932 resultados para Trauma, Posttraumatic Growth, Emergency Service Work, Personality, Coping, Ambulance, Paramedic


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In today’s world, many companies are concentrating on both their technology and human resources to provide them with their competitive advantage. Hence, understanding what motivates people is particularly important for managers in order to develop and sustain a competitive edge. As a result, numerous theories have been advanced to help our understanding of the subject matter and from these theories many motivational methods have evolved to enhance motivation within the workplace. In addition, research has been conducted on the various types of motivational techniques utilised by companies within Ireland. However, very little research has been completed within specific geographical regions in Ireland concerning the types of motivational techniques implemented at different job levels and their impact on employees work performance. Thus the objective of this research was to identify the motivational techniques utilised at different job levels within large manufacturing and service companies in the Northwest of Ireland and examine how these techniques influence the performance levels of employees. Furthermore, the study examined if these companies have changed from traditional ways of motivating employees to newer techniques. The research methodologies used to undertake the research included interviews with the HR managers and questionnaires completed by different employees at various job levels within the participating companies. Overall the conclusions were varied. Many different types of motivation techniques were found within the study’s participating companies. Irish companies are improving their motivational techniques, however most of these techniques are only used within higher job levels. In contrast to their American counterparts, a variety of motivational techniques are utilised and implemented at all job levels. On a more positive note, the majority of these motivational techniques do increase performance levels at all job levels. From the extensive primary and secondary research conducted, the thesis concludes by offering a number of recommendations to assist companies in further development of their motivational techniques for all job levels. These recommendations hope to augment the success of companies through an enhanced motivated workforce.

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The age, growth, maturity and population dynamics of lemon sole (Microstomus kitt), captured off the west coast of Ireland (ICES division Vllb), were determined for the period November 2000 to February 2002. The maximum age recorded was 14 years. Males of the population were dominated by 4 year olds, while females were dominated by 5 year olds. Females dominated the sex ratio in the overall sample, each month sampled, at each age and from 22cm in total length onwards (when N > 20). Possible reasons for the dominance of females in the sex ratio are discussed. Three models were used to obtain the parameters of the von Bertalanfly growth equation. These were the Ford-Walford plot (Beverton and Holt 1957), the Gulland and Holt plot (1959) and the Rafail (1973) method. Results of the fitted von Bertalanffy growth curves showed that female lemon sole o f f the west coast of Ireland grew faster than males and attained a greater size. Male and female lemon sole mature from 2 years of age onwards. There is evidence in the population o f a smaller asymptotic length (L«, = 34.47cm), faster growth rate (K = 0.1955) and younger age at first maturity, all of which are indicative o f a decrease in population size, when present results are compared to data collected in the same area 22 years earlier. Results of the yield per recruit curve indicate that lemon sole are currently being over-fished o f f the west coast of Ireland. Problems of selectivity within the sampling method, particularly at the discarding stage, may have influenced the outcome of results of the models used in the assessment of this stock. Therefore, additional/future work on this species should include catch data which incorporates discards and not landings data alone.

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Crustacean growth studies typically use modal analysis rather than focusing on the growth of individuals. In the present work, we use geometric morphometrics to determine how organism shape and size varies during the life of the freshwater crab, Aegla uruguayana Schmitt, 1942. A total of 66 individuals from diverse life cycle stages were examined daily and each exuvia was recorded. Digital images of the dorsal region of the cephalothorax were obtained for each exuvia and were subsequently used to record landmark configurations. Moult increment and intermoult period were estimated for each crab. Differences in shape between crabs of different sizes (allometry) and sexes (sexual dimorphism; SD) were observed. Allometry was registered among specimens; however, SD was not statistically significant between crabs of a given size. The intermoult period increased as size increased, but the moult frequency was similar between the sexes. Regarding ontogeny, juveniles had short and blunt rostrum, robust forehead region, and narrow cephalothorax. Unlike juveniles crabs, adults presented a well-defined anterior and posterior cephalothorax region. The rostrum was long and stylised and the forehead narrow. Geometric morphometric methods were highly effective for the analysis of aeglid-individual- growth and avoided excessive handling of individuals through exuvia analysis.

