755 resultados para Peer Group Review


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Ashby wrote about cybernetics, during which discourse he described a Law that attempts to resolve difficulties arising in complex situations – he suggested using variety to combat complexity. In this paper, we note that the delegates to the UN Framework Convention on Climate Change (UNFCCC) meeting in Kyoto, 1997, were offered a ‘simplifying solution’ to cope with the complexity of discussing multiple pollutants allegedly contributing to ‘climate change’. We assert that the adoption of CO2eq has resulted in imprecise thinking regarding the ‘carbon footprint’ – that is, ‘CO2’ – to the exclusion of other pollutants. We propose, as Ashby might have done, that the CO2eq and other factors within the ‘climate change’ negotiations be disaggregated to allow careful and specific individual solutions to be agreed on each factor. We propose a new permanent and transparent ‘action group’ be in charge of agenda setting and to manage the messy annual meetings. This body would be responsible for achieving accords at these annual meetings, rather than forcing this task on national hosts. We acknowledge the task is daunting and we recommend moving on from Ashby's Law to Beer's Viable Systems approach.

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Auditory Training (AT) describes a regimen of varied listening exercises designed to improve an individual’s ability to perceive speech. The theory of AT is based on brain plasticity (the capacity of neurones in the central auditory system to alter their structure and function) in response to auditory stimulation. The practice of repeatedly listening to the speech sounds included in AT exercises is believed to drive the development of more efficient neuronal pathways, thereby improving auditory processing and speech discrimination. This critical review aims to assess whether auditory training can improve speech discrimination in adults with mild-moderate SNHL. The majority of patients attending Audiology services are adults with presbyacusis and it is therefore important to evaluate evidence of any treatment effect of AT in aural rehabilitation. Ideally this review would seek to appraise evidence of neurophysiological effects of AT so as to verify whether it does induce change in the CAS. However, due to the absence of such studies on this particular patient group, the outcome measure of speech discrimination, as a behavioural indicator of treatment effect is used instead. A review of available research was used to inform an argument for or against using AT in rehabilitative clinical practice. Six studies were identified and although the preliminary evidence indicates an improvement gained from a range of AT paradigms, the treatment effect size was modest and there remains a lack of large-sample RCTs. Future investigation into the efficacy of AT needs to employ neurophysiological studies using auditory evoked potentials in hearing-impaired adults in order to explore effects of AT on the CAS.

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Medication reconciliation is an important process in reducing medication errors in many countries. Canada, the USA, and UK have incorporated medication reconciliation as a priority area for national patient safety initiatives and goals. The UK national guidance excludes the pediatric population. The aim of this review was to explore the occurrence of medication discrepancies in the pediatric population. The primary objective was to identify studies reporting the rate and clinical significance of the discrepancies and the secondary objective was to ascertain whether any specific interventions have been used for medication reconciliation in pediatric settings. The following electronic bibliographic databases were used to identify studies: PubMed, OVID EMBASE (1980 to 2012 week 1), ISI Web of Science, ISI Biosis, Cumulative Index to Nursing and Allied Health Literature, and OVID International Pharmaceutical Abstracts (1970 to January 2012). Primary studies were identified that observed medication discrepancies in children under 18 years of age upon hospital admission, transfer and discharge, or had reported medication reconciliation interventions. Two independent reviewers screened titles and abstracts for relevant articles and extracted data using pre-defined data fields, including risk of bias assessment. Ten studies were identified with variances in reportage of stage and rate of discrepancies. Studies were heterogeneous in definitions, methods, and patient populations. Most studies related to admissions and reported consistently high rates of discrepancies ranging from 22 to 72.3 % of patients (sample size ranging from 23 to 272). Seven of the studies were low-quality observational studies and three studies were 'grey literature' non-peer reviewed conference abstracts. Studies involving small numbers of patients have shown that medication discrepancies occur at all transitions of care in children. Further research is required to investigate and demonstrate how implementing medication reconciliation can reduce discrepancies and potential patient harm. © 2013 Springer International Publishing Switzerland.

