941 resultados para INTEGRATED MEDICINES MANAGEMENT


Relevância:

100.00% 100.00%

Publicador:

Resumo:

Doutoramento em Engenharia Agronómica - Instituto Superior de Agronomia - UL

Relevância:

100.00% 100.00%

Publicador:

Resumo:

Potato is the most important food crop after wheat and rice. A changing climate, coupled with a heightened consumer awareness of how food is produced and legislative changes governing the usage of agrochemicals, means that alternative more integrated and sustainable approaches are needed for crop management practices. Bioprospecting in the Central Andean Highlands resulted in the isolation and in vitro screening of 600 bacterial isolates. The best performing isolates, under in vitro conditions, were field trialled in their home countries. Six of the isolates, Pseudomonas sp. R41805 (Bolivia), Pseudomonas palleroniana R43631 (Peru), Bacillus sp. R47065, R47131, Paenibacillus sp. B3a R49541, and Bacillus simplex M3-4 R49538 (Ecuador), showed significant increase in the yield of potato. Using – omic technologies (i.e. volatilomic, transcriptomic, proteomic and metabolomic), the influence of microbial isolates on plant defence responses was determined. Volatile organic compounds of bacterial isolates were identified using GC/MS. RT-qPCR analysis revealed the significant expression of Ethylene Response Factor 3 (ERF3) and the results of this study suggest that the dual inoculation of potato with Pseudomonas sp. R41805 and Rhizophagus irregularis MUCL 41833 may play a part in the activation of plant defence system via ERF3. The proteomic analysis by 2-DE study has shown that priming by Pseudomonas sp. R41805 can induce the expression of proteins related to photosynthesis and protein folding in in vitro potato plantlets. The metabolomics study has shown that the total glycoalkaloid (TGA) content of greenhouse-grown potato tubers following inoculation with Pseudomonas sp. R41805 did not exceed the acceptable safety limit (200 mg kg-1 FW). As a result of this study, a number of bacteria have been identified with commercial potential that may offer sustainable alternatives in both Andean and European agricultural settings.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

This PowerPoint presentation goes over the ways in which aquatics pest and weeds can be controlled.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

Recreational shore fishing along 250 km of the south and south-west coast of Portugal was studied based on roving creel and aerial surveys. Surveys were conducted between August 2006 and July 2007, following a stratified random-sampling design and provided information on catch and effort, harvest and discards, angler demographics and fishing habits. Overall, 192 roving creel surveys, 24 aerial surveys and 1321 interviews were conducted. Based on the aerial surveys, a mean +/- s.e. total fishing effort of 705 236 +/- 32 765 angler h year(-1) was estimated, corresponding to 166 430 +/- 9792 fishing trips year(-1). Average time spent per fishing trip was 4.7 h. A total of 48 species, belonging to 22 families, were recorded in roving creel surveys. The most important species was Diplodus sargus, accounting for 44% of the total catches by number and 48% by mass. Estimated mean +/- s.e. total annual recreational shore fishing catch was 160.2 +/- 12.6 t year(-1) (788 049 +/- 54 079 fishes year(-1)), of which 147.4 +/- 11.9 t year(-1) (589 132 +/- 42 360 fishes year(-1)) was retained. Although overall shore-based recreational catches only corresponded to 0.8% of the commercial landings (only common species considered), D. sargus catches by recreational shore anglers were considerable, corresponding to 65% of the commercial landings. The implications of these results for integrated fisheries management and conservation are discussed, and future research proposed.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

A number of medicine selection methods have been used worldwide for formulary purposes. In Northern Ireland, integrated medicines management is being developed, and related projects have been carried out. This paper deals with the description of the STEPS (Safe Therapeutic Economic Pharmaceutical Selection) programme. The paper outlines the development of STEPS and its application as an element of a cost-effective medicines-management process in Northern Ireland.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

Rationale, aims and objectives: This study aimed to determine the value of using a mix of clinical pharmacy data and routine hospital admission spell data in the development of predictive algorithms. Exploration of risk factors in hospitalized patients, together with the targeting strategies devised, will enable the prioritization of clinical pharmacy services to optimize patient outcomes. 

