811 resultados para To-face Consultations
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Tutkimuksessa arvioidaan millaisia kyvykkyyksiä toimijoiltavaaditaan, jotta voidaan edistää verkostoja palvelevan innovaatiopolitiikan toteutumista ja toteuttaa käytäntölähtöistä innovaatiotoimintaa. Empiirinen osa tarkastelee Päijät-Hämeen toimijoiden asenneympäristöä ja toimimisen valmiuksia käytäntölähtöisen innovaatiotoiminnan tarpeisiin sopivaksi. Osaaminen kerääntyy yliopistopaikkakunnille ulkoisten suurtuotannon etujen mukaisesti. Ne alueet, joilla ei ole yliopistoa joutuvat luomaan muunlaista innovaatiokyvykkyyttä saavuttaakseen kilpailuetua. Siksi Päijät-Hämeen visiona on tulla johtavaksi käytäntölähtöisen innovaatiotoiminnan alueeksi hyvien toimintamallien ja tehokkaiden tiedonsiirtomekanismien avulla. Tämä vaatii alueen toimijoilta mm. korkeaa absorptiivista kapasiteettia ja heikkoja linkkejä alueen ulkopuolelle. Työn empiirinen osa koostuu 12:sta puolistrukturoidusta haastattelusta sekä kyselytutkimuksesta. Tiedonluonti ja -siirto alueelle nähtiin pääasiassa tutkimusmaailman tehtävänä, mutta varianssianalyysin perusteella tutkimusmaailma ei itse nähnyt olevansa siinä asemassa. Yhteisen kielen puuttuminen tutkimus- ja käytännön työelämän väliltä nähtiin puutteena.
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Ce travail a pour objectif d'étudier l'évolution du métier de médecin de premier recours à la lumière du réel de son activité. Afin de pallier les lacunes de la littérature, nous proposons d'investiguer les perceptions et les pratiques rapportées de médecins de premier recours, considérant leur activité comme située dans un contexte spécifique. Un cadre théorique multiréférencé, intégrant les apports de Bischoff (2012), de la théorie de l'activité (Engeström et al., 1999), de l'ergonomie (Daniellou, 1996 ; Falzon, 2004a; Leplat, 1997) et de certains courants de la psychologie du travail (Curie et al., 1990 ; Curie, 2000b ; Malrieu, 1989) permet de tenir compte de la complexité du travail des médecins de premier recours. Une méthodologie mixte, alliant une approche qualitative par entretiens semi-structurés (n=20) à une approche quantitative par questionnaire (n=553), a été développée. Les résultats de l'analyse thématique des entretiens mettent en évidence trois thèmes majeurs : l'Evolution du métier (Thème 1), caractérisé par les changements perçus, les demandes des populations qui consultent et les paradoxes et vécus des médecins ; les Ajustements et supports (Thème 2) mis en place par les médecins pour faire face aux changements et aux difficultés de leur métier ; les Perceptions et les attentes par rapport au métier (Thème 3), mettant en avant des écarts perçus entre la formation et la réalité du métier. La partie quantitative permet de répondre aux questionnements générés à partir des résultats qualitatifs et de généraliser certains d'entre eux. Suite à l'intégration des deux volets de l'étude, nous présentons une nouvelle modélisation du métier de médecin de premier recours, soulignant son aspect dynamique et évolutif. Cette modélisation rend possible l'analyse de l'activité réelle des médecins, en tenant compte des contraintes organisationnelles, des paradoxes inhérents au métier et du vécu des médecins de premier recours. L'analyse des limites de cette étude ouvre à de nouvelles perspectives de recherche. A l'issue de ce travail, nous proposons quelques usages pragmatiques, qui pourront être utiles aux médecins de premier recours et aux médecins en formation, non seulement dans la réalisation de leur activité, mais également pour le maintien de leur équilibre et leur épanouissement au sein du métier. - This study aims to investigate the evolution of primary care physicians' work, in the light of the reality of their activity. In order to overcome the limitations of the literature, we propose to focus on primary care physicians' reported perceptions and practices, considering their activity as situated in a specific context. The theoretical framework refers to Bischoff (2012), Activity theory (Engeström et al., 1999), ergonomy (Daniellou, 1996; Falzon, 2004a; Leplat, 1997) and work psychology (Curie et al., 1990 ; Curie, 2000b ; Malrieu, 1989) and enables to take into account the complexity of primary care physicians' work. This mixed methods study proposes semi-structured interviews (n=20) and a questionnaire (n=553). Thematic analysis of interviews points out three major themes : Evolution of work (Theme 1) is characterised by perceived changes, patients' expectations and paradoxes ; Adjustments and supports (Theme 2), that help to face changes and difficulties of work ; Perceptions related to work, including differences between work reality as represented during medical education/training and actual work reality. Quantitative part of the study enables to answer questions generated from qualitative results and to generalise some of them. Integration of qualitative and quantitative results leads to a new modelling of primary care physicians ' work, that is dynamic and evolutionary. This modelling is useful to analyse the primary care physicians' activity, including organisational constraints, paradoxes of work and how primary care physicians are experiencing them. Despite its limitations, this study offers new research perspectives. To conclude, we state pragmatic recommendations that could be helpful to primary care physicians in private practice and junior doctors, in order to realise their activity, to maintain their balance and to sustain their professional fulfilment.
