820 resultados para Focus


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The objectives of this study were to determine job attribute factors affecting overall job satisfaction and satisfaction factors predicting intention to choose and stay within a current job among managers of private clubs in the U.S. The findings indicate that selfworth and salary and benefits are significantly related to the overall job satisfaction. In addition, overall job satisfaction was a strong predictor for private club managers’ intention to choose the current job held, if given a second chance

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This study analyzes the rising importance of the development and enhancement of a health and wellness focus within resort hotels. Market trends, consumer demands, revitalization efforts, and bottomline impacts are examined as they relate to the resort spa industry of today.

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In the present work, the deviations in the solubility of CO2, CH4, and N2 at 30 °c in the mixed gases (CO2/CH4) and (CO2/N2) from the pure gas behavior were studied using the dual-mode model over a wide range of equilibrium composition and pressure values in two glassy polymers. The first of which was PI-DAR which is the polyimide formed by the reaction between 4, 6-diaminoresorcinol dihydrochloride (DAR-Cl) and 2, 2’-bis-(3, 4-dicarboxyphenyl) hexafluoropropane dianhydride (6FDA). The other glassy polymer was TR-DAR which is the corresponding thermally rearranged polymer of PI-DAR. Also, mixed gas sorption experiments for the gas mixture (CO2/CH4) in TR-DAR at 30°c took place in order to assess the degree of accuracy of the dual-mode model in predicting the true mixed gas behavior. The experiments were conducted on a pressure decay apparatus coupled with a gas chromatography column. On the other hand, the solubility of CO2 and CH4 in two rubbery polymers at 30⁰c in the mixed gas (CO2/CH4) was modelled using the Lacombe and Sanchez equation of state at various values of equilibrium composition and pressure. These two rubbery polymers were cross-linked poly (ethylene oxide) (XLPEO) and poly (dimethylsiloxane) (PDMS). Moreover, data about the sorption of CO2 and CH4 in liquid methyl dietahnolamine MDEA that was collected from literature65-67 was used to determine the deviations in the sorption behavior in the mixed gas from that in the pure gases. It was observed that the competition effects between the penetrants were prevailing in the glassy polymers while swelling effects were predominant in the rubbery polymers above a certain value of the fugacity of CO2. Also, it was found that the dual-mode model showed a good prediction of the sorption of CH4 in the mixed gas for small pressure values but in general, it failed to predict the actual sorption of the penetrants in the mixed gas.

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This project was funded by National Institute for Health Research (NIHR) Health Technology Assessment Programme and will be published in full in Health Technology Assessment; Vol. 20, No. 50. See the NIHR Journals Library website for further project information.

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Acknowledgements Thank you to all the participants who agreed to take part in the trial. This study was supported NHS Research Scotland (NRS), through Chief Scientist Office (CSO) and the Scottish Mental Health Research Network, and the Clinical Research Network-Mental Health. We are grateful to the Psychosis Research Unit (PRU) Service User Reference Group (SURG) for their consultation regarding the design of the study and contribution to the developments of study related materials. We are grateful to our Independent Trial Steering Committee and Independent Data Monitoring Committee for provided oversight of the trial. Funding This project was funded by the National Institute for Health Research Health Technology Assessment (NIHR HTA) programme (project number10/101/02) and will be published in full in Health Technology Assessment. Visit the HTA programme website for further project information. The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the HTA programme, NIHR, NHS or the Department of Health.

