329 research outputs found

    A Decision Support System for Intermodal Logistics under Considerations for Costs of Security

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    Global supply chains have been challenged by the increased awareness of security risks, including those of terrorism, theft, and damage, and the potential in these risks for significant damages. Additionally, the pressure security initiatives and regulations, particularly at sea and air ports, threaten to add to congestion at these hubs in the international flow of goods and materials. Improving the efficiency of the flow of goods and materials, and therefore the stability and competitiveness of their supply chains, is the focus of this research. A decision support to combine strategic objectives with operational transport decision making is built to incorporate security considerations

    The use of motivational interviewing in community nursing

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    While lifestyle-related conditions such as heart diseas, obesity and diabetes are on the rise, district nurse numbers are falling. At the same time, traditional methods for providing lifestyle advice on factors such as smoking, alcohol intake and exercise have proven to be ineffective. This article examines how a technique called motivational interviewing, which seeks to build a partnership with the client, can promote positive change by strengthening the person's own motivation to change

    CPA eldercare : a practitioner\u27s resource guide;

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    https://egrove.olemiss.edu/aicpa_guides/1115/thumbnail.jp

    The role of microbiology and pharmacy departments in the stewardship of antibiotic prescribing in European hospitals

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    This observational, cross-sectional study describes the role played by clinical microbiology and pharmacy departments in the stewardship of antibiotic prescribing in European hospitals. A total of 170 acute care hospitals from 32 European countries returned a questionnaire on antibiotic policies and practices implemented in 2001. Data on antibiotic use, expressed as De.ned Daily Doses per 100 occupied bed-days (DDD/100 BD) were provided by 139 hospitals from 30 countries. A total of 124 hospitals provided both datasets. 121 (71%) of Clinical Microbiology departments and 66 (41%) of Pharmacy departments provided out of hours clinical advice. 70 (41%) of microbiology/infectious disease specialists and 28 (16%) of pharmacists visited wards on a daily basis. The majority of laboratories provided monitoring of blood cultures more than once per day and summary data of antibiotic susceptibility testing (AST) for empiric prescribing (86% and 73% respectively). Most of the key laboratory and pharmacy-led initiatives examined did not vary signi.cantly by geographical location. Hospitals from the North and West of Europe were more likely to examine blood cultures more than once daily compared with other regions (p < 0.01). Hospitals in the North were least likely routinely to report susceptibility results for restricted antibiotics compared to those in the South-East and Central/Eastern Europe (p < 0.01). Hospital wards in the North were more likely to hold antibiotic stocks (100%) compared with hospitals in the South-East which were least likely (39%) (p < 0.001). Conversely, hospital pharmacies in the North were least likely to dispense antibiotics on an individual patient basis (16%) compared with hospital pharmacies from Southern Europe (60%) (p = 0.01). Hospitals that routinely reported susceptibility results for restricted antibiotics had signi.cantly lower median total antibiotic use in 2001 (p < 0.01). Hospitals that provided prescribing advice outside normal working hours had signi.cantly higher antibiotic use compared with institutions that did not provide this service (p = 0.01). A wide range of antibiotic stewardship measures was practised in the participating hospitals in 2001, although there remains great scope for expansion of those overseen by pharmacy departments. Most hospitals had active antibiotic stewardship programmes led by specialists in infection, although there is no evidence that these were associated with reduced antibiotic consumption. There was also no evidence that pharmacy services reduced the amount of antibiotics prescribed.The ARPAC study was funded by the European Commission (project QLK2-CT-2001-00915). F.M. MacKenzie was supported by the European Study Group on Antibiotic Policies to write this manuscript

    Sex-differences in reasons for non-participation at recruitment : Geelong Osteoporosis Study

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    Background : Understanding reasons for non-participation in health studies can help guide recruitment strategies and inform researchers about potential sources of bias in their study sample. Whilst there is a paucity of literature regarding this issue, it remains highly plausible that men and women may have varied reasons for declining an invitation to participate in research. We aimed to investigate sex-differences in the reasons for non-participation at baseline of the Geelong Osteoporosis Study (GOS). Methods : The GOS, a prospective cohort study, randomly recruited men and women aged 20 years and over from a region in south-eastern Australia using Commonwealth electoral rolls (2001&ndash;06 and 1993&ndash;97, respectively). Reasons for non-participation (n=1,200) were documented during the two recruitment periods. We used the Pearson&rsquo;s chi squared test to explore differences in the reasons for non-participation between men and women. Results : Non-participation in the male cohort was greater than in the female cohort (32.9% vs. 22.9%; p&lt;0.001). Overall, there were sex-differences in the reasons provided for non-participation (p&lt;0.001); apparent differences related to time constraints (men 26.3% vs. women 10.4%), frailty/inability to cope with or understand the study (men 18.7% vs. women 30.6%), and reluctance over medical testing (men 1.1% vs women 9.9%). No sex-differences were observed for non-participation related to personal reason/disinterest, and language- or travel-related reasons. Conclusions : Improving participation rates in epidemiological studies may require different recruitment strategies for men and women in order to address sex-specific concerns about participating in research
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