The compassion gap in UK universities

Context: This critical reflection is set in the context of increasing marketisation in UK higher education, where students are seen as consumers, rather than learners with power. The paper explores the dark side of academic work and the compassion gap in universities, in order to make recommendations for practice development in higher education and the human services. Aims: The paper aims to show how reflexive dialogue can be used to enable the development of compassionate academic practice. Conclusions and Implications for Practice: Toxic environments and organisational cultures in higher education have compounded the crisis in compassionate care in the NHS. Implications for practice are: • Narrative approaches and critical appreciative inquiry are useful methods with which to reveal, and rectify, failures of compassion; • Courageous conversations are required to challenge dysfunctional organisational systems and processes; • Leadership development programmes should include the application of skills of compassion in organisational settings.

The Data of Things: Strategies, Patterns and Practice of Cloud-based Participatory Sensing

The broad capabilities of current mobile devices have paved the way for Mobile Crowd Sensing (MCS) applications. The success of this emerging paradigm strongly depends on the quality of received data which, in turn, is contingent to mass user participation; the broader the participation, the more useful these systems become. However, there is an ongoing trend that tries to integrate MCS applications with emerging computing paradigms such as cloud computing. The intuition is that such a transition can significantly improve the overall efficiency while at the same time it offers stronger security and privacy-preserving mechanisms for the end-user. In this position paper, we dwell on the underpinnings of incorporating cloud computing techniques to facilitate the vast amount of data collected in MCS applications. That is, we present a list of core system, security and privacy requirements that must be met if such a transition is to be successful. To this end, we first address several competing challenges not previously considered in the literature such as the scarce energy resources of battery-powered mobile devices as well as their limited computational resources that they often prevent the use of computationally heavy cryptographic operations and thus offering limited security services to the end-user. Finally, we present a use case scenario as a comprehensive example. Based on our findings, we posit open issues and challenges, and discuss possible ways to address them, so that security and privacy do not hinder the migration of MCS systems to the cloud.

Ancillary services market clearing simulation: a comparison between deterministic and heuristic methods

Electricity market players operating in a liberalized environment requires access to an adequate decision support tool, allowing them to consider all the business opportunities and take strategic decisions. Ancillary services represent a good negotiation opportunity that must be considered by market players. For this, decision support tool must include ancillary market simulation. This paper proposes two different methods (Linear Programming and Genetic Algorithm approaches) for ancillary services dispatch. The methodologies are implemented in MASCEM, a multi-agent based electricity market simulator. A test case based on California Independent System Operator (CAISO) data concerning the dispatch of Regulation Down, Regulation Up, Spinning Reserve and Non-Spinning Reserve services is included in this paper.

Ancillary services dispatch using linear programming and genetic algorithm approaches

Electricity market players operating in a liberalized environment requires access to an adequate decision support tool, allowing them to consider all the business opportunities and take strategic decisions. Ancillary services represent a good negotiation opportunity that must be considered by market players. For this, decision support tools must include ancillary market simulation. This paper proposes two different methods (Linear Programming and Genetic Algorithm approaches) for ancillary services dispatch. The methodologies are implemented in MASCEM, a multi-agent based electricity market simulator. A test case concerning the dispatch of Regulation Down, Regulation Up, Spinning Reserve and Non-Spinning Reserve services is included in this paper.

Nursing Home-Acquired Pneumonia Presenting at the Emergency Department

Nursing home-acquired pneumonia (NHAP) is one of the most common infections arising amongst nursing home residents, and its incidence is expected to increase as population ages. The NHAP recommendation for empiric broad-spectrum antibiotic therapy, arising from the concept of healthcare-associated pneumonia, has been challenged by recent studies reporting low rates of multidrug-resistant (MDR) bacteria. This single center study analyzes the results of NHAP patients admitted through the Emergency Department (ED) at a tertiary center during the year 2010. There were 116 cases, male gender corresponded to 34.5 % of patients and median age was 84 years old (IQR 77-90). Comorbidities were present in 69.8 % of cases and 48.3 % of patients had used healthcare services during the previous 90 days. In-hospital mortality rate was 46.6 % and median length-of-stay was 9 days. Severity assessment at the Emergency Department provided CURB65 index score and respective mortality (%) results: zero: n = 0; one: n = 7 (0 %); two: n = 18 (38.9 %); three: n = 26 (38.5 %); four: n = 30 (53.3 %); and five; n = 22 (68.2 %); and sepsis n = 50 (34.0 %), severe sepsis n = 43 (48.8 %) and septic shock n = 22 (72.7 %). Significant risk factors for in-hospital mortality in multivariate analysis were polypnea (p = 0.001), age ≥ 75 years (p = 0.02), and severe sepsis or shock (p = 0.03) at the ED. Microbiological testing in 78.4 % of cases was positive in 15.4 % (n = 15): methicillin-resistant Staphylococcus aureus (26.7 %), Pseudomonas aeruginosa (20.0 %), S. pneumoniae (13.3 %), Escherichia coli (13.3 %), others (26.7 %); the rate of MDR bacteria was 53.3 %. This study reveals high rates of mortality and MDR bacteria among NHAP hospital admissions supporting the use of empirical broad-spectrum antibiotic therapy in these patients.

