An examination of the role of the sports and exercise medicine specialist in Ireland- from epidemiology to treatment

The expansion of the specialty of sports and exercise medicine (SEM) is a relatively recent development in the medical community and the role of the SEM specialist continues to evolve and develop. The SEM specialist is ideally placed to care for all aspects of physical activity not only in athletes but also in the general population. As an advocate for physical activity the SEM specialist plays a broad role in advising safe effective sports and recreation participation; screening for disease related to sports participation; examining and contributing to the evidence behind treatment strategies and evaluating any potential negative impact of sports injury prevention measures. In this thesis I will demonstrate the breadth of the role the Sports and Exercise Medicine Specialist from epidemiology to in-depth examination of treatment strategies. In Chapter 2, I examined the epidemiology of sports and recreation related injury (SRI) in Ireland, an area that has previously been poorly studied. We report on 3,172 SRI (14% of total presentations) presentations to the ED over 6 months. Paediatric patients (4-16 yrs) were over represented comprising 39.9% of all SRI presentation compared to 16% of total ED presentations and 18% of the general population. These injuries were serious (32% fractures) and though 49% of injuries occurred during organised competition/practice, 41.5% occurred during recreation-most often at home. In Chapter 3, I examined risk factors associated with hand injury in hurling. The previous chapter highlighted the importance of a firm evidence base underpinning treatment strategies. When measures to improve welfare are introduced not only must potential benefits be measured, so too must potential unwanted adverse outcomes. In this study I examined a cohort of adult hurlers who had presented to the ED with a hurling related injury in order to highlight the variables associated with hand injury in this population. I found the athletes who wore a helmet were far more likely (OR 3.15 95% CI (1.51-6.56) p= 0.002) to suffer a hand injury than athletes who did not. Very few of those interviewed (4.9%) used hand protection compared to 65% who used helmet and faceguard. The introduction of the helmet and faceguard in hurling has undeniably decreased the incidence of head and face injury in hurling. However in tandem with this intervention several observational studies have demonstrated an increase in the occurrence of hurling related hand injuries. This study highlights the importance of being cognisant of unanticipated or unintended consequences when implementing a new treatment or intervention. In Chapter 4, I examined the role of population screening as applied to sport and exercise. This is a controversial area –cardiac screening in the exercising population has been the subject of much debate. Specifically I define the prevalence of exercise induced bronchoconstriction (EIB) using a specifically designed sports specific field-testing protocol. In this study I found almost a third (29%) of a full international professional rugby squad had confirmed asthma or EIB, as compared with 12-15% of the general population. Despite regular medical screening, 5 ‘new’ untreated cases (12%) were elicited by the challenge test and in the group already on treatment for asthma/EIB; over 50% still displayed EIB. In Chapter 5, I examined the evidence supporting current treatment options for iliotibial band friction syndrome (ITBFS). The practice of sports medicine has traditionally been ‘eminence based’ rather than ‘evidence based’. This may be problematic as some of these practices are based upon flawed principles- for example the treatment of iliotibial band friction syndrome (ITBFS). In this chapter, using cadaveric and biomechanical studies I expand upon the growing base of evidence clarifying the anatomy and biomechanics of the area-thereby re-examining the principles on which current treatments are based. The role of the SEM specialist is broad; we chose to examine specific examples of some of the roles that they execute. An understanding of the epidemiology of SRI presenting to the ED has implications for individual patients, sports governing bodies and health resource utilisation. Population screening is an important tool in health promotion and disease prevention in the general population. Screening in SEM may have similar less well-recognised benefits. The SEM specialist needs to be conversant in screening for medical conditions concerning physical activity. A comprehensive understanding of the pathophysiology of a disease is required for its diagnosis and treatment. Due to the ongoing evolution of SEM many treatments are eminence-based rather than evidence‐based practice. Continued re-examination of the fundamentals of current practice is essential. An awareness of potential unwanted side effects is essential prior to the introduction of any new treatment or intervention. The SEM specialist is ideally placed to advise sports governing bodies on these issues prior to and during their implementation.