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THE YOUTH MOVEMENT NASHI (OURS) WAS FOUNDED IN THE SPRING of 2005 against the backdrop of Ukraine’s ‘Orange Revolution’. Its aim was to stabilise Russia’s political system and take back the streets from opposition demonstrators. Personally loyal to Putin and taking its ideological orientation from Surkov’s concept of ‘sovereign democracy’, Nashi has sought to turn the tide on ‘defeatism’ and develop Russian youth into a patriotic new elite that ‘believes in the future of Russia’ (p. 15). Combining a wealth of empirical detail and the application of insights from discourse theory, Ivo Mijnssen analyses the organisation’s development between 2005 and 2012. His analysis focuses on three key moments—the organisation’s foundation, the apogee of its mobilisation around the Bronze Soldier dispute with Estonia, and the 2010 Seliger youth camp—to help understand Nashi’s organisation, purpose and ideational outlook as well as the limitations and challenges it faces. As such,the book is insightful both for those with an interest in post-Soviet Russian youth culture, and for scholars seeking a rounded understanding of the Kremlin’s initiatives to return a sense of identity and purpose to Russian national life.The first chapter, ‘Background and Context’, outlines the conceptual toolkit provided by Ernesto Laclau and Chantal Mouffe to help make sense of developments on the terrain of identity politics. In their terms, since the collapse of the Soviet Union, Russia has experienced acute dislocation of its identity. With the tangible loss of great power status, Russian realities have become unfixed from a discourse enabling national life to be constructed, albeit inherently contingently, as meaningful. The lack of a Gramscian hegemonic discourse to provide a unifying national idea was securitised as an existential threat demanding special measures. Accordingly, the identification of those who are ‘notUs’ has been a recurrent theme of Nashi’s discourse and activity. With the victory in World War II held up as a foundational moment, a constitutive other is found in the notion of ‘unusual fascists’. This notion includes not just neo-Nazis, but reflects a chain of equivalence that expands to include a range of perceived enemies of Putin’s consolidation project such as oligarchs and pro-Western liberals.The empirical background is provided by the second chapter, ‘Russia’s Youth, the Orange Revolution, and Nashi’, which traces the emergence of Nashi amid the climate of political instability of 2004 and 2005. A particularly note-worthy aspect of Mijnssen’s work is the inclusion of citations from his interviews with Nashicommissars; the youth movement’s cadres. Although relatively few in number, such insider conversations provide insight into the ethos of Nashi’s organisation and the outlook of those who have pledged their involvement. Besides the discussion of Nashi’s manifesto, the reader thus gains insight into the motivations of some participants and behind-the-scenes details of Nashi’s activities in response to the perceived threat of anti-government protests. The third chapter, ‘Nashi’s Bronze Soldier’, charts Nashi’s role in elevating the removal of a World War II monument from downtown Tallinn into an international dispute over the interpretation of history. The events subsequent to this securitisation of memory are charted in detail, concluding that Nashi’s activities were ultimately unsuccessful as their demands received little official support.The fourth chapter, ‘Seliger: The Foundry of Modernisation’, presents a distinctive feature of Mijnssen’s study, namely his ethnographic account as a participant observer in the Youth International Forum at Seliger. In the early years of the camp (2005–2007), Russian participants received extensive training, including master classes in ‘methods of forestalling mass unrest’ (p. 131), and the camp served to foster a sense of group identity and purpose among activists. After 2009 the event was no longer officially run as a Nashi camp, and its role became that of a forum for the exchange of ideas about innovation, although camp spirit remained a central feature. In 2010 the camp welcomed international attendees for the first time. As one of about 700 international participants in that year the author provides a fascinating account based on fieldwork diaries.Despite the polemical nature of the topic, Mijnssen’s analysis remains even-handed, exemplified in his balanced assessment of the Seliger experience. While he details the frustrations and disappointments of the international participants with regard to the unaccustomed strict camp discipline, organisational and communication failures, and the controlled format of many discussions,he does not neglect to note the camp’s successes in generating a gratifying collective dynamic between the participants, even among the international attendees who spent only a week there.In addition to the useful bibliography, the book is back-ended by two appendices, which provide the reader with important Russian-language primary source materials. The first is Nashi’s ‘Unusual Fascism’ (Neobyknovennyi fashizm) brochure, and the second is the booklet entitled ‘Some Uncomfortable Questions to the Russian Authorities’ (Neskol’ko neudobnykh voprosov rossiiskoivlasti) which was provided to the Seliger 2010 instructors to guide them in responding to probing questions from foreign participants. Given that these are not readily publicly available even now, they constitute a useful resource from the historical perspective.

