838 resultados para end-to-side


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'If we do not cut social spending, we will end up like Greece'. Establishment politicians and media figures use this new ideological mantra throughout the Western world to frighten people into consenting to further neo-liberal restructuring along with cuts in social spending. This phrase and other ideologically laden assertions hide the real causes of the Greek public debt crisis. This commentary challenges the dominant discourse by contextualizing the Greek case within the larger global neo-liberal restructuring processes and then, drawing upon Gramsci's concept of the organic intellectual, proposes ways that the members of the Professional Association of Social Workers (PASW) can engage in a war of ideas and action, as organic intellectuals, to delegitimize the dominant discourse, which seeks consent for social spending cuts and further neo-liberal restructuring of society. © The Author(s) 2013.

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Background
Despite the recognized importance of end-of-life (EOL) communication between patients and physicians, the extent and quality of such communication is lacking.

Objective
We sought to understand patient perspectives on physician behaviours during EOL communication.

Design
In this mixed methods study, we conducted quantitative and qualitative strands and then merged data sets during a mixed methods analysis phase. In the quantitative strand, we used the quality of communication tool (QOC) to measure physician behaviours that predict global rating of satisfaction in EOL communication skills, while in the qualitative strand we conducted semi-structured interviews. During the mixed methods analysis, we compared and contrasted qualitative and quantitative data.

Setting and Participants
Seriously ill inpatients at three tertiary care hospitals in Canada.

Results
We found convergence between qualitative and quantitative strands: patients desire candid information from their physician and a sense of familiarity. The quantitative results (n = 132) suggest a paucity of certain EOL communication behaviours in this seriously ill population with a limited prognosis. The qualitative findings (n = 16) suggest that at times, physicians did not engage in EOL communication despite patient readiness, while sometimes this may represent an appropriate deferral after assessment of a patient's lack of readiness.

Conclusions
Avoidance of certain EOL topics may not always be a failure if it is a result of an assessment of lack of patient readiness. This has implications for future tool development: a measure could be built in to assess whether physician behaviours align with patient readiness.

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Background: Staff who provide end-of-life care to children not only have to deal with their own sense of loss, but also that of bereaved families. There is a dearth of knowledge on how they cope with these challenges.
Aim: The aim of this review is to explore the experiences of health care professionals who provide end-of-life care to children in order to inform the development of interventions to support them, thereby improving the quality of paediatric care for both children and their families.
Data sources: Searches included CINAHL, MEDLINE, Web of Science, EMBASE, PsychINFO, and The Cochrane Library in June 2015, with no date restrictions. Additional literature was uncovered from searching reference lists of relevant studies, along with contacting experts in the field of paediatric palliative care.
Design: This was a systematic mixed studies review. Study selection, appraisal and data extraction were conducted by two independent researchers. Integrative thematic analysis was used to synthesise the data.
Results: The 16 qualitative, six quantitative, and eight mixed-method studies identified included healthcare professionals in a range of settings. Key themes identified rewards and challenges of providing end-of-life care to children, the impact on staff’s personal and professional lives, coping strategies, and key approaches to help support staff in their role.
Conclusions: Education focusing on the unique challenges of providing end-of-life care to children and the importance of self-care, along with timely multidisciplinary debriefing are key strategies for improving healthcare staffs’ experiences, and as such the quality of care they provide.

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Drawing on post-marxist discourse theory inspired by the writings of Ernesto Laclau and Chantal Mouffe, this article puts the case for a literature on communism situated at the crossroads of critical theory, cultural studies and historiography. Specific illustration is provided by the author's own research on British communism and the Spanish Civil War. However, the scope of the article is much broader and it is intended as a contribution to the theoretical discussion of future possibilities for communist history-writing. The article concludes that discourse should be regarded neither as a flat surface of tightly knit signifiers nor as an impenetrable monolith of meaning systems. Rather, it should be seen as an inherently dynamic phenomenon, with its own condensations and dispersions along the historical continuum. In this lies its significance for historians of communism.

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Pre-publicity for the final volume of Harold Macmillan’s memoirs, At the End of the Day, stressed that it would provide the British side of the Cuban missile crisis for the first time. The Churchillian model chosen, changes required by the Cabinet Office and Macmillan’s desire to rebuke those political opponents who claimed that the crisis demonstrated a lack of British influence in Washington, however ensured a focus on his personal relationship with President Kennedy. His larding the text with contemporary observations from his diaries also skewed Macmillan’s account and, in particular, underplayed the significance of British moves at the United Nations in New York to secure a credible United Nations inspection regime and a US guarantee of the inviolability of Cuba. Careful reconstruction of Macmillan’s real-time experience of the Cuban missile crisis demonstrates the limitations of his own account of this event

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A Work Project, presented as part of the requirements for the Award of a Masters Degree in Management from the NOVA – School of Business and Economics

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This dissertation studies essentially how Millennials are changing the hotel industry, in the sense that new trends are emerging with this generation and hotels need to respond accordingly, in order to survive within their competitive industry. Emphasis is also given to Asian travellers, as the enlargement of these countries’ middle class populations is predicted, therefore making Asian travellers a valuable target for the hotel industry. To successfully target this segment, hoteliers need also to consider the cultural differences and aspirations that come together with the Asian travellers, and appropriately adapt their offer to them. I will then redirect this study to the city of Lisbon, the Portuguese capital, to analyse if Lisbon’s four and five-star hotel managers are aware of the new market trends, and to understand how they are changing their hotels in order to make them more attractive to Millennials and Asian travellers. Using a sample of 12 hotels (four and five-stars ratings), I have concluded that, although there is a notable undergoing process of adaptation to these guests, there is a long way ahead in order for Lisbon’s hotels to entirely please and retain millennial guests.

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Throughout recent years, there has been an increase in the population size, as well as a fast economic growth, which has led to an increase of the energy demand that comes mainly from fossil fuels. In order to reduce the ecological footprint, governments have implemented sustainable measures and it is expected that by 2035 the energy produced from renewable energy sources, such as wind and solar would be responsible for one-third of the energy produced globally. However, since the energy produced from renewable sources is governed by the availability of the respective primary energy source there is often a mismatch between production and demand, which could be solved by adding flexibility on the demand side through demand response (DR). DR programs influence the end-user electricity usage by changing its cost along the time. Under this scenario the user needs to estimate the energy demand and on-site production in advance to plan its energy demand according to the energy price. This work focuses on the development of an agent-based electrical simulator, capable of: (a) estimating the energy demand and on-site generation with a 1-min time resolution for a 24-h period, (b) calculating the energy price for a given scenario, (c) making suggestions on how to maximize the usage of renewable energy produced on-site and to lower the electricity costs by rescheduling the use of certain appliances. The results show that this simulator allows reducing the energy bill by 11% and almost doubling the use of renewable energy produced on-site.