A Study of the Relational Component in an Academic Advisor Professional Development Program

The purpose of the study was to investigate the significance of the relational component of academic advisor training and development in the learning opportunities of the professional development program and the advisors’ evaluation score at Florida International University.

El multilateralismo como intervencionismo. Estados Unidos y la Sociedad de Naciones en América Latina (1930-1946)

Este artículo analiza una dinámica de intervenciones de Estados Unidos en América Latina que no ha atraído suficientemente la atención de los historiadores. En los años treinta y cuarenta, cuando Europa se hundía en una nueva confrontación bélica, ciertos sectores del gobierno y del mundo empresarial norteamericano intentaron articular una nueva relación con los países del continente basada en una propuesta de multilateralismo que se había configurado dentro de la Sociedad de Naciones (SN). Estos estadounidenses intentaron establecer una dinámica de relaciones triangulares con los gobiernos latinoamericanos y los organismos técnicos de la SN. Gracias a ello, como se mostrará en este artículo para el caso del funcionamiento del Comité Fiscal de la Sociedad de Naciones, los latinoamericanos fueron capaces de influir en el tipo de políticas que debían emanar de esta relación triangular. La importancia de esta historia no es menor. La relación triangular entre Estados Unidos, América Latina y la SN sirvió de base para la reconstrucción de la gobernanza global liderada por los Estados Unidos tras la guerra.

Welke 'acteur' neemt de controllerrol als extraverte business partner?

