529 resultados para consultants
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Abstract : Since at least the 1980's, a growing number of companies have set up an ethics or a compliance program within their organization. However, in the field of study of business management, there is a paucity of research studies concerning these management systems. This observation warranted the present investigation of one company's compliance program. Compliance programs are set up so that individuals working within an organization observe the laws and regulations which pertain to their work. This study used a constructivist grounded theory methodology to examine the process by which a specific compliance program, that of Siemens Canada Limited, was implemented throughout its organization. In conformity with this methodology, instead of proceeding with the investigation in accordance to a particular theoretical framework, the study established a number of theoretical constructs used strictly as reference points. The study's research question was stated as: what are the characteristics of the process by which Siemens' compliance program integrated itself into the existing organizational structure and gained employee acceptance? Data consisted of documents produced by the company and of interviews done with twenty-four managers working for Siemens Canada Limited. The researcher used QSR-Nvivo computer assisted software to code transcripts and to help with analyzing interviews and documents. Triangulation was done by using a number of analysis techniques and by constantly comparing findings with extant theory. A descriptive model of the implementation process grounded in the experience of participants and in the contents of the documents emerged from the data. The process was called "Remolding"; remolding being the core category having emerged. This main process consisted of two sub-processes identified as "embedding" and "appraising." The investigation was able to provide a detailed account of the appraising process. It identified that employees appraised the compliance program according to three facets: the impact of the program on the employee's daily activities, the relationship employees have with the local compliance organization, and the relationship employees have with the corporate ethics identity. The study suggests that a company who is entertaining the idea of implementing a compliance program should consider all three facets. In particular, it suggests that any company interested in designing and implementing a compliance program should pay particular attention to its corporate ethics identity. This is because employee's acceptance of the program is influenced by their comparison of the company's ethics identity to their local ethics identity. Implications of the study suggest that personnel responsible for the development and organizational support of a compliance program should understand the appraisal process by which employees build their relationship with the program. The originality of this study is that it points emphatically that companies must pay special attention in developing a corporate ethics identify which is coherent, well documented and well explained.
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Dans le contexte de restrictions budgétaires où nous sommes présentement engagés, il deviendra de plus en plus nécessaire que les institutions démontrent l'efficacité de leurs services. Aux États-Unis depuis le début des années ‘70 on a, avec l'instauration du mouvement ''d'accountability", incité les intervenants du monde de la santé et de l'éducation à s'interroger sur l'efficacité des services dispensés. Au Québec, comme l'affirme Quesnel (1980), les institutions devront rendre des comptes en précisant les raisons qui expliquent s'ils ont atteint ou non les résultats souhaités. Au niveau des services de consultation, "l'accountability" permet d'établir une relation entre les consultants en psychologie et en orientation qui s'efforcent de rendre des comptes à leur directeur de service concernant le choix, la réalisation des activités et les résultats obtenus. Nous voulons par la présente recherche nous engager dans cette ère d'évaluation de qualités de services en utilisant un outil standardisé d'identification des préoccupations des étudiants du collégial, soit le questionnaire I.P.R. Ce questionnaire s'inscrit dans un processus d'où il tire d'ailleurs son titre : I pour identification des besoins des étudiants P pour programmation d'activités en réponse aux besoins exprimés R pour réalisation de la programmation et de l'évaluation Cet instrument subventionné par la Direction générale de l'enseignement collégial (D.G.E.C.) s'inscrit dans le cadre des modèles systémiques d'évaluation. Il permet aux services de psychologie, d'orientation, d'aide pédagogique individuelle, d'information scolaire et professionnelle, d'identifier l'importance des préoccupations des étudiants et de connaître leur besoin d'aide vis-à-vis ces préoccupations. À la lumière de ces résultats, les intervenants pourront programmer des activités répondant aux besoins des étudiants et pourront évaluer la réalisation de ces activités. […]
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This report describes my experience of nine months as a trainee of a CRO (Eurotrials, Scientific Consultants), as well as a trainee of a clinical research site (Clinical Academic Center – Braga, Association). This document describes the European framework about clinical research and the Portuguese situation compared to similar countries. The activities developed during this internship are also described. These activities are divided in two phases. The first one occurred in Eurotrials, Scientific Consultants, a CRO specialized in clinical research and scientific advice. The first weeks were dedicated to intensive self-training needed to perform CTA tasks. These tasks included qualification, initiation and monitoring activities related to clinical trials, as well as the development of a quality management system. The second phase took place on 2CA-Braga, a clinical research center located in Hospital of Braga. Clinical studies coordination was the main focus of this second phase of my internship, as well as negotiation of clinical studies agreements. I had also the opportunity to participate in “1as Jornadas de Investigação Clínica e Inovação” (1st Clinical Investigation and Innovation Conference) organized by 2CA-Braga. Globally, this internship was a great opportunity to get knowledge and experience in the implementation and management of clinical trials, in a CRO and clinical research site perspectives. These two perspectives provided an interesting overview about the scientific needs of different players involved in clinical research. To conclude, this internship strengthened the knowledge acquired from my academic background, which make me able to face and overcome new challenges in the clinical research area.