Methods: Predictive algorithms were developed using a number of detailed steps using a 75% sample of integrated medicines management (IMM) patients, and validated using the remaining 25%. IMM patients receive targeted clinical pharmacy input throughout their hospital stay. The algorithms were applied to the validation sample, and predicted risk probability was generated for each patient from the coefficients. Risk threshold for the algorithms were determined by identifying the cut-off points of risk scores at which the algorithm would have the highest discriminative performance. Clinical pharmacy staffing levels were obtained from the pharmacy department staffing database. 

Results: Numbers of previous emergency admissions and admission medicines together with age-adjusted co-morbidity and diuretic receipt formed a 12-month post-discharge and/or readmission risk algorithm. Age-adjusted co-morbidity proved to be the best index to predict mortality. Increased numbers of clinical pharmacy staff at ward level was correlated with a reduction in risk-adjusted mortality index (RAMI). 

Conclusions: Algorithms created were valid in predicting risk of in-hospital and post-discharge mortality and risk of hospital readmission 3, 6 and 12 months post-discharge. The provision of ward-based clinical pharmacy services is a key component to reducing RAMI and enabling the full benefits of pharmacy input to patient care to be realized.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

To examine the evidence regarding the effectiveness of medication reconciliation and review and to improve clinical outcomes in hospitals, the community, and aged care facilities.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

Asset service organisations often recognize asset management as a core competence to deliver benefits to their business. But how do organizations know whether their asset management processes are adequate? Asset management maturity models, which combine best practices and competencies, provide a useful approach to test the capacity of organisations to manage their assets. Asset management frameworks are required to meet the dynamic challenges of managing assets in contemporary society. Although existing models are subject to wide variations in their implementation and sophistication, they also display a distinct weakness in that they tend to focus primarily on the operational and technical level and neglect the levels of strategy, policy and governance as well as the social and human resources – the people elements. Moreover, asset management maturity models have to respond to the external environmental factors, including such as climate change and sustainability, stakeholders and community demand management. Drawing on five dimensions of effective asset management – spatial, temporal, organisational, statistical, and evaluation – as identified by Amadi Echendu et al. [1], this paper carries out a comprehensive comparative analysis of six existing maturity models to identify the gaps in key process areas. Results suggest incorporating these into an integrated approach to assess the maturity of asset-intensive organizations. It is contended that the adoption of an integrated asset management maturity model will enhance effective and efficient delivery of services.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

Background In a low socioeconomic status, small, rental retirement village, we have shown the older-aged managed their medicines poorly [1]. Objective As the number of participants was only 25, and the population in the rental retirement village turns over regularly; our objective was to determine whether the findings were consistent and ongoing. Methods We returned to the rental retirement villages after one and two years, and reassessed the management of medicines, using the same semi-structured interview method. Main outcome measure The main outcome measure was the perception of present and ongoing adherence. Results Although similar numbers (23-25) participated in the studies in 2011-2013, the actual participants changed with only 3 being interviewed on 3 occasions. Nevertheless, the findings over the 3 years were similar: less than 50% of the participants were adherent at the time of the study and unlikely to have problems in the next 6-12 months; only 50% had a good knowledge of their illnesses. Conclusions The management of medicines by the older-aged living in a low socioeconomic, rental retirement village is poor, and this finding is ongoing and consistent. This supports the need for extra assistance and resources for the older-aged, living in rental retirement villages, to manage their medicines.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

Clinical pathway is an approach to standardise care processes to support the implementations of clinical guidelines and protocols. It is designed to support the management of treatment processes including clinical and non-clinical activities, resources and also financial aspects. It provides detailed guidance for each stage in the management of a patient with the aim of improving the continuity and coordination of care across different disciplines and sectors. However, in the practical treatment process, the lack of knowledge sharing and information accuracy of paper-based clinical pathways burden health-care staff with a large amount of paper work. This will often result in medical errors, inefficient treatment process and thus poor quality medical services. This paper first presents a theoretical underpinning and a co-design research methodology for integrated pathway management by drawing input from organisational semiotics. An approach to integrated clinical pathway management is then proposed, which aims to embed pathway knowledge into treatment processes and existing hospital information systems. The capability of this approach has been demonstrated through the case study in one of the largest hospitals in China. The outcome reveals that medical quality can be improved significantly by the classified clinical pathway knowledge and seamless integration with hospital information systems.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

