WorldWideScience

Sample records for medicine stakeholder roles

  1. A quick needs assessment of key stakeholder groups on the role of family medicine in Zambia

    Directory of Open Access Journals (Sweden)

    J Sanders

    2017-10-01

    Full Text Available Background. Zambia is a nation of nine million people, and has too few physicians to meet the country’s health needs. Following the strategy of other sub-Saharan countries, Zambia has developed a training programme in family medicine to help improve the medical competencies of its physician workforce. A needs assessment was undertaken to better understand the landscape into which Zambian family medicine is being placed. Methods. In 2014, a nine-question survey in Likert-scale format was developed, validated, and then delivered to four stakeholder groups: (i practicing clinical physicians, (ii the general public, (iii the University of Zambia’s School of Medicine’s academic faculty and (iv medical students. The needs assessment was delivered through several different mechanisms: via web-based service, to respondents’ email addresses; in paper form, to population samples of convenience; and verbally, through face-to-face encounters. Results. The number of stakeholders from each group who responded to the needs assessment were: clinical physicians, 27; general public, 15; academic faculty, 14; and medical students, 31. Five of the nine survey statements achieved super-majority consensus, with >66% of stakeholders in each group agreeing. Two additional statements achieved a simple-majority consensus with >50% agreement within each stakeholder group. Conclusion. This survey suggests that there is a broad-based a priori understanding of family medicine in Zambia, and general agreement that its presence would be valuable to Zambia’s healthcare system.

  2. Information management to enable personalized medicine: stakeholder roles in building clinical decision support

    Directory of Open Access Journals (Sweden)

    Brinner Kristin M

    2009-10-01

    Full Text Available Abstract Background Advances in technology and the scientific understanding of disease processes are presenting new opportunities to improve health through individualized approaches to patient management referred to as personalized medicine. Future health care strategies that deploy genomic technologies and molecular therapies will bring opportunities to prevent, predict, and pre-empt disease processes but will be dependent on knowledge management capabilities for health care providers that are not currently available. A key cornerstone to the potential application of this knowledge will be effective use of electronic health records. In particular, appropriate clinical use of genomic test results and molecularly-targeted therapies present important challenges in patient management that can be effectively addressed using electronic clinical decision support technologies. Discussion Approaches to shaping future health information needs for personalized medicine were undertaken by a work group of the American Health Information Community. A needs assessment for clinical decision support in electronic health record systems to support personalized medical practices was conducted to guide health future development activities. Further, a suggested action plan was developed for government, researchers and research institutions, developers of electronic information tools (including clinical guidelines, and quality measures, and standards development organizations to meet the needs for personalized approaches to medical practice. In this article, we focus these activities on stakeholder organizations as an operational framework to help identify and coordinate needs and opportunities for clinical decision support tools to enable personalized medicine. Summary This perspective addresses conceptual approaches that can be undertaken to develop and apply clinical decision support in electronic health record systems to achieve personalized medical care. In

  3. Information management to enable personalized medicine: stakeholder roles in building clinical decision support.

    Science.gov (United States)

    Downing, Gregory J; Boyle, Scott N; Brinner, Kristin M; Osheroff, Jerome A

    2009-10-08

    Advances in technology and the scientific understanding of disease processes are presenting new opportunities to improve health through individualized approaches to patient management referred to as personalized medicine. Future health care strategies that deploy genomic technologies and molecular therapies will bring opportunities to prevent, predict, and pre-empt disease processes but will be dependent on knowledge management capabilities for health care providers that are not currently available. A key cornerstone to the potential application of this knowledge will be effective use of electronic health records. In particular, appropriate clinical use of genomic test results and molecularly-targeted therapies present important challenges in patient management that can be effectively addressed using electronic clinical decision support technologies. Approaches to shaping future health information needs for personalized medicine were undertaken by a work group of the American Health Information Community. A needs assessment for clinical decision support in electronic health record systems to support personalized medical practices was conducted to guide health future development activities. Further, a suggested action plan was developed for government, researchers and research institutions, developers of electronic information tools (including clinical guidelines, and quality measures), and standards development organizations to meet the needs for personalized approaches to medical practice. In this article, we focus these activities on stakeholder organizations as an operational framework to help identify and coordinate needs and opportunities for clinical decision support tools to enable personalized medicine. This perspective addresses conceptual approaches that can be undertaken to develop and apply clinical decision support in electronic health record systems to achieve personalized medical care. In addition, to represent meaningful benefits to personalized

  4. Stakeholders' Attitude to Genetically Modified Foods and Medicine

    OpenAIRE

    Amin, Latifah; Md Jahi, Jamaluddin; Md Nor, Abd Rahim

    2013-01-01

    Public acceptance of genetically modified (GM) foods has to be adequately addressed in order for their potential economic and social benefits to be realized. The objective of this paper is to assess the attitude of the Malaysian public toward GM foods (GM soybean and GM palm oil) and GM medicine (GM insulin). A survey was carried out using self-constructed multidimensional instrument measuring attitudes towards GM products. The respondents (n = 1017) were stratified according to stakeholders'...

  5. Stakeholders' attitude to genetically modified foods and medicine.

    Science.gov (United States)

    Amin, Latifah; Jahi, Jamaluddin Md; Nor, Abd Rahim Md

    2013-01-01

    Public acceptance of genetically modified (GM) foods has to be adequately addressed in order for their potential economic and social benefits to be realized. The objective of this paper is to assess the attitude of the Malaysian public toward GM foods (GM soybean and GM palm oil) and GM medicine (GM insulin). A survey was carried out using self-constructed multidimensional instrument measuring attitudes towards GM products. The respondents (n = 1017) were stratified according to stakeholders' groups in the Klang Valley region. Results of the survey show that the overall attitude of the Malaysian stakeholders towards GM products was cautious. Although they acknowledged the presence of moderate perceived benefits associated with GM products surveyed and were moderately encouraging of them, they were also moderately concerned about the risks and moral aspects of the three GM products as well as moderately accepting the risks. Attitudes towards GM products among the stakeholders were found to vary not according to the type of all GM applications but rather depend on the intricate relationships between the attitudinal factors and the type of gene transfers involved. Analyses of variance showed significant differences in the six dimensions of attitude towards GM products across stakeholders' groups.

  6. Medicine shortages in Fiji: A qualitative exploration of stakeholders' views.

    Science.gov (United States)

    Walker, Josephine; Chaar, Betty B; Vera, Numa; Pillai, Alvish S; Lim, Jessy S; Bero, Lisa; Moles, Rebekah J

    2017-01-01

    Medicine access is a human right; yet, concerningly, there are international instances of shortages. Quantitative data has allowed WHO to propose global solutions; however, individualised understanding of specific regions is still required to work towards national solutions. Fiji has an established issue with medication supply and the aim of this study was to use qualitative methods to gain a fuller understanding of this context. Semi-structured interviews were used to gain the perspective of key stakeholders involved in the Fijian medicine supply chain in regards to causes, impacts and possible solutions of medicine shortages. Thematic analysis was used to analyse the interview data. In total, 48 stakeholders participated and the information was synthesised into three main themes, causes, impacts and solutions and the sub-themes including; political, system and patient causes, adverse health effects on patients, professional dissatisfaction, monetary loss and loss of faith in the health system, workarounds, operation improvements, government intervention and education and training. The situation in Fiji is not dissimilar to other instances of shortages around the world and hence international solutions like that proposed by WHO are feasible; however, they must be modified to be uniquely Fijian to work in this context.

  7. Reviewing the role of stakeholders in Operational Research; A stakeholder theory perspective

    NARCIS (Netherlands)

    Gooyert, V. de; Rouwette, E.A.J.A.; Kranenburg, H.L. van; Freeman, R.E.

    2017-01-01

    The role of stakeholders in organizational decision-making is gaining more and more attention. Managers find that in order to create value sustainably and ethically, it is necessary to balance the interests of various stakeholders. This trend is reflected in the management literature, where much

  8. 76 FR 17659 - National Center for Complementary and Alternative Medicine Announcement of Stakeholder Roundtable

    Science.gov (United States)

    2011-03-30

    ... Complementary and Alternative Medicine Announcement of Stakeholder Roundtable ACTION: Notice. SUMMARY: The National Center for Complementary and Alternative Medicine (NCCAM) invites the public to a Stakeholder... Center for Complementary and Alternative Medicine (NCCAM) was established in 1999. The mission of NCCAM...

  9. Improving Quality Higher Education in Nigeria: The Roles of Stakeholders

    Science.gov (United States)

    Asiyai, Romina Ifeoma

    2015-01-01

    This paper discusses the roles of stakeholders in improving quality of university education in Nigeria. Internal and external stakeholders are identified and the various roles they could play in improving the quality of university education are discussed. The paper contends that continuous and holistic improvement in university education system…

  10. Redispensing of medicines unused by patients: a qualitative study among stakeholders.

    Science.gov (United States)

    Bekker, Charlotte L; Gardarsdottir, Helga; Egberts, Toine C G; Bouvy, Marcel L; van den Bemt, Bart J F

    2017-02-01

    Background Medication waste has undesirable economic and environmental consequences. This waste is partly unavoidable, but might be reduced by redispensing medicines unused by patients. However, there is little knowledge of stakeholders' views on the redispensing. Objective To identify the stakeholders' views on the redispensing of medicines unused by patients. Setting Dutch healthcare system. Method Semi-structured interviews were conducted with 19 Dutch stakeholders from September 2014 until April 2015. The interview guide included two themes: medication waste and redispensing of unused medicines. The latter included qualitative-, legal- and financial aspects and stakeholder involvement, with specific attention to the patient. Interview transcripts were subjected to thematic content analysis. Main outcome measure Requirements related to the redispensing of unused medicines. Results All stakeholders considered the redispensing of medicines desirable if the implementation is feasible and the requirements for the safe redispensing are met. All of them pointed out that the product quality of redispensed medicines should be guaranteed and that it should be clear who is responsible for the quality of redispensed medicines. The stakeholders stated that transparent communication to patients is essential to guarantee trust in the redispensing system and that patients should be willing to use redispensed medicines. Moreover, the redispensing system's benefits should outweigh the costs and a minimal economic value of medicines suitable for redispensing should be determined. Conclusion Redispensing unused medicines could decrease medication waste if several requirements are met. For successful implementation of a redispensing system, all relevant stakeholders should be involved and cooperate as a joint-force.

  11. role of stakeholders at cape coast ppag youth centre

    African Journals Online (AJOL)

    Elizabeth

    performed their roles as expected. It also sought to find out whether their roles had any significant impact on the lives of the youth as well as the centre. The study shows that both clients (youth) and service providers. (PPAG staff) do not enjoy any remarkable satisfaction from the services of the stakeholders. The actual roles ...

