Increasing Pneumoccal Vaccination Rates Among Patients 65 Years and Older in a Retail Clinic

Background: Despite the significant morbidity and mortality associated with pneumococcal disease, the national vaccination rates for pneumococcal vaccine for patients 65 years and older fall below the Healthy People goal of 2020. In recent years, there is a growing trend in the use of retail health clinics in the country. These retail health clinics can be an avenue to close the gap in the delivery of pneumococcal vaccination. The purpose of this project is to assess the baseline knowledge of retail health providers and their perception of barriers to pneumonia vaccinations. In addition, a program called The Four Pillars on Immunization Toolkit was implemented to increase pneumococcal immunization rates in a retail health clinic. Purpose: This project explored the baseline knowledge of the providers and the perceived barriers regarding the delivery of pneumococcal vaccination. Furthermore, The Four Pillars on Immunization Toolkit was utilized to increase immunization in a retail health clinic. Methods: The baseline knowledge and perception of barriers to delivering the pneumonia vaccination was assessed via an online survey. To increase the pneumococcal vaccination, the participants were educated on the Four Pillars on Immunization Toolkit before actual implementation. Results: The scores on the knowledge section of the survey ranged from 9% to 81%. These results indicated that providers working in the retail health setting could benefit from pneumococcal vaccination education. The results on the perception of barriers showed that providers working the retail clinics face barriers that prevent the recommendation or the giving of pneumococcal vaccination. In addition, the use of the Four Pillars on Immunization toolkit indicated a 10 % increase in pneumococcal vaccination rate when compared to the previous year. Conclusion: The result indicated that providers working in the retail clinic are generally knowledgeable about pneumonia vaccination; however, there is a gap noted on certain knowledge questions. In addition, providers noted barriers that prevent the recommendation or the giving of the pneumonia vaccination in this setting. The results suggested the use of the Four Pillars on Immunization Toolkit could be used as a tool in a retail clinic to improve delivery of important immunizations

Institutional Aspects of Fishery Management under the New Regime of the Oceans

This Article reviews the changes already made or envisaged in light of the relevant provisions of the 1982 United Nations Convention on the Law of the Sea and the biological characteristics of the living resources of the sea. The author argues that the establishment of exclusive economic zones necessitates the alteration of institutional arrangements developed over the last decades to promote international cooperation in the management of fisheries. The author describes the establishment of a network of regional fishery bodies and analyzes the effect of the 1982 Convention provisions concerning the institutional aspects of fishery management. The author then reviews the adjustments that have already been made to existing institutions and the creation of new institutions resulting from the establishment of exclusive economic zones

MODELO de GESTION ESTRATEGICA para el DESARROLLO de CAPACIDADES TECNOLOGICAS.

La fuerte competencia y la complejidad reinante en momentos donde la globalizaci\uf3n tiene cada vez mas auge, est\ue1n marcando tendencias para que las organizaciones concentren sus esfuerzos en gestionar estrat\ue9gicamente sus capacidades tecnol\uf3gicas. De all\ued que la experiencia de las organizaciones indica que la v\ueda para alcanzar la capacidad de competir es a trav\ue9s de la tecnolog\ueda e innovaci\uf3n, factor clave de la competitividad. El presente estudio es una investigaci\uf3n de \uedndole cuali-cuantitativo enmarcado en las ciencias sociales, de car\ue1cter f\ue1ctico, descriptivo, documental y de campo, consolid\ue1ndose en un proyecto factible que pretende proponer un modelo te\uf3rico de gesti\uf3n para el desarrollo de capacidades tecnol\uf3gicas orientado al crecimiento sostenido y sustentable del sector sisalero en el estado Lara. El marco de desempe\uf1o actual de los procesos estudiados y analizados, revela los efectos de la crisis del sector sisalero causados en gran medida por pol\uedticas del Estado poco c\uf3nsonas con el desarrollo de las capacidades estrat\ue9gicas, que por naturaleza dicho sector posee, que sumado a la casi nula articulaci\uf3n interinstitucional de los entes gubernamentales a nivel local y regional, agrava m\ue1s a\ufan dicha crisis. El modelo propuesto ser\ue1 exitoso en la medida que el desarrollo de capacidades tecnol\uf3gicas conduzca a cambios de paradigma en el gobierno local, regional y nacional; para revertir la situaci\uf3n de marginalidad y pobreza que presenta el sector estudiado.Palabras clave: Gesti\uf3n Estrat\ue9gica, Capacidades Tecnol\uf3gicas, Crecimiento Sostenido y Sustentable, Competitividad. SUMMARY: MODEL OF STRATEGIC MANAGEMENT BASED ON THE DEVELOPMENT OF TECHNOLOGICAL CAPABILITIES. Competitiveness and complexity are major expanding trends in the current globalization process, making organizations stress upon procuring strategic and technological capabilities. From this, organizational experience shows that technology and innovation are key factors to achieve such competitiveness,. The analysis reveals the strong impact of a sustained ill-defined public policy process upon the social and economic performance of Sisal industries located in the Lara region of Venezuela. Critical political and planning errors are found both on the lack of emphasis upon the development of organizational strategic capabilities and of interinstitutional articulation (mainly among local and regional public sector agencies), therefore, this work is aimed to propose a strategic management model to develop such capacities and capabilities in Sisal industries in the above mentioned region. The descriptive analysis was based on a field and survey research from a quali-quantitative approach of the sustainable development theory, in the social sciences field. Key words: Strategic Management, Technological Capabilities, Sustainable Growth, Competitivity

