The International <IR> Framework’s impact on the social and relationship disclosures in the healthcare industry

Abstract Background and Problem: The altering business world and the growing requests from stakeholders have resulted in the establishment of new reports. These are among others Sustainability reports and Integrated Reporting. On the contrary, traditional financial reports do not consider the significance of intangible assets in modern entities. The social and relationship capital has further shown to be important for firms, especially healthcare companies and pharmaceuticals, but is not as developed as other capitals within the <IR> framework and therefore not always included in annual reports. However too few disclosures within this area could lead to high liabilities. The IIRC launched the <IR> framework year 2013 as a solution, as it gives a more comprehensive view of the reporting entity. Within this framework there are six capitals: manufactured, human, financial, natural, intellectual and social and relationship.   Purpose: The purpose of this thesis is to find out how the International <IR> Framework has influenced the reporting of the social and relationship disclosures within the healthcare industry, to compare the reporting of the six medical firms chosen and to examine how the social concerns have been developed over time. Delimitations: This study is conducted over a period of three years, from year 2012 to year 2014. It only examines healthcare companies which use the International <IR> framework and it has solely focus on the social and relationship capital. All other capitals within the <IR> framework are excluded from the study. Method: This study has a qualitative research strategy and is based on information collected from published documents in form of annual reports. The annual reports from year 2010, 2011 and 2012 are used to find social and relationship disclosures and a disclosure scoreboard is used to find similarities, differences and patterns. Empirical Results and Conclusion: It has been found that the aggregated social and relationship disclosures have been reduced over time. The year followed by the release of the <IR> framework was seen to have the least disclosures and therefore conclusion was drawn that the <IR> framework had a negative influence on the social and relationship disclosures. There were also differences among the companies studied both in extent and content. The former could be linked to factors such as size and nationality and the latter could be linked to reputation preservation and legitimacy interests.

Clinical utility of amyloid PET imaging in the differential diagnosis of atypical dementias and its impact on caregivers

La maladie d’Alzheimer (MA) se caractérise pathologiquement par l’accumulation de plaques amyloïde dans le cerveau. La tomographie par émission de positrons (TEP) permet d’imager les plaques amyloïde in vivo. Le but de ce projet est d’évaluer le rôle de la TEP amyloïde dans le processus diagnostique de la MA dans des cas de démences atypiques. Le deuxième but de ce projet est de déterminer l’impact de la révélation d’un diagnostic plus certain chez les proches aidants. 28 patients sans diagnostic malgré une investigation exhaustive ont été sélectionnées et imagées avec le traceur amyloïde 18F-NAV4694 (âge 59,3 ans, é-t. 5,8; MMSE 21.4, é-t 6.0). Les neurologues référents documentaient par la suite tout changement de niveau de certitude, de diagnostic, de traitement et/ou de prise en charge. Les proches aidants consentants ont été rencontrés subséquemment, et un questionnaire avec une échelle de Likert a été utilisé afin de documenter l’impact de l’imagerie leur perception de la maladie. Notre cohorte a été également divisée entre amyloïde positifs (14/28) et négatifs (14/28). Un changement de diagnostic a lieu dans 9/28 cas (32,1% :17.8% ont changé de MA à non-MA, 14,3% de non-MA à MA). Il y avait une augmentation significative (p<0,05) de 44% dans la certitude du neurologue suite à cet examen. Un changement de prise en charge a été obtenu dans 20/28 (71,4%) des cas. Bien que non significatifs statistiquement, un impact favorable sur les proches-aidants a été noté. Cette étude suggère que l’imagerie amyloïde a un rôle bénéfique dans les cas de démences atypiques n’ayant pu être élucidés avec les techniques d’investigations actuellement recommandées. De plus, le processus a été perçu positivement par les proches aidants, notamment en encourageant du temps de qualité avec leurs personnes chères. Ceci illustre un rôle prometteur des biomarqueurs, qui sont de plus en plus explorés.

Indoor environment and the impact on the health of pre-exisiting asthmatics at work: the development of a risk management framework