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Introduction: There is increasing evidence that electronic prescribing (ePrescribing) or computerised provider/physician order entry (CPOE) systems can improve the quality and safety of healthcare services. However, it has also become clear that their implementation is not straightforward and may create unintended or undesired consequences once in use. In this context, qualitative approaches have been particularly useful and their interpretative synthesis could make an important and timely contribution to the field. This review will aim to identify, appraise and synthesise qualitative studies on ePrescribing/CPOE in hospital settings, with or without clinical decision support. Methods and analysis: Data sources will include the following bibliographic databases: MEDLINE, MEDLINE In Process, EMBASE, PsycINFO, Social Policy and Practice via Ovid, CINAHL via EBSCO, The Cochrane Library (CDSR, DARE and CENTRAL databases), Nursing and Allied Health Sources, Applied Social Sciences Index and Abstracts via ProQuest and SCOPUS. In addition, other sources will be searched for ongoing studies (ClinicalTrials.gov) and grey literature: Healthcare Management Information Consortium, Conference Proceedings Citation Index (Web of Science) and Sociological abstracts. Studies will be independently screened for eligibility by 2 reviewers. Qualitative studies, either standalone or in the context of mixed-methods designs, reporting the perspectives of any actors involved in the implementation, management and use of ePrescribing/CPOE systems in hospital-based care settings will be included. Data extraction will be conducted by 2 reviewers using a piloted form. Quality appraisal will be based on criteria from the Critical Appraisal Skills Programme checklist and Standards for Reporting Qualitative Research. Studies will not be excluded based on quality assessment. A postsynthesis sensitivity analysis will be undertaken. Data analysis will follow the thematic synthesis method. Ethics and dissemination: The study does not require ethical approval as primary data will not be collected. The results of the study will be published in a peer-reviewed journal and presented at relevant conferences.

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Technology: Infliximab and comparator biological such as adalimumab, etanercept, golimumab. Conditions: Ankylosing spondylitis (AS) Issue: Infliximab is registered to be used in patients with AS. The aim of the Report is to evaluate the clinical efficacy and safety of infliximab and comparator biologicals for the treatment of adult AS. Methods: Systematic literature review and analysis as well as meta-analysis (direct and indirect comparison) of published randomised controlled clinical trials (RCT) were performed, all relevant health economics literature were identified ad analysed. Results: Clinical efficacy of biological therapies is based on good clinical evidences regarding to all clinical efficacy endpoints (ASAS20, ASAS40, ASAS 5/6, and BASDAI 50% response). Altogether, 22 trials are included in our meta-analysis, 12 infliximab, 3 adalimumab studies, 6 etanercept and 1 golimumab. Efficacy of biological treatments for the treatment of AS has been established by clinical scientific evidences, significant improvement at all outcomes considered was confirmed. According to the results of indirect comparison, there were no significant difference between biological treatments and placebo in terms of safety and tolerability endpoints. We found no significant difference between the clinical efficacy and safety of infliximab, adalimumab, etanercept and golimumab therapies. Cost-utility analysis of adalimumab and/or infliximab, etanercept and golimumab treatment for AS were performed in the UK, Canada, The Netherlands, Germany, Spain and France. There are no cost-utility studies from Eastern Central Europe. Implications for decision making: Efficacy of infliximab and comparator biologicals for the treatment of Ankylosing Spondylitis (AS) was proved by clinical evidence, significant improvement at all outcomes considered was confirmed. We found no significant differences in efficacy and safety of different biological treatments. Health economics results suggest that biological therapies are cost-effective alternatives for the treatment of AS in group of developed high income countries. There is a lack of health economics results in Central-Eastern European countries however these data are more and more required by governments and funders as part of the company economic dossiers.