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This thesis looks at how ‘community archaeology’ ideals may influence an inclusive approach to Indigenous heritage management, ensuring Indigenous community power over processes to identify both past and present values of Country. Community archaeology was acclaimed by research archaeologists over a decade ago as a distinctive approach with its own set of practices to incorporate the local community’s perspectives of its past and current associations with place. A core feature of this approach in Australia is the major role the Indigenous community has in decisions about its heritage. Concurrently, considerable concern was being expressed that Indigenous heritage was not sufficiently addressed in environmental impact assessment processes ahead of development. Seen as absent from the process was the inclusion of Indigenous knowledge about both the pre- and post-contact story as well as any scientific advance in understanding an area’s Indigenous history. This research examines these contrasting perspectives seeking to understand the ideals of community archaeology and its potential to value all aspects of Indigenous heritage and so benefit the relevant community. The ideals of community archaeology build on past community collaborations in Australia and also respond to more recent societal recognition of Indigenous rights, reflected in more ethically inclusive planning and heritage statutes. Indigenous communities expressed the view that current systems are still not meeting these policy commitments to give them control over their heritage. This research has examined the on-the-ground reality of heritage work on the outskirts of Canberra and Melbourne. The case studies compare Victorian and ACT heritage management processes across community partnerships with public land managers, and examine how pre-development surveys operate. I conclude that considerable potential for achieving community archaeology ideals exists, and that they are occasionally partially realised, however barriers continue. In essence, the archaeological model persists despite a community archaeology approach requiring a wider set of skills to ensure a comprehensive engagement with an Indigenous community. Other obstacles in the current Indigenous heritage management system include a lack of knowledge and communication about national standards for heritage processes in government agencies and heritage consultants; the administrative framework that can result in inertia or silos between relevant agencies; and funding timeframes that limit possibilities for long-term strategic programs for early identification and management planning for Indigenous heritage. Also, Indigenous communities have varying levels of authority to speak for how their heritage should be managed, yet may not have the resources to do so. This thesis suggests ways to breach these barriers to achieve more inclusive Indigenous heritage management based on community archaeology principles. Policies for a greater acknowledgement of the Indigenous community’s authority to speak for Country; processes that enable and early and comprehensive ‘mapping’ of Country, and long-term resourcing of communities, may have been promised before. In this research I suggest ways to realise such goals.
