968 resultados para Benzodiazepine usage in Ireland


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The potential of online learning has long afforded the hope of providing quality education to anyone, anywhere in the world. The recent development of Massive Open Online Courses (MOOCs) heralded an exciting new breakthrough by providing free academic instruction and professional skills development from the world’s leading universities to anyone with the sufficient resources to access the internet. The research in Advancing MOOCs for Development Initiative study was designed to analyze the MOOC landscape in developing countries and to better understand the motivations of MOOC users and afford insights on the advantages and limitations of MOOCs for workforce development outcomes. The key findings of this study challenge commonly held beliefs about MOOC usage in developing countries, defying typical characterizations of how people in resource constrained settings use technology for learning and employment. In fact, some of the findings are so contrary to what has been reported in the U.S. and other developed environments that they raise new questions for further investigation.

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The underlying generic properties of {alpha}β TCRs that control MHC restriction remain largely unresolved. To investigate MHC restriction, we have examined the CTL response to a viral epitope that binds promiscuously to two human leukocyte Ags (HLAs) that differ by a single amino acid at position 156. Individuals expressing either HLA-B*3501 (156Leucine) or HLA-B*3508 (156Arginine) showed a potent CTL response to the 407HPVGEADYFEY417 epitope from EBV. Interestingly, the response was characterized by highly restricted TCR β-chain usage in both HLA-B*3501+ and HLA-B*3508+ individuals; however, this conserved TRBV9+ β-chain was associated with distinct TCR {alpha}-chains depending upon the HLA-B*35 allele expressed by the virus-exposed host. Functional assays confirmed that TCR {alpha}-chain usage determined the HLA restriction of the CTLs. Structural studies revealed significant differences in the mobility of the peptide when bound to HLA-B*3501 or HLA-B*3508. In HLA-B*3501, the bulged section of the peptide was disordered, whereas in HLA-B*3508 the bulged epitope adopted an ordered conformation. Collectively, these data demonstrate not only that mobile MHC-bound peptides can be highly immunogenic but can also stimulate an extremely biased TCR repertoire. In addition, TCR {alpha}-chain usage is shown to play a critical role in controlling MHC restriction between closely related allomorphs.

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Most environmental reporting studies have focused on developed countries. Only a handful number of studies are available on the developing countries, concentrating on the newly industrialized countries and African countries. No studies are available from South Asia except the widely quoted one of Singh and Ahuja (1983). Against this background, it is argued that an empirical study on environmental reporting practices in Bangladesh would make a significant contribution to the environmental reporting literature from the context of developing countries in general, and South Asian countries in particular. The study covers 30 recent annual reports of Bangladeshi companies relating to the year 1996. It shows that very limited environmental disclosure has been made. Although we have noted that 90% of companies made some environmental disclosures, the percentage of companies disclosing environmental information comes down to only 20 if we exclude disclosure related to expenditure on energy usage. In general, the quantity and the quality of disclosures seem to be inadequate and poor as compared to the environmental disclosures in the developed countries. The study concludes with an urge for further research in this regard.

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The nature of Discrete-Event Simulation (DES) and the use of DES in organisations is changing. Two important developments are the use of Visual Interactive Modelling systems and the use of DES in Business Process Management (BPM) projects. Survey research is presented that shows that despite these developments usage of DES remains relatively low due to a lack of knowledge of the benefits of the technique. This paper considers two factors that could lead to a greater achievement and appreciation of the full benefit of DES and thus lead to greater usage. Firstly in relation to using DES to investigate social systems, both in the process of undertaking a simulation project and in the interpretation of the findings a 'soft' approach may generate more knowledge from the DES intervention and thus increase its benefit to businesses. Secondly in order to assess the full range of outcomes of DES the technique could be considered from the perspective of an information processing tool within the organisation. This will allow outcomes to be considered under the three modes of organisational information use of sense making, knowledge creating and decision making which relate to the theoretical areas of knowledge management, organisational learning and decision making respectively. The association of DES with these popular techniques could further increase its usage in business.