This thesis examines the spatial and temporal variation in nitrogen dioxide (NO2) levels in Guernsey and the impacts on pre-existing asthmatics. Whilst air quality in Guernsey is generally good, the levels of NO2 exceed UK standards in several locations. The evidence indicates that people suffering from asthma have exacerbation of their symptoms if exposed to elevated levels of air pollutants including NO2, although this research has never been carried out in Guernsey before. In addition, exposure assessment of individuals is rarely carried out and research in this area is limited due to the complexity of undertaking such a study, which will include a combination of exposures in the home, the workplace and ambient exposures, which vary depending on the individual daily experience. For the first time in Guernsey, this research has examined NO2 levels in correlation with asthma patient admissions to hospital, assessment of NO2 exposures in typical homes and typical workplaces in Guernsey. The data showed a temporal correlation between NO2 levels and the number of hospital admissions and the trend from 2008-2012 was upwards. Statistical analysis of the data did not show a significant linear correlation due to the small size of the data sets. Exposure assessment of individuals showed a spatial variation in exposures in Guernsey and assessment in indoor environments showed that real-time analysis of NO2 levels needs to be undertaken if indoor micro environments for NO2 are the be assessed adequately. There was temporal and spatial variation in NO2 concentrations measured using diffusion tubes, which provide a monthly mean value, and analysers measuring NO2 concentrations in real time. The research shows that building layout and design are important factors for good air flow and ventilation and the dispersion of NO2 indoors. Environmental Health Officers have statutory responsibilities for ambient air quality, hygiene of buildings and workplace environments and this role needs to be co-ordinated with healthcare professionals to improve health outcomes for asthmatics. The outcome of the thesis was the development of a risk management framework for pre-existing asthmatics at work for use by regulators of workplaces and an information leaflet to assist in improving health outcomes for asthmatics in Guernsey.

Cannabinoids impact on pregnancy: effects in trophoblast cells

Cannabinoids (CBs) can be classified as: phytocannabinoids, the constituents of the Cannabis sativa plant; synthetic cannabinoids lab-synthesized and the endocannabinoids that are endogenous lipid mediators. Cannabinoid compounds activate cannabinoid receptors – CB1 and CB2. The most prevalent psychoactive phytocannabinoid is Δ9tetrahydrocannabinol (THC), but more than 60 different CBs were already identified in the plant. The best characterized endocannabinoids (eCBs) are anandamide (AEA) and 2arachidonoylglycerol (2-AG), that are involved in several physiological processes including synaptic plasticity, pain modulation, energy homeostasis and reproduction. On the other hand, some synthetic cannabinoids that were initially designed for medical research, are now used as drugs of abuse. During the period of placental development, highly dynamic processes of remodeling occur, involving proliferation, apoptosis, differentiation and invasion of trophoblasts. It is known that a tight control of eCBs levels is required for normal pregnancy progression and that eCBs are involved in trophoblast cells turnover. Therefore, by sharing activation of the same receptors, exposure to exocannabinoids either by recreational or medicinal use may lead to alterations in the eCBs levels and in the endocannabinoid system homeostasis In this work, it was studied the impact of CBs in BeWo trophoblastic cells and in primary cultures of human cytotrophoblasts. Cells were treated for 24 hours with different concentrations of THC, the synthetic cannabinoid WIN‐55,212 (WIN) and 2-AG. Treatment with THC did not affect BeWo cells viability while WIN and 2-AG caused a dose-dependent viability loss. Morphological studies together with biochemical markers indicate that 2-AG is able to induce apoptosis in cytotrophoblasts. On the other hand, morphological studies after acridine orange staining suggest that autophagy may take part in WIN-induced loss of cell viability. All cannabinoids caused a decrease in mitochondrial membrane potential (Δψm) but only 2-AG led to ROS/RNS generation, though no changes in glutathione levels were observed. In addition, ER-stress may be involved in the 2-AG induced-oxidative stress, as preliminary results point to an increase in CCAAT-enhancer-binding protein homologous protein (CHOP) expression. Besides the decrease in cell viability, alterations in cell cycle progression were observed. WIN treatment induced a cell cycle arrest in G0/G1 phase, whereas 2-AG induced a cell cycle arrest in G2/M phase. Here it is reinforced the relevance of cannabinoid signaling in fundamental processes of cell proliferation and cell death in trophoblast cells. Since cannabis-based drugs are the most consumed illicit drugs worldwide and some of the most consumed recreational drugs by pregnant women, this study may contribute to the understanding of the impact of such substances in human reproduction.

Gospel Music Training, Performance Practice and Its Impact on Leadership Development and Performed Nationalism in a Collegiate Military Choir

Since America’s beginnings as a British colony, its musical standards have adhered to those of Western Europe. For this reason, musical forms native to America like Black folk spirituals and Gospel music have historically been marginalized in favor of music in the Western classical tradition. Today, a bias towards music of the Western classical tradition exists in those American universities that grant music degrees. While this bias is understandable, inclusion of Gospel music history and performance practice would result in a more complete understanding of American music and its impact on American nationalism. The United States Naval Academy is one of the few American universities that have consistently elevated the performance of Gospel music to the level of Western Classical music within its institutional culture. The motivations for writing this document are to provide a brief history of Gospel music in the United States and of choral music at the Naval Academy. These historical accounts serve as lenses though which the intersection of Gospel music performance practice and leadership development at the United States Naval Academy may be observed. During the last two decades of the twentieth century, Gospel music intersected American military culture at the U.S. Naval Academy. After a few student-led attempts in the 1970s, a Gospel Choir was formed in 1986 but by 1990, it had become an official part of the Music Department. Ultimately, it received institutional support and today, the Gospel Choir is one of three touring choirs authorized to represent the Academy in an official capacity. This document discusses the promotion of Gospel music by the Naval Academy in its efforts to diversify Academy culture and ultimately, Naval and Marine Corps leadership. Finally, this dissertation examines the addition of performed cultural expression (Gospel music) in light of a shift in American nationalism and discusses its impact on Naval Academy culture.

