946 resultados para OD practitioner


Relevância:

10.00% 10.00%

Publicador:

Resumo:

Se estudia la influencia de los siguientes factores sobre el valor del cociente de feofitinización DO 435 nm/DO 415 nm en el líquen Anaptychia ciliaris (L.) Kórber: edad del líquen, concentración final de pigmentos, trasplante de los líquenes a áreas distintas sobre sustratos diferentes o similares y el valor de pH del sustrato original o el adoptado tras el trasplante. Se discute la utilización de A. ciliaris como un bioindicador de la presencia de factorcs acidificantes en la atmósfera o en el agua de lluvia que provoquen la feofitinización de las clorofilas.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

Una de las cuencas hidrográficas más importante de la Península es la del río Tajo, por su extensión y por su caudal. Se trata de una fosa tectónica calificable de modélica. Dos moles montañosas, el Sistema central y los Montes de Toledo en sentido amplio, la flanquean al Norte y al Sur. La dovela hundida, formada por idénticos materiales que las Sierras, granitos y gneis, alcanza una gran profundidad. Al Este el Sistema Ibérico castellano, principalmente calizo y mesozoico, cierra Castilla y la cuenca, viniendo a dar vida con el agua de sus nieves a un Tajo niño’. El inicio de su Historia Geológica podemos situarlo en el Paleozoico, tiempo geológico durante el cual los territorios donde hoy se sitúa la Meseta estaban formando grandes cordilleras producto de la Orogenia Herciniana. La última etapa de la formación de los relieves actuales de la cuenca la encontramos en la reactivación de los antiguos macizos arrasados. Se inicia con los materiales de la raña y sus equivalentes en el centro de la Cuenca o Fosa del Tajo, y se caracteriza por una progresiva individualización de los procesos, pasándose de las grandes superficies generalizadas en macizos y cuencas, Sierras y Fosa del Tajo, a las pequeñas llanuras en franja u orla, que quedan localizadas en cada cuenca fluvial a medida que éstas se van consolidando por jerarquización, y partir de un río generatriz o emisario principal, el Tajo. La tectónica, procesos posteriores de captura, reajustes climáticos..., no permiten aún determinar cuál fue el orden de jerarquía en los ríos que hoy conocemos; no obstante, puede aventurarse que Jarama-Henares, Perales-Alberche y Guadarrama serían los primeros y Manzanares, Guadalix, Tajuña, los siguientes, y así sucesivamente. La síntesis de la realidad geológica, litológica y climática va a coadyuvar, frenando o favoreciendo, el desarrollo y la diferenciación entre los paisajes vegetales de las zonas montañosas y los de las depresiones terciarias y penillanuras paleozoicas, en un territorio marcado por el predominio del clima mediterráneo continentalizado, con matices de montaña y áreas de influencia atlántica.

Relevância:

10.00% 10.00%

Publicador:

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.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

This article takes a multidimensional or biopsychosocial conception of drug dependency as its starting point. Within this analytical framework, we advocate making the intercultural dimension more visible, since it is essential for the design and implementation of integral intervention processes. We propose intercultural competence as a working model that can increase the capacities of institutions and professionals —a particularly important consideration in the case of social work— in order to effectively address the aforementioned cultural dimension. After an extensive review of the scientific literature, we have defined five processes that can contribute to strengthening an institution’s intercultural competence and four processes that can do the same for a professional’s intercultural competence. Though selected for application in the area of drug dependencies, all these processes can also prove useful in improving attention to any other kind of culturally diverse group or person.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

Objective To evaluate participants' perceptions of the impact on them of an additional six months' training beyond the standard 12 month general practice vocational training scheme. Design Qualitative study using focus groups. Setting General practice vocational training in Northern Ireland. Participants 13 general practitioner registrars, six of whom participated in the additional six months' training, and four trainers involved in the additional six months' training. Main outcome measures: Participants' views about their experiences in 18 month and 12 month courses. Results Participants reported that the 12 month course was generally positive but was too pressurised and focused on examinations, and also that it had a negative impact on self care. The nature of the learning and assessment was reported to have left participants feeling averse to further continuing education and lacking in confidence. In contrast, the extended six month component was reported to have restimulated learning by focusing more on patient care and promoting self directed learning. It developed confidence, promoted teamwork, and gave experience of two practice contexts, and was reported as valuable by both ex-registrars and trainers. However, both the 12 and 18 month courses left participants feeling underprepared for practice management and self care. Conclusions 12 months' training in general practice does not provide doctors with the necessary competencies and confidence to enter independent practice. The extended period was reported to promote greater professional development, critical evaluation skills, and orientation to lifelong learning but does not fill all the gaps.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