Agenda 21 may be considered the most significant programme of action influencing environmental policy for the Australian development and construction industry. The industry has remained one of the most rapidly expanding sectors; yet, we have seen the gradual process of exhausting natural resources and irreversible environmental degradation. Even with the introduction of numerous new environmental policies, it remains questionable as to whether real improvements have occurred across the industry. Legislative mechanisms to direct on-site environmental management appear deficient; information flows between participants along the supply chain appear to impact upon environmental management performance; and industry fragmentation remains compounded by ill-defined external, non-contractual supply chain influences that directly impact on contractual systems. Limited research has considered construction supply chain theory and environmental management particularly in reference to policy. The literature highlighted a need to develop a supply chain model which seeks to integrate chain actors and government regulators through holistic information management. The model assumes that fundamental to industry change is statutory control to mandate construction environmental management plans. However, industry change and subsequent environmental management rely upon effective information dissemination. The next stage involves model refinement, investigating barriers and enablers to widespread diffusion of such an innovative integrated environmental management system.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

Invasive plant species threaten natural areas by reducing biodiversity and altering ecosystem functions. They also impact agriculture by reducing crop and livestock productivity. Millions of dollars are spent on invasive species control each year, and traditionally, herbicides are used to manage invasive species. Herbicides have human and environmental health risks associated with them; therefore, it is essential that land managers and stakeholders attempt to reduce these risks by utilizing the principles of integrated weed management. Integrated weed management is a practice that incorporates a variety of measures and focuses on the ecology of the invasive plant to manage it. Roadways are high risk areas that have high incidence of invasive species. Roadways act as conduits for invasive species spread and are ideal harborages for population growth; therefore, roadways should be a primary target for invasive species control. There are four stages in the invasion process which an invasive species must overcome: transport, establishment, spread, and impact. The aim of this dissertation was to focus on these four stages and examine the mechanisms underlying the progression from one stage to the next, while also developing integrated weed management strategies. The target species were Phragmites australis, common reed, and Cisrium arvense, Canada thistle. The transport and establishment risks of P. australis can be reduced by removing rhizome fragments from soil when roadside maintenance is performed. The establishment and spread of C. arvense can be reduced by planting particular resistant species, e.g. Heterotheca villosa, especially those that can reduce light transmittance to the soil. Finally, the spread and impact of C. arvense can be mitigated on roadsides through the use of the herbicide aminopyralid. The risks associated with herbicide drift produced by application equipment can be reduced by using the Wet-Blade herbicide application system.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

This paper focuses on identifying and analysing the elements of Strategic Management for infrastructure and engineering assets. These elements are contended to involve an understanding of governance, corporate policy, corporate objectives, corporate strategy and interagency collaboration and will in turn, allow the ability determine a broader and more comprehensive framework for engineering asset management, ie a ‘staged approach’ to understanding how assets are managed within organisations. While the assets themselves have often been the sole concern for good management practices, other social and contextual elements have come into the mix in order to promote strategic asset management. The development of an integrated approach to asset management is at the base of the research question. What are the considerations and implications for adopting and implementing an integrated strategic asset management (ISAM) framework? While operational matters have been given prominence, a subset of corporate governance, Asset Governance, details the policies and processes needed to acquire, utilise, maintain and account for an organisation’s assets. Asset governance stems from the organisation’s overarching corporate governance principles; as a result it defines the management context in which engineering asset management is implemented. This aspect will be examined to determine the appropriate relationship between organisational strategic management and strategic asset management to further the theoretical engagement with the maturity of strategy,policy and governance for infrastructure and engineered assets. Asset governance stems from the organisation’s overarching corporate governance principles; as a result it defines the management context in which engineering asset management is implemented. The research proceeds by a document analysis of corporate reports and policy recommendations in terms of infrastructure and engineered assets. The paper concludes that incorporating an integrated asset management framework can promote a more robust conceptualisation of public assets and how they combine to provide a comprehensive system of service outcomes.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