  12. Improving access to medicines via the Health Impact Fund in India: a stakeholder analysis.

    Science.gov (United States)

    McMullan, Patrick; Ajay, Vamadevan S; Srinivas, Ravi; Bhalla, Sandeep; Prabhakaran, Dorairaj; Banerjee, Amitava

    2018-01-01

    In India, 50-65% of the population face difficulties in accessing medicines. The Health Impact Fund (HIF) is a novel proposal whereby pharmaceutical companies would be paid based on the measured global health impact of their drugs. We conducted a key stakeholder analysis to explore access to medicines in India, acceptability of the HIF and potential barriers and facilitators at policy level. To conduct a stakeholder analysis of the HIF in India: to determine key stakeholder views regarding access to medicines in India; to evaluate acceptability of the HIF; and to assess potential barriers and facilitators to the HIF as a policy. In New Delhi, we conducted semi-structured interviews. There was purposive recruitment of participants with snowball sampling. Transcribed data were analysed using stakeholder analysis frameworks and directed content analysis. Participation rate was 29% (14/49). 14 semi-structured interviews were conducted among stakeholders in New Delhi. All participants highlighted access to medicines as a problem in India. There were mixed views about the HIF in terms of relevance and scaleability. Stakeholders felt it should focus on diseases with limited or no market and potentially incorporate direct investment in research. First, access to medicines is perceived to be a major problem in India by all stakeholders, but affordability is just one factor. Second, stakeholders despite considerable support for the idea of the HIF, there are major concerns about scaleability, generalisability and impact on access to medicines. Third, the HIF and other novel drug-related health policies can afford to be more radical, e.g. working outside the existing intellectual property rights regime, targeting generic as well as branded drugs, or extending to research and development. Further innovations in access to medicines must involve country-specific key stakeholders in order to increase the likelihood of their success.

  13. Role of Stakeholders at Cape Coast PPAG Youth Centre ...

    African Journals Online (AJOL)

    The study investigated whether the activities or the roles performed by the various stakeholders at the Cape Coast Planned Parenthood Association of Ghana (PPAG) youth centre impacted positively on the youth behaviour and performance at the centre. The sample comprised 22 teachers, 50 parents and 3 social welfare ...

  14. Rising stakeholder expectations and the changing role of public relations

    Energy Technology Data Exchange (ETDEWEB)

    Grossberndt, D. [BP Canada Energy Company, Calgary, AB (Canada)

    2004-07-01

    The role of public relations is changing along with growing public awareness of stakeholder's ability to intervene in the development of energy projects. Public relations and community consultation departments must work closely together to ensure that consistent messages are being delivered to the public. This presentation explained how to develop a successful public relations strategy ranging from environmental risk assessment to community consultation. It also discussed the degree to which effective and ongoing communication with stakeholders prevents opposition and negative media coverage.

  15. The IMO Technical Panel, its role and its stakeholdering process

    International Nuclear Information System (INIS)

    Cary, R.

    1999-01-01

    Some insight is provided for IPPSO members into the IMO Technical Panel (TP), its scope, modus operandi, and stakeholdering process. The TP is one of 3 panels recommended by the MDC and defined in the IMP bylaws. Its role is to consider rule changes and make recommendations to the IMO board. The aims of the Technical Panel are listed. The priority issues with significant direct impact on generators are: import and export transmission, including access to the inter-ties, and the Financial Transmission Rights associated with inter-ties, procedures governing new investment in transmission, participation and prudential requirements, and residual risk location, facility aggregation rules, local market power migration, must-run contracts; principles and forms of agreement, penalties for non-compliance with rules, and transitional provisions around market opening. The excluded major market design principles to be resolved by others are covered, as well as how it is decided what issues need attention. The TP does its work by: work planning, policy consultation, rule guidance and direction requests, and proposed rule amendments. Further points are listed concerning: how the TP secures stakeholder input, how the IPPSO stakeholder consultation process works, import and export transmission issues, and accreditation and prudential requirements

  16. The Role of Private Stakeholders in Disaster and Humanitarian Operations

    Directory of Open Access Journals (Sweden)

    Tharcisio Cotta Fontainha

    2016-06-01

    Full Text Available The role of private stakeholders in disaster operations goes far beyond the delivery of profits to its shareholders. Disasters and humanitarian operations literature acknowledges the importance of private sector in disaster lifecycle; however, it lacks an analysis of the risks and benefits of each different form of their engagement in such operations (contractual relationships, one-off relationships and CSR - Corporate Social Responsibility partnerships. To address this research gap, a literature review was conducted on papers covering the perspective of private stakeholders when engaging in disaster and humanitarian operations with stakeholders from public and social groups. The results revealed that some challenges are specific from one approach and others are common for all of them. Moreover, despite the increasing of reputation capital and organizational learning being used to motivate CSR approach, they are mentioned as benefits in approaches with lower engagement - contractual and one-off relationship approaches. Thus, the benefits and risks of each approach need to be carefully addressed by scholars and field professionals in order to seek better results from the engagement of private organizations.

  17. Generic medicines and generic substitution: contrasting perspectives of stakeholders in Ireland.

    Science.gov (United States)

    O'Leary, A; Usher, C; Lynch, M; Hall, M; Hemeryk, L; Spillane, S; Gallagher, P; Barry, M

    2015-12-15

    The Health (Pricing and Supply of Medical Goods) Act 2013 passed into law in July 2013 and legislated for generic substitution in Ireland. The aim of the study was to ascertain the knowledge and perceptions of stakeholders i.e. patients, pharmacists and prescribers, of generic medicines and to generic substitution with the passing of legislation. Three stakeholder specific questionnaires were developed to assess knowledge of and perceptions to generic medicines and generic substitution. Purposive samples of patients, prescribers and pharmacists were analysed. Descriptive quantitative and qualitative analyses were undertaken. A total of 762 healthcare professionals and 353 patients were recruited. The study highlighted that over 84% of patients were familiar with generic medicines and are supportive of the concept of generic substitution. Approximately 74% of prescribers and 84% of pharmacists were supportive of generic substitution in most cases. The main areas of concern highlighted by the healthcare professionals that might impact on the successful implementation of the policy, were the issue of bioequivalence with generic medicines, the computer software systems used at present in general practitioner (GP) surgeries and the availability of branded generics. The findings from this study identify a high baseline rate of acceptance to generic medicines and generic substitution among patients, prescribers and pharmacists in the Irish setting. The concerns of the main stakeholders provide a valuable insight into the potential difficulties that may arise in its implementation, and the need for on-going reassurance and proactive dissemination of the impact of the generic substitution policy. The existing positive attitude to generic medicines and generic substitution among key stakeholders in Ireland to generic substitution, combined with appropriate support and collaboration should result in the desired increase in rates of prescribing, dispensing and use of generic

  18. Ethical theory and stakeholder-related decisions: The role of stakeholder culture

    NARCIS (Netherlands)

    T.M. Jones; W.A. Felps (William); G. Bigley

    2007-01-01

    textabstractWe use convergent elements of major ethical theories to create a typology of corporate stakeholder cultures—the aspects of organizational culture consisting of the beliefs, values, and practices that have evolved for solving problems and otherwise managing stakeholder relationships. We

  19. Key stakeholder perspectives on the barriers and solutions to pharmacy practice towards complementary medicines: an Australian experience.

    Science.gov (United States)

    Ung, Carolina Oi Lam; Harnett, Joanna; Hu, Hao

    2017-08-09

    Although pharmacists are entrusted to play a role in ensuring the safe and appropriate use of all medicines, in general, the inclusion of complementary medicines (CMs) into their professional practice has not been observed. The purpose of this study was to explore the perceptions and opinions of pharmacists and 8 key stakeholder leaders regarding the barriers that hinder pharmacists from providing care related to the use of CMs by patients/consumers and to identify solutions that would support pharmacists' in extending their role in this area. Semi-structured key informant interviews were conducted with 2 practicing pharmacists, 1 pharmacy owner, 1 key representative of a pharmacist professional organization, 1 key representative of a consumer advocacy group, 1 key representative of a medical professional organization, 1 key representative from a complementary medicine practitioner professional organization, 1 leader within a pharmacy school, 2 senior staff from a regulatory authority, and 1 key representative of the complementary medicine industry in Australia. A total of 9 barriers were identified in this study. Barriers including a lack of CMs knowledge, doubts about the evidence-base, a lack of research skills and access to reliable and reputable information dominated the discussions. A total of 7 solutions were proposed. Of those, the integration of CMs curricula into under-graduate and professional pharmacy education, and defining a clearer role for pharmacists' standard of practice were considered the most important. Apposing opinions about the role of naturopaths in pharmacies were identified.. It is anticipated that pharmacists will be required to formalise a role in ensuring the safe and appropriate use of complementary medicines to fulfil their professional and ethical responsibilities. However, pharmacists in general are not ready to take up this extended role. Individual key stakeholder groups have considered the existing barriers and have proposed

  20. The Role of Stakeholders in Cultural Entrepreneurship Management

    Directory of Open Access Journals (Sweden)

    Zemite Ieva

    2016-06-01

    Full Text Available The skills and knowledge of the owners and employees of cultural enterprises on economic use of financial resources do not guarantee valuable artistic results. Therefore, a substantiated question has arisen: how to evaluate management in enterprises with bad financial ratios and outstanding artistic indicators. The existing definitions of cultural management (Aageson, 2008; Hagoort, 2007; Klamer, 1999; Stam, 2006; Nordman, 2003 also do not provide precise suggestions for determining the most important indicators in the evaluation of cultural management. The question is how to evaluate management in cultural entrepreneurship by determining the most important indicators for a cultural enterprise’s performance improvement. In order to define the goal of the stakeholders’ (artists, clients, media, arts scholars, third parties providing funds, cooperation partners engagement, it is necessary to analyse the area of an enterprise’s activities, and in what way and by what kind of activities it is possible to engage the stakeholders. During the course of empirical research, it is planned to disclose, analyse and interpret the subjective reasons of pursuit. Although a numerical evaluation of stakeholders was obtained during the research and data analysis performed by Spearman’s rho correlation calculations, the obtained results during the interpretation have not been generalised. The research results reveal the role of the cultural enterprise’s stakeholders’ engagement in the evaluation of management, point to the importance of the goals’ analysis as well as the analysis of each stakeholder’s engagement, and define the criteria for evaluating the activities in cultural entrepreneurship.

  1. Providing Quality Therapeutics in Switzerland: Role of the Stakeholders and Recent Incentives for Further Improvements.

    Science.gov (United States)

    Besson, Marie; Samer, Caroline; Rollason, Victoria; Dayer, Pierre; Desmeules, Jules

    2015-07-01

    Quality therapeutics play an important role in Switzerland's health care and economy. Switzerland holds a key position in the world of research and development, as well as in drug production. Recently, new emphasis has been placed on promoting clinical research and maintaining Switzerland's position as a center of excellence in the field. Recent revisions to the law regarding medical trials in human research allow for better allocation of regulatory resources and simplified procedures for drugs already authorized in Switzerland. The country has its own regulatory agency, the Swiss Agency for Therapeutic Products (Swissmedic), which is a public institution of the Swiss government. Swissmedic is responsible for ensuring safety in medicines, particularly regarding authorizations and market surveillance in the sector of medicinal products and medical devices. Although the centralized authorization procedure of the European Union for medicines does not apply to Switzerland, there are mutual recognition mechanisms between the Swiss medicine regulatory authority and the European Medicines Agency. Swissmedic is also in charge of postmarketing safety and oversees the national pharmacovigilance center, which collaborates closely with the World Health Organization center in Uppsala. In addition, university hospital-based clinical pharmacologists, who are involved in basic science and clinical research, regulatory affairs, ethics committees, and pharmacovigilance, promote quality therapeutics. This article discusses the role of the various stakeholders and the recent efforts made to provide a better allocation of resources aimed at further improving quality therapeutics in Switzerland. Copyright © 2015 Elsevier HS Journals, Inc. All rights reserved.