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Objective: To measure changes in dispensing activity in a UK repeat dispensing pilot study and to estimate any associated cost savings. Method: Patients were provided with two successive three-monthly repeat prescriptions containing all of the items on their "repeat medicines list" and valid at a study pharmacy. Pharmacists consulted with patients at the time of supply and completed a patient-monitoring form. Prescriptions with pricing data were returned by the UK Prescription Pricing Authority. These data were used to calculate dispensing activity, the cost of dispensed items and an estimate of cost savings on non-dispensed items. A retrospective identification of items prescribed during the six months prior to the project was used to provide a comparison with those dispensed during the project and thus a more realistic estimate of changes. Setting: 350 patients from two medical practices in a large English City, with inner city and suburban locations, and served by seven pharmacies. Key findings: There were methodological challenges in establishing a robust framework for calculating changes. Based on all of the items that patients could have obtained from their repeat list, 23.8% were not dispensed during the intervention period. A correction was then made to allow for a comparison with usage in the six months prior to the study. Based on the corrected data, there was an estimated 11.3% savings in drug costs compared with the pre-intervention period. There was a marked difference in changes between the two practices, the pharmacies and individual patients. The capitation-based remuneration method was acceptable to all but one of the community pharmacists. Conclusion: The repeat dispensing system reduced dispensing volume in comparison with the control period. A repeat dispensing system with a focus on patients' needs and their use of medicines might be cost neutral.

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Recent debates about national identity, belonging and community cohesion can appear to suggest that ethnicity is a static entity and that ethnic difference is a source of conflict in itself. "Ethnicities and Values in a Changing World" presents an alternative account of ethnicity and calls into question models of community cohesion that present ethnicity as the source of antagonisms and differences that must be overcome. It suggests instead that ethnicity is itself multiple and changing and is unlikely to be a basis for articulating shared values. This volume brings together an international team of leading scholars in the field of ethnic studies in order to examine innovative articulations of ethnicity and challenge the contention that ethnicity is static or that it necessarily represents traditional values and cultures. Asserting that ethnicity is deployed in part as an expression of values and a model of ethical practice, this book examines displays of ethnicity as assertions of identity and statements about way of life, sense of entitlement and manner of connection to others. "Ethnicities and Values in a Changing World" draws together debates about the articulation of ethnic identity, the nature of our relation to each other and discussions of everyday ethics, thus engaging with discussions of racism, multiculturalism and community cohesion. As such, it will appeal not only to sociologists, but to anyone working in the fields of cultural studies, race and ethnicity, globalization, migration and anthropology. Table of Contents: Introduction: ethnicities, values and old-fashioned racism, Gargi Bhattacharyya; Teaching race and racism in the 21st century: thematic considerations, Howard Winant; Diaspora conversations: ethics, ethicality, work and life; Migrant women's networking: new articulations of transnational ethnicity, Ronit Lentin; 'The people do what the political class isn't able to do': antigypsyism, ethnicity denial and the politics of racism without racism, Robbie McVeigh; Violent urban protest - identities, ethics and Islamism, Max Farrar; Beliefs, boundaries and belonging: African Pentecostals in Ireland, Abel Ugba; On being a 'good' refugee, John Gabriel and Jenny Harding; Narrating lived experience in a binational community in Costa Rica, Carlos Sandoval Garcia; Conclusion: ethnicity and ethicality in an unequal world, Gargi Bhattacharyya; Index.