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Résumé: At least since the Great Depression, explaining why there are business fluctuations has been one of the biggest challenges that the science of economics has had to face. The hope is that if we could better understand recessions, then we could also be more successful in overcoming them. This dissertation consists of three papers that are part of the general endeavor of economists to understand these fluctuations. The first paper discusses, for a particular model, whether a result related to fluctuations would still hold if time were modeled as continuous rather than discrete. The two other papers focus on price stickiness. The second paper discusses why, after a large devaluation, prices of non-tradables may change by only a small amount in comparison to the magnitude of the devaluation. The third paper examines price adjustment in a model in which information is imperfect and it is costly to change prices.
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Globalization and new information technologies mean that organizations have to face world-wide competition in rapidly transforming, unpredictable environments, and thus the ability to constantly generate novel and improved products, services and processes has become quintessential for organizational success. Performance in turbulent environments is, above all, influenced by the organization's capability for renewal. Renewal capability consists of the ability of the organization to replicate, adapt, develop and change its assets, capabilities and strategies. An organization with a high renewal capability can sustain its current success factors while at the same time building new strengths for the future. This capability does not only mean that the organization is able to respond to today's challenges and to keep up with the changes in its environment, but also that it can actas a forerunner by creating innovations, both at the tactical and strategic levels of operation and thereby change the rules of the market. However, even though it is widely agreed that the dynamic capability for continuous learning, development and renewal is a major source of competitive advantage, there is no widely shared view on how organizational renewal capability should be defined, and the field is characterized by a plethora of concepts and definitions. Furthermore,there is a lack of methods for systematically assessing organizational renewal capability. The dissertation aims to bridge these gaps in the existing research by constructing an integrative theoretical framework for organizational renewal capability and by presenting a method for modeling and measuring this capability. The viability of the measurement tool is demonstrated in several contexts, andthe framework is also applied to assess renewal in inter-organizational networks. In this dissertation, organizational renewal capability is examined by drawing on three complimentary theoretical perspectives: knowledge management, strategic management and intellectual capital. The knowledge management perspective considers knowledge as inherently social and activity-based, and focuses on the organizational processes associated with its application and development. Within this framework, organizational renewal capability is understood as the capacity for flexible knowledge integration and creation. The strategic management perspective, on the other hand, approaches knowledge in organizations from the standpoint of its implications for the creation of competitive advantage. In this approach, organizational renewal is framed as the dynamic capability of firms. The intellectual capital perspective is focused on exploring how intangible assets can be measured, reported and communicated. From this vantage point, renewal capability is comprehended as the dynamic dimension of intellectual capital, which consists of the capability to maintain, modify and create knowledge assets. Each of the perspectives significantly contributes to the understanding of organizationalrenewal capability, and the integrative approach presented in this dissertationcontributes to the individual perspectives as well as to the understanding of organizational renewal capability as a whole.