  2. A practical approach to communicating benefit-risk decisions of medicines to stakeholders.

    Science.gov (United States)

    Leong, James; Walker, Stuart; Salek, Sam

    2015-01-01

    The importance of a framework for a systematic structured assessment of the benefits and risks has been established, but in addition, it is necessary that the benefit-risk decisions and the processes to derive those decisions are documented and communicated to various stakeholders for accountability. Hence there is now a need to find appropriate tools to enhance communication between regulators and other stakeholders, in a manner that would uphold transparency, consistency and standards. A retrospective, non-comparative study was conducted to determine the applicability and practicality of a summary template in documenting benefit-risk assessment and communicating benefit-risk balance and conclusions for reviewers to other stakeholders. The benefit-risk (BR) Summary Template and its User Manual was evaluated by 12 reviewers within a regulatory agency in Singapore, the Health Sciences Authority (HSA). The BR Summary Template was found to be adequate in documenting benefits, risks, relevant summaries and conclusions, while the User Manual was useful in guiding the reviewer in completing the template. The BR Summary Template was also considered a useful tool for communicating benefit-risk decisions to a variety of stakeholders. The use of a template may be of value for the communicating benefit-risk assessment of medicines to stakeholders.

  3. Leading change in higher education. The role of transformational and stakeholder management

    OpenAIRE

    Sucozhañay Calle, Dolores

    2015-01-01

    Summary…iii Samenvatting . iv Resumen . vii Acknowledgments ix Table of Contents. xi List of tables xiii List of figures . xiii CHAPTER I General Introduction 2 CHAPTER II Transformational leadership and stakeholder management in library change . 47 CHAPTER III Successful change: the role of transformational leadership and stakeholder management in universities ... 73 CHAPTER IV Transformational leadership and stakeholder management: A...

  4. Stakeholders in nursing education: their role and involvement.

    Science.gov (United States)

    Virgolesi, M; Marchetti, A; Piredda, M; Pulimeno, A M L; Rocco, G; Stievano, A; De Marinis, M G

    2014-01-01

    In literature, there is evidence that all stakeholders need to be involved in the curricula building process to make sure that health professionals are "educated" to meet the stakeholders' "demands". In Italy, the involvement of stakeholders in the definition of university curricula is ratified by various regulations. To describe the major experiences of stakeholder involvement in nursing education, identify the main stakeholders for nursing education, and the processes in which they are involved. The search strategy included an electronic exploration of the relevant databases. The search terms were: Stakeholders, Curriculum, Nursing Education combined with Boolean operators. The references of the retrieved articles were hand searched for additional related studies. Most of the studies identified were from the United Kingdom, Australia, and the USA. In Italy, no relevant studies were found. The most frequently identified stakeholders were: students, clinicians, educators, nurse managers. They were mainly involved during profound changes in the curricula and the implementation of new educational approaches. Stakeholders are mostly involved in countries with a private funding system for universities. Such funding systems have probably developed in the academia a greater propensity to involve stakeholders, to provide recognition of success when starting new programs, and are perceived more as marketing research. This seems contrary to the spirit of the Italian and European regulatory interventions, which instead, provide a structured commitment to consolidating and expanding the collaboration among universities, users, and the world of labor. This latter collaboration should facilitate internship activities, lifelong learning, and employability of the newly-graduated professionals.

  5. Stakeholders' perspectives on the regulation and integration of complementary and alternative medicine products in Lebanon: a qualitative study.

    Science.gov (United States)

    Alameddine, Mohamad; Naja, Farah; Abdel-Salam, Sarah; Maalouf, Salwa; Matta, Claudia

    2011-08-28

    The regulation of the markets for Complementary and Alternative Medicine (CAM) products presents a global challenge. There is a dearth of studies that have examined or evaluated the regulatory policies of CAM products in the Eastern Mediterranean Region (EMR). We investigate the regulatory frameworks and the barriers for the proper regulation and integration of CAM products in Lebanon, as an example of an EMR country with a weak public infrastructure. We utilized a qualitative study design involving a series of semi-structured interviews with stakeholders of the CAM market in Lebanon. Snowball sampling was used to identify interviewees; interviews continued until the "saturation" point was reached. A total of 16 interviews were carried out with decision makers, representatives of professional associations, academic researchers, CAM product importers, policy makers and a media representative. Interviews were transcribed and thematic analysis of scripts was carried out. There was a consensus among all stakeholders that the regulation of the market for CAM products in Lebanon needs to be strengthened. Thematic analysis identified a number of impediments jeopardizing the safety of public consumption and hindering the integration of CAM therapies into mainstream medicine; including: weak infrastructure, poor regulation, ineffective policies and politics, weak CAM awareness and sub-optimal coordination and cooperation among stakeholders. With respect to policy instruments, voluntary instruments (self regulation) were deemed ineffective by stakeholders due to poor awareness of both users and providers on safe use of CAM products. Stakeholders' rather recommended the adoption of a combination of mixed (enhancing public awareness and integration of CAM into medical and nursing curricula) and compulsory (stricter governmental regulation) policy instruments for the regulation of the market for CAM products. The current status quo with respect to the regulation of CAM products

  6. The Role of Tertiary Education Stakeholders in Stemming the Tide of ...

    African Journals Online (AJOL)

    It then examines the causes and consequences of cultism on campus. The role which the authors feel that stakeholders in the educational enterprise should play are succinctly spelt out. Among the stakeholders for whom certain specific roles have been spelt out are the government (federal and state), parents, students, ...

  7. Views from stakeholders regarding stakeholder involvement and their own role - Views from Operators

    International Nuclear Information System (INIS)

    Baecker, Axel

    2006-01-01

    The German unification caused enormous economic and social impacts on the previous East German state. The nuclear power plant complex in Greifswald and the surrounding region was no exception. Energiewerke Nord GmbH (EWN) as owner of the NPP site in Greifswald must stop the operation of all fife operating 440 MW units with Russian type rectors and also all construction works on the other three NPP units and the decision was taken to decommission all plants, mainly due to a lack of political acceptance and secured financial basis. Thus, EWN was faced with a formidable task, virtually from one day to another, to close down and decommission a major nuclear site under the mentioned boundary conditions. Initially, difficulties were caused by massive personnel reductions (from around 4900 operational and 8000 construction staff to just 1200 employees), in combination with the introduction of a market economy and West German laws and procedures. In a closed co-operation with all stakeholders EWN has now reached an optimal size for its decommissioning tasks as well as for the future industrial use of the former NPP site

  8. The role of Stakeholders on implementing Universal Services in Vietnam

    DEFF Research Database (Denmark)

    Do Manh, Thai; Falch, Morten; Williams, Idongesit

    2015-01-01

    in performing the policy. The authors are to examine the stakeholders such as the national government, international organizations, policy intermediaries, companies, and customers/citizens via applying the qualitative method to gather data and analyse the secondary document. The qualitative approach...

  9. Perspectives on the role of stakeholders in knowledge translation in health policy development in Uganda.

    Science.gov (United States)

    Nabyonga Orem, Juliet; Marchal, Bruno; Mafigiri, DavidKaawa; Ssengooba, Freddie; Macq, Jean; Da Silveira, Valeria Campos; Criel, Bart

    2013-08-19

    Stakeholder roles in the application of evidence are influenced by context, the nature of the evidence, the policy development process, and stakeholder interactions. Past research has highlighted the role of stakeholders in knowledge translation (KT) without paying adequate attention to the peculiarities of low-income countries. Here we identify the roles, relations, and interactions among the key stakeholders involved in KT in Uganda and the challenges that they face. This study employed qualitative approaches to examine the roles of and links among various stakeholders in KT. In-depth interviews were conducted with 21 key informants and focused on the key actors in KT, their perceived roles, and challenges. Major stakeholders included civil society organizations with perceived roles of advocacy, community mobilization, and implementation. These stakeholders may ignore unconvincing evidence. The community's role was perceived as advocacy and participation in setting research priorities. The key role of the media was perceived as knowledge dissemination, but respondents noted that the media may misrepresent evidence if it is received in a poorly packaged form. The perceived roles of policy makers were evidence uptake, establishing platforms for KT and stewardship; negative roles included ignoring or even misrepresenting evidence that is not in their favor. The roles of parliamentarians were perceived as advocacy and community mobilization, but they were noted to pursue objectives that may not be supported by the evidence. The researchers' main role was defined as evidence generation, but focusing disproportionately on academic interests was cited as a concern. The donors' main role was defined as funding research and KT, but respondents were concerned about the local relevance of donor-supported research. Respondents reported that links among stakeholders were weak due to the absence of institutionalized, inclusive platforms. Challenges facing the stakeholders in

  10. A method to evaluate the role of stakeholder dynamics in IT based innovation adoption processes.

    Science.gov (United States)

    Postema, Tim

    2010-01-01

    The introduction of new information technology in organizations seems to lead to mixed results in practice. Innovation adoption success is dependent on user commitment and absorption of the innovation in work processes. For that reason, much can be gained in insights in the role of stakeholders during innovation adoption. In this article we are presenting an evaluation method for stakeholder dynamics during the IT based innovation journey in relation to innovation adoption predictors. The method covers two evaluation elements of these stakeholder dynamics; (a) the changing nature of stakeholder salience and changing role involvements of stakeholders on the one hand, and (b) the changing nature of stakeholder-innovation interaction during the adoption processes on the other. It is argued that a stakeholder's capacity and intentions together determine his role involvement and influence on innovation adoption and thus its decision making unit membership. To further enhance usability of the described method, we propose the use of structured implementation activities and their effect during different phases of the innovation journey on the decision making unit as constructed through stakeholder analysis.

  11. Stakeholders' roles and responsibilities regarding quality of care.

    Science.gov (United States)

    Huotari, Päivi; Havrdová, Zuzana

    2016-10-10

    Purpose The purpose of this paper is to describe how different stakeholders (society, managers, employees and clients) can together ensure the quality of care. Design/methodology/approach Qualitative data were collected from four focus group interviews conducted in three countries. All interviewees were pursuing a master's degree in social and/or health care management and had begun working in their field after completing their bachelor's degree. The data were analysed using inductive content analysis. Findings The society and managers are responsible for the care system as a whole and must apply system-oriented, rather than sector-oriented, thinking. Employees are responsible for ensuring the continuity of client services in their work, and managers and employees share the responsibility of achieving the organisational goals and quality standards. The clients are responsible for acting as responsible service users and providing the required information to obtain care. Communication was strongly emphasised in the data, and it necessitates cross-professional and organisational boundaries, professional and political boundaries, as well as boundaries between the professional and the client. Research limitations/implications Since the interviewees were all pursuing a master's degree in social and/or health care management, when reflecting on their work experience, they may have also been reflecting what they had learned in university. Practical implications This study emphasises the importance of collaboration and communication between stakeholders in ensuring the quality of care. Unpredictable economies, the ageing population and the ongoing integration and reorganisation of health and social care services in Europe highlight systematic and strategic approach in quality of care. Originality/value This paper claims that communication between different care stakeholders gives a more systematic and coherent framework for the quality of care. Quality of care is a

  12. The views of key stakeholders in Zimbabwe on the introduction of postgraduate family medicine training: A qualitative study.