Gallegos y demas españoles que os hallais en Portugal: la patria os ha llamado diferentes veces para que tomaseis parte en las acciones valerosas de vuestros paisanos, y ... aunque es cierto que muchos naturales de Galicia han vuelto á su patria, no ha podido ver sin dolor muchos millares de jovenes robustos que se han echo sordos á sus voces ... No han bastado para persuadiros los diferentes bandos que ha publicado la Junta Superior de Galicia .. Si dentro de ocho dias de publicada esta convencios os presentais voluntariamente ... al Ministro Plenipotenciario de vuestra nacion ... no perdereis ningun derecho ...

Copia digital. Valladolid : Junta de Castilla y León. Consejería de Cultura y Turismo, 2012-2013Texto fechado en Lisboa, diciembre de 181

Défibrillateur automatique implantable (DAI): principes de base et indications cliniques actuelles [Implantable cardiac defibrillator (ICD): basics and present clinical guidelines].

An implantable cardiac defibrillator (ICD) is a cardiac implantable electronic device that is capable of identifying and treating ventricular arrhythmias. Consideration about the type of ICD to select for a given patient include whether the patient has bradycardia requiring pacing support, has associated atrial tachyarrhythmias, or would benefit from cardiac resynchronization therapy. The ICD functions by continuously monitoring the patient's cardiac rate and delivering therapies (anti-tachycardia pacing, shocks) when the rate exceeds the programmed rate "cutoff". Secondary prevention trials have demonstrated that ICDs reduce the incidence of arrhythmic death and total mortality in patients presenting with a cardiac arrest. ICDs are also indicated for primary prevention of sudden cardiac death in specific high-risk subgroups of patients

Ergotherapie bei Personen mit M. Parkinson mit Deep Brain Stimulation : eine Angebotserweiterung

Hintergrund: In der universitären Akut-Neurorehabilitation Inselspital (NREH) in Bern sollen ab 2017 Personen mit M. Parkinson (PmP) und neuer Deep Brain Stimulation Implantation (DBS) während einer Dauer von maximal drei Wochen stationär rehabilitiert werden. Ziel: Das Ziel dieser Arbeit ist es, ein Dokument zu den Rollen und Aufgaben der Ergotherapie NREH bei PmP mit DBS zu erarbeiten. Zudem sollen Inhalte für die Wissensvermittlung für die Ergotherapie definiert und ein Plan erstellt werden. Methode: Die Basis ist eine Literatursuche zur Ergotherapie bei M. Parkinson und DBS und zur Wissensvermittlung in professionellen Teams zwischen 2005 und 2016. Diese Resultate werden evaluiert und mit den Möglichkeiten und Grenzen der NREH verglichen. Aus dieser Synthese wird ein Dokument Rollen und Aufgaben der Ergotherapie NREH bei PmP mit DBS und ein Plan zur Wissensvermittlung erarbeitet. Ergebnisse: Das Dokument Rollen und Aufgaben der Ergotherapie bei PmP mit DBS, wie auch der Plan für die Wissensvermittlung sind erarbeitet. Spezifische Literatur zu Ergotherapie bei M. Parkinson und DBS ist nicht vorhanden, weshalb drei Leitlinien und eine Review zur Ergotherapie bei PmP verwendet werden. Zur Erarbeitung der Wissensvermittlung werden vier Studien eingeschlossen. Die Ergebnisse unterstützen die Positionierung der Ergotherapie im interprofessionellen Team. Schlussfolgerung: Mit der Erarbeitung des Dokuments Rollen und Aufgaben der Ergotherapie NREH bei PmP mit DBS und der Planung der Wissensvermittlung wurde eine Basis für die Behandlung der PmP mit DBS gelegt

Re-entrant ventricular tachycardia as a complication of ablation of idiopathic ventricular premature beats from the right outflow tract: a case report.