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La formule coopérative constitue un instrument de développement privilégié par certains gouvernements et organismes de coopération internationale. De 1976 à 1985, le Conseil de la coopération du Québec (C.C.Q.), par le biais de son service international, est intervenu dans de nombreux projets coopératifs dans des pays en développement. En 1985, le C.C.Q. abandonnait ces activités qui furent transférées à un nouvel organisme: la Société de coopération pour le développement international (SOCODEVI). La Société de développement international Desjardins (S.D.I.D.), œuvre également à l'étranger depuis 1970, particulièrement dans le secteur de l'épargne et du crédit. En outre, quelques autres organismes collaborent à des projets coopératifs bien qu'ils ne privilégient pas ce secteur d'intervention. Ces divers organismes font régulièrement appel à des consultants experts et à des coopérants pour intervenir auprès des coopératives dans des pays en développement. Les premiers remplissent des mandats ponctuels alors que les seconds travailleront sur place pour une période minimale de deux ans dans la plupart des cas. Ces coopérants doivent faire preuve avant tout de compétence professionnelle, mais également de connaissances sur la coopération internationale et du coopératisme et posséder certaines qualités personnelles. Avant leur départ pour l'étranger, ils prennent part à un programme de formation devant les préparer à affronter les réalités du milieu où ils seront appelés à oeuvrer. Ce programme couvre différents aspects: la problématique du développement, la coopération internationale, le pays d'intervention, le coopératisme, etc... Notre intérêt pour l'éducation coopérative comme objet de cet essai résulte d'une demande de SOCODEVI à l'effet de concevoir un document de formation devant être utilisé dans le cadre d'un programme de formation s'adressant à des personnes en provenance de ses sociétés membres. Notre tâche ayant été limitée, en définitive, à la conception d'un document de référence, il nous apparaissait intéressant, à partir de là, de concevoir entièrement une session de formation sur le coopératisme; d'autant plus que ce type d'activité ne semble pas exister chez ces organismes de coopération internationale. Nous présentons donc une session de formation au coopératisme s'adressant à de futurs coopérants qui en ont une connaissance très limitée. Avant de toucher le noeud de ce travail, il nous sera cependant utile, dans un premier temps, de situer les principaux organismes de coopération internationale qui pourraient avoir besoin de ce type de formation. Dans une deuxième partie, nous aborderons les aspects théoriques sur lesquels nous nous baserons pour ensuite construire un modèle d'éducation coopérative constituant un plan général guidant la conception et le déroulement d'activités de formation. C'est à partir de ce modèle que nous présenterons, dans un quatrième temps, une session complète d'éducation coopérative destinée à de futurs coopérants. Ensuite, nous évaluerons cette session par rapport aux aspects théoriques de base et aux principes soutenant notre modèle. Pour conclure, nous proposerons un outil qui, croyons-nous, pourrait permettre d'entretenir la réflexion des coopérants tout au long de leur intervention et d'enrichir la littérature coopérative sur les pratiques dans différents pays en développement. Il s'agit du "diagnostic coopératif".
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Depuis quelques décennies, la consultation en contexte organisationnel constitue une pratique professionnelle importante. L’efficacité de la consultation est l’un des enjeux de la pratique tant pour les clients que pour les consultants. Certains auteurs ont développé des modèles pour comprendre le processus de consultation et ses composantes. La documentation sur l’efficacité de la consultation fait ressortir la contribution de la relation client-consultant comme facteur explicatif. Toutefois, peu d’études se sont penchées sur le lien statistique entre la relation client-consultant et l’efficacité de la consultation comme pratique globale. Cette recherche s’intéresse à la relation client-consultant telle qu’exprimée par ses activités (variable indépendante) et à leurs portées sur l’efficacité de la consultation organisationnelle (variable dépendante) telle qu’évaluée par des clients. Les bases théoriques et empiriques en contextes clinique et organisationnel portent à croire qu’il existe une relation positive significative entre ces deux variables. Ainsi, pour cette étude, une hypothèse est posée : les activités de la relation client-consultant sont en relation de façon positive avec l’efficacité de la consultation telle qu’évaluée par le client. Cette étude a été menée auprès de 88 clients. Les données utilisées pour cette étude ont été recueillies en un seul temps de mesure avec deux instruments combinés dans le questionnaire CERCC-CL édité sur Internet, via Survey Monkey, et crypté pour assurer la sécurité et la confidentialité des données. Les résultats révèlent que la relation se décline en quatre dimensions : 1) entente professionnelle; 2) réciprocité; 3) soutien du consultant et 4) compatibilité personnelle. L’hypothèse est en grande partie corroborée; trois dimensions de la relation, soit (1) entente professionnelle, (2) réciprocité et (4) compatibilité personnelle, influencent la qualité d’une démarche de consultation, l’un des deux critères de l’efficacité et l’efficacité de la consultation dans sa globalité. La compatibilité personnelle (4) influence les résultats à valeur ajoutée, le second critère de l’efficacité. Le score global de la relation client-consultant permet de prédire de façon significative les deux facteurs d’efficacité de la consultation et l’efficacité globale. L’ensemble de ces résultats apporte un premier éclairage sur la contribution potentielle de deux nouveaux questionnaires permettant au client et au consultant de s’évaluer en cours de processus ou à la fin de celui-ci. Les résultats contribuent surtout à la considération et à une meilleure compréhension de l’importance de la relation client-consultant pour expliquer l’efficacité d’une intervention. La relation client-consultant selon la perspective du client, principal acteur à satisfaire, favorise une vision positive du mandat. Pour le consultant, cette étude fait valoir l’importance de miser et de parfaire ses habiletés relationnelles indépendamment de son domaine d’expertise s’il veut être efficace dans sa pratique de la consultation.
