709 research outputs found
Management and prevention of refeeding syndrome in medical inpatients: An evidence-based and consensus-supported algorithm
No full textObjectives:Refeeding syndrome (RFS) can be a life-threatening metabolic condition after nutritional re-plenishment if not recognized early and treated adequately. There is a lack of evidence-based treatmentand monitoring algorithm for daily clinical practice. The aim of the study was to propose an expert con-sensus guideline for RFS for the medical inpatient (not including anorexic patients) regarding risk factors,diagnostic criteria, and preventive and therapeutic measures based on a previous systematic literaturesearch.Methods:Based on a recent qualitative systematic review on the topic, we developed clinically relevantrecommendations as well as a treatment and monitoring algorithm for the clinical management of in-patients regarding RFS. With international experts, these recommendations were discussed and agreementwith the recommendation was rated.Results:Upon hospital admission, we recommend the use of specific screening criteria (i.e., low bodymass index, large unintentional weight loss, little or no nutritional intake, history of alcohol or drug abuse)for risk assessment regarding the occurrence of RFS. According to the patient’s individual risk for RFS, acareful start of nutritional therapy with a stepwise increase in energy and fluids goals and supplemen-tation of electrolyte and vitamins, as well as close clinical monitoring, is recommended. We also proposecriteria for the diagnosis of imminent and manifest RFS with practical treatment recommendations withadoption of the nutritional therapy.Conclusion:Based on the available evidence, we developed a practical algorithm for risk assessment, treat-ment, and monitoring of RFS in medical inpatients. In daily routine clinical care, this may help to optimizeand standardize the management of this vulnerable patient population. We encourage future quality studiesto further refine these recommendations
Dem Verstehen auf der Spur ‒ Unterrichtsstudien als transdiziplinäre Kooperation zur forschenden Entwicklung des Mathematikunterrichts: Ausgewählte Befunde zu den Grundvorstellungen von Schülerinnen und Schülern in Bezug auf das Rechnen mit negativen Zahlen aus dem Forschungs- und Entwicklungsprojekt „Positive Beispiele zu negativen Zahlen“
No full textKullmann H, Friedli R, Hattermann M. Dem Verstehen auf der Spur ‒ Unterrichtsstudien als transdiziplinäre Kooperation zur forschenden Entwicklung des Mathematikunterrichts: Ausgewählte Befunde zu den Grundvorstellungen von Schülerinnen und Schülern in Bezug auf das Rechnen mit negativen Zahlen aus dem Forschungs- und Entwicklungsprojekt „Positive Beispiele zu negativen Zahlen“. In: Koch B, Freke N, Kullmann H, Textor A, Zenke T, eds. Praxisforschung zum inklusiven Unterricht – Ergebnisse aus der Laborschule Bielefeld. Bad Heilbrunn: Klinkhardt; In Press
Liberalization of the Swiss Letter Market and the Viability of Universal Service Obligations
No full textWe discuss the ongoing liberalization process in the market for addressed letter mail in Switzerland. The core of the paper is an assessment of the liberalization's impact on the financial viability of various universal service obligations with and without access to the incumbent's downstream delivery network for customers and competitors. We propose a simple calibrated model of the Swiss letter market offering theoretical insights into the mechanics of market opening along with quantitative conclusions bearing direct policy relevance. The extent of the entrants' market coverage and the equilibrium in the resulting price competition are endogenously determined. Our simulations suggest caution in introducing full market opening. For the scenarios considered, the model shows that either the burden of the USO must be reduced (e.g. with respect to the frequency and the coverage of delivery and / or through price differentiation). Alternatively, other means of assuring financial stability of Swiss Post must be sought, be it through external funds or demand stimulation through new producs, possibly in the worksharing domain.Liberalization, Mail, Universal Service Obligation
Giedion and America: Repositioning the History of Modern Architecture
No full textSigfried Giedion (1888–1968), one of the main protagonists of the architectural avant-garde in Europe, paradoxically achieved this reputation in America, far from his homeland. Nearly all of Giedion’s books written after his initial stay at Harvard University were published in English long before they became available in his native German. Reto Geiser sheds new light on Giedion’s life and reassesses his work through the lens of cultural transformation and modernization processes. The author questions the unbroken line of developments portrayed in the historiography of modern architecture, and argues that Giedion’s position in between two cultural spheres not only caused ruptures and contradictions in his work but also productively shaped its reception on either side of the Atlantic