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It is the size of the elasticity of substitution that has been the central issue in the long debate over the possibility of continuous growth in the presence of exhaustible resources. This paper reviews the debate and comes to the surprising conclusion that , unnoticed by the pessimists, the optimist position has gradually evolved so that it now approximates that of the pessimists. The paper also summarises some preliminary work by the author that indicates that this common position may not be correct

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This paper has three contributions. First, it shows how field work within small firms in PR Chinese has provided new evidence which enables us to measure and calibrate Entrepreneurial Orientation (EO), as ‘spirit’, and Intangible Assets (IA), as ‘material’, for use in models of small firm growth. Second, it uses inter-item correlation analysis and both exploratory and confirmatory factor analysis to provide new measures of EO and IA, in index and in vector form, for use in econometric models of firm growth. Third, it estimates two new econometric models of small firm employment growth in PR China, under the null hypothesis of Gibrat’s Law, using our two new index-based and vector-based measures of EO and IA. Estimation is by OLS with adjustment for heteroscedasticity, and for sample selectivity. Broadly, it finds that EO attributes have had little significant impact on small firm growth, and indeed innovativeness and pro-activity paradoxically may even dampen growth. However, IA attributes have had a positive and significant impact on growth, with networking, and technological knowledge being of prime importance, and intellectual property and human capital being of lesser but still significant importance. In the light of these results, Gibrat’s Law is generalized, and Jovanovic’s learning theory is extended, to emphasise the importance of IA to growth. These findings cast new empirical light on the oft-quoted national slogan in PR China of “spirit and material”. So far as small firms are concerned, this paper suggests that their contribution to PR China’s remarkable economic growth is not so much attributable to the ‘spirit’ of enterprise (as suggested by propaganda) as, more prosaically, to the pursuit of the ‘material’.

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BACKGROUND: The number of requests to pre-hospital emergency medical services (PEMS) has increased in Europe over the last 20 years, but epidemiology of PEMS interventions has little be investigated. The aim of this analysis was to describe time trends of PEMS activity in a region of western Switzerland. METHODS: Use of data routinely and prospectively collected for PEMS intervention in the Canton of Vaud, Switzerland, from 2001 to 2010. This Swiss Canton comprises approximately 10% of the whole Swiss population. RESULTS: We observed a 40% increase in the number of requests to PEMS between 2001 and 2010. The overall rate of requests was 35/1000 inhabitants for ambulance services and 10/1000 for medical interventions (SMUR), with the highest rate among people aged ≥ 80. Most frequent reasons for the intervention were related to medical problems, predominantly unconsciousness, chest pain respiratory distress, or cardiac arrest, whereas severe trauma interventions decreased over time. Overall, 89% were alive after 48 h. The survival rate after 48 h increased regularly for cardiac arrest or myocardial infarction. CONCLUSION: Routine prospective data collection of prehospital emergency interventions and monitoring of activity was feasible over time. The results we found add to the understanding of determinants of PEMS use and need to be considered to plan use of emergency health services in the near future. More comprehensive analysis of the quality of services and patient safety supported by indicators are also required, which might help to develop prehospital emergency services and new processes of care.

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This paper reports on one of the first empirical attempts to investigate small firm growth and survival, and their determinants, in the Peoples’ Republic of China. The work is based on field work evidence gathered from a sample of 83 Chinese private firms (mainly SMEs) collected initially by face-to-face interviews, and subsequently by follow-up telephone interviews a year later. We extend the models of Gibrat (1931) and Jovanovic (1982), which traditionally focus on size and age alone (e.g. Brock and Evans, 1986), to a ‘comprehensive’ growth model with two types of additional explanatory variables: firm-specific (e.g. business planning); and environmental (e.g. choice of location). We estimate two econometric models: a ‘basic’ age-size-growth model; and a ‘comprehensive’ growth model, using Heckman’s two-step regression procedure. Estimation is by log-linear regression on cross-section data, with corrections for sample selection bias and heteroskedasticity. Our results refute a pure Gibrat model (but support a more general variant) and support the learning model, as regards the consequences of size and age for growth; and our extension to a comprehensive model highlights the importance of location choice and customer orientation for the growth of Chinese private firms. In the latter model, growth is explained by variables like planning, R&D orientation, market competition, elasticity of demand etc. as well as by control variables. Our work on small firm growth achieves two things. First, it upholds the validity of ‘basic’ size-age-growth models, and successfully applies them to the Chinese economy. Second, it extends the compass of such models to a ‘comprehensive’ growth model incorporating firm-specific and environmental variables.

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BACKGROUND: Aging of the population in all western countries will challenge Emergency Departments (ED) as old patients visit these health services more frequently and present with special needs. The aim of this study is to describe the trend in ED visits by patients aged 85 years and over between 2005 and 2010, and to compare their service use to that of patients aged 65-84 years during this period and to investigate the evolution of these comparisons over time. METHODS: Data considered were all ED visits to the University of Lausanne Medical Center (CHUV), a tertiary Swiss teaching hospital, between 2005 and 2010 by patients aged 65 years and over (65+ years). ED visit characteristics were described according to age group and year. Incidence rates of ED visits and length of ED stay were calculated. RESULTS: Between 2005 and 2010, ED visits by patients aged 65 years and over increased by 26% overall, and by 46% among those aged 85 years and over (85+ years). Estimated ED visit incidence rate for persons aged 85+ years old was twice as high as for persons aged 65-84 years. Compared to patients aged 65-84 years, those aged 85+ years were more likely to be hospitalized and have a longer ED stay. This latter difference increased over time between 2005 and 2010. CONCLUSIONS: Oldest-old patients are increasingly using ED services. These services need to adapt their care delivery processes to meet the needs of a rising number of these complex, multimorbid and vulnerable patients.

