501 resultados para reconciliation


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Introduction and Objectives: With the population ageing, there is a growing number of people who have several comorbidities and make use of a variety of drugs. These factors lead to a greater predisposition to adverse drug events, as well as to medication errors. The clinical pharmacist is the most indicated health professional to target these issues. The aims of this study were to analyze the profile of medication reconciliation and assess the role of the clinical pharmacist regarding medication adherence. Material and Methods: Prospective observational cohort study conducted from Jan-Mar 2013 at the Surgical Clinic of the University Hospital of the University of Sao Paulo. 117 admitted patients - over the age of 18 years, under continuous medication use and with length of hospitalization up to 120h - were included. Discrepancies were classified as intentional/unintentional and according to their risk to cause harm, and interventions were divided into accepted/not accepted. Medication adherence was measured by Morisky questionnaire. Results and Conclusions: Only 30% of hospital prescriptions showed no discrepancies between the medications that the patient was using at home and those which were being prescribed at the hospital and more than one third of those had the potential to cause moderate discomfort or clinical deterioration. One third of total discrepancies were classified as unintentional. About 90% of the interventions were accepted by the medical staff. In addition, about 63% of patients had poor adherence to drug therapy. The study revealed the importance of the medication reconciliation at patient admission, ensuring greater safety and therapeutic efficacy of the treatment during hospitalization, and orienting the patient at discharge, assuring the therapy safety.

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Reconciliation is the occurrence of friendly behaviour between opponents shortly after an aggressive conflict. In primate groups, reconciliation reduces aggression and post-conflict arousal. Aggression within a group can also increase arousal of bystanders (e.g. increase bystanders’ rates of self-directed behaviour). Since reconciliation reduces aggression between opponents, we tested whether it also reduces self-directed behaviour in bystanders. Following aggression in a captive group of hamadryas baboons, one observer conducted a focal sample on one of the combatants to document reconciliation and a second observer simultaneously conducted a focal sample on a randomly selected bystander. Matched control observations were then collected on the same individuals in a nonaggressive context to obtain baseline levels of behaviour. The self-directed behaviour of bystanders was elevated after witnessing a fight compared to baseline levels. If combatants reconciled aggression, bystander rates of self-directed behaviour significantly decreased. If combatants did not reconcile aggression, bystander rates of self-directed behaviour remained at elevated levels, significantly higher than after reconciliation. If combatants affiliated with partners other than their original opponent, bystander rates of self-directed behaviour did not decrease. The rate of bystander self-directed behaviour after a combatant affiliated with its opponent was significantly lower than the rate after a combatant affiliated with other animals. Witnessing aggression increased arousal in bystanders, and reconciliation between the combatants was accompanied by reduced bystander arousal. The reduction was specific to contexts in which former opponents interacted. We suggest that bystanders recognized the functional significance of this conflict resolution mechanism when it occurred in their group.

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Reconciliation is the occurrence of friendly behaviour between opponents shortly after an aggressive conflict. In primate groups, reconciliation reduces aggression and postconflict arousal. Aggression within a group can also increase arousal of bystanders (e.g. increase bystanders' rates of self-directed behaviour). Since reconciliation reduces aggression between opponents, we tested whether it also reduces self-directed behaviour in bystanders. Following aggression in a captive group of hamadryas baboons, one observer conducted a focal sample on one of the combatants to document reconciliation and a second observer simultaneously conducted a focal sample on a randomly selected bystander. Matched control observations were then collected on the same individuals in a nonaggressive context to obtain baseline levels of behaviour. The self-directed behaviour of bystanders was elevated after witnessing a fight compared to baseline levels. If combatants reconciled aggression, bystander rates of self-directed behaviour significantly decreased. If combatants did not reconcile aggression, bystander rates of self-directed behaviour remained at elevated levels, significantly higher than after reconciliation. If combatants affiliated with partners other than their original opponent, bystander rates of self-directed behaviour did not decrease. The rate of bystander self-directed behaviour after a combatant affiliated with its opponent was significantly lower than the rate after a combatant affiliated with other animals. Witnessing aggression increased arousal in bystanders, and reconciliation between the combatants was accompanied by reduced bystander arousal. The reduction was specific to contexts in which former opponents interacted. We suggest that bystanders recognized the functional significance of this conflict-resolution mechanism when it occurred in their group. (c) 2013 The Association for the Study of Animal Behaviour. Published by Elsevier Ltd. All rights reserved.

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Writing center scholarship and practice have approached how issues of identity influence communication but have not fully considered ways of making identity a key feature of writing center research or practice. This dissertation suggests a new way to view identity -- through an experience of "multimembership" or the consideration that each identity is constructed based on the numerous community memberships that make up that identity. Etienne Wenger (1998) proposes that a fully formed identity is ultimately impossible, but it is through the work of reconciling memberships that important individual and community transformations can occur. Since Wenger also argues that reconciliation "is the most significant challenge" for those moving into new communities of practice (or, "engage in a process of collective learning in a shared domain of human endeavor" (4)), yet this challenge often remains tacit, this dissertation examines and makes explicit how this important work is done at two different research sites - a university writing center (the Michigan Tech Multiliteracies Center) and at a multinational corporation (Kimberly-Clark Corporation). Drawing extensively on qualitative ethnographic methods including interview transcriptions, observations, and case studies, as well as work from scholars in writing center studies (Grimm, Denney, Severino), literacy studies (New London Group, Street, Gee), composition (Horner and Trimbur, Canagarajah, Lu), rhetoric (Crowley), and identity studies (Anzaldua, Pratt), I argue that, based on evidence from the two sites, writing centers need to educate tutors to not only take identity into consideration, but to also make individuals' reconciliation work more visible, as it will continue once students and tutors leave the university. Further, as my research at the Michigan Tech Multiliteracies Center and Kimberly-Clark will show, communities can (and should) change their practices in ways that account for reconciliation work as identity, communication, and learning are inextricably bound up with one another.