Reto y confrontación en el enfoque centrado en la persona
No full textIn this article the role of the challenge in the person centered approach is analized. With this aim the author has planned a small-scale research study using an open questionaire with a sample of 10 therapists and 15 clients. From this study it would appear that challenge, in terms of the opportunities and freedoms offered by the core conditions, is an integral part of the person centered approach.En este artículo la autora reflexiona sobre el papel que juegan el reto y la confrontación en el enfoque centrado en la persona. A este fin se plantea un estudio a pequeña escala a través de un cuestionario suministrado a una muestra reducida de diez terapeutas y quince clientes. Del análisis de sus resultados se deduce que reto y confrontación, en términos de nuevas oportunidades y alternativas son elementos nucleares del enfoque centrado en la persona
Evaluation der Bündner Tourismusreform 2006–2013
No full textDer vorliegende Bericht beinhaltet die Ergebnisse einer Evaluation der siebenjährigen Tourismusreform im Kanton Graubünden. Als Haupterkenntnis kann festgestellt werden, dass die Bündner Tourismusreform notwendig war und dass dabei die Regierung und insbesondere das Amt für Wirtschaft und Tourismus (AWT) eine wichtige Rolle spielte. Die Zielsetzungen der Reform waren äusserst ambitiös formuliert. Rückblickend erscheint es deshalb auch plausibel, dass in der kurzen Reformzeit nicht alle Ergebnis- und Wirkungsziele vollumfänglich erreicht wurden. Dennoch kann festgehalten werden, dass sich mit Hilfe der Reform die Voraussetzungen für einen wettbewerbsfähigen Bündner Tourismus verbessert haben. Aufgrund der grossen Bedeutung des Tourismus im Kanton Graubünden hat deren Regierung im Jahr 2006 das Projekt „Wettbewerbsfähige Strukturen und Aufgabenteilung im Bündner Tourismus“ initiiert und für den Zeitraum 2006-2012 dafür CHF 18 Mio. gesprochen. Hauptziel der Reform war es, marktfähigere Destinationsmanagement-Organisationen (DMO) und Regionale Tourismusorganisationen (ReTO) zu schaffen. Damit verbunden war eine effektivere und effizientere Aufteilung für Marktbearbeitung in den Kern-, Aufbau- und Zielmärkten. Flankierend zum Projekt wurden Massnahmen wie „Qualitätsprogramm Graubünden“ oder „Natur- und kulturnaher Tourismus“ gemeinsam mit den Destinationen entwickelt und umgesetzt.
Die Evaluation basiert auf drei Audit-Ansätzen. Im Prämissen-Audit wurden die Annahmen, Handlungsfelder und Zielsetzungen der Reform hinterfragt. Eine Überprüfung der Planungsprozesse, der Abläufe und der Organisation fand im Prozess-Audit statt. Schliesslich wurden im Ergebnis-Audit die unmittelbaren Erfolge der Reform analysiert. Daneben wurden auch die beiden flankierenden Massnahmen „Qualitätsprogramm Graubünden“ und „Natur- und kulturnaher Tourismus“ einer kritischen Überprüfung unterzogen. Im Bericht wird zudem diskutiert, welche Prozesse sowohl aus tourismuspolitischer Sicht als auch an der Basis konstruktiv verliefen und zu beachtlichen Ergebnissen führten, aber auch, wo der Reformprozess Reibungsverluste hervorrief. Die gewonnenen Erkenntnisse sollen bei einem Folgeprogramm genutzt werden
Farmacetiskā aprūpe un tās uzlabošanas iespējas Reto slimību pacientiem
No full textVeselības vadībaVeselības aprūpeHealth ManagementHealth CareFarmaceitiskā aprūpe un tās būtiskā nozīme pacientu veselības aprūpē ir jau gadiem aktuāla tēma farmaceitu darba ikdienā. Pieaugot reto slimību diagnostikai, pētniecībai un ārstēšanas iespējām, aptiekās pieaug arī medikamentu pieejamība šo slimību pacientiem. To, kādas ir farmaceitu zināšanas par reto slimību pacientiem, to diagnozēm un pielietojamo medikamentozo terapiju, pētīja darba autore.
Maģistra darba tēma ir “Farmaceitiskā aprūpe un tās uzlabošanas iespējas reto slimību pacientiem Latvijā”. Maģistra darba mērķis bija izpētīt farmaceitisko aprūpi reto slimību pacientiem un izstrādāt priekšlikumus tās pilnveidošanai Latvijā.
Pētījuma jautājumi:
1. Kādas konceptuālās pieejas pastāv un kāda ir starptautiskā prakse reto slimību pacientu farmaceitiskajā aprūpē?
2. Kāds ir reto slimību pacientu aprūpes un medikamentozās ārstēšanas nodrošinājums Latvijā?
3. Kāds ir farmaceitu pieejamās informācijas, zināšanu un profesionālās pieredzes līmenis par retajām slimībām un to medikamentozo ārstēšanu?