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There are many ways in which research messages and findings can be extended to the expansive cotton community. As everyone learns differently it is crucial that information is delivered in a variety of ways to meet the various learning needs of the CottonInfo team’s broad audience. In addition different cotton production areas often require targeted information to address specific challenges. Successful implementation of innovative research outcomes typically relies on a history of cultivated communication between the researcher and the end-user, the grower. The CottonInfo team, supported by a joint venture between Cotton Seed Distributors, Cotton Research Development Corporation, Cotton Australia and other collaborative partners, represents a unique model of extension in Australian agriculture. Industry research is extended via regionally based Regional Development Officers backed by support from Technical Specialists. The 2015 Cotton Irrigation Technology Tour is one example of a successful CottonInfo capacity building activity. This tour took seven CRDC funded irrigation-specific researchers to Emerald, Moree and Nevertire to showcase their research and technologies. These events provided irrigators and consultants with the opportunity to hear first-hand from researchers about their technologies and how they could be applied onfarm. This tour was an example of how the CottonInfo team can connect growers and researchers, not only to provide an avenue for growers to learn about the latest irrigation research, but for researchers to receive feedback about their current and future irrigation research.
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Soil Health, Soil Biology, Soilborne Diseases and Sustainable Agriculture provides readily understandable information about the bacteria, fungi, nematodes and other soil organisms that not only harm food crops but also help them take up water and nutrients and protect them from root diseases. Complete with illustrations and practical case studies, it provides growers and their consultants with holistic solutions for building an active and diverse soil biological community capable of improving soil structure, enhancing plant nutrient uptake and suppressing root pests and pathogens.
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Les exigences pour pratiquer comme infirmière en santé mentale au Québec augmentent et se modifient sans cesse, et ce, à une vitesse effarante. Sur le terrain, des constats tels que des tensions de rôles et un important taux de roulement du personnel infirmier dénotent des difficultés de la part des infirmières à exercer pleinement leurs fonctions. L’écart se creusant entre le rôle prescrit et le rôle exercé, les organisations se tournent de plus en plus vers les démarches qui permettent de gérer les compétences. Ces démarches s'accompagnent d'un arsenal d'outils dont fait souvent partie le profil de compétences qui vise à répertorier les compétences attendues d'un employé en vue d'orienter son développement professionnel entre autres. Face aux nombreux échecs que connaissent les démarches compétence, des études tendent à démontrer la pertinence d'aborder cet outil à partir du vécu subjectif du principal intéressé, soit l'utilisateur, et non l'inverse. La présente recherche vise donc à explorer l’effet anticipé d’un profil de compétences sur les motivations psychologiques et les tensions de rôle des infirmières en santé mentale. Six infirmières se sont projetées dans le futur, le temps d'un entretien semi-dirigé, afin de s'imaginer utiliser le profil de compétences élaboré dans le cadre d'une démarche compétence en cours d'implantation dans le centre de soins en santé mentale où elles travaillent. Un devis qualitatif et un traitement des informations à l’aide de la théorisation ancrée ont servi de cadre d’analyse pour explorer l’expérience des infirmières. Les résultats ont permis de révéler que le profil de compétences constitue bien plus qu'un outil de gestion; il véhicule une identité de rôle suggéré s'érigeant comme un miroir devant l'infirmière, qui est invitée à porter un regard sur sa propre identité de rôle et à traiter cette dualité. Plus précisément, il ressort que, suite à un traitement cognitif du rôle suggéré par le profil de compétences, les infirmières s'attendent à s'y identifier de trois façons différentes, celles-ci prenant la forme de reflets du rôle professionnel exercé ou souhaité renvoyés par le profil de compétences : un reflet dissocié du rôle, un reflet structurant du rôle et un reflet édifiant du rôle. Les résultats révèlent également que la façon dont les infirmières s'identifient par anticipation au profil de compétences influence leurs intentions de l'utiliser : le reflet dissocié du rôle est associé à une dérogation, le reflet structurant du rôle est associé à une adoption et le reflet du rôle édifiant est associé à une appropriation. Des résultats inattendus ont permis de dégager des facteurs incitatifs à l'identification au profil de compétences ainsi que l'idéalisation d'une dimension collective du profil de compétences. Les trois reflets de l'identification anticipée au profil de compétences et les intentions d'utilisation associées offrent ainsi une grille de lecture pertinente pour les gestionnaires et les consultants souhaitant accompagner les infirmières dans l'appropriation de leur profil de compétences. Les résultats soutiennent l'importance d'explorer les intentions d'utilisation des infirmières en identifiant les motivations psychologiques sous-jacentes et, partant, de mieux comprendre comment et à quel point elles s'identifient ou non au rôle suggéré par le profil de compétences. Cette compréhension permet aux infirmières de réfléchir à la construction de leur identité professionnelle et à s'outiller de stratégies identitaires leur permettant de négocier plus harmonieusement l'intériorisation de l'identité de rôle suggéré par le profil de compétences. Bien que d'autres recherches soient nécessaires pour approfondir l'identification au profil de compétences, les résultats apportent une clé de compréhension dans le domaine scientifique de la gestion des compétences au Québec, jusqu'ici peu documenté.
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The purpose of the current thesis is to develop a better understanding of the interaction between Spanish and Quichua in the Salcedo region and provide more information for the processes that might have given rise to Media Lengua, a ‘mixed’ language comprised of a Quichua grammar and Spanish lexicon. Muysken attributes the formation of Media Lengua to relexification, ruling out any influence from other bilingual phenomena. I argue that the only characteristic that distinguishes Media Lengua from other language contact varieties in central Ecuador is the quantity of the overall Spanish borrowings and not the type of processes that might have been employed by Quichua speakers during the genesis of Media Lengua. The results from the Salcedo data that I have collected show how processes such as adlexification, code-mixing, and structural convergence produce Media Lengua-type sentences, evidence that supports an alternative analysis to Muysken’s relexification hypothesis. Overall, this dissertation is developed around four main objectives: (1) to describe the variation of Spanish loanwords within a bilingual community in Salcedo; (2) to analyze some of the prominent and recent structural changes in Quichua and Spanish; (3) to determine whether Spanish loanword use can be explained by the relationship consultants have with particular social categories; and (4) to analyze the consultants’ language ideologies toward syncretic uses of Spanish and Quichua. Overall, 58% of the content words, 39% of the basic vocabulary, and 50% of the subject pronouns in the Salcedo corpus were derived from Spanish. When compared to Muysken’s description of highlander Quichua in the 1970’s, Spanish loanwords have more than doubled in each category. The overall level of Spanish loanwords in Salcedo Quichua has grown to a level between highlander Quichua in the 1970’s and Media Lengua. Similar to Spanish’s lexical influence in Media Lengua, the increase of Spanish borrowings in today’s rural Quichua can be seen in non-basic and basic vocabularies as well as the subject pronoun system. Significantly, most of the growth has occurred through forms of adlexification i.e., doublets, well-established borrowings, and cultural borrowings, suggesting that ‘ordinary’ lexical borrowing is also capable of producing Media Lengua-type sentences. I approach the second objective by investigating two separate phenomena related to structural convergence. The first examines the complex verbal constructions that have developed in Quichua through Spanish loan translations while the second describes the type of Quichua particles that are attached to Spanish lexemes while speaking Spanish. The calquing of the complex verbal constructions from Spanish were employed when