993 resultados para priority setting


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Objective: An exploratory study to identify patterns of communication behaviour among hospital based healthcare workers.

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Objectives: To estimate the incidence of HIV and hepatitis C virus and risk factors for seroconversion among a cohort of injecting drug users.

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Both lifestyle and geography make the delivery of consumer health information in the rural setting unique. The Planetree Health Resource Center in The Dalles, Oregon, has served the public in a rural setting for the past eight years. It is a community-based consumer health library, affiliated with a small rural hospital, Mid-Columbia Medical Center. One task of providing consumer health information in rural environments is to be in relationship with individuals in the community. Integration into community life is very important for credibility and sustainability. The resource center takes a proactive approach and employs several different outreach efforts to deepen its relationship with community members. It also works hard to foster partnerships for improved health information delivery with other community organizations, including area schools. This paper describes Planetree Health Resource Center's approach to rural outreach.

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Dialectical Behavioral Therapy (DBT) is an empirically supported therapy developed to treat individuals with Borderline Personality Disorder that has sustained efficacy following completion of the treatment (Linehan, 1993; Van Den Bosch et al., 2005). The core concepts of DBT include mindfulness, interpersonal effectiveness, emotional regulation, and distress tolerance, which seek to foster more functional ways of interacting with others, coping with distress, and managing difficult emotions. Using a standard DBT format in a corrections setting can be difficult due to the population's multifaceted composition. The Denver County Jail is a unique corrections setting because it contains a unit specifically developed for male inmates with mental health issues. A corrections modified, time-limited DBT curriculum was developed to fit the needs of this unique population. During the course of the group, staff appeared to be accepting of the group material and initial feedback from inmates and officers was positive.

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Abstract This paper investigates themes and parallels related to the traumatic experiences women face within the correctional setting and how these experiences influence women's behavior choices that increase their risk of recidivism. Intersubjective Systems Theory is used to conceptualize the distinct dynamics and impact of trauma with this particular population. Intersubjectivity also informs the changes needed to create an environment that would help women in correctional settings to heal, avoid recidivism, and foster successful community reintegration. Principles from Intersubjective Systems Theory are reviewed in this paper to demonstrate: (a) how developmental trauma impacts the lives of incarcerated women, (b) how these women's attempts at self-healing are often maladaptive and lead to arrests, (c) how the current climate in corrections leads to retraumatization and promotes later recidivism, and (d) what changes in the corrections system would promote optimal healing and better outcomes for incarcerated women. Improved outcomes are defined as healthy boundaries, empowerment in choice of relationships, improvement of social support and occupational skills, and reduction of relapse and recidivism.

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As society becomes increasingly less binary, and moves towards a more spectrum based approach to mental illness, medical illness, and personality, it becomes necessary to address this shift within formerly rigid institutions. This paper explores this shift as it is occurring within correctional settings around the United States concerning the medical care, housing, and safety of transgendered inmates. As there is no legal standard for the housing or access to gender-affirming medical care (i.e., hormone therapy, sexual reassignment surgery), these issues are addressed on an institutional level, with very little consistency throughout the country. Currently, most institutions follow a genitalia-based system of classification. Within the system, core beliefs are held, some adaptive and some no longer adaptive, that drive the system's behavior and outcomes. With regard to transgendered inmates, several underlying beliefs within the system serve to maintain the status quo; however, the most basic underpinning is the system's reliance on a binary gender system. As views of humane treatment of the incarcerated expand and modernize, the role of mental health within corrections has also expanded. Psychologists, social workers, counselors, and psychiatrists are found in almost all correctional facilities, and have become a voice of advocacy for an often underserved population.

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Backbone networks are responsible for long-haul data transport serving many clients with a large volume of data. Since long-haul data transport service must rely on a robust high capacity network the current technology broadly adopted by the industry is Wavelength Division Multiplexing (WDM). WDM networks enable one single ber to operate with multiple high capacity channels, drastically increasing the ber capacity. In WDM networks each channel is associated with an individual wavelength. Therefore a whole wavelength capacity is assigned to a connection, causing waste of bandwidth in case the connection bandwidth requirement is less than the channel total capacity. In the last half decade, Elastic Optical Networks (EON) have been proposed and developed based on the fexible use of the optical spectrum known as the exigrid. EONs are adaptable to clients requirements and may enhance optical networks performance. For these reasons, research community and data transport providers have been demonstrating increasingly high interest in EONs which are likely to replace WDM as the universally adopted technology in backbone networks in the near future. EONs have two characteristics that may limit its ecient resources use. The spectrum fragmentation, inherent to the dynamic EON operation, decrease the network capacity to assign resources to connection requests increasing network blocking probability. The spectrum fragmentation also intensifides the denial of service to higher rate request inducing service unfairness. Due to the fact EONs were just recently developed and proposed, the aforementioned issues were not yet extensively studied and solutions are still being proposed. Furthermore, EONs do not yet provide specific features as differentiated service mechanisms. Differentiated service strategies are important in backbone networks to guarantee client\'s diverse requirements in case of a network failure or the natural congestion and resources contention that may occur at some periods of time in a network. Impelled by the foregoing facts, this thesis objective is three-fold. By means of developing and proposing a mechanism for routing and resources assignment in EONs, we intend to provide differentiated service while decreasing fragmentation level and increasing service fairness. The mechanism proposed and explained in this thesis was tested in a EON simulation environment and performance results indicated that it promotes beneficial performance enhancements when compared to benchmark algorithms.

