932 resultados para APN Intensivists Initiatives


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Esta dissertação tem por finalidade evidenciar os “Impactos Decorrentes da Expansão da Cidade de Assomada”. Propõe-se ainda, analisar a relação urbanorural no município de Santa Catarina, Cabo Verde. Essa análise incidiu sobre os dados da sua ocupação, que remonta à 2ª metade do século XIX, no decurso da crise e decadência da primeira cidade de Cabo Verde (Ribeira Grande, atual Cidade- Velha) e às conjunturas regionais e nacionais que condicionaram sua trajetória, bem como, os principais agentes intervenientes na transformação do espaço urbano de Assomada (Estado, proprietários de terra e comerciantes), sobretudo, no período que decorre de 1961 a 2003. A pesquisa empreendida demonstra que a “ruralidade” é um dos aspectos fundamentais de Santa Catarina, abrangendo 21,3% da população rural do território nacional e 37,9% da ilha de Santiago. Do ponto de vista urbanístico, o mapeamento da evolução da cidade de Assomada, referente à área ocupada pelas edificações nesse lapso de tempo, permite-nos perceber um crescimento bastante acelerado desse espaço urbano, sobretudo, a partir dos anos 90. Dois aspectos importantes se encontram na base dessa transformação: a Independência Nacional ocorrida em 1975 e a Emigração. Com a Independência, o país passou a beneficiar de amplos programas de cooperação internacional o que veio a reforçar a sua importância econômica e política, visualizada através de projetos industrializantes, infra-estruturas e equipamentos de diversas naturezas. Esses investimentos foram por sua vez reforçados por aportes dos emigrantes, que passaram a ser um dos parceiros fundamentais no desenvolvimento de Santa Catarina, através de iniciativas privadas e empresariais, como a construção de residências e constituição de empresas. A análise do indicador uso e ocupação do solo urbano permitiu-nos identificar alguns impactos ambientais causados, sobretudo, pela falta de instrumentos de gestão urbanística, ausência de cadastro municipal e uma deficiente fiscalização dos órgãos administrativos.

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Recent policy developments in public health care systems lead to a greater diversity in health care. Decentralisation, either geographically or at an institutional level, is the key force, because it encourages innovation and local initiatives in health care provision. The devolution of responsibilities allows for a sort of de-construction of the status quo by changing both organizational forms and service provision. The new organizations enjoy greater freedom in the way they pay their staff, and are judged according to their results. These organizations may retain financial surpluses, develop spin-off companies and commission a range of specialised services (such as Diagnostic and Treatment Centres in UK) from providers outside the institutional setting in order to have more access to capital markets. However this diversity may generate a feeling of lack of commitment to a national health service and ultimately a loss of social cohesion. By fiscal decentralisation to regional authorities or planned delegation of financial agreements to the providers, financial incentives are more explicit and may seem to place profit-making above a commitment to better health care. An evaluation of the myths and realities of the decentralization process is needed. Here, I offer an assessment pros and cons of the decentralization process of health care in Spain, drawing on the experience of regional reforms from the pioneering organisational innovations implemented in Catalonia in 1981, up to the observed dispersion of health care spending per capita among regions at present.

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Initiatives in electronic conveyancing and registration show the potential of new technologies to transform such systems, reducing costs and enhancing legal security. However,they also incur substantial risks of transferring costs and risks among registries, conveyancersand rightholders, instead of reducing them; entrenching the private interests of conveyancers,instead of increasing competition and disintermediating them; modifying the allocation of tasksin a way that leads in the long term to the debasement of registries of rights with indefeasibletitle into mere recordings of deeds; and empowering conveyancers instead of transactors andrightholders, which increases costs and reduces security. Fulfilling the promise of newtechnologies in both costs and security requires strengthening registries incentives andempowering rightholders in their interaction with registries.

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Digital libraries (DL) are seen as a hope to developing countries in their struggle for accessing bibliographic resources, especially in a context where the traditional distribution mechanisms failed tragically. Several difficulties are however faced by these countries to build and use digital libraries, due mainly to its high development costs and to the poor existing ICT resources in these countries. This paper discusses the importance of digital libraries for developing countries and introduces the main challenges they face in building and using such libraries. The current alternatives and major initiatives for making digital information accessible to developing countries are also addressed.