speaking standard Quichua. Since this standard form is typically used by language purists, I argue that their use of calques is a strategy of exploiting the full range of expression from Spanish without incorporating any of the Spanish lexemes which would give the appearance of ‘contamination’. The use of Quichua particles in local varieties of Spanish is a defining characteristic of Quichuacized Spanish, spoken most frequently by women and young children in the community. Although the use of Quichua particles was probably not the main catalyst engendering Media Lengua, I argue that its contribution as a source language to other ‘mixed’ varieties, such as Media Lengua, needs to be accounted for in descriptions of BML genesis. Contrary to Muysken’s representation of relatively ‘unmixed’ Spanish and Quichua as the two source languages of Media Lengua, I propose that local varieties of Spanish might have already been ‘mixed’ to a large degree before Media Lengua was created. The third objective attempts to draw a relationship between particular social variables and the use of Spanish loanwords. Whisker Boxplots and ANOVAs were used to determine which social group, if any, have been introducing new Spanish borrowings into the bilingual communities in Salcedo. Specifically, I controlled for age, education, native language, urban migration, and gender. The results indicate that none of the groups in each of the five social variables indicate higher or lower loanword use. The implication of these results are twofold: (a) when lexical borrowing occurs, it is immediately adopted as the community-wide norm and spoken by members from different backgrounds and generations, or (b) this level of Spanish borrowing (58%) is not a recent phenomenon. The fourth and final objective draws on my ethnographic research that addresses the attitudes of syncretic language use. I observed that Quichuacized Spanish and Hispanicized Quichua are highly stigmatized varieties spoken by the country’s most marginalized populations and families, yet within the community, syncretic ways of speaking are in fact the norm. It was shown that there exists a range of different linguistic definitions for ‘Chaupi Lengua’ and other syncretic language practices as well as many contrasting connotations, most of which were negative. One theme that emerged from the interviews was that speaking syncretic varieties of Quichua weakened the consultant’s claim to an indigenous identity. The linguistic and social data presented in this dissertation supports an alternative view to Muysken’s relexification hypothesis, one that has the advantage of operating with well-precedented linguistic processes and which is actually observable in the present-day Salcedo area. The results from the study on lexical borrowing are significant because they demonstrate how a dynamic bilingual speech community has gradually diversified their Quichua lexicon under intense pressure to shift toward Spanish. They also show that Hispanicized Quichua (Quichua with heavy lexical borrowing) clearly arose from adlexification and prolonged lexical borrowing, and is one of at least six identifiable speech styles found in Salcedo. These results challenge particular interpretations of language contact outcomes, such as, ones that depict sources languages as discrete and ‘unmixed.’ The bilingual continuum presented in this thesis shows on the one hand, the range of speech styles that are accessible to different speakers, and on the other hand, the overlapping, syncretic features that are shared among the different registers and language varieties. It was observed that syncretic speech styles in Salcedo are employed by different consultants in varied interactional contexts, and in turn, produce different evaluations by other fellow community members. In the current dissertation, I challenge the claim that relexification and Media Lengua-type sentences develop in isolation and without the influence of other bilingual phenomena. Based on Muysken's Media Lengua example sentences and the speech styles from the Salcedo corpus, I argue that Media Lengua may have arisen as an institutionalized variant of the highly mixed "middle ground" within the range of the Salcedo bilingual continuum discussed above. Such syncretic forms of Spanish and Quichua strongly resemble Media Lengua sentences in Muysken’s research, and therefore demonstrate how its development could have occurred through several different language contact processes and not only through relexification.