Which 'actor' takes the management accountant role as an extravert business partner? Does a relation between the personal trait Extraversion and fulfilling a management accountant role as a business partner exist? Open Universiteit Nederland End thesis MSc Management, Accounting & Finance Support 1: Prof. dr. A.C.N. van de Ven RA Support 2: dr. P.C.M. Claes Examinator: dr. P. Kamminga Date of approval: September 3, 2014 student: P.R. van der Wal (studentnumber 839104017 email petervanderwal2003@yahoo.com The main question of this research is: Does a relation between the personal trait Extraversion and fulfilling a management accountant role as a business partner exist? This research is based on the dataset obtained by the controller survey 2013, executed in commission of the 'Open Universiteit' (Bork & van der Wal, 2014). From the literature review it is clear: among other management accountant roles we need business partners. And there is a relation between the personal trait Extraversion and fulfilling the role as business partner. At the same time a lack of necessary personal traits for this role has been noticed, among which is Extraversion. The factor- and cluster analyses reported by Bork & van der Wal (2014) resulted in the identification of two types of management accountant roles. In this extended research TYPE II is identified as a business partner because (s)he practices activity-combinations which are related to strategy, analyzing, supporting management in decision making, advisory, change-agency and representing the organization. 36% of the population of Dutch management accountants with a master degree (or similar) meet with the role of the business partner. Although the fulfillment of the role (TYPE II) is not purely business partnering. E.g. reporting and scorekeeping are still activities executed by TYPE II and it is not clear to what extent. Apart from that, role TYPE I executes change management and risk-management activities, which are (according to the definition) activities that belong to the business partner. The role as business partner is practiced but not that optimal as defined in theory. The logistic regression analyses on the survey-data show that Extraversion among three other triggers is significant for the prediction of the fulfillment of the management accountant role (Bork & van der Wal, 2014). A more extravert personal trait predicts a preference for TYPE II, which relates to the business partner. This 'in depth research' concentrated on the relation between the Big Five personal traits and the six activity-combinations (factors) instead of on the two clusters (I and II). The statistic analyses confirm the predicting influence of Extraversion on the business partner role. Although, except for one factor, no extra significance has been found in this additional research. The essential question can be confirmed positively: the management accountant role business partner exists in practice, some management accountants are more extravert then others, and there is a positive relation between extraversion and fulfilling the business partner role. Some formulated research limitations are related to the statistical weakness of some prediction outcomes and to interpretation differences that might occur. Further research can e.g. concentrate on the other personal traits and the significance for role-differentiation in education programs. The management accountant survey 2013 Management accountant roles in 2013 in the Netherlands Open Universiteit Nederland End thesis MSc Management, Accounting & Finance Support 1: Prof. dr. A.C.N. van de Ven RA Support 2: dr. P.C.M. Claes Examinator: dr. P. Kamminga Date of approval: September 3, 2014 student: P.R. van der Wal and H.J. Bork studentnumber: 839104017 and 838532340) email: petervanderwal2003@yahoo.com and hjbork@hotmail.com This paper describes the conceptual model and results of the 'management accountants survey 2013'. The survey is part of a longitudinal survey, earlier executed in 2004, 2007 and 2010 under responsibility of the 'Open Universiteit Nederland'. Secondly the dataset of this survey will be used by us to do our own analyses on the predicting value of the triggers 'personality factor: extraversion' and 'lever of control: interactive controls' on the management accounting role that comes close to a role defined as 'Business Partner'. Scientific research shows that there are different management accounting roles, and that these roles change and that preferences exist for certain roles (Verstegen B. , Loo, Mol, Slagter, & Geerkens, 2007). The main question that will be answered in this paper is which coherent combinations of activities are being executed by management accountants in 2013 in the Netherlands by master-graduates? And secondly which triggers of management accountants' activities predict to which cluster a management accountant belongs? The conceptual model of this research has been developed in 2004 (Verstegen B. , Loo, Mol, Slagter, & Geerkens, 2007). For this research the same 37 activities as in the former researches are included (appendix 1). In the trigger-set (appendix 1) some adaptations have been made for reasons of restricting the length of the survey and to pinpoint on particular research goals (e.g. personality and levers of control). The coherent combinations of activities were found by a factor-analysis and the groups of controllers by a cluster analysis. A regression analysis shows which trigger-items are most significant. The survey has been sent to 2.353 students that finished a controller-study on a Dutch University. There was a 9% (211) response with a completely filled survey. 137 of which indicated to work in a controller-function at the moment. These controllers have been included in the results. The factor-analysis results in six different coherent combinations of activities (factors). Shortly these factors are: advising top management on strategic level with result-effecting information (1), organizing internal reporting (2) organizing and representing the organization on external reporting (3), advising and managing changes by shortcomings in processes and control systems (4), maintaining and managing administrative organization- , information- and control systems (5) and organizing/executing risk management and internal audit (6). Factors 4, 5 and 6 are clustered in cluster TYPE I (125 controllers) and factors 1, 2 and 3 in cluster TYPE II (69 controllers). TYPE II can be associated with the management accountant role 'Business Partner', although the accountant keeps partly active in a scorekeeper role. The four most significant triggers for predicting being a TYPE II controller are 'Executing a risk-management task in order to meet compliance standards' (1), extraversion (2), company size in terms of fte (3) and gender (4).

Humanização do atendimento à criança na atenção básica: visão dos profissionais

Objetivou-se compreender a humanização do atendimento à criança na Atenção Básica na visão dos profissionais. Estudo qualitativo, realizado em uma Unidade de Saúde da Família de Natal-RN, Brasil. Dezesseis profissionais responderam a um formulário contendo questões referentes ao atendimento à criança, à humanização e às práticas realizadas para humanizar o atendimento. Os dados foram categorizados por temas e analisados a partir dos princípios da Política Nacional de Humanização. Para os profissionais, humanizar o atendimento envolve acolher, escutar, aconselhar sobre o que está sendo realizado com a criança, valorizar a família, e tornar o sujeito ativo no atendimento, mesmo que de forma incipiente. A maioria dos profissionais descreveu atendimento que valorizava parte dos princípios da política de humanização, mesmo com dificuldades para implementá-los na rotina. Requer, portanto, estímulos e atualização dos profissionais para uma postura autocrítica sobre o atendimento