    Science.gov (United States)

    Sururu, Cherifa; Mash, Robert

    2017-09-12

    Strengthening primary health care (PHC) is a priority for all effective health systems, and family physicians are seen as a key member of the PHC team. Zimbabwe has joined a number of African countries that are seriously considering the introduction of postgraduate family medicine training. Implementation of training, however, has not yet happened. To explore the views of key stakeholders on the introduction of postgraduate family medicine training. Key academic, governmental and professional stakeholders in Zimbabwean health and higher education systems. Twelve semi-structured interviews were conducted with purposively selected key stakeholders. Data were recorded, transcribed and analysed using the framework method. Anticipated benefits: More effective functioning of PHC and district health services with reduced referrals, improved access to more comprehensive services and improved clinical outcomes. Opportunities: International trend towards family medicine training, government support, availability of a small group of local trainers, need to revise PHC policy. Anticipated barriers: Family medicine is unattractive as a career choice because it is largely unknown to newly qualified doctors and may not be recognised in private sector. There is concern that advocacy is mainly coming from the private sector. Threats: Economic conditions, poor remuneration, lack of funding for resources and new initiatives, resistance from other specialists in private sector. Stakeholders anticipated significant benefits from the introduction of family medicine training and identified a number of opportunities that support this, but also recognised the existence of major barriers and threats to successful implementation.

  13. The role of stakeholder involvement in risk communication

    International Nuclear Information System (INIS)

    Renn, O.

    2004-01-01

    Inviting stakeholders to be part of the decision making process in risk analysis and management improves the likelihood that the resulting decision will be accepted. Unfortunately, early public involvement may compromise, however, the objective of efficient and effective risk reduction or violate the principle of fairness. Another problem is that the public consists of many groups with different value structures and preferences. Without a systematic procedure to reach consensus on values and preferences, the public's position often appears as unclear. Participatory processes are thus needed that combine technical expertise, rational decision making, and public values and preferences. The recent report by the National Academy of Sciences encourages risk professionals to foster citizen participation and public involvement in risk management. The report emphasizes the need for a combination of assessment and dialogue which the authors have framed the 'analytic-deliberative' approach. The popularity associated with the concepts of two-way-communication, trust-building, and citizen participation, however, obscures the challenge of how to put these noble goals into practice and how to ensure that risk management reflects competence, efficiency, and fair burden sharing. This paper discusses the potential and requirements for stakeholder participation in the field of risk management and communication. (orig.)

  14. The Role of Symbolic Capital in Stakeholder Disputes

    DEFF Research Database (Denmark)

    Benn, Suzanne; Jones, Richard

    2009-01-01

    This paper examines almost 30 years of disputation concerning the disposal of the world's largest stockpile of the toxic organochlorine, hexachlorbenzene. It describes the study of a chemicals company in its attempt to manage the disposal of the toxic waste in a collaborative fashion with governm......This paper examines almost 30 years of disputation concerning the disposal of the world's largest stockpile of the toxic organochlorine, hexachlorbenzene. It describes the study of a chemicals company in its attempt to manage the disposal of the toxic waste in a collaborative fashion...... with government, environmentalists and the local community. The study describes the new processes and structures specifically designed to address the decision-making and the issues of stakeholder perception and identity construction which have influenced the outcomes. Decision-making in such disputes is often...... corporate actors prioritize the building and maintaining of identity and symbolic capital rather than an active collaboration to solve the ongoing issue of the waste. As well, issues of access to expert knowledge highlight the relationship between conditions of uncertainty, technoscientific expertise...

  15. Complicity Revisited: Balancing Stakeholder Input and Roles in Evaluation Use

    Science.gov (United States)

    Sturges, Keith M.

    2015-01-01

    Drawing on a qualitative study of an educational reform and its external evaluation, I describe how a well-intentioned but poorly conceptualized evaluation helped perpetuate asymmetries in the generation and use of evaluation findings. This article explores this project's failure to clarify evaluator roles, identify intended users and expected…

  16. Incorporating Role of Stakeholders into Corporate CSR Strategy For Sustainable Growth: An Exploratory Study

    Directory of Open Access Journals (Sweden)

    Tanggamani Vani

    2017-01-01

    Full Text Available In today’s modern day context, Corporate Social Responsibility (CSR become the mantra for businesses as it can be seen as a strategic approach for firms to be succeed in their business endeavours. Hence, it remains the most widely used concept to refer to organizational- stakeholder relationships. An understanding about a stakeholder approach to CSR is an important means for a firm to enhance their commitment to operate in an economically, socially and environmentally sustainable manner. In support with above arguments, this article presents a theoretical proposition based on stakeholder theory for better CSR and firm performance. By drawing upon classic work in the field, the paper offers conceptual discussion and then systematically develops a means of stakeholder approach into corporate CSR strategy. The aim of this paper is to demonstrates the need for a firm to enhance further understanding about the role of stakeholders in the context of corporate CSR strategy, which is increasingly necessary in view of the fact that business entities are absolutely essential for economic development, but at the same time, their business activities pose a huge impact to society and the environment. Thus, firm's CSR disclosure is a pivotal tool to establish a relationship of working together with the stakeholders that ensures mutual benefit and continue to be a firm that is needed by society. This article contributes to the literature by providing a fundamental explanation of how a business should embrace responsibility for the impact of its activities on the stakeholders across various levels of the value chain. By doing so, firms are offered a means to take a much more proactive approach to CSR through the stakeholder approach which is precisely helpful in measuring the effectiveness of any CSR initiative on the society to foster business sustainability.

  17. Towards sustainable biotechnology innovation in Africa : The roles of stakeholders in local contexts

    NARCIS (Netherlands)

    Roelofs, Caspar

    2015-01-01

    Aim To contribute to sustainable crop-biotechnology innovation in African contexts by operationalizing guiding concepts from Science, Technology and Society (STS) studies. Objectives To explore the roles of different stakeholders in crop-biotechnology innovation processes in Africa; To explore how

  18. Shifting nature conservation approaches in Nature 2000 and the implications for the roles of stakeholders

    NARCIS (Netherlands)

    Ferranti, F.; Turnhout, E.; Beunen, R.; Behagel, J.H.

    2013-01-01

    This paper analyses Natura 2000 as a shifting configuration of different approaches to nature conservation and discusses the consequences of these shifts for the roles of the stakeholders affected by this policy. Natura 2000 started with a technocratic approach that privileged conservation

  19. Competing Structure, Competing Views: The Role of Formal and Informal Social Structures in Shaping Stakeholder Perceptions

    Directory of Open Access Journals (Sweden)

    Christina Prell

    2010-12-01

    Full Text Available What is social structure, and how does it influence the views and behaviors of land managers? In this paper, we unpack the term "social structure" in the context of current research on institutions, social networks, and their role(s in resource management. We identify two different kinds of structure, formal and informal, and explore how these link to views of land management and management practice. Formal structures refer to intentionally designed organizations that arise out of larger institutional arrangements; informal ones refer to social networks, based on the communication contacts individuals possess. Our findings show significant correlations between respondents' views regarding land management and their social networks; it is these informal structures that have greater influence on what stakeholders perceive. These findings suggest that stakeholders are less influenced by their particular organizational affiliation or category (e.g., "conservationist" versus "farmer", and more by whom they speak with on a regular basis regarding land management. We conclude with a discussion on the practical implications for resource managers wishing to "design" participatory management, arguing that, if "diversity" is the goal in designing such participatory processes, then diversity needs to translate beyond stakeholder categories to include consideration for the personal, social networks surrounding stakeholders.

  20. 75 FR 63143 - Solicitation of Input From Stakeholders Regarding Administration of the Veterinary Medicine Loan...

    Science.gov (United States)

    2010-10-14

    ... determines have a shortage of veterinarians, such as food animal medicine, public health, epidemiology, and... the practice of food animal medicine in veterinarian shortage situations. NARETPA section 1415A... Administration of the Veterinary Medicine Loan Repayment Program (VMLRP) AGENCY: National Institute of Food and...

  1. Stakeholder roles for fostering ambidexterity in Sub-Saharan African agricultural netchains for the emergence of multi-stakeholder cooperatives

    NARCIS (Netherlands)

    Pérez Perdomo, S.A.; Farrow, A.; Trienekens, J.H.; Omta, S.W.F.

    2015-01-01

    The Sub-Saharan African smallholder agricultural sector faces multiple and usually complex challenges, which can potentially be overcome by collective action. Smallholder farmers and other value chain stakeholders can tackle temporal, structural and contextual challenges by joining multi-level

  2. Determinants of stakeholders' attitudes towards a new technology: nanotechnology applications for food, water, energy and medicine

    NARCIS (Netherlands)

    Dijk, van H.; Fischer, A.R.H.; Marvin, H.J.P.; Trijp, van H.C.M.

    2017-01-01

    Stakeholder risk and benefit perceptions and attitudes towards a technology matter for the societal response to these technologies. This is especially the case for technological innovations where the public has no direct experience with the technology and its applications. In such cases, expert

  3. Role of laboratory medicine in collaborative healthcare.

    Science.gov (United States)

    Watson, Ian D; Wilkie, Patricia; Hannan, Amir; Beastall, Graham H

    2018-04-09

    Healthcare delivery and responsibility is changing. Patient-centered care is gaining international acceptance with the patient taking greater responsibility for his/her health and sharing decision making for the diagnosis and management of illness. Laboratory medicine must embrace this change and work in a tripartite collaboration with patients and with the clinicians who use clinical laboratory services. Improved communication is the key to participation, including the provision of educational information and support. Knowledge management should be targeted to each stakeholder group. As part of collaborative healthcare clinical laboratory service provision needs to be more flexible and available, with implications for managers who oversee the structure and governance of the service. Increased use of managed point of care testing will be essential. The curriculum content of laboratory medicine training programs will require trainees to undertake practice-based learning that facilitates interaction with patients, clinicians and managers. Continuing professional development for specialists in laboratory medicine should also embrace new sources of information and opportunities for collaborative healthcare.

  4. External Stakeholders' Roles and Factors Influencing Their Participation in Developing Generic Skills for Students in Vietnamese Universities

    Science.gov (United States)

    Nghia, Tran Le Huu

    2018-01-01

    External stakeholders have increasingly participated in instructional and training activities in higher education; however, their contribution has not yet been adequately documented, especially in non-Western university contexts. This article reports a study that examined external stakeholders' roles and factors influencing their participation in…

  5. Experiential Learning through Role-Playing: Enhancing Stakeholder Collaboration in Water Safety Plans

    Directory of Open Access Journals (Sweden)

    Giuliana Ferrero

    2018-02-01

    Full Text Available Improved water safety management, as addressed by the Sustainable Development Goals, can be aided by Water Safety Planning, a risk-assessment and risk-management approach introduced by the World Health Organization and implemented to date in 93 countries around the globe. Yet, this approach still encounters some challenges in practice, including that of securing collaboration among the broad range of stakeholders involved. This paper presents a role-playing game designed to foster stakeholder collaboration in Water Safety Plans (WSP. In this role-play, participants take on different stakeholders’ roles during a collective (team-based decision-making process to improve water supply safety in a fictive town. The game is the result of a transdisciplinary initiative aimed at integrating knowledge across technical and governance aspects of WSPs into an active learning experience for water sector actors from diverse backgrounds. It exposes participants to the four phases of Kolb’s experiential learning cycle: concrete experience, reflective observation, conceptualization and active experimentation. This paper discusses potential impacts of the WSP role-play, including skills and knowledge development among participants, which can support cross-sectoral integration and dealing with complexity in decision-making. These are capacity assets strongly needed to address water safety management challenges in a sustainable way.

