future developments and requirements (13 items). Analysis of all final interview transcriptions was at a national level using an elaborate common coding scheme. Although an interest in employability emerged, actual policy and action lagged behind. The recession in the ICT sector at the time of the investigation and the developmental stage of the sector in each participating country appeared connected. Ageing was not seen as a major issue in the ICT sector because managers considered ICT to be a relatively young sector. There appeared to be a serious lack of investment in the development of expertise of ICT professionals. Generalization of the results to large organizations in the ICT sector should be made with caution. The interview protocol developed is of value for further research and complements survey research undertaken within the employability field of study. It can be concluded that proactive HRM (Human Resource Management) policies and strategies are essential, even in times of economic downturn. Employability management activities are especially important in the light of current career issues. The study advances knowledge regarding HRM practices adopted by SMEs in the ICT sector, especially as there is a gap in knowledge about career development issues in that particular sector.
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Background: Team-based working is now an inherent part of effective health care delivery. Previous research has identified that team working is associated with positive mental health and well-being outcomes for individuals operating in an effective team environment. This is a particularly important topic in the health services context, although little empirical attention has been paid to mental-health services. Psychiatric nurses work on a day-to-day basis with a particularly stressful and demanding client group in an environment which is characterised by high demands, uncertainty, and limited resources. This paper specifically focuses on psychiatric nurses working in National Health Service (NHS) and casts some light on the ways in which effective team-based working can help to alleviate a number of occupational stressors and strains. Method: A questionnaire method (2005 NHS Staff Survey) was employed to collect data from 6655 psychiatric nurses from 64 different NHS Trusts. The hypotheses were concerned with four overall measures from the survey; effective team working, occupational stress, work pressure and social support. Hypothesis 1 stated that effective team working will have a significant negative relationship with occupational stress and work pressure. Further, Hypothesis 2 stated that social support from supervisors and co-workers will moderate this relationship. Findings: Data was treated with a series of regression analyses. For Hypothesis 1, working in a real team did have main effects on work pressure and accounted for 1.6 per cent of the variance. Using the Nagelkerke R square value, working in a real team also had main effects on occupational stress an accounted for approximately 2.8 per cent of the variance. Further, the Exp (B) value of 0.662 suggests that the odds of suffering from occupational stress are cut by 33.8 per cent when a psychiatric nurse works in a real team. Results failed to provide support for Hypothesis 2. The analysis then went on to adopt a unique approach for assessing the extent of real team-based working, distinguishing between real teams, and a number of pseudo team typologies, as well as the absence of teamwork all together. As was hypothesised, results demonstrated that psychiatric nurses working in real teams (ones with clear objectives, where-by team members work closely with one another to achieve team objectives and meet regularly to discuss team effectiveness and how it can be improved) experienced the lowest levels of stress and work pressure of the sample. However, contrary to prediction, results indicated that psychiatric nurses working in any type of pseudo team actually experienced significantly higher levels of stress and work pressure than those who did not report as working in a team at all. Discussion: These findings have serious implications for NHS Mental Health Trusts, which may not be implementing, structuring and managing their nursing teams adequately. Indeed, results suggest that poorly-structured team work may actually facilitate stress and pressure in the workplace. Conversely, well-structured real teams serve to reduce stress and work pressure, which in turn not only enhances the working lives and well-being of psychiatric nurses, but also greatly improves the service that the NHS provides to its users.
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A bipoláris világrendszer megszűnése a XX. század utolsó évtizedében új helyzetet teremtett a globális politikai és gazdasági viszonyokban, ugyanakkor nem mellékesen a hadiiparban is. A szerző, szem előtt tartva a hatalmi viszonyok jövőbeli elkerülhetetlen átrendeződését, elsősorban a katonai szektor előtt álló, a XXI. századra előrevetíthető kihívásokat, lehetőségeket, a szektor jövőbeli pályáját tekinti át. A hadiiparral kapcsolatban indokolt a hidegháború utáni világ fegyverkezési helyzetének, fegyveres erőinek számbavétele csakúgy, mint a releváns elméleti keretek ismertetése, továbbá a fontos globális szereplők biztonságpolitikájának vizsgálata. A katonai szektor jelenének és jövőjének alapos elemzése nem nélkülözheti a katonai kiadások jelenlegi – a világgazdasági válság által befolyásolt – és a következő évtizedekben várható alakulásának vizsgálatát. Végül, de nem utolsó sorban a szerző áttekinti a XXI. századi haditechnikai forradalom már most látható és a jövőben valószínűsíthető vívmányait, a fontosabb haditechnikai tendenciákat, illetve elemzi a nemzetközi fegyverpiac helyzetét. __________________ The end of the Cold War led to a new situation in global political and economic affairs, as well as in the military sector. The author, taking into consideration the inevitable future power shifts, provides an overview of the challenges, possibilities and future paths of the military sector. Relevant issues include assessing the arms and armed forces of the post-Cold War era, as well as the analysis of theoretical frameworks and the security policies of the important global actors. Understanding the present and the future of the military sector is not possible without the thorough analysis of military expenditures and their likely future trends. The author also overviews the outcomes of the 21st century revolution in military technology and analyses the global arms market.