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The extraordinary growth of the Irish economy since the mid-1990s - the 'Celtic Tiger' - has attracted a great deal of interest, commentary and research. Indeed, many countries look to Ireland as an economic development role model, and it has been suggested that Ireland might provide key lessons for other EU members as they seek to achieve the objectives set out in the Lisbon Agenda. Much of the discussion of Ireland's growth has focused on its possible triggers: the long term consequences of the late 1980s fiscal stabilisation; EU structural funds; education; wage moderation; and devaluation of the Irish punt. The industrial policy perspective has highlighted the importance of inflows of foreign direct investment, but a notable absence from the discourse on the 'Celtic Tiger' has been any mention of the role of new business venture creation and entrepreneurship. In this paper we use unpublished Irish VAT data for the years 1988 to 2004 to provide the first detailed look at national trends in business birth and death rates in Ireland over the 'take-off' period. We also use sub-national VAT data to shed light on spatial trends in new venture creation. Our overall conclusions are that new business formation made no detectable contribution to the acceleration of Ireland's growth in the late 1990s, although we do find evidence of spatial convergence in per capita business stocks.

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Operation of reverse osmosis (RO) in cyclic batch mode can in principle provide both high energy efficiency and high recovery. However, one factor that causes the performance to be less than ideal is longitudinal dispersion in the RO module. At the end of the batch pressurisation phase it is necessary to purge and then refill the module. During the purge and refill phases, dispersion causes undesirable mixing of concentrated brine with less concentrated feed water, therefore increasing the salt concentration and energy usage in the subsequent pressurisation phase of the cycle. In this study, we quantify the significance of dispersion through theory and experiment. We provide an analysis that relates the energy efficiency of the batch operation to the amount of dispersion. With the help of a model based on the analysis by Taylor, dispersion is quantified according to flow rate. The model is confirmed by experiments with two types of proprietary spiral wound RO modules, using sodium chloride (NaCl) solutions of concentration 1000 to 20,000 ppm. In practice the typical energy usage increases by 4% to 5.5% compared to the ideal case of zero dispersion.

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The extraordinary growth of the Irish economy since the mid-1990s—the ‘Celtic Tiger’—has attracted a great deal of interest, commentary and research. Indeed, many countries look to Ireland as an economic development role model, and it has been suggested that Ireland might provide key lessons for other EU members as they seek to achieve the objectives set out in the Lisbon Agenda. Much of the discussion of Ireland’s growth has focused on its possible triggers: the long-term consequences of the late 1980s fiscal stabilisation, EU structural funds, education, wage moderation and devaluation of the Irish punt. The industrial policy perspective has highlighted the importance of inflows of foreign direct investment, but a notable absence from the discourse on the ‘Celtic Tiger’ has been any mention of the role of new business venture creation and entrepreneurship. In this paper we use unpublished Irish VAT data for the years 1988–2004 to provide the first detailed look at national trends in business birth and death rates in Ireland over the ‘take-off’ period. We also use sub-national VAT data to shed light on spatial trends in new venture creation. Our overall conclusions are that new business formation made no detectable contribution to the acceleration of Ireland’s growth in the late 1990s, although we do find evidence of spatial convergence in per capita business stocks.

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This submission for a PhD by previously published work is based upon six publications in peer reviewed journals, reflecting a 9-year research programme. My research has shown, in a coherent and original way, the difficulty in treating people with dementia with safe and effective medication whilst providing research-founded guidance to develop mechanisms to optimise medication choice and minimise iatrogenic events. A wide range of methods, including systematic reviews, meta-analysis, randomised controlled trials (RCTs), quantitative research and mixed methods were used to generate the data, which supported the exploration of three themes. The first theme, to understand the incidence and causes of medication errors in dementia services, identified that people with dementia may be more susceptible to medication-related iatrogenic disease partly due to inherent disease-related characteristics. One particular area of concern is the use of anti-psychotics to treat the Behavioural and Psychological Symptoms of Dementia (BPSD). The second and third themes, respectively, investigated a novel pharmacological and health services intervention to limit anti-psychotic usage. The second phase found that whilst the glutamate receptor blocker memantine showed some promise, further research was clearly required. The third phase found that anti-psychotic usage in dementia may be higher than official figures suggest and that medication review linking primary and secondary care can limit such usage. My work has been widely cited, reflecting a substantial contribution to the field, in terms of our understanding of the causes of, and possible solutions to limit, medication-related adverse events in people with dementia. More importantly, this work has already informed clinical practice, patients, carers and policy makers by its demonstrable impact on health policy. In particular my research has identified key lines of enquiry for future work and for the development of my own personal research programme to reduce the risk associated with medication in this vulnerable population.