  6. The role of stakeholders in the provision and management of water kiosks in Nkolokoti, Blantyre (Malawi)

    Science.gov (United States)

    Jimu, Ignasio Malizani

    Incongruent interests as well as unfulfilled aspirations of different stakeholders, including the city assembly, the water utility, local political leaders, and the water users are the catalyst of problems of management of water kiosks, at least as illustrated by the case study of Nkolokoti Township in Malawi. While noting that the rationality of water kiosks is to provide potable water to households that are unable to afford a private connection, political interference and inefficient management of revenues from public water kiosks imply that the goals are unattained. It also challenges the thinking that community involvement is a solution to problems of access to clean water among the low income people. The paper further demonstrates effects of institutional weaknesses or failures of other key stakeholders, a group that includes the Blantyre Water Board and the Blantyre City Assembly. Better management of water kiosks and sustainable supply of water to low income households requires a multi-pronged approach that involves clarification of roles and satisfactory performance of the same by different stakeholders. In terms of methodology, the paper is based on informal observations and formal and semi-structured interviews with key informants.

  7. Role of nuclear medicine in dentistry

    Directory of Open Access Journals (Sweden)

    Shazia Mushtaq

    2013-01-01

    Full Text Available Nuclear medicine studies often play a significant role in the diagnosis and treatment of oral and maxillofacial diseases. While not commonly used in everyday dental practice, the dental provider should have a conversational knowledge of these imaging modalities and understand the indications and limitations of these studies. The purpose of this review is to discuss the nuclear medicine studies that have applications in the head and neck region as well as their indications, limitations, and diagnostic conclusions that can be drawn from these studies.

  8. Role of honey in modern medicine

    Directory of Open Access Journals (Sweden)

    Sultan Ayoub Meo

    2017-07-01

    Full Text Available Use of honey has a very long history. Honey has been used since ancient time due to its nutritional and therapeutic values. There had been varied ways of consumption honey including its use as a sweetener and flavoring agent. Honey is produced all over the world. The most important nutriment of honey is carbohydrates present in the form of monosaccharides, fructose and glucose. Honey plays an important role as an antioxidant, anti-inflammatory, anti-bacterial agent and augments the adherence of skin grafts and wound healing process. The role of honey has been acknowledged in the scientific literature and there is convincing evidence in support of its antioxidant and antibacterial nature, cough prevention, fertility and wound healing properties. However, its use has been controversially discussed and has not been well accepted in the modern medicine. The aim of this review was explore and highlight the role of honey in modern medicine.

  9. Evaluation of the Role of Public Outreach and Stakeholder Engagement in Stormwater Funding Decisions in New England

    Science.gov (United States)

    A detailed report examining the role of public outreach and stakeholder engagement in stormwater funding decisions based on the experiences of eleven small and medium-sized communities in New England.

  10. The Impact of Stakeholders' Roles within the Livestock Industry on Their Attitudes to Livestock Welfare in Southeast and East Asia.

    Science.gov (United States)

    Sinclair, Michelle; Zito, Sarah; Phillips, Clive J C

    2017-01-25

    Stakeholders in the livestock industry are in a position to make critical choices that directly impact on animal welfare during slaughter and transport. Understanding the attitudes of stakeholders in livestock-importing countries, including factors that motivate the stakeholders to improve animal welfare, can lead to improved trade relations with exporting developed countries and improved animal welfare initiatives in the importing countries. Improving stakeholder attitudes to livestock welfare may help to facilitate the better welfare that is increasingly demanded by the public for livestock. Knowledge of the existing attitudes towards the welfare of livestock during transport and slaughter provides a starting point that may help to target efforts. This study aimed to investigate the animal welfare attitudes of livestock stakeholders (farmers, team leaders, veterinarians, business owners, business managers, and those working directly with animals) in selected countries in E and SE Asia (China, Thailand, Viet Nam, and Malaysia). The factors that motivated them to improve animal welfare (in particular their religion, knowledge levels, monetary gain, the availability of tools and resources, more pressing community issues, and the approval of their supervisor and peers) were assessed for their relationships to stakeholder role and ranked according to their importance. Stakeholder roles influenced attitudes to animal welfare during livestock transport and slaughter. Farmers were more motivated by their peers compared to other stakeholders. Business owners reported higher levels of motivation from monetary gain, while business managers were mainly motivated by what was prescribed by the company for which they worked. Veterinarians reported the highest levels of perceived approval for improving animal welfare, and all stakeholder groups were least likely to be encouraged to change by a 'western' international organization. This study demonstrates the differences in

  11. 77 FR 67330 - Solicitation of Input From Stakeholders Regarding the Veterinary Medicine Loan Repayment Program...

    Science.gov (United States)

    2012-11-09

    ... Independence Avenue SW., Washington, DC 20250-2299. Hand Delivery/Courier: VMLRP; Policy and Oversight Division... Agriculture; STOP 2299; 1400 Independence Avenue SW.; Washington, DC 20250-2299; Voice: (202) 559-5088; Email... attendance at an accredited college of veterinary medicine that result in a degree of Doctor of Veterinary...

  12. 76 FR 68126 - Solicitation of Input From Stakeholders Regarding the Veterinary Medicine Loan Repayment Program...

    Science.gov (United States)

    2011-11-03

    ... area. Loan repayment benefits are limited to payments of the principal and interest on government and commercial loans received for the attendance at an accredited college of veterinary medicine that result in a... greatest need. This section also provides that loan repayments may consist of payments of the principal and...

  13. Examining the Role of Stakeholder’s in Adopting Enterprise Application Integration Technologies in Local Government Domain

    OpenAIRE

    Muhammad Mustafa Kamal; Vishanth Weerakkody

    2010-01-01

    The realisation of innovative technological transformation in providing electronic services (e-Services) has often been associated with the presence of a number of prime stakeholders who perform their requisite functions in the organisation. In context of this research, the authors examine the potential role of key stakeholders involved in the Enterprise Application Integration (EAI) adoption process. Literature exemplifies that EAI technologies are large, comprehensive solutions that are com...

  14. Value-Driven Population Health: An Emerging Focus for Improving Stakeholder Role Performance.

    Science.gov (United States)

    Allen, Harris; Burton, Wayne N; Fabius, Raymond

    2017-12-01

    Health and health care in the United States are being jeopardized by top-end spending whose share of the gross domestic product continues to increase even as aggregate health outcomes remain mediocre. This paper focuses on a new approach for improving stakeholder role performance in the marketplace, value-driven population health (VDPH SM ). Devoted to maximizing the value of every dollar spent on population health, VDPH holds much promise for ameliorating this dilemma and exerting a constructive influence on the reshaping of the Affordable Care Act. This paper introduces VDPH and differentiates the science underlying it from the management that serves to make good on its potential. To highlight what VDPH brings to the table, comparisons are made with 3 like-minded approaches to health reform. Next, 2 areas are highlighted, workplace wellness and the quality and cost of health care, where without necessarily being recognized as such, VDPH has gained real traction among 2 groups: leading employers and, more recently, leading providers. Key findings with respect to workplace wellness are assessed in terms of psychometric performance to evaluate workplace wellness and to point out how VDPH can help direct future employer initiatives toward firmer scientific footing. Then, insights gleaned from the employer experience are applied to illustrate how VDPH can help guide future provider efforts to build on the model developed. This paper concludes with a framework for the use of VDPH by each of 5 stakeholder groups. The discussion centers on how VDPH transcends and differentiates these groups. Implications for health reform in the recently altered political landscape are explored.

  15. Pathogenesis and role of nuclear medicine

    International Nuclear Information System (INIS)

    Freedman, P. N; Korowlay, N. A

    2002-01-01

    The means by which replication of viruses takes place is explained, as it helps in the understanding of how viruses spread in the blood and how antiretroviral drugs work. The most important viruses, from a health care workers point of view, are hepatitis B and C and human immunodefiency virus (HIV). Whether nuclear medicine has a role to play in the diagnosis of these viruses, and the oportunistic infections that go with them, is debatable. Several radiopharmaceuticals are extremely sensitive for infection and tumor imaging but lack specificity. Patients' treatment is often not based on the outcome of the investigation but rather on preset protocols. AIDS patients are put on prophylactic antibiotic treatment as protection against infections such as toxoplasmosis and pneumocystis carinii pneumonia and there is a poor prognosis for AIDS patients with tumors (Au)

  16. Reviewing the Role of Stakeholders in Operational Research: Opportunities for Group Model Building

    NARCIS (Netherlands)

    Gooyert, V. de; Rouwette, E.A.J.A.; Kranenburg, H.L. van

    2013-01-01

    Stakeholders have always received much attention in system dynamics, especially in the group model building tradition, which emphasizes the deep involvement of a client group in building a system dynamics model. In organizations, stakeholders are gaining more and more attention by managers who try

  17. How stakeholder roles, power, and negotiation impact natural resource policy: A political economy view

    Science.gov (United States)

    Caughlan, L.

    2002-01-01

    Natural resource management decisions are complicated by multiple property rights, management objectives, and stakeholders with varying degrees of influence over the decision making process. In order to make efficient decisions, managers must incorporate the opinions and values of the involved stakeholders as well as understand the complex institutional constraints and opportunities that influence the decision-making process. Often this type of information is not understood until after a decision has been made, which can result in wasted time and effort.The purpose of my dissertation was to show how institutional frameworks and stakeholder involvement influence the various phases of the resource management decision-making process in a public choice framework. The intent was to assist decision makers and stakeholders by developing a methodology for formally incorporating stakeholders'' objectives and influence into the resource management planning process and to predict the potential success of rent-seeking activity based on stakeholder preferences and level of influence. Concepts from decision analysis, institutional analysis, and public choice economics were used in designing this interdisciplinary framework. The framework was then applied to an actual case study concerning elk and bison management on the National Elk Refuge and Grand Teton National Park near Jackson, Wyoming. The framework allowed for the prediction of the level of support and conflict for all relevant policy decisions, and the identification of each stakeholder''s level of support or opposition for each management decision.

  18. The moderating role of stakeholder pressure in the relationship between CSR practices and financial performance in a globalizing world

    DEFF Research Database (Denmark)

    Haleem, Fazli; Farooq, Sami; Boer, Harry

    2015-01-01

    Manufacturing Strategy Survey (IMSS-VI). Hierarchical regression is used to investigate three hypotheses on the relationships between CSR practices, financial performance and the influence of context and stakeholder pressures. The results show that CSR practices affect financial performance positively, while......Studies based on the role of context and stakeholder pressures on the relationship between CSR practices and financial performance are few and inconclusive. Aimed at contributing to filling this gap, the paper is based on data collected in 2013 from the sixth round of the International...

  19. The role of primary care in adult weight management: qualitative interviews with key stakeholders in weight management services

    OpenAIRE

    Blane, David N.; Macdonald, Sara; Morrison, David; O’Donnell, Catherine A.

    2017-01-01

    Background Primary care has a key role to play in the prevention and management of obesity, but there remain barriers to engagement in weight management by primary care practitioners. The aim of this study was to explore the views of key stakeholders in adult weight management services on the role of primary care in adult weight management. Methods Qualitative study involving semi-structured interviews with nine senior dietitians involved in NHS weight management from seven Scottish health bo...