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El trabajo analiza la problemática de la consulta de las fuentes estadísticas para los estudios industriales. Para ello primero plantea unas reflexiones sobre las dificultades generales con los que se tiene que enfrentar el investigador en relación con el tema. Después examina las principales fuentes a las que se puede acudir para el análisis de las localizaciones industriales, tomando como referencia las existentes para la región aragonesa. En cada una plantea su nivel de acceso, sus contenidos y sus problemas.
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El tren de alta velocidad (TAV) está viviendo un auge importante en España. Ello implica una transformación territorial como resultado de una modificación del comportamiento de los viajeros debido a una mejora en el transporte ferroviario interurbano. En este contexto hay un elemento que ha obtenido una atención insuficiente. Se trata del acceso a la estación como parte fundamental del viaje puerta-a-puerta. Para hacer frente a la carencia de datos estadísticos sobre este aspecto, hemos realizado una encuesta a los viajeros de alta velocidad en la línea Madrid – Barcelona, que ayuda responder a la pregunta: ¿Cómo llega el viajero a la estación? Es imprescindible conocer este aspecto para planificar y realizar actuaciones de mejora intermodal adecuadas. Los resultados muestran que el acceso en vehículo privado es preponderante y que existe la necesidad de ofrecer más alternativas atractivas para acceder a las estaciones. Se concluye además que las estaciones centrales son preferibles, ya que generan una movilidad más sostenible.
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El artículo es un estudio realizado con el objetivo de observar la utilización de recursos de aprendizaje en diferentes asignaturas presenciales, semipresenciales y no presenciales de la Universidad de Lleida. La investigación se desarrolló bajo la modalidad de estudio de casos, recogiendo datos de profesorado y estudiantado a través de análisis documental, cuestionarios y entrevistas. El estudio mostró que, independientemente de la modalidad formativa de las asignaturas, se utilizaba una variedad considerable de recursos para hacer llegar la información a los estudiantes, aunque se detectó una baja mediación entre los materiales que el profesorado publicaba y el acceso a estos por parte de los estudiantes. Consideramos que todavía queda camino por recorrer en el aprovechamiento de los recursos TIC en los procesos formativos universitarios.
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Interaction is a basic element in any educational process, and it is something that needs to be reconsidered in the light of technology. In order to examine the methodological changes that ICTs bring to teaching from an interaction perspective, a study was carried out at the University of Lleida to observe interaction processes in various face-to-face, blended learning and e-learning subjects. The methodological design was based on three data collection techniques: documentary analysis of subject curricula, lecturer and student questionnaires, and lecturer interviews. The data showed that, as the online component of subjects increased, the lecturers and students used more technological tools to communicate (e-mail, forums, chats, social networks, etc.). Furthermore, we found that the lecturers and students basically communicated for academic purposes. While they hardly ever communicated for personal reasons (guidance, support, etc.), they claimed that closer contact with a non-academic focus would be preferable. We also observed that the students’ work was more individual in e-learning subjects. Although there is still a considerable way to go in ICT-mediated lecturer-student interaction, both the lecturers and students recognise the potential of such technologies, even though they still do not use them as they feel they should.