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Oribatid mites are one of the most abundant and species rich group in soil mesofauna. In spite of this, we have limited knowledge on the role they play in ecological processes. Since they are small like other mesofauna members and live a hidden life, their observation is difficult. Their life style, interactions with other organisms and role in soil decomposition processes can be investigated with laboratory experiments more exactly and effectively. While the literature of microcosm studies is very extensive, relatively few review papers have been written about the methodology of microcosm studies. The present review summarizes details of techniques that have been applied laboratory microcosms involving oribatid mites. It is shown what one should keep in mind in planning, composing and setting up a microcosm. Our comparative evaluation reveals how the laboratory experiments were maintained and manipulated and what kind of information was extracted. This methodological review can be useful in preparing microcosm experiments applied to other animal groups as well.

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The purpose of this study was to examine the effectiveness of peer counseling on high school students who have previously failed two or more classes in a nine week quarter.^ This study was constructed by comparing students who previously failed and were subsequently given peer counseling with a matched group of students who failed and did not receive peer counseling.^ To test the proposed research question, 324 students from a large urban school system were randomly chosen from a computer generated list of students who failed courses, matched on variables of number of classes failed, grade level and gender. One student from each matched pair was randomly placed in either the experimental or control group. 162 students from Group 1 (experimental) were assigned a peer counselor with their pair assigned to Group 2 (control). Group 1 received peer counseling at least 4 times during the third nine week academic quarter (Quarter 3) while Group 2 did not.^ The Grade Point Averages (GPA) for all students were collected both at the end of Quarter 2 and Quarter 3, at which time peer counseling was terminated. GPA's were also collected nine weeks after counseling was terminated.^ Results were determined by multiple regression, analysis of covariance and t-test. A level of significance was set at.05. There was significant increase in the GPA's of those counseled students immediately after peer counseling and also nine weeks after counseling was terminated, while the group not receiving peer counseling showed no increase. It was noted that there were significantly more school drop-outs from the non-counseled group than the counseled group. The number of classes failed, high school attended, grade level and gender were not found to be significant.^ The conclusion from this study was that peer counseling does impact significantly on the GPA's of students experiencing academic failure. Recommendations from this study were to implement and expand peer counseling programs with more failing students, continue counseling for longer than one quarter, include students in drop-out programs and students from different socio-economic and racial backgrounds, and conduct subsequent evaluation. ^

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The current study examined the influence of weak parental and peer attachment on academic achievement among late adolescent college students. In previous research, weak attachment to parents and/or peers had been found to have an adverse influence on the academic success of college students. This study also examined the potential moderating influence of several cognitive and non-cognitive psychosocial variables that might act as protective factors for weakly attached students and, therefore, enhance their academic competence. Data regarding attachment, cognitive variables, and non-cognitive variables were collected using several self-report measures. The multi-ethnic sample of students in this study (n = 357) attended an urban university. Students were classified into one of nine parental-peer attachment groups (e.g., Low-Low, Medium-Medium, High-High). Attachment groups were compared in terms of cognitive and non-cognitive variables. Contrary to the hypothesis, no statistically significant academic achievement differences were revealed for the group of college students who perceived themselves to be weakly attached to both parents and peers. Analysis of variance (ANOVA) identified the High-High group to be significantly different in terms of academic outcome variables from the other eight groups while the Low-Low group had significantly lower levels of non-cognitive variables than several of the other attachment groups. Hierarchical multiple regression analyses revealed that cognitive variables accounted for significant amounts of variance in academic outcomes and that several non-cognitive variables were significant predictors of scholastic competence. Correlational analyses revealed that parental and peer attachment were positively correlated with several cognitive and non-cognitive variables but neither was significantly correlated with self-reported college GPA. In general, the findings do not provide support for a main effect of weak attachment to parents and peers upon academic adversity among college students. Results suggest that both cognitive variables and non-cognitive variables may moderate academic risk due to weak attachment to parents and peers. Descriptive within group analyses of the Low-Low group revealed a heterogeneous group of students with regards to academic outcomes and scores on non-cognitive measures. Gender and ethnic differences were found for attachment status but not for cognitive or non-cognitive variables. Implications for interventions and suggestions for future research are presented. ^