  20. INTEGRATING THE ROLES OF STAKEHOLDERS IN PREVENTING THE HIV/AIDS TRANSMISSION IN EAST JAVA, INDONESIA

    Directory of Open Access Journals (Sweden)

    Toetik Koesbardiati

    2017-08-01

    Full Text Available HIV/AIDS prevention is very important and absolutely necessary. HIV transmission is now entering a fairly alarming level, in which people with HIV/AIDS in certain subpopulations are emerging. Special steps and resources are thus needed to cope with the condition. There are some phenomena potentially encourage HIV transmissions, such as the increasingly common free sex, homosexuality, the use of unsafe and unsterile syringes in narcotics consumption, commercial sex workers and various high-risk sexual activities. One of the crucial concerns that arises when sending prostitutes back to their hometowns without any coordinated and holistic mechanism is that the prostitutes may cause the spreading of HIV/AIDS in their hometowns. The research objective is to provide the material (input how the prostitutes themselves may cause the spreading of HIV/AIDS. The research employed descriptive method with a qualitative approach. The results showed that the implementation and the role division in the closure have been highly coordinated and holistic. The leading sector in the role division is the Social Welfare epartment of the Government in Surabaya. In terms of health aspects for the former prostitutes sent back to their hometowns, there has been no policies related to medical screening designed to identify the disease early. Screening is very important for early diagnosis during the post-closure phase. The screening mechanism is that the Provincial Health Department has to optimize the monitoring, coordination, cooperation, agreements and partnerships with stakeholders such as the Local Health Department and the National/Provincial/Distric AIDS Commission, NGOs that are concerned with the problems of HIV-AIDS, international organizations, professional organizations, community leaders, religious leaders and universities.

  1. Building corporate reputation with stakeholders: exploring the role of message ambiguity for social marketers

    OpenAIRE

    Dickinson-Delaporte, Sonia; Beverland, Michael B.; Lindgreen, Adam

    2010-01-01

    Purpose – Managing the corporate reputation of hybrid firms (organizations that act commercially to pursue social agendas) involves particular challenges because of competing stakeholder interests. With reference to the Trappist beer market, the paper seeks to identify the value of message ambiguity in reducing stakeholder tension, while simultaneously achieving a clear market positioning.\\ud \\ud Design/methodology/approach – In total, 25 in-depth interviews were conducted with brand marketer...

  2. Development and challenges of palliative care in Indonesia: role of psychosomatic medicine.

    Science.gov (United States)

    Putranto, Rudi; Mudjaddid, Endjad; Shatri, Hamzah; Adli, Mizanul; Martina, Diah

    2017-01-01

    To summarize the current status of palliative care and the role of psychosomatic medicine in Indonesia. Palliative care is not a new issue in Indonesia, which has been improving palliative care since 1992 and developed a palliative care policy in 2007 that was launched by the Indonesian Ministry of Health. However, the progress has been slow and varied across the country. Currently, palliative care services are only available in a few major cities, where most of the facilities for cancer treatment are located. Psychosomatic medical doctors have advantages that contribute to palliative care because of their special training in communication skills to deal with patients from the standpoints of both mind and body. Palliative care services in Indonesia are established in some hospitals. Future work is needed to build capacity, advocate to stakeholders, create care models that provide services in the community, and to increase the palliative care workforce. Psychosomatic medicine plays an important role in palliative care services.

  3. ROLE OF GEMS IN INDIAN MEDICINE

    Science.gov (United States)

    Murthy, S.R.N.

    1991-01-01

    This paper is the first attempt in introducing the medicinal importance of gems as found in the Sanskrit text ‘Rasaratnasamuccaya’, which has been rendered an English translation here. The modern physicians and gemologists will find this study quite useful in continuing research and, thus, develop a new field of gem medicine. PMID:22556526

  4. The role of veterinary medicine regulatory agencies.

    Science.gov (United States)

    Smith, M V

    2013-08-01

    An effective animal medicine regulatory programme includes a systematic, evidence-based means of documenting the safety and effectiveness of products before they are produced, marketed or used in a particular country or region. The programme must also include adequate monitoring and controls over the use of these substances. It is clearthat such programmes provide veterinarians, farmers and other animal medicine users with greater assurance that veterinary drugs and biologicals will be safe and effective in preventing and mitigating disease. It is important that these regulatory controls include programmes to ensure that human food obtained from treated animals is safe and that all potential toxicological and microbiological hazards that may be associated with the use of veterinary medicines have been adequately evaluated. There is a great need worldwide for veterinary medicines that provide needed therapies for vast numbers of animals and animal species and, in the case of food-producing animals, for medicinal products that enhance the productivity and efficiency of food production and ensure food safety when they are used in accordance with their approval specifications. The public health mission of regulatory agencies succeeds when they are able to put into the hands of the user an approved, safe and effective, well-manufactured and appropriately labelled medicine, and when there are adequate controls in place to assure proper compliance.

  5. Stakeholder diversity and the comprehensiveness of sustainability decisions : the role of collaboration and conflict

    NARCIS (Netherlands)

    Curşeu, Petru Lucian; Schruijer, S.G.L.

    2017-01-01

    We review the literature (2007–2016) on the quality of sustainability decisions and we introduce an integrative conceptual framework that distinguishes between a beneficial and a detrimental path that explain the influence of stakeholder diversity on the comprehensiveness of sustainability

  6. Employee stakeholders' role in ensuring alignment between employee and organizational branding

    DEFF Research Database (Denmark)

    Thomsen, Elisabeth Houe

    2014-01-01

    The aim of this article is to examine the relationship between two different yet overlapping groups with the same goal of representing the business in a consistent way - namely management and employees. In practice though, the management stakeholder group often determines what to communicate, and...

  7. Occupational health and safety policy and psychosocial risks in Europe: the role of stakeholders' perceptions.

    Science.gov (United States)

    Iavicoli, Sergio; Natali, Elena; Deitinger, Patrizia; Maria Rondinone, Bruna; Ertel, Michael; Jain, Aditya; Leka, Stavroula

    2011-06-01

    Psychosocial risks are now largely acknowledged throughout Europe as important challenges in occupational health and safety. However, there appear to be wide gaps in perception between experts and the general population on the nature and the relevance of psychosocial risks that have a potential impact on policy development and implementation in this area. This study investigated the level of knowledge among European stakeholders, of legislation on occupational safety and health, focusing particularly on psychosocial risk factors. 75 members of employers' associations, trade unions and government institutions from 21 countries in the European Union (EU) participated in the study. In addition, to further elaborate the findings of the survey, focus groups were organised during a 2-day stakeholder workshop. The level of application of European Directive 89/391 for the assessment and management of psychosocial risks and work-related stress was largely reported by the stakeholders as inadequate. This opinion was more marked in the new EU27 countries than the older EU15, and the difference was significant as regards the impact of the Directive on the assessment and management of psychosocial risks. Overall, psychosocial risks and work-related stress were reported to be important occupational health and safety concerns; however there were important differences among stakeholders in different countries. Despite the development of knowledge and activities on both the policy and practice levels in recent years, further work is still needed to harmonize stakeholder perceptions in this area in the various EU member states. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  8. Stakeholder Views of Nanosilver Linings: Macroethics Education and Automated Text Analysis Through Participatory Governance Role Play in a Workshop Format.

    Science.gov (United States)

    Dempsey, Joshua; Stamets, Justin; Eggleson, Kathleen

    2017-06-01

    The Nanosilver Linings role play case offers participants first-person experience with interpersonal interaction in the context of the wicked problems of emerging technology macroethics. In the fictional scenario, diverse societal stakeholders convene at a town hall meeting to consider whether a nanotechnology-enabled food packaging industry should be offered incentives to establish an operation in their economically struggling Midwestern city. This original creative work was built with a combination of elements, selected for their established pedagogical efficacy (e.g. active learning, case-based learning) and as topical dimensions of the realistic scenario (e.g. nanosilver in food packaging, occupational safety and health). The product life cycle is used as a framework for integrated consideration of scientific, societal, and ethical issues. The Nanosilver Linings hypothetical case was delivered through the format of the 3-hour workshop Ethics when Biocomplexity meets Human Complexity, providing an immersive, holistic ethics learning experience for STEM graduate students. Through their participation in the Nanosilver Linings case and Ethics when Biocomplexity meets Human Complexity workshop, four cohorts of science and engineering doctoral students reported the achievement of specific learning objectives pertaining to a range of macroethics concepts and professional practices, including stakeholder perspectives, communication, human values, and ethical frameworks. Automated text analysis of workshop transcripts revealed differences in sentiment and in ethical framework (consequentialism/deontology) preference between societal stakeholder roles. These resources have been recognized as ethics education exemplars by the U.S. National Academy of Engineering .

  9. An Empirical Analysis of Stakeholders' Influence on Policy Development: the Role of Uncertainty Handling

    Directory of Open Access Journals (Sweden)

    Rianne M. Bijlsma

    2011-03-01

    Full Text Available Stakeholder participation is advocated widely, but there is little structured, empirical research into its influence on policy development. We aim to further the insight into the characteristics of participatory policy development by comparing it to expert-based policy development for the same case. We describe the process of problem framing and analysis, as well as the knowledge base used. We apply an uncertainty perspective to reveal differences between the approaches and speculate about possible explanations. We view policy development as a continuous handling of substantive uncertainty and process uncertainty, and investigate how the methods of handling uncertainty of actors influence the policy development. Our findings suggest that the wider frame that was adopted in the participatory approach was the result of a more active handling of process uncertainty. The stakeholders handled institutional uncertainty by broadening the problem frame, and they handled strategic uncertainty by negotiating commitment and by including all important stakeholder criteria in the frame. In the expert-based approach, we observed a more passive handling of uncertainty, apparently to avoid complexity. The experts handled institutional uncertainty by reducing the scope and by anticipating windows of opportunity in other policy arenas. Strategic uncertainty was handled by assuming stakeholders' acceptance of noncontroversial measures that balanced benefits and sacrifices. Three other observations are of interest to the scientific debate on participatory policy processes. Firstly, the participatory policy was less adaptive than the expert-based policy. The observed low tolerance for process uncertainty of participants made them opt for a rigorous "once and for all" settling of the conflict. Secondly, in the participatory approach, actors preferred procedures of traceable knowledge acquisition over controversial topics to handle substantive uncertainty. This

  10. STAKEHOLDER DISTRUST - Implications of Distrust Research for Stakeholder Theory

    OpenAIRE

    Laude, Daniel; Weibel, Antoinette; Sachs, Sybille; Schafheitle, Simon Daniel

    2017-01-01

    Stakeholder theory has addressed the role of trust in organization-stakeholder relationships in depth. Although it is similarly relevant, distrust as a distinct construct from (low) trust has received relatively little consideration by stakeholder theorists. Thus, this article focuses on stakeholder distrust and reflects on the findings of distrust research in organizational studies and the implications for stakeholder theory. For this purpose, we conduct a systematic literature review of org...

  11. Examining critical factors affecting graduate retention from an emergency medicine training program in Addis Ababa, Ethiopia: a qualitative study of stakeholder perspectives

    Directory of Open Access Journals (Sweden)

    Meredith Jane Kuipers

    2017-04-01

    Full Text Available Background: In Ethiopia, improvement and innovation of the emergency care system is hindered by lack of specialist doctors trained in emergency medicine, underdeveloped emergency care infrastructure, and consumable resource limitations. Our aim was to examine the critical factors affecting retention of graduates from the Addis Ababa University (AAU post-graduate emergency medicine (EM training program within the Ethiopian health care system. Methods: Qualitative interviews were conducted with current AAU EM residents and stakeholders in Ethiopian EM. Mixed-methods inductive thematic analysis was performed. Results: Resident and stakeholder participants identified critical factors in three domains: the individual condition, the occupational environment, and the national context. Within each domain, priority themes emerged from the responses, including the importance of career satisfaction over the career continuum (individual condition, the opportunity to be involved in the developing EM program and challenges associated with resource, economic, and employment constraints (occupational environment, and perceptions regarding the state of awareness of EM and the capacity for change at the societal level (national context. Conclusions: This work underscores the need to resolve multiple systemic and cultural issues within the Ethiopian health care landscape in order to address EM graduate retention. It also highlights the potential success of a retention strategy focused on the career ambitions of keen EM doctors.