Business development in Siemens global shared services delivery center Portugal

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

How to monitor and improve Unilever JM Supply Chain processes to become the best of Portugal’s sector in 2015?

Unilever Jerónimo Martins is a Portuguese joint-venture leading firm in what concerns the supply chain industry of fast-moving consumer goods in Portugal. The scope of analysis of this Work Project is focusing on Unilever-JM operations and services in the Portuguese market regarding quality, efficiency and effectiveness over B2B customers. It will be analysed the possibility of development and implementation of a performance measurement system, Tableau de Bord, which will be crucial for the identification of potential opportunities of improvement with impact in the supply chain processes. This will be completed through the establishment of KPI’s to monitor and manage periodically logistics, planning and customer service processes’ performance, which are the ones where the bottlenecks are impacting more in the supply chain. In this work project the nexus causality for the problems will also be discussed and some recommendations will be prepared to tackle the inefficiencies found through the monitoring of the previous core processes, in order to improve efficacy and quality service of the supply chain.

Statistics as a basis for discrimination in the insurance business

The European Court of Justice has held that as from 21 December 2012 insurers may no longer charge men and women differently on the basis of scientific evidence that is statistically linked to their sex, effectively prohibiting the use of sex as a factor in the calculation of premiums and benefits for the purposes of insurance and related financial services throughout the European Union. This ruling marks a sharp turn away from the traditional view that insurers should be allowed to apply just about any risk assessment criterion, so long as it is sustained by the findings of actuarial science. The naïveté behind the assumption that insurers’ recourse to statistical data and probabilistic analysis, given their scientific nature, would suffice to keep them out of harm’s way was exposed. In this article I look at the flaws of this assumption and question whether this judicial decision, whilst constituting a most welcome landmark in the pursuit of equality between men and women, has nonetheless gone too far by saying too little on the million dollar question of what separates admissible criteria of differentiation from inadmissible forms of discrimination.

NAV Portugal's performance within the single European Sky Initiative

NAV Portugal is the Air Navigation Service Provider in Portugal, providing air traffic control services in the airspace under the country’s responsibility. Recently, the company has been included in an initiative launched by the European Commission, called the Single European Sky. This aims for a unification of the European airspace, improving it in four main pillars: safety, capacity, environment, and cost-efficiency. To each of them, Key Performance Indicators need to be computed and monitored, all having pre-defined targets. The presented work project will be analyzing how NAV Portugal is doing in the pillar of capacity, proving suggestions if needed.

Evaluation of outpatient child-adolescent mental health services (CAMHS) in Attica-Greece

ABSTRACT: Background: Childhood is a critical time for social and emotional development, educational progress and mental health prevention. Mental health for children and adolescents is defined by the achievement of expected developmental, cognitive, social and emotional skills. The development of child-adolescent mental health services (CAMHS) is a necessity for each country, not only as a prevention measure for the wellbeing of people, but also as an investment to the future of countries. Qualitative evaluation of services is the only way to ensure whether services function under quality standards and increase the possibility of better outcomes for their patients. This study examines the greek outpatient CAMHS against the British Standards of National Institute of Excellence for community CAMHS. The Standards assessed refer to the areas of Assessment, Care and Intervention. Objectives: The main objectives of the study are 1) to evaluate Greek outpatient CAMHS in the Attica region 2) to promote the evaluation process for mental health services in Greece. Methods: Due to the fact that Greek services are based on the British model, the tool used was the British self-review questionnaire of Quality Network for Community CAMHS(QNCC).The tool was translated, adapted and posted to services. Twelve out of twenty outpatient CAMHS of Attica (including Athens) responded. Data was collected and performed by the Statistical Package for Social Sciences SPSS. Results: The study resulted that the CAMHS examined, meet moderately the British Standards of 1) Referral and Access, 2) Assessment & Care planning, 3) Care & Intervention. Two out of twelve services examined, meet the standards of "Assessment and Care" in a higher percentage between 75% and 100%. Conclusions: The paper describes a satisfactory function of CAMHS in Attica prefecture taking into consideration the extremely difficult political situation of Greece at the time of the research. Strong and weak domains are identified. Also the translation and adaptation of British tools promote the evaluation process and quality assurance of Greek CAMHS.