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This dissertation explores the Rastafari movement and the Nation of Islam as institutions that provide a group-identity for their adherents. The study seeks to determine the characteristics of the identity that is institutionalized by each movement, and the nature of the institutionalization process. The research was conducted primarily in South Florida where both movements exist. An extensive literature review in conjunction with in-depth field interviews were used as the primary research methodologies. What was of particular interest were the reasons that the members of the movements chose one movement over the other, also the similarities and dissimilarities between the movements in their role as institutions for group-identity formation. The research showed that both movements imbued their members with a sense of pride, high self-esteem and a strong sense of race consciousness. In addition, it showed that there was significant variation in identity orientation within the Rastafari Movement, which contrasted with the Nation of Islam where the identity variations within the movement were negligible. This was due largely to the difference in structure between the movements, the Nation of Islam being a centrally organized movement with one leader while the Rastafari movement is a decentralized polycephalous one. ^ Both movements were found to be millenarian in nature, essentially because of the significant utility of the concept that their members would rise to prominence through God's grace. Additionally, both movements were identified as expressive social movements, since they were determined as being primarily concerned with changing the attitudes of their members rather than effecting structural social change. ^

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In - Appraising Work Group Performance: New Productivity Opportunities in Hospitality Management – a discussion by Mark R. Edwards, Associate Professor, College of Engineering, Arizona State University and Leslie Edwards Cummings, Assistant Professor, College of Hotel Administration University of Nevada, Las Vegas; the authors initially provide: “Employee group performance variation accounts for a significant portion of the degree of productivity in the hotel, motel, and food service sectors of the hospitality industry. The authors discuss TEAMSG, a microcomputer based approach to appraising and interpreting group performance. TEAMSG appraisal allows an organization to profile and to evaluate groups, facilitating the targeting of training and development decisions and interventions, as well as the more equitable distribution of organizational rewards.” “The caliber of employee group performance is a major determinant in an organization's productivity and success within the hotel and food service industries,” Edwards and Cummings say. “Gaining accurate information about the quality of performance of such groups as organizational divisions, individual functional departments, or work groups can be as enlightening...” the authors further reveal. This perspective is especially important not only for strategic human resources planning purposes, but also for diagnosing development needs and for differentially distributing organizational rewards.” The authors will have you know, employee requirements in an unpredictable environment, which is what the hospitality industry largely is, are difficult to quantify. In an effort to measure elements of performance Edwards and Cummings look to TEAMSG, which is an acronym for Team Evaluation and Management System for Groups. They develop the concept. In discussing background for employees, Edwards and Cummings point-out that employees - at the individual level - must often possess and exercise varied skills. In group circumstances employees often work at locations outside of, or move from corporate unit-to-unit, as in the case of a project team. Being able to transcend individual-to-group mentality is imperative. “A solution which addresses the frustration and lack of motivation on the part of the employee is to coach, develop, appraise, and reward employees on the basis of group achievement,” say the authors. “An appraisal, effectively developed and interpreted, has at least three functions,” Edwards and Cummings suggest, and go on to define them. The authors do place a great emphasis on rewards and interventions to bolster the assertion set forth in their thesis statement. Edwards and Cummings warn that individual agendas can threaten, erode, and undermine group performance; there is no - I - in TEAM.

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The mature market, defined as age 55 and up and consisting of approximately 64 million Americans, is expected to increase. Studies show that this group travels more frequently, travels greater distances, and stays longer. The authors seek to determine if underlying dimensions exist for the mature individual with regard to the selection criteria for lodging when traveling for pleasure, and to determine if differences exist between various demographic subsegments of this market with regard to these underlying dimensions.

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U.S. visitor demand for the China travel experience is anticipated to rise significantly through 2105, causing the Chinese government to employ 100 million service providers over the next six years and raising concern about service delivery and perceptions of the on-site China experience. In an effort to better understand these issues concerning U.S. visitors, this study investigated two specific types of U.S. travelers to China: Group Package Tour (GPT) visitors and Free Independent Travel (FIT) visitors. Results indicated that GPT visitors were more likely to be older and have higher household income than FIT visitors. Four trip-related characteristics of GPT and FIT visitors were found to be significantly different, with GPT visitors showing higher levels of satisfaction with the overall China on-site travel experience.

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