Persistent identifier Studies

The studies have aimed to overcome the confusing variety of existing persistent identifier systems, by; analysing the current national URN:NBN and other identifier initiatives providing guidelines for an international harmonized persistent identifier framework that serves the long-term preservation needs of the research and cultural heritage communities advising these communities about a roadmap to gain the potential benefits. This roadmap also includes a blueprint for an organisation for the distribution and maintenance of the Persistent Identifier infrastructure. These studies are connected to the broader PersId project with DEFF, SURF, DANS, the national libraries of Germany, Finland and Sweden and CNR and FDR from Italy. A number of organisations have been involved in the process: Europeana, the British library, the Dutch Royal Library, the National library of Norway and the Ministry of Education, Flanders, Belgium. PersID - III: Current State and State of the Art (IIIa) & User Requirements (IIIb) (Persistent Identifier: urn:nbn:nl:ui:13-9g4-i1s) PersID - IV: Prototype for a Meta Resolver System/ Work on Standards (Persistent Identifier: urn:nbn:nl:ui:13-wt1-6n9) PersID - V: Sustainability (Persistent Identifier: urn:nbn:nl:ui:13-o4p-8py) Please note that there are also two broader reports on the project as a whole: PersID - I: Project report and II:Communication. For further information please visit the website of the Persistent Identifier project: www.persid.org

Humanização do atendimento à criança na atenção básica: visão dos profissionais

Objetivou-se compreender a humanização do atendimento à criança na Atenção Básica na visão dos profissionais. Estudo qualitativo, realizado em uma Unidade de Saúde da Família de Natal-RN, Brasil. Dezesseis profissionais responderam a um formulário contendo questões referentes ao atendimento à criança, à humanização e às práticas realizadas para humanizar o atendimento. Os dados foram categorizados por temas e analisados a partir dos princípios da Política Nacional de Humanização. Para os profissionais, humanizar o atendimento envolve acolher, escutar, aconselhar sobre o que está sendo realizado com a criança, valorizar a família, e tornar o sujeito ativo no atendimento, mesmo que de forma incipiente. A maioria dos profissionais descreveu atendimento que valorizava parte dos princípios da política de humanização, mesmo com dificuldades para implementá-los na rotina. Requer, portanto, estímulos e atualização dos profissionais para uma postura autocrítica sobre o atendimento

Fluxo de Informação Financeira entre o Território Nacional e os Teatros de Operaçõe s: Abordagem Sociocrítica em contexto de mudança

O presente Trabalho de Investigação Aplicada encontra-se subordinado ao tema “Fluxo de Informação Financeira entre o Território Nacional e os Teatros de Operações: Abordagem Sociocrítica em contexto de mudança.”. Tendo em conta o contexto económico que o país atravessa, e que indiretamente afeta as organizações do Estado, através das consequentes reduções orçamentais, torna-se imprescindível que exista um aproveitamento dos recursos muito mais eficiente e eficaz. Neste contexto e face à existência em Território Nacional do Sistema Integrado de Gestão nas Instituições do Ministério de Defesa Nacional, nomeadamente no Exército, revelou-se indispensável a implementação desta ferramenta de gestão nas Forças Nacionais Destacadas dos Teatros de Operações. Desta forma, o objetivo geral desta investigação é identificar as limitações e potencialidades que a recente implementação do Sistema Integrado de Gestão nos Teatros de Operações provocou no desempenho das funções dos Oficiais de Finanças. Neste trabalho procuramos ainda identificar o impacto da harmonização dos procedimentos contabilísticos na execução orçamental, as melhorias do processo de tomada de decisão, a harmonização na realização do relato financeiro, e consequentes alterações nos procedimentos de mudança de contingente, bem como as alterações na execução das diferentes fases do Registo Contabilístico do Fundo de Maneio. Para a elaboração desta investigação aplicou-se o método hipotético-dedutivo, sendo desenvolvida segundo objetivos descritivos e exploratórios com o intuito de identificar, explorar e descrever as limitações e potencialidades da implementação do Sistema Integrado de Gestão na Força Nacional Destacada do Kosovo, recorrendo ao estudo exploratório/descritivo, enquadrando-se ainda na categoria do Estudo de Caso. No sentido de atingir os objetivos propostos inicialmente foram elaborados e aplicados diferentes inquéritos por entrevista. Após a análise e discussão dos resultados foi possível concluir que a informação contabilística disponível em tempo real, de forma imediata e oportuna, permite aos Oficiais de Finanças serem mais eficazes e assertivos no aconselhamento ao Comandante, assim como origina uma melhor e mais célere tomada de decisão em Teatro de Operações e para toda cadeia de comando em Território Nacional. Outra grande mais-valia foi a possibilidade de reduzir significativamente o Fundo de Maneio. Alcançado o final desta investigação, foi possível concluir que não existem limitações do Sistema Integrado de Gestão nos Teatros de Operações que não existam em Território Nacional, sendo dessa forma possível constatar que as possíveis melhorias são a implementação da contabilidade analítica e a integração de todas as áreas desta ferramenta, permitindo tirar total partido da mesma.