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The chapter examines possibilities for industrial policy in African countries through the lens of lessons that can be learned from the industrial policy approaches pursued in Ireland as well as in East Asia. As latecomers to industrialization, the small African economies are well positioned to undertake such an exercise, we suggest. This chapter provides some novel insights by providing a comparison between Ireland and the small African economies. To our knowledge such a comparison offers a unique contribution. Cognizant of the fact that a “one size fits all” approach to industrial policy is not appropriate in the African context, we argue in favor of the adoption of a more “holistic” approach to industrial policy in these economies. Such an approach we argue should focus simultaneously on demand and supply factors of industrial development, and on microeconomic as well as macroeconomic factors.

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Purpose - This paper aims to provide empirical results which suggest that there is a need for more widespread adoption of supply chain management among Irish firms. Design/methodology/approach - The Republic of Ireland is a small, open, trade-dependent economy and is one of the fastest growing economies in the developed world. However, due to rising costs, there is an increasing trend in Ireland to outsource lower function manufacturing processes to lower-cost locations but to retain high-skill functions (such as R&D). This trend, together with other factors such as its peripheral location, suggests that supply chain management is critical from an Irish perspective. In order to gain unique insights of current levels of awareness/adoption of SCM and the potential impact SCM could have on competitiveness, a survey was conducted among 776 Irish firms. Findings - Overall, the findings suggest that many firms in Ireland pay lip-service to the importance of SCM elements and objectives but the majority of firms, about two thirds, have only a passing understanding of what constitutes SCM. Only 25 per cent adopt SCM programmes and only 9 per cent of Irish companies have a specialised SCM or logistics manager. The gaps in their understanding of SCM are matched by the gaps in their awareness of key costs (e.g. 59 per cent of companies do not know their total supply chain costs). While there are supply chain management adopters in Ireland that are already well up the s-curve of innovation transfer, it is the larger group of less aware companies that must become better at how they manage their supply chains. Originality/value - The paper offers a useful insight into supply chain management and its role in Irish industry. © Emerald Group Publishing Limited.

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The increasing importance of environmental sustainability has sharpened the focus on the need for innovative approaches to the purchasing of transport and logistics services. This article points out some of the challenges that purchasers of transport and logistics services, as well as their suppliers in the third party logistics (3PL) industry, are facing. These include the need for closer collaboration between 3PLs and their customers, as well as developing systems for the robust assessment of the environmental sustainability of services. The article is based on several years’ research experience in Ireland, Italy and Sweden.

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A strong focus of NITL’s research activity is on monitoring the extent to which SCM principles and concepts are adopted by organisations based in Ireland. For more than a decade this work has aimed to develop a profile of SCM adoption, as well as identifying some of the critical success factors and barriers influencing firms in their attempts to improve supply chain capability and performance. This article explains the role of SCM in Ireland’s economic recovery and provides an overview of NITL’s latest findings in relation to the adoption of SCM practices by firms in Ireland.

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Information and Communications Technology (ICT) is widely regarded as a key integration enabler in contemporary supply chain configurations. Furthermore, recent years have seen the vertical disintegration of supply chains as increasing numbers of manufacturers and retailers outsource significant parts of their supply chain functionality. In this environment, Third Party Logistics (3PL) providers - the majority of which are small companies - play a pivotal role. This raises important questions about the usage of ICT in this sector. However, there is a paucity of research in the field of small 3PLs with little empirical investigation into the usage of ICT by such firms. This paper presents the results of a survey on ICT systems usage in a sample of small Italian 3PLs. The results provide a technological profile of the surveyed companies, as well as an analysis of the role of ICT in customising services and of the factors influencing technology adoption.