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This paper reports on one of the first empirical attempts to investigate small firm growth and survival, and their determinants, in the Peoples’ Republic of China. The work is based on field work evidence gathered from a sample of 83 Chinese private firms (mainly SMEs) collected initially by face-to-face interviews, and subsequently by follow-up telephone interviews a year later. We extend the models of Gibrat (1931) and Jovanovic (1982), which traditionally focus on size and age alone (e.g. Brock and Evans, 1986), to a ‘comprehensive’ growth model with two types of additional explanatory variables: firm-specific (e.g. business planning); and environmental (e.g. choice of location). We estimate two econometric models: a ‘basic’ age-size-growth model; and a ‘comprehensive’ growth model, using Heckman’s two-step regression procedure. Estimation is by log-linear regression on cross-section data, with corrections for sample selection bias and heteroskedasticity. Our results refute a pure Gibrat model (but support a more general variant) and support the learning model, as regards the consequences of size and age for growth; and our extension to a comprehensive model highlights the importance of location choice and customer orientation for the growth of Chinese private firms. In the latter model, growth is explained by variables like planning, R&D orientation, market competition, elasticity of demand etc. as well as by control variables. Our work on small firm growth achieves two things. First, it upholds the validity of ‘basic’ size-age-growth models, and successfully applies them to the Chinese economy. Second, it extends the compass of such models to a ‘comprehensive’ growth model incorporating firm-specific and environmental variables.

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The work of this thesis would like to investigate two particular questions about the care of underage: on the one hand, the maltreatment, and the mother's desire on the other hand. About the first, this proposal try to underscore the elaborate irregularity and disparity related to this phenomenon and his historical evolution. The objective's thesis propose to underline that the abuse crosses the crisis of educational dimension inside and outside the family. We are talking about a type of crisi that places at the origin of a specific clinic and that it is about the maltreatment designated, at the same time, to cope with the educational void and with the ill-treated under age's hardships. The so-called clinic of the maltreatment horns, therefore, with the purpose to join and to set in order the normative and educational aspects. However, the prescriptive requirement is intended to measure against the same one crisis in a paradoxical way; the laws and the juveniles court must make up for the lack absence of the rules that characterized the maltreatment, getting around to use the typical reference that traditionally were been at the base of the educational way's construction. The same crimes on underage often found in the father the responsibility. The requirements and the therapeutic needs has utilized the theoretical construct of the trauma as the key line of clinical practice. On the one hand, the trauma was been paired controversially to the psychoanalytical concepts as the notion of the phantom, in the same manner that the objective truth is been opposed to the notion of the imagination and fantasy; on the other hand, the trauma was gotten to be the mark and the characteristic that defined the individual identity of the mistreated persons, regardless of the person's clinical structure or, generally, regardless of the their individual position. Both the normative demand and therapeutic converge on the idealization of the imaginary figure that is able to supply to every type of maltreatment: the mother. This position is connected on theoretical construct well-established in the mythology, that associated the mother figure to a natural dimension; this is related to the second point at issue: the mother's desire. The awareness of the mother figure in natural and idealized terms describes accusingly and negatively the trauma, without seeing the difference between trauma that helps to give a structure to the individual position from the trauma solely devastating. The mother's mythology, therefore, is in an evident antagonism with the female figure and woman's sexuality. In these way the maltreatment's clinic suggests that a woman is able to be a mother only when she doesn't appreciate the rule of female. This situation preclusives a comparison with own sexuality and gives to the women a complex of castration. The clinic cases reported highlight as these difficulties are the expression of the familiarity's heredity that wasn't been sufficiently elaborated. This condition (into the relation between mother and his child) turn the infant in the incapacity to symbolized and it doesn't help him to accede to the positive trauma, to the language and to the edipic rule; this is the reason why the child toils difficulties to approach to own personality and to orient himself in the relation with his body, with the body of the adults and the same age children.

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Modern macroeconomic theory utilises optimal control techniques to model the maximisation of individual well-being using a lifetime utility function. Agents face choices over current and future consumption (with resultant implied savings decisions) seeking to maximise the present value of current plus future well-being. However, such inter-temporal welfare-maximising assumptions remain empirically untested. In the work presented here we test whether welfare was in (historical) fact maximised in the US between 1870-2000 and find empirical support for the optimising basis of growth theory, but only once a comprehensive view of what constitutes a country’s wealth or capital is taken into account.