This article provides an account of practice-based research of, at least, one-star quality in terms of its contribution to both theory and practice. Aimed at practitioner (as opposed to academic) psychologists, the article addresses a dimension of the practitioner role that has remained silent in the literature. The article makes creative and original connections between school effectiveness, school improvement and education in a divided society. Post 11th September, the article was described as being highly original, significant and relevant to all practising educational psychologists. Concrete evidence for this is gained from, eg: hits on the online electronic version (2002-2003 Annual Report of the Association of Educational Psychologists), citations in reviews of research, and author invitations to present his work at UK and international practitioner psychology conferences. The article is published in the premier journal reporting on quality applied educational research and practice within the United Kingdom and beyond.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

Objectives: To determine whether diagnostic triage by general practitioners (GPs) or rheumatology nurses (RNs) can improve the positive predictive value of referrals to early arthritis clinics (EACs).

Methods: Four GPs and two RNs were trained in the assessment of early in?ammatory arthritis (IA) by four visits to an EAC supervised by hospital rheumatologists. Patients referred to one of three EACs were recruited for study and assessed independently by a GP, an RN and one of six rheumatologists. Each assessor was asked to record their clinical ?ndings and whether they considered the patient to have IA. Each was then asked to judge the appropriateness of the referral according to predetermined guidelines. The rheumatologists had been shown previously to have a satisfactory level of agreement in the assessment of IA.

Results: Ninety-six patients were approached and all consented to take part in the study. In 49 cases (51%), the rheumatologist judged that the patient had IA and that the referral was appropriate. The assessments of GPs and RNs were compared with those of the rheumatologists. Levels of agreement were measured using the kappa value, where 1.0 represents total unanimity. The kappa value was
0.77 for the GPs when compared with the rheumatologists and 0.79 for the RNs. Signi?cant stiffness in the morning or after rest and objective joint swelling were the most important clinical features enabling the GPs and RNs to discriminate between IA and non-IA conditions.

Conclusion: Diagnostic triage by GPs or RNs improved the positive predictive value of referrals to an EAC with a degree of accuracy approaching that of a group of experienced rheumatologists.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

This article reports on the first extensive survey of Approved Social Worker (ASW) activity under the Mental Health (Northern Ireland) Order 1986. The integrated health and social services organizational structure, the adverse effects on individual mental health of the legacy of thirty years of civil conflict and the move from hospital to community care are significant features which have influenced the delivery of mental health social work services locally. The practice and experience of ASWs was surveyed by postal questionnaire and user and carer experience of compulsory hospital admission was investigated by a series of focus groups. The study revealed that two‐thirds of ASWs had experience of acting as an applicant in compulsory hospital admission during the past two years. Nearly half (42 per cent) of these ASWs had reported experience of between one and five admissions and one‐tenth had completed over twenty admissions in the two‐year period. In only a small minority of cases did joint face‐to‐face assessment with the General Practitioner (doctor) take place; nearly half of ASWs reported difficulties in obtaining transport; and only one‐fifth of ASWs had experience of acting as a second approved social worker. Half of ASWs reported experience of guardianship, either as applicant or in making the recommendation. Both service users and carers reported a lack of understanding about the role of the ASW and complained about the lack of alternative resources that ASWs could use to prevent hospital admissions. These findings are discussed and a number of recommendations are proposed for improvements to approved social worker practice.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