  12. The role of symbolic capital in stakeholder disputes: decision-making concerning intractable wastes.

    Science.gov (United States)

    Benn, Suzanne; Jones, Richard

    2009-04-01

    This paper examines almost 30 years of disputation concerning the disposal of the world's largest stockpile of the toxic organochlorine, hexachlorbenzene. It describes the study of a chemicals company in its attempt to manage the disposal of the toxic waste in a collaborative fashion with government, environmentalists and the local community. The study describes the new processes and structures specifically designed to address the decision-making and the issues of stakeholder perception and identity construction which have influenced the outcomes. Decision-making in such disputes is often theorized from the perspective of the emergence of highly individualized and reflexive risk communities and changing modes and expectations of corporate responsibility as a result of detraditionalization. We argue that the stakeholder interaction in this study reflects competing discourses in which corporate actors prioritize the building and maintaining of identity and symbolic capital rather than an active collaboration to solve the ongoing issue of the waste. As well, issues of access to expert knowledge highlight the relationship between conditions of uncertainty, technoscientific expertise and identity. The events of the study highlight the challenges faced by contemporary technoscientific corporations such as chemicals companies as they must deliver on requirements of transparency and openness, while maintaining technoscientific capacity and strong internal identity. We conclude that the study demonstrates the co-existence of social processes of individualization and detraditionalization with quasi-traditions which maintain authority, thus challenging the radical distinctions made in the literature between modernity and late or reflexive modernity.

  13. [The role of imagination in modern medicine].

    Science.gov (United States)

    Schott, Heinz

    2004-06-01

    In Renaissance and early modern times, the concept of imagination (Latin imaginatio) was essential for the (natural) philosophical explanation of magic processes, especially in the anthropology of Paracelsus. He assumed that imagination was a natural vital power including cosmic, mental, phychical, and physical dimensions. The Paracelsians criticized traditional humor pathology ignoring their theory of' 'natural magic'. On the other hand, they were criticized by their adversaries as charlatans practicing 'black magic'. About 1800, in between enlightenment and romanticism, the healing concept of, animal magnetism' (Mesmerism) evoked an analogous debate, whether, magnetic' phenomena originated from a real (physical) power (so-called, fluidum') or were just due to fantasy or imagination (German Einbildungskraft). At the end of the 19th century, the French internist Hippolyte Bernheim created-against the background of medical hypnosis (hypnotism') as a consequence of Mesmerism - his theory of suggestion and autosuggestion: a new paradigm of psychological respectively psychosomatic medicine, which became the basis for the concept of, placebo' in modern biomedicine. From now on, all the effects of, alternative medicine' could easily be explained by the, placebo-effect', more or less founded - at least unconsciously - on fraud.

  14. Stakeholder Dissonance

    DEFF Research Database (Denmark)

    Lauesen, Linne Marie

    2016-01-01

    The purpose of this chapter is to investigate the question of whether corporate social responsibility (CSR) can be used as a link of trust between business and society, and which role CSR plays in recovering distrust in businesses. It uses a mixed methods study of processes of moving businesses...... within the Danish water sector from a general trust-breakdown to trust recovery from 2003 to 2013. Trust recovery is found to depend on stakeholders’ mutual engagement with each other and their willingness to share knowledge and learn from each other’s professional and institutional cultures....... This chapter suggests a theoretical extension of Bogenschneider and Corbett’s (2010) Community Dissonance Theory to embrace multiple stakeholders each having their own complex and unique culture and communication modus based on their institutional, professional or individual comprehensive language universes...

  15. A quick needs assessment of key stakeholder groups on the role of ...

    African Journals Online (AJOL)

    African Journal of Health Professions Education ... Zambia is a nation of nine million people, and has too few physicians to meet the country's health needs. ... other sub- Saharan countries, Zambia has developed a training programme in family medicine to help improve the medical competencies of its physician workforce.

  16. Innovation in cardiovascular disease in Europe with focus on arrhythmias: current status, opportunities, roadblocks, and the role of multiple stakeholders.

    Science.gov (United States)

    Prinzen, Frits W; Dagres, Nikolaos; Bollmann, Andreas; Arnar, David O; Bove, Sylvie; Camm, John; Casadei, Barbara; Kirchhof, Paulus; Kuck, Karl-Heinz; Lumens, Joost; Michel, Martin C; Schwartz, Peter J; Van Vleymen, Betty; Vardas, Panos; Hindricks, Gerhard

    2017-06-12

    The European Heart Rhythm Association (EHRA) held an Innovation Forum in February 2016, to consider issues around innovation. The objective of the forum was to extend the innovation debate outside of the narrow world of arrhythmia specialists and cardiology in general, and seek input from all stakeholders including regulators, strategists, technologists, industry, academia, health providers, medical societies, payers, and patients. Innovation is indispensable for a continuing improvement in health care, preferably at higher efficacy and lower costs. It requires people who have been trained in a good scientific environment, high-quality research for achieving ground breaking inventions and the certainty of return on innovation investments. In the context of cardiovascular disease, innovation can imply better risk assessment and stratification, device technology, drug development, and process design. Several areas of promising developments were identified as well as several roadblocks to innovation. To drive innovation forward all stakeholders need to play a significant role. In a globalized and extremely competitive world, the leading role of Europe in medical innovation can only be achieved through a combined and well-coordinated effort from all involved parties. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.

  17. Congenital Hypothyroidism: Role of Nuclear Medicine.

    Science.gov (United States)

    Keller-Petrot, Isabelle; Leger, Juliane; Sergent-Alaoui, Aline; de Labriolle-Vaylet, Claire

    2017-03-01

    Thyroid scintigraphy holds a key place in the etiologic workup of neonatal hypothyroidism. Routine screening for this disorder in maternity hospitals in industrialized countries, for nearly 40 years, has permitted early treatment and thereby helped to prevent its physical and mental complications. Neonatal hypothyroidism affects approximately 1 in 3000 births. The most common causes are abnormal thyroid gland development and defective hormone synthesis by an eutopic thyroid gland. The incidence of the latter has risen in recent years, for reasons that remain unclear. A thorough etiologic workup helps to determine the disease type. Current guidelines recommend thyroid imaging by means of ultrasound and scintigraphy. Ultrasound should be done by a practitioner trained to examine the cervical region of newborns, as the thyroid is very small and must be distinguished from the particular aspect of the "thyroid empty lodge." Ultrasound lacks sensitivity for detecting small ectopic glands but is the gold standard for measuring thyroid dimensions. Scintigraphy provides an etiologic diagnosis in most cases. The two isotopes used in this setting are technetium-99m and iodine-123. The latter isotope gives more contrast and allows the perchlorate discharge test to be performed to detect abnormal iodide organification in the neonate with an eutopic thyroid. If scintigraphy cannot be performed during the neonatal period, a postponed procedure can be achieved after 3 years of age. Close cooperation between the nuclear medicine physician and the pediatric endocrinologist is crucial for timely and optimized scintigraphy. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Role of radiology in occupational medicine

    International Nuclear Information System (INIS)

    Vehmas, T.

    2004-01-01

    This review discusses the contribution of radiology to occupational medicine as well as work-related problems in radiology dept.s. Research issues are emphasized. Radiology has been used especially when diagnosing occupational respiratory and locomotive system problems and solvent-induced encephalo- and hepatopathy. The aim of research in these areas is usually to characterize occupational diseases and to identify physico-chemical hazards in the work place by comparing between groups of workers and non-exposed controls. Radiological imaging allows an objective characterization of the disease, and it may clarify the pathogenesis of the process and provide a useful epidemiological tool. Advanced statistical methods are often needed to adjust analyses for confounding variables. As the diagnostic requirements are increasing, more sensitive and sophisticated radiological methods, such as high-resolution computed tomography, magnetic resonance imaging and magnetic resonance spectroscopy, may be required for the early recognition of occupational health risks. This necessitates good cooperation between occupational health units and well-equipped imaging dept.s. Considering occupational problems in radiology departments, the increasing use of digital radiology requires ergonomic measures to control and prevent locomotive problems caused by work with computers. Radiation protection measures are still worth concern, especially in interventional radiology

  19. Stakeholder Governance

    DEFF Research Database (Denmark)

    Flak, Leif Skiftenes; Rose, Jeremy

    2005-01-01

    The e-government field, like most young fields, lacks a strong body of well-developed theory. One strategy for coping with theoretical immaturity is to import and adapt theories from other, more mature fields. This study reviews Stakeholder Theory (ST) and investigates its potential in relation...... to e-Government. Originally a management theory, stakeholder theory advocates addressing the concerns of all stakeholders in a firm, as opposed to concentration on the interests of senior managers and stockholders. Apart from the original profit focus, there is no serious conceptual mismatch between...... stakeholder theory and government’s objective of providing policy and services for citizens and organizations – society’s stakeholders. Potential problems with adapting a management theory to a government setting are discussed. The paper further discusses how information technology impacts a stakeholder model...

  20. Strategies for Increasing the Role of Family Medicine in Mexican Health Care Reform.

    Science.gov (United States)

    Ramírez Aranda, José Manuel; van Weel, Chris; Goodyear-Smith, Felicity

    2017-01-01

    There is little or no role for primary care and family medicine in current health reforms in Mexico. However, robust evidence shows that primary care helps prevent morbidity and mortality and increases health equity. Mexico has participated in several international meetings sponsored by the World Organization of National Colleges, Academies and Academic Associations and the North American Primary Care Research Group that are aimed at increased understanding of national health systems and the need to strengthen primary care for improved health outcomes. From 1 of these meetings the Cancún Manifesto emerged, with a strategic plan to increase the stature and impact of the Mexican College of Family Physicians (COLMEXAC) in strengthening primary care in Mexico. We aim to describe this strategic plan and discuss its early implementation, and for this account to serve as a possible formula for other countries. The 5 specific strategies discussed are 1) the need for consensus on the leading role of the Mexican family physician in the national health system; 2) health ecology research; 3) to improve the perception of patients about the benefits of primary care and family medicine; 4) to organize meetings of health providers, users, and other stakeholders; and 5) to promote the professionalization of COLMEXAC as a legal entity. © Copyright 2017 by the American Board of Family Medicine.

  1. Precision or Personalized Medicine for Cancer Chemotherapy: Is there a Role for Herbal Medicine.

    Science.gov (United States)

    Wang, Zhijun; Liu, Xuefeng; Ho, Rebecca Lucinda Ka Yan; Lam, Christopher Wai Kei; Chow, Moses Sing Sum

    2016-07-07

    Although over 100 chemotherapeutic agents are currently available for the treatment of cancer patients, the overall long term clinical benefit is disappointing due to the lack of effectiveness or severe side effects from these agents. In order to improve the therapeutic outcome, a new approach called precision medicine or personalized medicine has been proposed and initiated by the U.S. National Institutes of Health. However, the limited availability of effective medications and the high cost are still the major barriers for many cancer patients. Thus alternative approaches such as herbal medicines could be a feasible and less costly option. Unfortunately, scientific evidence for the efficacy of a majority of herbal medicines is still lacking and their development to meet FDA approval or other regulatory agencies is a big challenge. However, herbal medicines may be able to play an important role in precision medicine or personalized medicine. This review will focus on the existing and future technologies that could speed the development of herbal products for treatment of resistant cancer in individual patients. Specifically, it will concentrate on reviewing the phenotypic (activity based) rather than genotypic (mechanism based) approach to develop herbal medicine useful for personalized cancer chemotherapy.