Améliorer la compréhension et la gestion des conflits d’intérêts des experts conseillant la prise de décisions en santé publique

Étude de cas / Case study

Améliorer la compréhension et la gestion des conflits d’intérêts des experts conseillant la prise de décisions en santé publique

Étude de cas / Case study

Academic catalog

This annual catalog from Piedmont Technical College includes the following: academic calendar, president’s message, general information, admissions information, financial information, student affairs, advising and registration, student records information, academic Information, academic programs, course descriptions, economic Development and Continuing Education Division and administration, faculty and staff.

The Weight of Language and Action: Epistemic Stance, Methodological Action,and Theoretical Perspective in Knowledge Organization

Knowledge organization (KO) research is a field of scholarship concerned with the design, study and critique of the processes of organizing and representing documents that societies see as worthy of preserving (Tennis, 2008). In this context we are concerned with the relationship between language and action.On the one hand, we are concerned with what language can and does do for our knowledge organization systems (KOS). For example, how do the words NEGRO or INDIAN work in historical and contemporary indexing languages? In relation to this, we are also concerned with how we know about knowledge organization (KO) and its languages. On the other hand, we are concerned with how to act given this knowledge. That is, how do we carry out research and how do we design, implement, and evaluate KO systems?It is important to consider these questions in the context of our work because we are delegated by society to disseminate cultural memory. We are endowed with a perspective, prepared by an education, and granted positions whereby society asks us to ensure that documentary material is accessible to future generations. There is a social value in our work, and as such there is a social imperative to our work. We must act with good conscience, and use language judiciously, for the memory of the world is a heavy burden.In this paper, I explore these two weights of language and action that bear down on KO researchers. I first summarize what extant literature says about the knowledge claims we make with regard to KO practices and systems. To make it clear what it is that I think we know, I create a schematic that will link claims (language) to actions in advising, implementing, or evaluating information practices and systems.I will then contrast this with what we do not know, that is, what the unanswered questions might be (Gnoli, 2008 ; Dahlberg, 2011), and I will discuss them in relation to the two weights in our field of KO.Further, I will try to provide a systematic overview of possible ways to address these open questions in KO research. I will draw on the concept of elenchus - the forms of epistemology, theory, and methodology in KO (Tennis, 2008), and framework analysis which are structures, work practice, and discourses of KO systems (Tennis, 2006). In so doing, I will argue for a Neopragmatic stance on the weight of language and action in KO (Rorty, 1982 ; 2000). I will close by addressing the lacuna left in Neopragmatic thought – the ethical imperative to use language and action in a particular good and moral way. That is, I will address the ethical imperative of KO given its weights, epistemologies, theories, and methods. To do this, I will review a sample of relevant work on deontology in both western and eastern philosophical schools (e.g., Harvey, 1995).The perspective I want to communicate in this section is that the good in carrying out KO research may begin with epistemic stances (cf., language), but ultimately stands on ethical actions. I will present an analysis describing the micro and the macro ethical concerns in relation to KO research and its advice on practice. I hope this demonstrates that the direction of epistemology, theory, and methodology in KO, while burdened with the dual weights of language and action, is clear when provided an ethical sounding board. We know how to proceed when we understand how our work can benefit the world.KO is an important, if not always understood, division of labor in a society that values its documentary heritage and memory institutions. Being able to do good requires us to understand how to balance the weights of language and action. We must understand where we stand and be able to chart a path forward, one that does not cause harm, but adds value to the world and those that want to access recorded knowledge.