Implementation progress of mental health services in Rwanda: Bugesera district case

RESUMO: O Ministério da Saúde do Governo do Ruanda identifica a saúde mental como uma área de prioridade estratégica para a intervenção em resposta à alta carga dos transtornos mentais no Ruanda. Ao longo dos últimos 20 anos após o genocídio, o sector público reconstruiu sua Resposta Nacional de Saúde Mental com base no acesso equitativo aos cuidados, através do desenvolvimento de uma Política Nacional de Saúde Mental e novas estruturas de saúde mental. A política de Saúde Mental do Ruanda, revista em 2010, prima pela descentralização e integração dos serviços de saúde mental em todas as estruturas nacionais do sistema de saúde e ao nível da comunidade. O presente estudo de caso tem como objetivo avaliar a situação do sistema de saúde mental de um distrito típico de uma área rural no Ruanda, e sugerir melhorias, incluindo algumas estratégias para monitoras as mudanças. Os resultados do estudo permitirão ao Ruanda reforçar a sua capacidade para implementar o Plano Nacional de Saúde Mental ao nível dos distritos. O relatório também será útil para monitorar o progresso da implementação de serviços de saúde mental nos distritos, incluindo a prestação de serviços de base comunitária e a participação dos usuários, suas famílias e outros interessados na promoção, prevenção, assistência e reabilitação em saúde mental. Este estudo também procurou avaliar o progresso da implementação dos cuidados de saúde mental a nível descentralizado, com vista a compreender as implicações em termos de recursos desses processos. Foi realizada uma análise situacional num local do distrito, baseado em entrevistas com as principais partes interessadas responsáveis, usando o Instrumento de Avaliação de Sistemas de Saúde Mental da Organização Mundial da Saúde (WHO-AIMS). Os resultados sugerem que os recursos humanos para a saúde mental e serviços de base comunitária de saúde mental no distrito continuam a ser extremamente limitados. Os profissionais de saúde mental são adicionalmente limitados na sua capacidade para oferecer intervenções de emergência a pacientes psiquiátricos e garantir a continuidade do tratamento farmacológico a pacientes com condições crônicas. Para planejar efetivamente, de acordo com as necessidades da comunidade, sugerimos que o sistema de saúde mental deve envolver também os representantes das famílias e dos usuários no processo de planificação de modo a melhorar a sua contribuição no processo de implementação das atividades de saúde mental. Este estudo de caso do Distrito de Bugesera oferece a primeira análise de nível distrital dos serviços de saúde mental no Ruanda, e pode servir como uma mais-valia para a melhoria do sistema de saúde mental, incluindo a advocacia para a melhoria da qualidade dos cuidados de saúde mental a este nível, aumentando o financiamento para a implementação de serviços clínicos de saúde mental e os recursos humanos disponíveis para a prestação de cuidados de saúde mental, principalmente a nível dos cuidados primários.--------------------- ABSTRACT: To deal with the high burden of mental health disorders resulting from consequences of the 1994 genocide against Tutsis, the Rwanda Ministry of Health (MoH) considers mental health as a priority intervention. For the last 20 years, Ministry of Health focused on rebuilding a national and equity-oriented mental health program responding to the population needs in mental health. Mental health services are now decentralized and integrated in the national health system, from the community level up to the referral level. This study assessed the situation of mental health services in one rural district in Rwanda. It was aimed at assessing the progress of implementation of mental health care at the decentralized level, focusing on resource implications and processes. This study is based on interviews conducted with key stakeholders, using the World Health Organization's Assessment Instrument for Mental Health Systems (WHO-AIMS). Findings show that human resources for mental health care and community-based mental health services of the assessed district remain extremely limited. Mental health professionals face limitation regarding the ability to provide emergency management of psychiatric patients and to ensure continuity of psychopharmacological treatment of patients with chronic conditions. To improve the implementation process of mental health interventions and activities, a planning process based on community needs and the involvement of representatives of families and users in planning process should be considered. The Bugesera case study on the situation of mental health services can serve as a baseline for improvement of the mental health program in Rwanda, in terms of quality care services, infrastructure and equipment, human and financial resources.

The role of the intelligence service in preventing and combating transnational terrorism

Outrora dominado por ameaças provenientes de Estados-nação, o cenário global actual, dominado por uma rápida mudança de poderes que nos apresenta uma interacção complexa entre múltiplos actores, onde inimigos desconhecidos, anteriormente bem identificados, é actualmente controlado por grupos terroristas bem preparados e bem organizados. Hezbollah é reconhecido como um dos grupos terroristas mais capazes, com uma extensa rede fora do Líbano dedicada a tráfico de droga, armas e seres humanos, tal como o branqueamento de capitais para financiar o terrorismo, representando um grande foco de instabilidade à segurança. Como instrumento de Estado, os serviços de informações detêm a capacidade de estar na linha da frente na prevenção e combate ao terrorismo. Todavia, para compreender este fenómeno é necessário analisar os actores desta ameaça. À luz desta conjuntura, esta dissertação está dividida em três capítulos principais que visam responder às seguintes questões fundamentais: O que é o terrorismo? Como opera um grupo terrorista transnacional? Será que os serviços de informações têm as ferramentas necessárias para prevenir e combater estas ameaças?