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La interacción, un elemento básico en cualquier proceso formativo, debe replantearse con la irrupción de la tecnología. Con la intención de abordar los cambios metodológicos que las TIC implican en la docencia desde la perspectiva de la interacción que generan, se planteó un estudio en la Universidad de Lérida para observar los procesos que interactúan en diferentes asignaturas en función de si éstas se desarrollaban bajo la modalidad presencial, semipresencial o no presencial. El diseño metodológico se articuló alrededor de tres técnicas de recogida de datos: análisis documental de programas de asignaturas, cuestionarios a profesores y estudiantes y entrevistas a profesores. Los datos mostraron que, conforme aumenta la no presencialidad de las asignaturas, profesorado y estudiantado utilizaban más herramientas tecnológicas (correo electrónico, foro, chat, redes sociales...) para comunicarse. Además, el tipo de comunicación imperante tenía finalidades académicas, mientras que se producía una escasa interacción para aspectos más personales (de orientación, apoyo...); en este sentido, tanto profesorado como estudiantado preferirían un contacto más cercano no tan centrado en los elementos académicos del proceso. También observamos que en las asignaturas en línea se desarrolla un trabajo más individual por parte del estudiantado. Aunque todavía queda camino por recorrer en la interacción docente-discente a través de las TIC, los agentes implicados en el proceso reconocen sus potencialidades, pero aún no las utilizan como consideran que convendría hacerse.
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El artículo está basado en un estudio realizado con el objetivo de observar el desarrollo de los procesos de evaluación en diferentes asignaturas presenciales, semipresenciales y no presenciales de la Universidad de Lleida. Se recogieron datos a través de análisis documental de planificaciones, un cuestionario a profesorado y estudiantado y entrevistas a profesorado. Los datos mostraron diferentes percepciones sobre las estrategias de evaluación entre docentes y discentes. También que a medida que aumenta la no presencialidad se desarrollan más estrategias de evaluación continuada.
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London : Joseph Mawman 1802
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London : Joseph Mawman 1802
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A growing body of evidence has shown the efficacy of brief intervention (BI) for hazardous and harmful alcohol use in primary health care settings. Evidence for efficacy in other settings and effectiveness when implemented at larger scale are disappointing. Indeed, BI comprises varying content; exploring BI content and mechanisms of action may be a promising way to enhance efficacy and effectiveness. Medline and PsychInfo, as well as references of retrieved publications were searched for original research or review on active ingredients (components or mechanisms) of face-to-face BIs [and its subtypes, including brief advice and brief motivational interviewing (BMI)] for alcohol. Overall, BI active ingredients have been scarcely investigated, almost only within BMI, and mostly among patients in the emergency room, young adults, and US college students. This body of research has shown that personalized feedback may be an effective component; specific MI techniques showed mixed findings; decisional balance findings tended to suggest a potential detrimental effect; while change plan exercises, advice to reduce or stop drinking, presenting alternative change options, and moderation strategies are promising but need further study. Client change talk is a potential mediator of BMI effects; change in norm perceptions and enhanced discrepancy between current behavior and broader life goals and values have received preliminary support; readiness to change was only partially supported as a mediator; while enhanced awareness of drinking, perceived risks/benefits of alcohol use, alcohol treatment seeking, and self-efficacy were seldom studied and have as yet found no significant support as such. Research is obviously limited and has provided no clear and consistent evidence on the mechanisms of alcohol BI. How BI achieves the effects seen in randomized trials remains mostly unknown and should be investigated to inform the development of more effective interventions.