Objective: To apply the UK Medical Research Council (MRC) framework for development and evaluation of trials of complex interventions to a primary healthcare intervention to promote secondary prevention of coronary heart disease. Study Design: Case report of intervention development. Methods: First, literature relating to secondary prevention and lifestyle change was reviewed. Second, a preliminary intervention was modeled, based on literature findings and focus group interviews with patients (n = 23) and staff (n = 29) from 4 general practices. Participants’ experiences of and attitudes toward key intervention components were explored. Third, the preliminary intervention was pilot-tested in 4 general practices. After delivery of the pilot intervention, practitioners evaluated the training sessions, and qualitative data relating to experiences of the intervention were collected using semistructured interviews with staff (n = 10) and patient focus groups (n = 17). Results: Literature review identified 3 intervention components: a structured recall system, practitioner training, and patient information. Initial qualitative data identified variations in recall system design, training requirements (medication prescribing, facilitating behavior change), and information appropriate to the prospective study participants. Identifying detailed structures within intervention components clarified how the intervention could be tailored to individual practice, practitioner, and patient needs while preserving the theoretical functions of the components. Findings from the pilot phase informed further modeling of the intervention, reducing administrative time, increasing practical content of training, and omitting unhelpful patient information. Conclusion: Application of the MRC framework helped to determine the feasibility and development of a complex intervention for primary care research.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

The aim of this work is to show the type of media coverage done by the newspapers La Razón, El País and Público about the 15-M social movement during the time that the camping at Sol took place. Specifically, in terms of how the characterization of the “indignados” (outraged) got made. Based on our previous descriptive observations, we approached a visual analysis of the photographs published on the paper editions of those mainstream media from May 15-June 12 of the 2011. we started from a total sample of 379 items, developing:1) A content analysis of La Razón, El País, and Público; the most frequents words of each media, articles classifications from the reviews found on them (expositive, positive-evaluation, negative-evaluation).2) An analysis of the 408 images obtained from the total sample, which establishes a clear evolution of the “indignados” profile and how differently each media took the movement as such. That’s, when they stop naming them “indignados”, and recognize its nature as social movement by calling it: “Movimiento 15-M"...

Relevância:

10.00% 10.00%

Publicador:

Resumo:

Se propone un planteamiento teórico/conceptual para determinar si las relaciones interorganizativas e interpersonales de la netchain de las cooperativas agroalimentarias evolucionan hacia una learning netchain. Las propuestas del trabajo muestran que el mayor grado de asociacionismo y la mayor cooperación/colaboración vertical a lo largo de la cadena están positivamente relacionados con la posición horizontal de la empresa focal más cercana del consumidor final. Esto requiere una planificación y una resolución de problemas de manera conjunta, lo que está positivamente relacionado con el mayor flujo y diversidad de la información/conocimiento obtenido y diseminado a lo largo de la netchain. Al mismo tiempo se necesita desarrollar un contexto social en el que fluya la información/conocimiento y las nuevas ideas de manera informal y esto se logra con redes personales y, principalmente, profesionales y con redes internas y, principalmente, externas. Todo esto permitirá una mayor satisfacción de los socios de la cooperativa agroalimentaria y de sus distribuidores y una mayor intensidad en I+D, convirtiéndose la netchain de la cooperativa agroalimentaria, así, en una learning netchain.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

Aim The aim of this paper is to challenge recent sceptical approaches to the possibility of validating qualitative research and to underline the benefits of adopting a realist approach to validity. Background In recent discussion about the methodological bases for qualitative research it has been argued that, because different methodologies take different approaches to validity, attempts to develop a common set of validation criteria are futile. On the basis of this sceptical view, a number of strategies for judging qualitative research have been proposed. These include suggestions that: it should be judged according to aesthetic or rhetorical criteria, rather than epistemological validity; responsibility for appraisal should move from researchers to readers; each methodology should be assessed individually according to its own merits. Discussion None of these suggestions provide a viable alternative to validity, defined as the extent to which research reflects accurately that to which it refers. Because the form of research does not determine its content, replacement of epistemology by aesthetics is unsustainable. Because research reports mediate between writer and reader, a one-sided approach to this relationship constitutes a false dichotomy. If we accept the criterion of practitioner confidence as a means of judging methodological approaches, this involves rejection of judgement according to a methodology�s own merits. Conclusion If qualitative research is actually about something, and if it is required to provide beneficial information, then a realist approach to validity holds out greatest promise.