We report an unusual case of non-sustained ventricular tachycardia (NSVT) from the epicardial part of the right ventricular outflow tract (RVOT). A 37-year-old woman who underwent in 2006 an ablation for idiopathic ventricular premature beats (VPBs) from the RVOT presented with pre-syncopal NSVT in 2016. A cardiac workup showed no coronary disease, normal biventricular function, and no enhancement on cardiac magnetic resonance imaging. A metabolic positron emission tomography scan excluded inflammation. Biopsies revealed normal desmosomal proteins. An endocardial mapping revealed an area of low voltage potential (<0.5 mV) at the antero-septal aspect of the RVOT corresponding to the initial site of ablation from 2006. Activation mapping revealed poor prematurity and pace-mapping showed unsatisfactory morphologies in the RVOT, the left ventricle outflow tract and the right coronary cusp. An epicardial map revealed a low voltage area at the antero-septal aspect of the RVOT with fragmented potentials opposite to the endocardial scar. Pace-mapping demonstrated perfect match. An NSVT was induced and local electrocardiogram showed mid-diastolic potentials. Ablation was applied epicardially and endocardially without any complication. The patient was arrhythmia free at 4-year follow-up. Cardiac workup allowed to exclude specific conditions such as arrhythmogenic cardiomyopathy, tetralogy of Fallot, sarcoidosis, or myocarditis as a cause for NSVT from the RVOT. The epi and endocardial map showed residual scar subsequent to the first ablation which served as substrate for the re-entrant NSVT. This is the first case which describes NSVT from the epicardial RVOT as a complication from a previous endocardial ablation for idiopathic VPB

Violences conjugales durant la grossesse, quel est le rôle de la sage-femme dans le dépistage et l'accompagnement des femmes ?: travail de Bachelor

Ce travail identifie l'efficacité d'un moyen de dépistage et l'adéquation d'un modèle d'accompagnement des victimes de violences conjugales durant la grossesse. Cette revue de la littérature est composée de cinq articles issus des bases de données suivantes : PubMed, CINHAL et explore RERO. Ces derniers ont été sélectionnés entre janvier 2018 et mai 2019. Ils ont alors été analysés et critiqués, puis les résultats ont été discutés

Emprendimiento peruano en el marco del desarrollo sostenible

in the Peruvian context, entrepreneurship has become a determining factor in driving the country’s social and economic progress. In addition, it plays an active role in the achievement of the Sustainable Development Goals proposed by the United Nations. The main objective of the study was to establish the relationship between Peruvian entrepreneurship and sustainable development. A quantitative, non-experimental, correlational and cross-sectional approach was used the study population was established using data from the technical report EntrepreneurialDemographics of Peru, according to this report, 2,054 ventures were registered and established in the year 2021, with a life cycle of two years atthe time of the study. For the sample, 746 ventures were purposively selected. A questionnaire composed of 40 items with Likert-type responseoptions was used, was validated by five experts and its reliability was established through the Cronbach’s Alpha measure, obtaining a very reliablecoefficient of 0.93. The resulting data were analyzed using the SPSS version 25 statistical software. The results revealed a moderate positivecorrelation between entrepreneurship in Peru and sustainable development. In conclusion, entrepreneurship in Peru is significantly related tosustainable development, especially in terms of contributing to the SDGs and promoting innovation and adaptability. However, greater attentionto community engagement is required to strengthen the relationship between entrepreneurship and the broader community.en el contexto peruano, el emprendimiento se ha consolidado como un factor determinante para impulsar el progreso social y económico del país. Además, desempeña un papel activo en la consecución de los Objetivos de Desarrollo Sostenible propuestos por las Naciones Unidas. El objetivo central del estudio fue establecer la relación entre el emprendimiento peruano y el desarrollo sostenible. Se utilizó un enfoque cuantitativo, no experimental, correlacional y transversal. La población de estudio se estableció utilizando datos del informe técnico Demografía Empresarial del Perú, según este informe, se registraron y establecieron 2054 emprendimientos en el año 2021, con un ciclo de vida de dos años en el momento del estudio. Para la muestra se seleccionaron intencionalmente 746 emprendimientos. Se utilizó un cuestionario compuesto por 40 ítems con opciones de respuesta tipo Likert, fue validado por cinco expertos y se estableció su confiabilidad a través de la medida Alfa de Cronbach, obteniendo un coeficiente muy confiable de 0.93. Los datos resultantes fueron analizados utilizando el programa estadístico SPSS versión 25. Los resultados revelaron una correlación positiva moderada entre el emprendimiento en Perú y el desarrollo sostenible. En conclusión, el emprendimiento en Perú está relacionado de manera significativa con el desarrollo sostenible, especialmente en términos de contribución a los ODS y la promoción de la innovación y adaptabilidad. Sin embargo, se requiere una mayor atención a la participación comunitaria para fortalecer la relación entre el emprendimiento y la comunidad en general