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In Shelby County v. Holder the Supreme Court invalidated key provisions of the Voting Rights Act of 1965 based on Congress’s failure to justify the formula used to determine which jurisdictions would be subject to the Act’s pre-clearance requirement of submitting all changes to voting procedures to the Justice Department for prior approval. This short essay explores one problematic feature of the Court’s analysis: its refusal to consider the legislative record as adequate because it was created to justify the coverage formula after the fact, rather than to facilitate deliberation on the coverage formula before a decision had been made. This reasoning essentially imports from administrative law a rule called the Chenery principle, and as this essay explains, it does so without justification. The differences between administrative and legislative decision making processes compel different treatment by the courts, and treating legislative records like administrative ones, in essence, asks of Congress something it is institutionally ill-equipped to perform. It sets Congress up to fail.

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A wealth of open educational resources (OER) focused on green topics is currently available through a variety of sources, including learning portals, digital repositories and web sites. However, in most cases these resources are not easily accessible and retrievable, while additional issues further complicate this issue. This paper presents an overview of a number of portals hosting OER, as well as a number of “green” thematic portals that provide access to green OER. It also discusses the case of a new collection that aims to support and populate existing green collections and learning portals respectively, providing information on aspects such as quality assurance/collection and curation policies, workflow and tools for both the content and metadata records that apply to the collection. Two case studies of the integration of this new collection to existing learning portals are also presented.

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This paper draws mainly on the work of Elizabeth Sanders who has being practising, thinking and mapping participatory design research for over 25 years, connecting it to insights from Maturana (1984), Capra (2002), Jovchelovitch (1995, 2000, 2007) and Preece (2011), to propose that the process of design per se is a relational domain of cocreativity that is essential to construct a way toward deeper sustainability.

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First and second year students enrolled in a four-year movement education based university Physical Education program completed a questionnaire regarding their expectations on entering university. In addition, graduates of the program were interviewed, one year after graduation, with regard to their understanding of and attitude towards movement education and how these had developed relative to their overall degree program. Most students had no knowledge of movement education prior to entering the program and the selection of this particular program was simply coincidental with their desire to pursue physical education. Whereas the students did participate in an activity course and a theory course in Year 1, it was only when participating in a Year 2 movement course which combined theory and practice within the same course that students recognized the movement base of the content. The progress of the students through the program reflects distinct declarative and procedural stages in knowledge development followed by an ability to generalize that knowledge a conceptual stage. The real understanding of movement education came as the students were required to teach movement education to students, children, and other groups.

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European public sectors are particularly affected by the demographic challenge and an ageing and shrinking workforce. According to OECD statistics, over 30% of public employees of central government in 13 countries will leave during the next 15 years. Moreover, the public sector has as compared to the private sector to rely on a much older workforce, who will have to work longer in future. Against this background, European governments need to react and re-think major elements of current HR and organisational management in the public sector. Particularly the skills in age management should be improved in order to also maintain in future a highly productive, competent and efficient public sector and to ensure that public employees stay longer ‘employable’, ‘healthy’, ‘fit for the job’ and ‘up to the task’. The survey suggests some solutions by investing more in three priority areas in the field of HRM.

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Standards reduce production costs and increase products’ value to consumers. Standards however entail risks of anti-competitive abuse. After the adoption of a standard, the chosen technology normally lacks credible substitutes. The owner of the patented technology might thus have additional market power relative to locked-in licensees, and might exploit this power to charge higher access rates. In the economic literature this phenomenon is referred to as ‘hold-up’. To reduce the risk of hold-up, standard-setting organisations often require patent holders to disclose their standard-essential patents before the adoption of the standard and to commit to license on fair, reasonable and non-discriminatory (FRAND) terms. The European Commission normally investigates unfair pricing abuse in a standard-setting context if a patent holder who committed to FRAND ex-ante is suspected not to abide to it ex-post. However, this approach risks ignoring a number of potential abuses which are likely harmful for welfare. That can happen if, for example, ex-post a licensee is able to impose excessively low access rates (‘reverse hold-up’) or if a patent holder acquires additional market power thanks to the standard but its essential patents are not encumbered by FRAND commitments, for instance because the patent holder did not directly participate to the standard setting process and was therefore not required by the standard-setting organisations to commit to FRAND ex-ante. A consistent policy by the Commission capable of tackling all sources of harm should be enforced regardless of whether FRAND commitments are given. Antitrust enforcement should hinge on the identification of a distortion in the bargaining process around technology access prices, which is determined by the adoption of the standard and is not attributable to pro-competitive merits of any of the involved players.