Prevenção terciária em saúde mental : novas respostas em Portugal

RESUMO - Apresenta-se a caracterização e a descrição das novas respostas, bem como dos dispositivos que as permitiram organizar, quanto à prevenção terciária em saúde mental em Portugal. Detalha-se a Região de Lisboa e Vale do Tejo por ser a que mais estruturas criou e que foi alvo do estudo das autoras. Até ao final de 2001 beneficiavam 754 pessoas desta oferta de serviços no nosso país, das quais 473 na Região de Lisboa e Vale do Tejo. A maior parte destes beneficiários, 299, participa em actividades de fórum sócio-ocupacional, estando 99 pessoas inseridas em estruturas residenciais. Daí que se entenda que houve uma melhoria quanto à cobertura de necessidades em termos de prevenção terciária/ reabilitação no nosso país. Considera-se, contudo, que ainda muito está por fazer, uma vez que se continua muito aquém dos ratios de oferta de serviços internacionalmente recomendados. Considera-se desejável que se alargue e aprofunde este projecto, enquadrado com mais rigor em termos de diagnóstico de necessidades nacionais e com uma coordenação mais centralizada que potencie uma melhor gestão do seu quadro de exigências.

A importância da Polícia Municipal na segurança

The challenge of this work is to assess the importance of the municipal police in improving the safety of citizens, if gauging from this reality through contributions from the Municipal Police Guimarães. The IV Constitutional Review in 1997, enabled the Portuguese municipalities creating administrative police bodies. These services, known as Municipal Police, have gradually come up in several municipalities. Currently the Municipal Police have their fundamental legal regulations of Law No. 19/2004 of 20 May, which, according to the Portuguese Constitution provides that these must be seen as municipal services, which act in a space territorially delimited, which corresponds to the municipality that each belongs. Under Article 237, paragraph 3, of the Constitution, the Municipal Police are municipal services, which shall cooperate in the maintenance of public order and protection of local communities, acting in cooperation with the security forces, public security functions. The safety concept has been taking an increasingly significant importance within the population. Is also no doubt say that, currently, insecurity affects all of society and is a major concern of law enforcement authorities. To find suitable answers we found that there are several studies on these subjects. In order to be able to make our contribution, text looks us on this subject, having had the support of the Municipal Police Guimarães, in the preparation of this work. Thus, based on a survey, they were sounded out, as privileged actors, agents of the Municipal Police Guimarães, in order to know their perceptions with regard to security issues faced in the context of security. We understand ask them to answer in particular the following questions: What are the most facilitators situations of crime? How important is the Municipal Police Guimarães in crime prevention? What are the strategies for prevention of incivilities? What other skills that can be conferred upon the Municipal Police? The results obtained allowed us to conclude that incivilities facilitate the occurrence of crimes and that the Municipal Police may have a more active role in the security of the population. If you were given other duties, in addition to that already have, the Municipal Police could reach another level of effectiveness. However we understand that any change to the tasks of this police need a serious and profound reflection, to find complementary alternatives with the security forces, which does not conflict with current assignments of any of the parties or with the interests of citizens.

How small accounting firms can compete in an environment in which the big four are getting bigger

This paper sets out to determine how small accounting firms can compete in the United States in the early 21st century. The first chapter identifies the central goal of the paper: namely, to use existing literature and market data to define a business strategy for Ross & Moncure, Inc., a small accounting firm in the metropolitan Washington area. The second chapter is a literature review, and in it the author finds that large accounting firms are advantaged in terms of reputation, ability to diversify, and ability to retain employees, but are disadvantaged in their ability to form longstanding successful relationships with clients. In the third chapter, the author explores the relationship between the Big Four firms and their employees. The goal of this chapter is to determine how small accounting firms can compete for top talent in the HR market, and the author finds that this can be done by offering faster career progression and more client interaction. The fourth chapter looks at the market for accounting services in the United States, exploring the different options that consumers have to meet their accounting needs. It is found in this chapter that big and small accounting firms tend to compete for clients of different profiles. In the fifth chapter, the author uses proprietary company data to explore the composition, existing strategy and culture of Ross & Moncure. In the sixth chapter, all of the previous chapters come together to formulate a strategy and plan for action for Ross & Moncure: specifically, that the firm should further cultivate networks and relationships, and should create a fulfilling professional environment by increasing client-employee interaction, encouraging external education, and allowing employees to take on many different projects