Revisión de la literatura científica sobre publicidad de medicamentos de venta libre y comportamiento del consumidor

El consumo de medicamentos es un asunto que actualmente se ha convertido en una preocupación a nivel global, ya que no todos los medicamentos están sujetos a prescripción médica, y esto implica que su consumo dependa de otras fuentes de información, como la publicidad masiva o el consejo de personas legas, entre otros. Esta revisión se basó en la publicidad y el impacto que tiene esta frente al consumidor. La presente revisión se dividió en dos categorías dado la relevancia del tema, en la primera se encuentra las características de los medicamentos de venta libre donde se evidenció cómo funciona el sector de la industria farmacéutica, las características de los medicamentos en general y los riesgos del abuso de este comportamiento. Así mismo, en la segunda categoria se habló sobre la publicidad y mercadeo de ventas libres donde se evidenció el alto impacto que tiene la publicidad en el consumidor, las restricciones que hay en el contexto nacional e internacional.

La atención a la diversidad: experiencia del Proyecto UNA Educación de Calidad, de la Universidad Nacional de Costa Rica

Recibido 16 de julio de 2010 • Aceptado 31 de agosto de 2010 • Corregido 04 de octubre de 2010  Debido al marco jurídico actual, en los últimos años, el sistema educativo costarricense ha experimentado cambios significativos, tanto en los niveles internacional como nacional. Estos van desde la promulgación de la Ley 7600 Igualdad de Oportunidades para las Personas con Discapacidad en Costa Rica (Costa Rica, Asamblea Legislativa,1996) hasta el planteamiento de la Ley 8661 Convención sobre los Derechos Humanos de las Personas con Discapacidad (Costa Rica, Asamblea Legislativa, 2008). Por lo anterior, el espacio temporal en el que emergió el Proyecto UNA Educación de Calidad, en 1998 y el contexto en el cual estaba inmerso el Sistema Educativo Nacional, particularmente, en el ámbito universitario, la propuesta pedagógica que se presenta da muestra de una transición entre el modelo rehabilitador y el modelo social, específicamente, dentro de cada uno de estos, el respectivo abordaje educativo, que abarca desde los procedimientos de la integración a los de la educación inclusiva. Desde esta perspectiva, se presenta las vivencias y estrategias desplegadas desde el Proyecto UNA Educación de Calidad. El fin es proporcionar apoyo y seguimiento, en su formación profesional, a un grupo de la diversidad, constituido por los estudiantes con necesidades educativas matriculados en la Universidad Nacional. De esta forma, se pretenden hacer efectivos sus derechos de acceder a una educación superior de calidad, de acuerdo con sus características personales y sociales, y promover su permanencia e inserción socio-laboral. Los retos que impone la atención a la diversidad en el contexto universitario son un desafío plasmado en el quehacer cotidiano del Proyecto UNA Educación de Calidad. Estas transformaciones se vislumbran en la constante reconstrucción de las estrategias utilizadas, al tener, como aspectos esenciales, el empleo de equipo tecnológico y programas de computación especializados. Estos les permitirán a los estudiantes acceder a la información y a la comunicación; la asesoría y la capacitación de los académicos y del personal administrativo; el establecimiento de estrategias de apoyo colaborativo entre los miembros de la comunidad universitaria, así como, la búsqueda de cooperación en el ámbito nacional e internacional para el desarrollo de nueva iniciativas.