Millennial-scale fluctuations of the European Ice Sheet at the end of the last glacial, and their potential impact on global climate

Reconstructing Northern Hemisphere ice-sheet oscillations and meltwater routing to the ocean is important to better understand the mechanisms behind abrupt climate changes. To date, research efforts have mainly focused on the North American (Laurentide) ice-sheets (LIS), leaving the potential role of the European Ice Sheet (EIS), and of the Scandinavian ice-sheet (SIS) in particular, largely unexplored. Using neodymium isotopes in detrital sediments deposited off the Channel River, we provide a continuous and well-dated record for the evolution of the EIS southern margin through the end of the last glacial period and during the deglaciation. Our results reveal that the evolution of EIS margins was accompanied with substantial ice recession (especially of the SIS) and simultaneous release of meltwater to the North Atlantic. These events occurred both in the course of the EIS to its LGM position (i.e., during Heinrich Stadial –HS– 3 and HS2; ∼31–29 ka and ∼26–23 ka, respectively) and during the deglaciation (i.e., at ∼22 ka, ∼20–19 ka and from 18.2 ± 0.2 to 16.7 ± 0.2 ka that corresponds to the first part of HS1). The deglaciation was discontinuous in character, and similar in timing to that of the southern LIS margin, with moderate ice-sheet retreat (from 22.5 ± 0.2 ka in the Baltic lowlands) as soon as the northern summer insolation increase (from ∼23 ka) and an acceleration of the margin retreat thereafter (from ∼20 ka). Importantly, our results show that EIS retreat events and release of meltwater to the North Atlantic during the deglaciation coincide with AMOC destabilisation and interhemispheric climate changes. They thus suggest that the EIS, together with the LIS, could have played a critical role in the climatic reorganization that accompanied the last deglaciation. Finally, our data suggest that meltwater discharges to the North Atlantic produced by large-scale recession of continental parts of Northern Hemisphere ice sheets during HS, could have been a possible source for the oceanic perturbations (i.e., AMOC shutdown) responsible for the marine-based ice stream purge cycle, or so-called HE's, that punctuate the last glacial period.

The fisheries of the Kyoga lakes and the likely impact on them by human activities in the catchment

A review of the historical development of the fishery resources of the Kyoga basin shows that the fishery based on the alien fishes which surplanted the indigenous species in the 1960's and early 1970's has been evolving. The record catches of the 19705 and early 1980's were mainly influenced by increased nutrient supply and enlarged lake volume. The sudden collapse in the fishery particularly of the Nile perch in the mid 1980's was most probably imposed by bad fishing regimes. However, future trends in the fisheries of the Kyoga basin will most likely be controlled by nutrient availability and dynamics as well as by the impact of mans activities in the Kyoga catchment.

Forty years of consumer protection, 1975-2015 : the Department of Consumer Affairs’ impact on South Carolina

This gives a short history of the Department of Consumer Affairs.

PISA Tests and their Impact on Georgian Education System

The article discusses the PISA (Programme for International Student Assessment) tests and their impact on the Georgian Education System. It analyzes the deplorable results of Georgian 15-yearolds in PISA 2009 and investigates the reasons based on different reports. The article also discusses the reasons for the temporary suspension of the project on the Georgian side. Since certain participatory countries are dissatisfied with the attitudes of this program, the article also refers to the criticism of PISA. The conclusion is that PISA and other international tests contain considerably important information. If these data with a diagnostic feature are used for working out the education policy in an appropriate way, they can become the key instrument for obtaining favourable results in reforming the Education System. Therefore, PISA appears to be essential for Georgia too, as such assessment gives an opportunity to concentrate on the national core curriculum and content analysis. In order to estimate all the strengths and weaknesses of the Education System, it is quite reasonable to conduct such surveys in every country. The article concludes with recommendations for PISA 2015 as to how to use the reports for further progress.

