728 research outputs found

    Indicadores sustentables del transporte en una industria de consumo masivo

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    Tesis (Maestr铆a en Direcci贸n de Negocios) -- Universidad Nacional de C贸rdoba. Facultad de Ciencias Econ贸micas; Argentina, 2017.Los l铆mites de este trabajo se circunscriben a la log铆stica del transporte del producto terminado de consumo masivo de Dul-Ce. Al buscar el desarrollo de una gesti贸n sustentable, Dul-Ce no puede escapar a la magnitud del movimiento de sus 600 camiones diarios que emiten Gases de Efecto Invernadero (GEI) al ambiente. Debido a la importancia del desarrollo de una gesti贸n sustentable para la empresa, la Direcci贸n de Dul-Ce en conjunto con el Gerente de Sustentabilidad solicitaron a Log铆stica la incorporaci贸n de un indicador de sustentabilidad en los objetivos divisionales del negocio log铆stica. Los datos expresados, fundamentan la importancia de conocer la cantidad de GEI generados por los transportes de Dul-Ce y la implementaci贸n de medidas que promuevan su reducci贸n, para de esta manera seguir alineado al pilar de la empresa que busca el desarrollo de una gesti贸n sustentable.Fil: Grbich, Alejandra Mariela. Universidad Nacional de C贸rdoba. Facultad de Ciencias Econ贸micas; Argentina

    The clinical and social dimensions of prescribing palliative home oxygen for refractory dyspnea

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    Background: Chronic breathlessness is a significant problem in palliative care and oxygen is often prescribed in an attempt to ameliorate it. Often, this prescription falls outside the current funding guidelines for long-term home oxygen use. The aim of this qualitative study was to understand the factors that most influence Australian specialist palliative care nurses\u27 initiation of home oxygen for their patients. Methods: A series of focus groups were held across three states in Australia in 2011 involving specialist palliative care nurses. The invitation to the nurses was sent by e-mail through their national association. Recorded and transcribed data were coded for themes and subthemes. A summary, which included quotes, was provided to participants to confirm. Results: Fifty-one experienced palliative care nurses participated in seven focus groups held in three capital cities. Two major themes were identified: 1) logistic/health service issues (not reported in this paper as specific to the Australian context) involving the local context of prescribing and, 2) clinical care issues that involved assessing the patient\u27s need for home oxygen and ongoing monitoring concerns. Palliative care nurses involved in initiating or prescribing oxygen often reported using oxygen as a second-line treatment after other interventions had been trialed and these had not provided sufficient symptomatic benefit. Safety issues were a universal concern and a person living alone did not emerge as a specific issue among the nurses interviewed. Conclusion: The role of oxygen is currently seen as a second-line therapy in refractory dyspnea by specialist palliative care nurses

    The Image of Taiwan as a Travel Destination: Perspectives from Mainland China

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    This study presents the perceived and projected image of Taiwan as a travel destination from perspectives from Mainland China. The perceived image of Taiwan was examined by interviewing 28 Mainland Chinese; the projected image of Taiwan was investigated by analyzing articles in China's most popular travel magazines. The different types of images of Taiwan among visitors, nonvisitors, and travel magazines were compared. The projected image changed notably after the opening of Taiwan's tourism to travelers from Mainland China. The results of this study could help destination marketing organizations to assess their marketing strategies for the Mainland Chinese travel market

    Health visitors鈥 perception of their role in the universal childhood immunisation programme and their communication strategies with parents

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    Aim: This study explored health visitors鈥 perception of their role in the universal childhood immunisation programme with particular emphasis on influencing factors and communication strategies. Background: The majority of parents鈥 consent to immunisation, but some find decision-making in this area difficult and have unmet information needs. In the United Kingdom, health visitors routinely provide immunisation information for parents, whereas general practitioners (GPs) and practice nurses tend to administer vaccines and respond to parents/carers鈥 questions. Research has investigated health professionals鈥 views and knowledge about immunisation, but less is understood about health visitors鈥 role and how they communicate with parents. Method: Following the Local Research Ethics and Research Governance permissions, all health visitors (n5120) working in one county in the United Kingdom were invited to participate in the study. Semistructured interviews (n522) were undertaken using a prompt guide. The interviews were transcribed verbatim. Thematic analysis using an iterative approach was used to explore the data facilitated by NVIVOTM software. Findings: Five themes emerged from the interviews. These were health visitors鈥檖rofessional role; identity and perceived barriers and communication strategies, parents鈥 right to choose, confidence in measles, mumps, and rubella (MMR) vaccination and communicating with migrant families about immunisation. There were differences between the health visitors in their perceptions of their roles, skills and knowledge and communication strategies. Health visitors perceived that GPs and practice nurses took a paternalistic approach to the provision of immunisation information, while they used a parental decision making model. Health visitors reported a loss of professional confidence following the MMR crisis. Conclusion: Given the evidence that some parents find it difficult to gain the information they need about immunisation and health visitors鈥 acknowledgement that their usual communication models were not effective during the MMR crisis, we feel specific communication skills training is needed to enable health professionals to provide parents with appropriate decision support

    The 100 patient stories project: Patient and family member views on how clinicians (should) enact Open Disclosure - a qualitative study

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    Objectives To investigate patients鈥 and family members鈥 perceptions and experiences of disclosure of healthcare incidents and to derive principles of effective disclosure. Design Retrospective qualitative study based on 100 semi-structured, in depth interviews with patients and family members. Setting Nationwide multisite survey across Australia. Participants 39 patients and 80 family members who were involved in high severity healthcare incidents (leading to death, permanent disability, or long term harm) and incident disclosure. Recruitment was via national newspapers (43%), health services where the incidents occurred (28%), two internet marketing companies (27%), and consumer organisations (2%). Main outcome measures Participants鈥 recurrent experiences and concerns expressed in interviews. Results Most patients and family members felt that the health service incident disclosure rarely met their needs and expectations. They expected better preparation for incident disclosure, more shared dialogue about what went wrong, more follow-up support, input into when the time was ripe for closure, and more information about subsequent improvement in process. This analysis provided the basis for the formulation of a set of principles of effective incident disclosure. Conclusions Despite growing prominence of open disclosure, discussion about healthcare incidents still falls short of patient and family member expectations. Healthcare organisations and providers should strengthen their efforts to meet patients鈥 (and family members鈥) needs and expectations