El sector energético, en España en particular, y de forma similar en los principales países de Europa, cuenta con una significativa sobrecapacidad de generación, debido al rápido y significativo crecimiento de las energías renovables en los últimos diez años y la reducción de la demanda energética, como consecuencia de la crisis económica. Esta situación ha hecho que las centrales térmicas de generación de electricidad, y en concreto los ciclos combinados de gas, operen con un factor de utilización extremadamente bajo, del orden del 10%. Además de la reducción de ingresos, esto supone para las plantas trabajar continuamente fuera del punto de diseño, provocando una significativa pérdida de rendimiento y mayores costes de explotación. En este escenario, cualquier contribución que ayude a mejorar la eficiencia y la condición de los equipos, es positivamente considerada. La gestión de activos está ganando relevancia como un proceso multidisciplinar e integrado, tal y como refleja la reciente publicación de las normas ISO 55000:2014. Como proceso global e integrado, la gestión de activos requiere el manejo de diversos procesos y grandes volúmenes de información, incluso en tiempo real. Para ello es necesario utilizar tecnologías de la información y aplicaciones de software. Esta tesis desarrolla un concepto integrado de gestión de activos (Integrated Plant Management – IPM) aplicado a centrales de ciclo combinado y una metodología para estimar el beneficio aportado por el mismo. Debido a las incertidumbres asociadas a la estimación del beneficio, se ha optado por un análisis probabilístico coste-beneficio. Así mismo, el análisis cuantitativo se ha completado con una validación cualitativa del beneficio aportado por las tecnologías incorporadas al concepto de gestión integrada de activos, mediante una entrevista realizada a expertos del sector de generación de energía. Los resultados del análisis coste-beneficio son positivos, incluso en el desfavorable escenario con un factor de utilización de sólo el 10% y muy prometedores para factores de utilización por encima del 30%. ABSTRACT The energy sector particularly in Spain, and in a similar way in Europe, has a significant overcapacity due to the big growth of the renewable energies in the last ten years, and it is seriously affected by the demand decrease due to the economic crisis. That situation has forced the thermal plants and in particular, the combined cycles to operate with extremely low annual average capacity factors, very close to 10%. Apart from the incomes reduction, working in out-of-design conditions, means getting a worse performance and higher costs than expected. In this scenario, anything that can be done to improve the efficiency and the equipment condition is positively received. Asset Management, as a multidisciplinary and integrated process, is gaining prominence, reflected in the recent publication of the ISO 55000 series in 2014. Dealing Asset Management as a global, integrated process needs to manage several processes and significant volumes of information, also in real time, that requires information technologies and software applications to support it. This thesis proposes an integrated asset management concept (Integrated Plant Management-IPM) applied to combined cycle power plants and develops a methodology to assess the benefit that it can provide. Due to the difficulties in getting deterministic benefit estimation, a statistical approach has been adopted for the cot-benefit analysis. As well, the quantitative analysis has been completed with a qualitative validation of the technologies included in the IPM and their contribution to key power plant challenges by power generation sector experts. The cost- benefit analysis provides positive results even in the negative scenario of annual average capacity factor close to 10% and is promising for capacity factors over 30%.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

Purpose - The purpose of the paper is to develop an integrated quality management model, which identifies problems, suggests solutions, develops a framework for implementation and helps evaluate performance of health care services dynamically. Design/methodology/approach - This paper uses logical framework analysis (LFA), a matrix approach to project planning for managing quality. This has been applied to three acute healthcare services (Operating room utilization, Accident and emergency, and Intensive care) in order to demonstrate its effectiveness. Findings - The paper finds that LFA is an effective method of quality management of hospital-based healthcare services. Research limitations/implications - This paper shows LFA application in three service processes in one hospital. However, ideally this is required to be tested in several hospitals and other services as well. Practical implications - In the paper the proposed model can be practised in hospital-based healthcare services for improving performance. Originality/value - The paper shows that quality improvement in healthcare services is a complex and multi-dimensional task. Although various quality management tools are routinely deployed for identifying quality issues in health care delivery and corrective measures are taken for superior performance, there is an absence of an integrated approach, which can identify and analyze issues, provide solutions to resolve those issues, develop a project management framework (planning, monitoring, and evaluating) to implement those solutions in order to improve process performance. This study introduces an integrated and uniform quality management tool. It integrates operations with organizational strategies. © Emerald Group Publishing Limited.