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The traditionally coercive and state-controlled governance of protected areas for nature conservation in developing countries has in many cases undergone change in the context of widespread decentralization and liberalization. This article examines an emerging "mixed" (coercive, community- and market-oriented) conservation approach in managed-resource protected areas and its effects on state power through a case study on forest protection in the central Indian state of Madhya Pradesh. The findings suggest that imperfect decentralization and partial liberalization resulted in changed forms, rather than uniform loss, of state power. A forest co-management program paradoxically strengthened local capacity and influence of the Forest Department, which generally maintained its territorial and knowledge-based control over forests and timber management. Furthermore, deregulation and reregulation enabled the state to withdraw from uneconomic activities but also implied reduced place-based control of non-timber forest products. Generally, the new policies and programs contributed to the separation of livelihoods and forests in Madhya Pradesh. The article concludes that regulatory, community- and market-based initiatives would need to be better coordinated to lead to more effective nature conservation and positive livelihood outcomes.

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This document is intended to lay the foundation for resource reduction strategies in new construction, renovation and demolition. If you have an innovative idea or information that you believe should be included in future updates of this manual please email Shelly Codner at scodner@region12cog.org or Jan Loyson at Jan.Loyson@Iowalifechanging.com. Throughout this manual, we use the term “waste reduction” to define waste management initiatives that will result in less waste going to the landfill. In accordance with the waste management hierarchy these practices include reducing (waste prevention), reusing (deconstruction and salvage), recycling and renewing (making old things new again) - in that order. This manual will explain what these practices are and how to incorporate them into your projects.

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La recerca tracta sobre els diferents mecanismes que les ciutats i les regions utilitzen per millorar la seva imatge. En aquest sentit, el treball se centra en la marca-ciutat, el màrqueting de ciutats i els diferents models de comunicació emprats per exaltar la reputació dels territoris. Pel que fa la segona part de la recerca, consisteix en l’estudi de la marca-ciutat Barcelona en els àmbits dels negocis, la societat del coneixement, el turisme, la sostenibilitat i la qualitat de vida i la cultura. Per tant, el propòsit d’aquesta recerca és comprendre quines accions desenvolupen els principals actors per incentivar els negocis a Barcelona, descobrir quines iniciatives s’han pres per potenciar l’economia del coneixement, el turisme, la sostenibilitat i la qualitat de vida i la indústria cultural a la ciutat de Barcelona

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This Executive Order expects the State government to help more than 5,800 offenders released to Iowa communities each year, affecting public safety, public health, economic and community well-being and family relationships. Offenders re-entry initiatives involve collaborative partnerships amongst corrections, other agencies and the community.

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Els objectius d'aquest informe són realitzar un estudi de la tècnica en la digitalització, l'emmagatzematge i l'accés a les tesis doctorals electròniques, per tal de fer una proposta d’organització al Consorci de Biblioteques Universitàries de Catalunya (CBUC). Actualment, tot i que existeixen diverses iniciatives a Europa, és als EUA on la digitalització de tesis doctorals s’ha desenvolupat més amb la creació de la Networked Digital Library for Theses and Dissertation (NDLTD), i ha estat qui ha definit els estàndards en aquest camp. En el següent informe es planteja i es recomana al CBUC l’adhesió institucional a l’NDLTD per poder gaudir de la seva experiència.