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Purpose: To determine whether the ‘through-focus’ aberrations of a multifocal and accommodative intraocular lens (IOL) implanted patient can be used to provide rapid and reliable measures of their subjective range of clear vision. Methods: Eyes that had been implanted with a concentric (n = 8), segmented (n = 10) or accommodating (n = 6) intraocular lenses (mean age 62.9 ± 8.9 years; range 46-79 years) for over a year underwent simultaneous monocular subjective (electronic logMAR test chart at 4m with letters randomised between presentations) and objective (Aston open-field aberrometer) defocus curve testing for levels of defocus between +1.50 to -5.00DS in -0.50DS steps, in a randomised order. Pupil size and ocular aberration (a combination of the patient’s and the defocus inducing lens aberrations) at each level of blur was measured by the aberrometer. Visual acuity was measured subjectively at each level of defocus to determine the traditional defocus curve. Objective acuity was predicted using image quality metrics. Results: The range of clear focus differed between the three IOL types (F=15.506, P=0.001) as well as between subjective and objective defocus curves (F=6.685, p=0.049). There was no statistically significant difference between subjective and objective defocus curves in the segmented or concentric ring MIOL group (P>0.05). However a difference was found between the two measures and the accommodating IOL group (P<0.001). Mean Delta logMAR (predicted minus measured logMAR) across all target vergences was -0.06 ± 0.19 logMAR. Predicted logMAR defocus curves for the multifocal IOLs did not show a near vision addition peak, unlike the subjective measurement of visual acuity. However, there was a strong positive correlation between measured and predicted logMAR for all three IOLs (Pearson’s correlation: P<0.001). Conclusions: Current subjective procedures are lengthy and do not enable important additional measures such as defocus curves under differently luminance or contrast levels to be assessed, which may limit our understanding of MIOL performance in real-world conditions. In general objective aberrometry measures correlated well with the subjective assessment indicating the relative robustness of this technique in evaluating post-operative success with segmented and concentric ring MIOL.

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The focus of this discussion paper is the need for effective professional socialisation of student nurses and the degree to which core values and culture are transferred through University schools of nursing, the academic teaching staff and to the student nurses.
UK schools of nursing had progressively transferred into university institutions more than two decades ago. Schools of nursing and the teaching academics within them, to a greater or lesser extent, impact on and help to professionally socialize student nurses. Professed core values of universities whilst including a focus on excellence and innovation, perhaps also include, collegiality, integrity and social commitment to care. These are all qualities, which should be core values and elements
of the transferable professional culture to student nurses. Notwithstanding the professed core values, at least in some areas of UK universities there is some evidence of increasing competition and a disproportionate research market driven focus. This can reflect back into schools of nursing and is inconsistent with nursing professional values.

This paper explores the degree to which the professed core values of universities and the institutional culture are necessarily enacted, and the degree to which
any dissonance in the institutions professed/enacted core values and culture reflect through the schools of nursing and impact in the professional socialisation of student nurses. The paper also explores the degree to which effective leadership in schools of nursing can help to maintain professional core values and a culture of nursing professional

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The lack of flexibility in logistic systems currently on the market leads to the development of new innovative transportation systems. In order to find the optimal configuration of such a system depending on the current goal functions, for example minimization of transport times and maximization of the throughput, various mathematical methods of multi-criteria optimization are applicable. In this work, the concept of a complex transportation system is presented. Furthermore, the question of finding the optimal configuration of such a system through mathematical methods of optimization is considered.

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Progressive multifocal leukoencephalopathy (PML) caused by reactivation of the JC virus (JCV), a human polyomavirus, occurs in autoimmune disorders, most frequently in systemic lupus erythematosus (SLE). We describe a HIV-negative 34-year-old female with SLE who had been treated with immunosuppressant therapy (IST; steroids and azathioprine) since 2004. In 2011, she developed decreased sensation and weakness of the right hand, followed by vertigo and gait instability. The diagnosis of PML was made on the basis of brain MRI findings (posterior fossa lesions) and JCV isolation from the cerebrospinal fluid (700 copies/ml). IST was immediately discontinued. Cidofovir, mirtazapine, mefloquine and cycles of cytarabine were sequentially added, but there was progressive deterioration with a fatal outcome 1 year after disease onset. This report discusses current therapeutic choices for PML and the importance of early infection screening when SLE patients present with neurological symptoms. In the light of recent reports of PML in SLE patients treated with rituximab or belimumab, we highlight that other IST may just as well be implicated. We conclude that severe lymphopenia was most likely responsible for JCV reactivation in this patient and discuss how effective management of lymphopenia in SLE and PML therapy remains an unmet need.