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13-16-vuotiaiden purentaelimistön toimintahäiriöt ja päänsärky Tutkimuksen tarkoituksena oli selvittää purentaelimistön toimintahäiriöihin (TMD) liittyvien oireiden ja kliinisten löydösten esiintyvyyttä ja muutosta kolmen vuoden seurannan aikana päänsärystä kärsivillä nuorilla ja heidän verrokeillaan, TMD-löydösten yhteyttä eri tyyppisiin päänsärkyihin ja päänsärkyyn liittyviin tekijöihin, TMD-löydöksiä ennustavia tekijöitä sekä perhetaustan osuutta TMD-löydösten esiintyvyyteen. Tutkimus perustui kahteen laajaan koululaismateriaaliin Turun seudulla. Ensimmäinen 13-vuotiaiden nuorten ryhmä (n = 311) osallistui myös 16-vuotiaana seuranta-tutkimukseen. Toisen 13-vuotiaiden nuorten ryhmän (n = 154) äidit (n = 154) osallistuivat myös tutkimukseen, jossa selvitettiin tapaus-verrokkiasetelmassa TMD-löydösten ja päänsärkyjen esiintyvyyttä kahdessa sukupolvessa. Nuoret jaettiin päänsärkyryhmiin ja terveisiin kontrolleihin IHS (1988) päänsärky-kriteerien mukaisesti kyselykaavakkeen ja lääkärin suorittaman haastattelun ja kliinisen tutkimuksen antamien tietojen perusteella. Lääkäri määritteli äitien päänsärkydiagnoosin kyselykaavakkeen tietojen perusteella. Kaikki nuoret ja heidän äitinsä haastateltiin ja heille tehtiin kliininen purentafysiologinen tutkimus sokkoutetusti. Tutkimuksen tulokset osoittivat, että tytöillä esiintyi TMD-löydöksiä selvästi enemmän kuin pojilla sekä ennen puberteettia että sen jälkeen. Tutkimuksessa havaittiin selkeä yhteys TMD-löydösten ja molempien päänsärkytyyppien, migreenin ja episodisen tensiotyyppisen päänsäryn, välillä. Kolmen vuoden seurannan aikana TMD-löydöksissä havaittiin runsasta muutosta ja iän myötä vähenemistä, mutta TMD-oireiden kohdalla ei vastaavaa muutosta todettu. TMD-löydösten ja niska-hartiaseudun lihaskipujen välillä havaittiin yhteys 13-vuotiailla nuorilla. Mikään päänsärkyyn liittyvistä tekijöistä 13-vuotiailla ei osoittautunut ennustavaksi taustatekijäksi myöhemmille TMD-löydöksille. TMD-löydösten suhteen ei todettu perheyhteyttä. Päänsäryistä kärsivillä nuorilla on enemmän myös muita kiputiloja, kuten purentaelimistön toimintahäiriöitä ja niska-hartiaseudun kipuja, kuin heidän terveillä verrokeillaan. 1316 vuoden iässä nämä löydökset ovat valtaosaltaan lieviä ja vaihtelevia.
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BACKGROUND: Transactional sex is associated with the HIV epidemic among young people in Uganda. Few quantitative studies based on nationally representative survey data explored the relationship between sexual behaviors, HIV infection, and transactional sex. OBJECTIVE: This study aimed to determine the associations between risky sexual behaviors, participation in transactional sex, and HIV sero-status among men and women aged 15-24 in Uganda. DESIGN: The study uses data from the Uganda AIDS Indicator Survey, a cross-sectional national HIV serological study conducted in 2011. We analyzed data on 1,516 men and 2,824 women aged 15-24 who had been sexually active in the 12 months preceding the survey. Private, face-to-face interviews were also conducted to record the sociodemographics, sexual history, and experiences of sexual coercion. Logistic regression analysis was performed to measure associations between sexual behaviors and transactional sex, and associations between HIV sero-status and transactional sex. RESULTS: Among young people who had been sexually active in the 12 months prior to the survey, 5.2% of young men reported paying for sex while 3.7% of young women reported receiving gifts, favors, or money for sex. Lower educational attainment (ORadjusted 3.25, CI 1.10-9.60) and experience of sexual coercion (ORadjusted 2.83, CI 1.07-7.47) were significantly associated with paying for sex among men. Multiple concurrent sexual relationships were significantly associated with paying for sex among young men (ORadjusted 5.60, CI 2.08-14.95) and receiving something for sex among young women (ORadjusted 8.04, CI 2.55-25.37). Paying for sex among young men and having three to five lifetime sexual partners among young women were associated with increased odds of testing positive for HIV. CONCLUSIONS: Transactional sex is associated with sexual coercion and HIV risk behaviors such as multiple concurrent sexual partnerships among young people in Uganda. In addition, transactional sex appears to place young men at increased risk for HIV in Uganda. Both sexes appear equally vulnerable to risks associated with transactional sex, and therefore should be targeted in intervention programs. In addition, strengthening universal education policy and improving school retention programs may be beneficial in reducing risky sexual behaviors and transactional sex.