992 resultados para Donnellan, Keith
Resumo:
Awareness of climate change and adaptations of building stock play a key role in the UK government’s environmental agenda. While some European countries and countries like Japan move forward by bringing their sustainability agenda to the public sector, the UK seems to be slow in embracing these ideas and long term sustainability in improved products and processes for better performance, efficiency and innovative application of renewable technology is yet to come. While funding remains a major constraint research show that a number of detrimental issues including; organisation, risk, mind sets of the stakeholders, planning constraints, reluctance to accept change and the unexploited markets are major contributing factors. Most of these barriers can be overcome with research, development and information and knowledge transfer techniques. Educating all stakeholders can act as an accelerator for innovation. This paper examines innovation in the built environment and how research and education can stimulate this process. It explores drivers and barriers for innovation and how research and education in construction, design, engineering and project management can enhance this process. It presents and discusses lessons learnt from two action research projects in relation to innovation.
Resumo:
The UK government has been promoting innovation in the construction sector to improve the sustainability of the built environment. It has the potential and strength in developing construction research in design and engineering, but the impact of these processes seems to be slow in reaching the residential sector. While funding remains a major constraint research show that a number of detrimental issues including; organisation, risk, mind sets of the stakeholders, planning constraints,reluctance to accept change and the unexploited markets are major contributing factors. Most of these barriers can be overcome with research, development and information and knowledge transfer techniques. Educating all stakeholders can act as an accelerator for innovation. Given the large stock of existing dwellings, the situation is compounded, by issues related to climate change, to the point that this problem can no longer be ignored and requires an urgent response from all sectors involved. This paper attempts to highlight some of the key issues that are important in accelerating innovation in the housing sector. It briefly looks at the process of innovation in housing and presents lessons learnt from two research projects. The drivers and barriers and the role played by the government are examined in relation to the housing context.
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Purpose: The purpose of this paper is to describe the problems encountered and the solutions developed when using benchmarking and key performance indicators (KPIs) to monitor a major UK social house building innovation (change) programme. The innovation programme sought improvements to both the quality of the house product and the procurement process. Design/methodology/approach: Benchmarking and KPIs were used to quantify performance and in-depth case studies to identify underlying cause and effect relationships within the innovation programme. Findings: The inherent competition between consortium members; the complexity of the relationship between the consortium and its strategic partner; the lack of an authoritative management control structure; and the rapidly changing nature of the UK social housing market all proved problematic to the development of a reliable and robust monitoring system. These problems were overcome by the development of multi-dimensional benchmarking model that balanced the needs and aspirations of the individual organisations with the broader objectives of the consortium. Research limitations/implications: Whilst the research methodology provides insight into the factors that affected the performance of a major innovation programme its findings may not be representative of all projects. Practical implications: The lessons learnt should assist those developing benchmarking models for multi-client consortia. Originality/value: The work reported in this paper describes an inclusive approach to benchmarking in which a multiple client group and their strategic partner sought to work together for shared gain. Very few papers have addressed this issue.
Resumo:
Hyperadrenocorticism is a rare endocrine disease in the cat; it is characterized by elevated blood cortisol level that generates numerous clinical signs including hyperglycemia, polyuria, polydipsia, polyphagia and skin diseases. The average age of onset is around 10 years. This disease usually occurs link with other endocrine disorders such as diabetes mellitus.The disease can be produced by functional alteration of the pituitary gland or the adrenal. A case report, with differential diagnosis and review of the literature, is presented.
Resumo:
Antecedentes. Pes Adulto planus (pie plano) es un problema común encontrado por muchos profesionales de la salud. A pesar de la percepción de que el pie plano puede causar dolor y deteriorar su función, la disponibilidad y el uso generalizado de diversos tratamientos, no hay consenso sobre la estrategia óptima de tratamiento. Objetivo. Evaluar la efectividad de las intervenciones conservadoras (no quirúrgicos) para pie plano en los adultos. Método. Se realizó una búsqueda sistemática de la literatura. Esto incluye: el Registro Cochrane Central de Ensayos Controlados; los Juicios CMSG Especializados Registro; una búsqueda electrónica se realizó utilizando MEDLINE (1960 a junio de 2012), EMBASE (1980 a junio de 2012), y CINAHL (1982 - junio de 2012). Revistas especializadas, listas de referencias de ensayos y artículos de revisión se realizaron búsquedas manuales. Criterios de selección: Ensayos aleatorios o cuasialeatorios de intervenciones de tratamiento para el pie plano en los adultos. Se excluyeron los ensayos que incluyeron patologías específicas como el dolor plantar del talón, las fracturas por sobrecarga de los metatarsianos, disfunción del tendón tibial posterior-, fracturas de tobillo, patologías del pie reumatoide, enfermedades neuromusculares y las complicaciones del pie diabético. Recopilación y análisis de datos: Dos autores seleccionaron de forma independiente los resultados de la búsqueda para identificar a aquellos que satisfacen los criterios de inclusión y evaluaron la calidad de los incluidos mediante una lista de control basado en la Evaluación de la Colaboración Cochrane de Riesgo. Esta herramienta se centró en el riesgo de la selección, el rendimiento, la detección, la heterogeneidad y el sesgo de notificación. Resultados. Cuatro ensayos, con 140 sujetos, cumplieron los criterios de inclusión para la revisión. Los cuatro fueron juzgados como de alto riesgo de sesgo en al menos un área, y también estaban en riesgo de sesgo incierto en al menos otra zona. Todos anotaron altamente en relación al sesgo de deserción, debido al corto seguimiento tiempos y diseños experimentales utilizados. Los datos no se agruparon debido al alto nivel de heterogeneidad identificada en las intervenciones evaluadas, los participantes seleccionados y medir los resultados. Los resultados de un estudio sugieren que después de cuatro semanas de uso ortesis puede resultar en una mejora significativa en vaivén lateral medio, y pueden resultar en una mejor, aunque no significativa, en general relacionados con la calidad de vida de los pies (Roma 2004). Un estudio (Redmond 2009) sugiere que su efecto sobre la distribución de la presión plantar en el pie puede no depender de si son personalizados o dispositivos prefabricados. Aunque este estudio se identificaron cambios significativos en algunas variables de presión plantar tanto con la costumbre y dispositivos prefabricados, otro (Esterman 2005) no encontró ningún efecto significativo de longitud ¾ ortesis prefabricadas sobre el dolor, la incidencia de lesiones, salud pie o de calidad de vida en un grupo de reclutas de la fuerza aérea. El cuarto estudio (Jung 2009) sugiere que el ejercicio de los músculos intrínsecos del pie puede mejorar el efecto de las ortesis. A pesar de estos resultados, ya que cada estudio incurrió riesgo de sesgo en al menos un área no se pueden sacar conclusiones
Resumo:
To investigate the numbers and types of joint and soft tissue injections performed by general practitioners (GPs) and to explore attitudes to training in joint and soft tissue injection and perceived barriers to performing injections.
Resumo:
Training on patients in addition to conventional mannequins increased GPs shoulder injection activity and their level of confidence.Hospital injection clinicsa may provide a suitable setting in which to train GPs interested in developing their shoulder joint injection skills