Dietary programme impact on biochemical markers in diabetics: systematic review

Given the high prevalence of diabetes in the population and in the elderly, it’s crucial to raise awareness of the need for people to change their eating habits and adopt healthier lifestyles. Nutrition interventions emphasizing the promotion of healthy eating have been shown to be an important point in Diabetes Mellitus treatment since it fosters a better glycaemic control. Objectives: To determine the effectiveness of the implementation of a dietary programme in the amounts of glucose and the lipid profile in patients with Diabetes mellitus. Methods A systematic review of the literature published in 2015 in PubM

Study of led lamps technologies impact on the utility

With the growing interest in the issue of reducing powerconsumption in electricity applications, energy-saving devises and the problem of their operation gains more attention. The increase in the utilization of energy-saving lamps, especially LED lamps, leads to the wide interest in their influence on the power system. The impact of discussed devices on the voltage and current in the grid must be thoroughly studied before launching devices into the market. The studies undertaken on the LED lamps present in a wide range the issue of harmonic emission from lamps and their influence on power quality. Due to many anufacturing technologies, different LED devices can have various effects on the utility. It is significant to carry out researches concerning the adverse effects of energy-saving lamps in order to utilize devices that meet certain requirements which are set by the international commissions.

Dietary program impact on biochemical markers in diabetics: systematic review

Diabetes mellitus is a chronic disorder with major expansion worldwide. It’s estimated that the number of diabetes sufferers increase rapidly in the coming decades due to the population ageing (Ena,2016;IDF,2015). The nutrition intervention emphasizing the promotion of healthy eating has been shown to be an importante point in Diabetes Mellitus treatment since it fosters a better glycemic control and lipid profile (ADA2016).

Nutritional status and its impact on time and relocation in postoperative complications of abdominal patients undergoing surgery

Introduction: The nutritional state is the independent factor that most influences the post-operational results in elective surgeries. Objective: to evaluate the influence of the nutritional state on the hospitalization period and on the post-operative complications of patients submitted to abdominal surgery. Methods: prospective study with 99 surgical patients over 18 years of age, submitted to abdominal surgeries in the period from April to October of 2013, in the Instituto de Medicina Integral Professor Fernando Figueira (IMIP). All patients were submitted to anthropometric nutritional evaluations through the body mass Index (BMI), arm circumference (AC) and triceps skinfold thickness (TEST). The biochemical evaluation was carried out from the leukogram and serum albumin results. The identification of candidate patients to nutritional therapy (NT) was carried out through the nutritional risk (NR) evaluation by using the BMI, loss of weight and hypoalbuminemia. The information about post-operational complications, hospitalization period and clinical diagnosis was collected from the medical records. Program SPSS version 13.0 and significance level of 5% were used for the statistical analysis. Results: The malnutrition diagnosed by the AC showed significant positive association with the presence of post-operative complications (p=0.02) and with hospitalization period (p=0.02). The presence of NR was greater when evaluated by hypoalbuminemia (28.9%), however, only 4% of the sample carried out the NT in the pre-operational period. The hospitalization period was greater for patients with malignant neoplasia (p<0.01). Conclusion: The malnutrition diagnosis of patients submitted to abdominal surgeries is associated to greater risk of post-operational complications and longer hospitalization permanence.

Plant Migrations Impact on Potential Vegetation and Carbon Redistribution in Northern North America from Climate Change

Forests have a prominent role in carbon storage and sequestration. Anthropogenic forcing has the potential to accelerate climate change and alter the distribution of forests. How forests redistribute spatially and temporally in response to climate change can alter their carbon sequestration potential. The driving question for this research was: How does plant migration from climate change impact vegetation distribution and carbon sequestration potential over continental scales? Large-scale simulation of the equilibrium response of vegetation and carbon from future climate change has shown relatively modest net gains in sequestration potential, but studies of the transient response has been limited to the sub-continent or landscape scale. The transient response depends on fine scale processes such as competition, disturbance, landscape characteristics, dispersal, and other factors, which makes it computational prohibitive at large domain sizes. To address this, this research used an advanced mechanistic model (Ecosystem Demography Model, ED) that is individually based, but pseudo-spatial, that reduces computational intensity while maintaining the fine scale processes that drive the transient response. First, the model was validated against remote sensing data for current plant functional type distribution in northern North America with a current climatology, and then a future climatology was used to predict the potential equilibrium redistribution of vegetation and carbon from future climate change. Next, to enable transient calculations, a method was developed to simulate the spatially explicit process of dispersal in pseudo-spatial modeling frameworks. Finally, the new dispersal sub-model was implemented in the mechanistic ecosystem model, and a model experimental design was designed and completed to estimate the transient response of vegetation and carbon to climate change. The potential equilibrium forest response to future climate change was found to be large, with large gross changes in distribution of plant functional types and comparatively smaller changes in net carbon sequestration potential for the region. However, the transient response was found to be on the order of centuries, and to depend strongly on disturbance rates and dispersal distances. Future work should explore the impact of species-specific disturbance and dispersal rates, landscape fragmentation, and other processes that influence migration rates and have been simulated at the sub-continent scale, but now at continental scales, and explore a range of alternative future climate scenarios as they continue to be developed.