Hipotēze: Farmaceitiskā aprūpe reto slimību pacientiem būtiski atšķiras no tradicionālās farmaceitiskās aprūpes. Hipotēze tiek apstiprināta ar šādiem pētījuma secinājumiem:
1. 38% respondentu jeb 43 farmaceiti daļēji iztaujā pacientus par viņu diagnozēm un lietotajiem medikamentiem, savukārt 23% jeb 26 farmaceiti neuzdod pacientiem jautājumus par blakusslimībām vai lietotajiem medikamentiem, kā arī pacienti farmaceitiem neatklāj savas diagnozes, tādējādi neveidojas dialogs, kura laikā var tikt sniegta kvalitatīva farmaceitiskā aprūpe.
2. 70% jeb 80 farmaceitu uzskata, ka farmaceitiskās aprūpes plāns retu slimību pacientam ir nepieciešams, 83% jeb 5 eksperti uzskata, ka nav nepieciešams, kā arī 100% jeb visi 4 pacienti atbildēja, ka aptiekā nav nepieciešams farmaceitiskās aprūpes plāns reto slimību pacientiem.
Maģistra darbā ir 95 lappuses, 3 pielikumi, 22 tabulas, 14 attēli un 57 literatūras avoti.Pharmaceutical care and its essential role in patient health care has been a topical issue in the daily work of pharmacists for years. As the diagnosis, research and treatment options for rare diseases increase, so does the availability of medicines in pharmacies.
What is the knowledge of pharmacists about patients with rare diseases, their diagnoses and applicable drug therapy researched by the author of the paper.
Master's thesis topic Pharmaceutical care and its improvement opportunities for rare disease patients in Latvia.
The aim of the master's thesis is to study pharmaceutical care for patients with rare diseases and to develop proposals for its improvement in Latvia.
Research questions
1. What conceptual approaches exist and what is the international practice in pharmaceutical care for patients with rare diseases?
2. What is the provision of care and medical treatment for patients with rare diseases in Latvia?
3. What is the level of information, knowledge and professional experience available to pharmacists on rare diseases and their medical treatment?
Hypothesis: Pharmaceutical care for patients with rare diseases differs significantly from traditional pharmaceutical care. The hypothesis is confirmed by the following conclusions of the study:
1. 38% of respondents, or 43 pharmacists, partially ask patients about their diagnoses and medications, 23% or 26 pharmacists do not ask patients questions about co-morbidities or medications used, patients do not disclose their diagnoses to pharmacists, thus there is no dialogue during which quality pharmaceutical care can be provided.
2. 70% or 80 pharmacists believe that a pharmaceutical care plan for a rare disease patient is necessary, 83% or 5 experts believe that it is not necessary, as well as 100% or all 4 patients answered that a pharmacy does not need a pharmaceutical care plan for a rare disease patient.
Master's thesis consists of 95 Pages, 3 Appendice, 22 tables, 14 figures, and 57 literature sources
LA "SIEMBRA DEL PETRÓLEO": UN RETO PERENNE
No full textEl autor, desarrolla en este trabajo, la compleja y rica discusiva en torno a la industria del petróleo en Venezuela, destacando los aportes de paradigmas del pensamiento como Juan Pablo Pérez Alfonzo, ex- ministro de Energía y Minas en 1945 y 1958. La tesis de la "Siembra del Petróleo" expuesta por Arturo Uslar Pietri, y otros autores, se presenta como un reto permanente de las sociedades petroleras como la venezolana. Aunque comparte la orientación social de la actual política del gobierno del presidente Hugo Chávez, critica la voracidad del gasto fiscal. ABSTRACT The author develops in this work a rich and complex discussion about the oil industry in Venezuela emphasizing the contributions of paradigms of the thought like Juan Pablo Perez Alfonzo, ex- energy and mines minister in 1945 and 1958. The thesis of the sowing of oil (sembrar el petróleo) exposed by Arturo Uslar Pietri and other authors appears like a permanent challenge for oil societies like the Venezuelan. Although sharing the social direction of the current oil policy of president Chavez government, the author criticizes its voracity on the fiscal cost
Comunicación Global. El Reto Gerencial
No full textMax Römer PierettiLa responsabilidad de los gerentes en el ámbito de las comunicaciones de su empresa hace vital el conocimiento de las herramientas filosóficas y políticas que pueden mover a su e,presa hacia el camino del éxtio. Manejar las herramientas de la comunicación globla será el elemento diferenciador de las empresas en un futuro no muy lejano.Este artículo es una síntesis del libro Comunicación Global: el reto gerencial, el cual a su vez es un resumen de la tesis con el mismo nombre, que permitió al autor obtener su doctorado en Ciencias de la Información en la Universidad de La Laguna, Tenerife, España.AbstractThe responsability of the managers in the ambit of communications in their companies, make vital the knowledge of the philosophical and political tools that can move their enterprises towards the road of success. Handling the tools of global communication will be the differentiating element of enterprises in a not far away future.This article is a synthesis of the book Global Communications: The Managing Challenge, which is summary of the thesis with the same name that permitted the author obtain his doctorate in Sciences of the Information in the University of La Laguna, Tenerife, Spain
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