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PURPOSE: Health-related quality of life (HRQoL) is considered a representative outcome in the evaluation of chronic disease management initiatives emphasizing patient-centered care. We evaluated the association between receipt of processes-of-care (PoC) for diabetes and HRQoL. METHODS: This cross-sectional study used self-reported data from non-institutionalized adults with diabetes in a Swiss canton. Outcomes were the physical/mental composites of the short form health survey 12 (SF-12) physical composite score, mental composite score (PCS, MCS) and the Audit of Diabetes-Dependent Quality of Life (ADDQoL). Main exposure variables were receipt of six PoC for diabetes in the past 12 months, and the Patient Assessment of Chronic Illness Care (PACIC) score. We performed linear regressions to examine the association between PoC, PACIC and the three composites of HRQoL. RESULTS: Mean age of the 519 patients was 64.5 years (SD 11.3); 60% were male, 87% reported type 2 or undetermined diabetes and 48% had diabetes for over 10 years. Mean HRQoL scores were SF-12 PCS: 43.4 (SD 10.5), SF-12 MCS: 47.0 (SD 11.2) and ADDQoL: -1.6 (SD 1.6). In adjusted models including all six PoC simultaneously, receipt of influenza vaccine was associated with lower ADDQoL (β=-0.4, p≤0.01) and foot examination was negatively associated with SF-12 PCS (β=-1.8, p≤0.05). There was no association or trend towards a negative association when these PoC were reported as combined measures. PACIC score was associated only with the SF-12 MCS (β=1.6, p≤0.05). CONCLUSIONS: PoC for diabetes did not show a consistent association with HRQoL in a cross-sectional analysis. This may represent an effect lag time between time of process received and health-related quality of life. Further research is needed to study this complex phenomenon.

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Cancer immunotherapy has come a long way. The hope that immunological approaches may help cancer patients has sparked many initiatives in research and development (R&D). For many years, progress was modest and disappointments were frequent. Today, the increasing scientific and medical knowledge has established a solid basis for improvements. Considerable clinical success was first achieved for patients with hematological cancers. More recently, immunotherapy has entered center stage in the development of novel therapies against solid cancers. Together with R&D in angiogenesis, the field of immunology has fundamentally extended the scientific scope, which has evolved from a cancer-cell-centered view to a comprehensive and integrated vision of tumor biology. Current R&D is focused on a large array of possible disease mechanisms, driven by cancer cells, and amplified by tumor stroma, inflammatory and immunological actors, blood and lymph vessels, and the "macroenvironment," i.e. systemic mechanisms of the host, particularly of the haematopoietic system. Contrasting to this large spectrum of pathophysiological events promoting tumor growth, only a small number of biological mechanisms, namely of the immune system, have the potential to counteract tumor growth. They are of prime interest because therapeutic enhancement may result in clinical benefit for patients. This special issue is dedicated to immunotherapeutics against cancer, with particular emphasis on vaccination and combination therapies, providing updates and extended insight in this booming field.

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According to most political scientists and commentators, direct democracy seems to weaken political parties. Our empirical analysis in the 26 Swiss cantons shows that this thesis in its general form cannot be maintained. Political parties in cantons with extensive use of referendums and initiatives are not in all respects weaker than parties in cantons with little use of direct democratic means of participation. On the contrary, direct democracy goes together with more professional and formalized party organizations. Use of direct democracy is associated with more fragmented and volatile party systems, and with greater support for small parties, but causal interpretations of these relationships are difficult.

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The Department of Corrections is pleased to provide its Annual Performance Report for fiscal year 2005 in compliance with requirements of the Iowa’s Accountable Government Act. The following pages outline the Department’s overall mission and purpose, key products and activities, Strategic Plan initiatives, Performance Plan results and highlights of services to Iowans during the last fiscal year.

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The “Iowa Innovators” series is a joint project of the Iowa Newspaper Association and the Iowa Department of Economic Development (IDED). The series is an outgrowth of an idea from member INA publishers. “Iowa Innovators” articles describe initiatives that Iowa communities have used to improve their ability to attract business and industry and demonstrate community innovation. The articles also describe Iowa companies on the leading edge of technology, business expansion, workforce development and recycling.

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The “Iowa Innovators” series is a joint project of the Iowa Newspaper Association and the Iowa Department of Economic Development (IDED). The series is an outgrowth of an idea from member INA publishers. “Iowa Innovators” articles describe initiatives that Iowa communities have used to improve their ability to attract business and industry and demonstrate community innovation. The articles also describe Iowa companies on the leading edge of technology, business expansion, workforce development and recycling.