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Members of the General Assembly asked the Legislative Audit Council to review the operations of the South Carolina Transportation Infrastructure Bank, a state agency that awards grants and loans to local and state agencies primarily for large transportation construction projects. The primary audit objectives were to review compliance with state law and policies regarding: The awarding of grants and loans for transportation construction projects ; The use of project revenues and whether funds dedicated to specific projects have been comingled with funds dedicated to other projects ;• Proper accounting and reporting procedures ; The process for repayment of revenue bonds ; Hiring of consultants, attorneys, and bond credit rating agencies ; Ethics.
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Odour impacts and concerns are an impediment to the growth of the Australian chicken meat industry. To manage these, the industry has to be able to demonstrate the efficacy of its odour reduction strategies scientifically and defensibly; however, it currently lacks reliable, cost effective and objective tools to do so. This report describes the development of an artificial olfaction system (AOS) to measure meat chicken farm odour. This report describes the market research undertaken to determine the demand for such a tool, the development and evaluation of three AOS prototypes, data analysis and odour prediction modelling, and the development of two complementary odour measurement tools, namely, a volatile organic compound (VOC) pre-concentrator and a field olfactometer. This report is aimed at investors in poultry odour research and those charged with, or interested in, assessment of odour on chicken farms, including farm managers, integrators, their consultants, regulators and researchers. The findings will influence the focus of future environmental odour measurement research.
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Cette thèse se propose de comparer exhaustivement trois systèmes de divination par voie de tirage au sort qui ont été contemporains dans l’antiquité tardive. À l’aide d’une analyse rigoureuse des thèmes évoqués, des stratégies rhétoriques employées, du vocabulaire présent et des probabilités d’obtention des réponses offertes, plusieurs points communs ressortent. Les énoncés positifs et négatifs se veulent, dans tous les cas, équilibrés et ils optent souvent pour des variantes temporelles afin de tempérer les prédictions. Lorsqu’ils ne s’appliquent pas à des questions spécifiques, ils misent sur l’imaginaire des consultations littéraires qui allie proverbes et éléments épiques, sans toutefois déroger des thèmes communs liés aux préoccupations quotidiennes des consultants. La rhapsodomancie s’inscrit dans cette mouvance et prouve à quel point l’épopée est une source propice à l’élaboration de systèmes oraculaires, sans jamais que le contexte narratif et littéraire des vers sélectionnés n’entre en jeu.
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Dissertação (mestrado)—Universidade de Brasília, Departamento de Geografia, Programa de Pós-Graduação em Geografia, 2016.
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Background: To achieve good outcomes in critically ill obstetric patients, it is necessary to identify organ dysfunction rapidly so that life-saving interventions can be appropriately commenced. However, timely access to clinical chemistry results is problematic, even in referral institutions, in the sub-Saharan African region. Reliable point-of-care tests licensed for clinical use are now available for lactate and creatinine. Aim: We aimed to assess whether implementation of point-of-care testing for lactate and creatinine is feasible in the obstetric unit at the Queen Elizabeth Central Hospital (QECH) in Blantyre, Malawi, by obtaining the opinions of clinical staff on the use of these tests in practice. Methods: During a two-month evaluation period nurse-midwives, medical interns, clinical officers, registrars, and consultants were given the opportunity to use StatStrip® and StatSensor® (Nova Biomedical, Waltham, USA) devices, for lactate and creatinine estimation, as part of their routine clinical practice in the obstetric unit. They were subsequently asked to complete a short questionnaire. Results: Thirty-seven questionnaires were returned by participants: 22 from nurse-midwives and the remainder from clinicians. The mean satisfaction score for the devices was 7.6/10 amongst clinicians and 8.0/10 amongst nurse-midwives. The majority of participants stated that the obstetric high dependency unit (HDU) was the most suitable location for the devices. For lactate, 31 participants strongly agreed that testing should be continued and 24 strongly agreed that it would influence patient management. For creatinine, 29 strongly agreed that testing should be continued and 28 strongly agreed that it would influence their patient management. Twenty participants strongly agreed that they trust point-of-care devices. Conclusions: Point-of-care clinical chemistry testing was feasible, practical, and well received by staff, and was considered to have a useful role to play in the clinical care of sick obstetric patients at this referral centre.