  2. Using Role-Play for Expert Science Communication with Professional Stakeholders in Flood Risk Management

    Science.gov (United States)

    McEwen, Lindsey; Stokes, Alison; Crowley, Kate; Roberts, Carolyn

    2014-01-01

    This paper explores role-play pedagogies in learning and communicating about cutting-edge flood science by flood risk management professionals in local government. It outlines role-play process/structure and evaluates participant perceptions of their learning experiences. Issues were impacts of prior role-play experience on attitudes brought to…

  3. Techno-economic assessment and policy of gas power generation considering the role of multiple stakeholders in China

    International Nuclear Information System (INIS)

    Dong Jun; Zhang Xu; Xu Xiaolin

    2012-01-01

    In accordance with the energy planning in China, within the “Twelfth Five-Year” period (2011–2015), the proportion of natural gas among primary energy consumption is expected to increase from the current 4% to 8%. In 2015, about 17 natural gas pipelines will be completed. This paper reviews the current situation of gas power generation, analyzes the main opportunities and obstacles of gas power generation development in China, and conducts a techno-economic assessment of the natural gas power generation, taking into account the role and the interaction of the multiple stakeholders in the natural gas industry chain. Taking a power plant fueled with the natural gas transported by the second West-to-East Pipeline as an example, it is found that the on-grid power price fluctuates upward with the rise of gas price and downward with the increase of annual utilization hours, and the influences of tax policies on the on-grid power price prove to be highly significant. As the analysis and calculation indicate, the environmental benefits of natural gas power generation ought to be strongly emphasized, compared with coal-fired power generation. Finally, this paper puts forward specific policy recommendations, from the perspectives of electricity price, gas price, tax, power grid dispatching, etc. - Highlights: ► Presents the opportunities and obstacles of gas power generation development in China. ► Analyzes the interactions of multiple stakeholders in the natural gas industry chain. ► Conducts a techno-economic assessment on the natural gas power generation. ► Discusses the responsibilities and risks of multiple stakeholders. ► Puts forward policy recommendations, from electricity price, gas price, tax, etc.

  4. Stakeholders' perspectives on access-to-medicines policy and research priorities in Latin America and the Caribbean: face-to-face and web-based interviews.

    Science.gov (United States)

    Azeredo, Thiago Botelho; Luiza, Vera Lucia; Oliveira, Maria Auxiliadora; Emmerick, Isabel Cristina Martins; Bigdeli, Maryam

    2014-06-25

    This study aims to rank policy concerns and policy-related research issues in order to identify policy and research gaps on access to medicines (ATM) in low- and middle-income countries in Latin America and the Caribbean (LAC), as perceived by policy makers, researchers, NGO and international organization representatives, as part of a global prioritization exercise. Data collection, conducted between January and May 2011, involved face-to-face interviews in El Salvador, Colombia, Dominican Republic, and Suriname, and an e-mail survey with key-stakeholders. Respondents were asked to choose the five most relevant criteria for research prioritization and to score policy/research items according to the degree to which they represented current policies, desired policies, current research topics, and/or desired research topics. Mean scores and summary rankings were obtained. Linear regressions were performed to contrast rankings concerning current and desired policies (policy gaps), and current and desired research (research gaps). Relevance, feasibility, and research utilization were the top ranked criteria for prioritizing research. Technical capacity, research and development for new drugs, and responsiveness, were the main policy gaps. Quality assurance, staff technical capacity, price regulation, out-of-pocket payments, and cost containment policies, were the main research gaps. There was high level of coherence between current and desired policies: coefficients of determination (R2) varied from 0.46 (Health system structure; r = 0.68, P metrics approaches, contributing to priority setting methodology development, with country and regional level stakeholder participation. Stakeholders received feedback with the results, and we hope to have contributed to the discussion and implementation of ATM research and policy priorities in LAC.

  5. The role of pharmacognosy in modern medicine.

    Science.gov (United States)

    Kinghorn, A Douglas

    2002-02-01

    Drugs of natural origin continue to be important for the treatment of many diseases worldwide. Pharmacognosy, a long-established pharmaceutical science, has played a diverse role in the discovery, characterisation, production and standardisation of these drugs. The relevance of this discipline in terms of research and teaching has increased in the last decade as members of the public in developed countries have turned to the use of herbal remedies for the self-medication of minor diseases. However, many phytomedicines require further investigation for their clinical effectiveness, while others need to be thoroughly investigated for their potential health risks or interactions with prescription drugs.

  6. Review Article: "Adaptive governance and resilience: the role of multi-stakeholder platforms in disaster risk reduction"

    Directory of Open Access Journals (Sweden)

    R. Djalante

    2012-09-01

    Full Text Available Disaster impacts are more frequent, deadly and costly. The social and environmental consequences are increasingly complex and intertwined. Systematic as well as innovated strategies are needed to manage the impacts. Disaster Risk Reduction (DRR is a systematic approach to manage disaster risks while adaptive governance (AG is suggested as an alternative approach for governing complex problems such as disasters. The author proposes that the AG can be practicalised through a mechanism of multi-stakeholder platforms (MSPs, interpreted as multiplicity of organisations at different scales of governance working towards more coordinated and integrated actions in DRR. Ten MSPs are selected at the global, regional, national and local level, focussing on the Indonesian MSPs. The literature reviews and in-depth interviews with key respondents in Indonesia show that the international and regional MSPs tend to have more human, technical and financial capacity than national and local MSPs. The author finds that most MSP roles focus on the coordination amongst multitudes of organisations. Only those MSPs that are able to generate new funding have the capacity to implement direct risk reduction activities. The development of the MSP is highly influenced by the UNISDR system operating at different levels. Particularly in Indonesia, MSP are also influenced by the operations of various UN and international organisations. Finally, the paper suggests the need for more provision of technical supports to local MSPs, more linkages with established networks in DRR and broader stakeholders involvement within the MSPs.

  7. The role of pharmacognosy in modern medicine and pharmacy.

    Science.gov (United States)

    Jones, William P; Chin, Young-Won; Kinghorn, A Douglas

    2006-03-01

    This review details the contribution to modern medicine and pharmacy made by natural products and drugs derived from natural products, with an emphasis on essential medicines and new introductions to the market. Areas covered include recent advances in the development of drugs derived from marine organisms, microbes, terrestrial animals, and vascular plants, and current issues regarding botanical medicines. The role of natural products in drug discovery and development is evaluated, particularly with regard to their value as sources of drug leads with "drug-like" properties. A rationale for the success of natural products research in providing new drugs and drug prototypes is presented, drawing on lines of evidence from chemical informatics and chemical ecology. Several innovative strategies for natural products drug discovery and evaluation of botanical medicines are also reviewed.

  8. Role of Proteomics in the Development of Personalized Medicine.

    Science.gov (United States)

    Jain, Kewal K

    2016-01-01

    Advances in proteomic technologies have made import contribution to the development of personalized medicine by facilitating detection of protein biomarkers, proteomics-based molecular diagnostics, as well as protein biochips and pharmacoproteomics. Application of nanobiotechnology in proteomics, nanoproteomics, has further enhanced applications in personalized medicine. Proteomics-based molecular diagnostics will have an important role in the diagnosis of certain conditions and understanding the pathomechanism of disease. Proteomics will be a good bridge between diagnostics and therapeutics; the integration of these will be important for advancing personalized medicine. Use of proteomic biomarkers and combination of pharmacoproteomics with pharmacogenomics will enable stratification of clinical trials and improve monitoring of patients for development of personalized therapies. Proteomics is an important component of several interacting technologies used for development of personalized medicine, which is depicted graphically. Finally, cancer is a good example of applications of proteomic technologies for personalized management of cancer. © 2016 Elsevier Inc. All rights reserved.

  9. Exploring the role of economics in prioritization in public health: what do stakeholders think?

    Science.gov (United States)

    Phillips, Ceri J; Fordham, Richard; Marsh, Kevin; Bertranou, Evelina; Davies, Shân; Hale, Janine; Kingsley, Michael; Parke, Sian; Porteous, Carol; Rance, Jaynie; Warm, Daniel

    2011-10-01

    Debates surrounding the use of conventional approaches in public health and the existence of perceived barriers to using the results of economic evaluations have led to questions posed as to how to establish priorities within public health schemes. The aims of this study were therefore to explore the feasibility and validity of economic evaluation techniques in developing priorities within public health programmes and consider the extent to which different presentational approaches are likely to be incorporated into decision-making, from perspectives of relevant stakeholders. An advisory board, representative of potential users of economic evaluations, was set up to identify preferences for how findings from economic evaluations might be presented to decision makers and to test the impact of different approaches, different outputs and different presentational styles. The board was divided into two groups, each of which was given three hypothetical 'scenarios' to consider. The scenarios comprised descriptions of methods and outputs, with costs, effects, target population and context of intervention constant across all scenarios. The perceived validity of estimates of effectiveness was vitally important, along with sufficient information to gauge whether designs were appropriate and to assess implementation practicalities. Cost-benefit analysis and cost-utility analysis were the preferred approaches despite their complexity, although participants required benchmarks to place net-benefit estimates from cost-benefit analyses into context. Further research is required to substantiate and build on these preliminary findings and collaborations between economists and policy makers are needed to develop clear, rigorous and standard guidance relating to economic evaluation, recognizing the diversity of public health strategies.

  10. Analysis on The Roles of Stakeholders in The Management of Integrated Breeding Beef Cattle Farm Program at PT KPC East Kutai

    Directory of Open Access Journals (Sweden)

    J. Ariansyah

    2013-08-01

    Full Text Available An analysis of the roles of stakeholders was conducted as a continuity program of Peternakan Sapi Terpadu (PESAT; integrated beef cattle farm following the coal mining deactivation by PT Kaltim Prima Coal (KPC of East Kutai, East Kalimantan. The purpose of this study was to formulate stakeholders relation in the future program. The stakeholders involved in this program were PT KPC, local breeders, Sekolah Tinggi Ilmu Pertanian (STIPER; Agriculture Academy of East Kutai, and the local government of East Kutai. The stakeholders analysis was based on the variables of the importance and influence from every analyzed stakeholder. The analysis model used here was the model introduced by Reed et al. (2009. According to the result of the stakeholders analysis, PT KPC was in the key-player quadrant, which score is 25 in both of the interest and the influencial level, while the three others, such as, local breeders, STIPER of East Kutai, and the East Kutai Government were in the subject quadrant. Their score were 24 and 7 for Local breeders, 21 and 9 for STIPER of East Kutai, and 16 and 13 for The East Kutai Government. It means, they had high interest but low influence to the program. The conclusion of this analysis shows that PT KPC is still dominating in the PESAT program management, whereas the three other stakeholders are acting merely as program users that have low involvement in the program management.

  11. Role of nuclear medicine in imaging companion animals

    International Nuclear Information System (INIS)

    Currie, Geoffrey M.; Wheat, Janelle M.

    2005-01-01

    The role of equine nuclear medicine in Australia has been previously described in this journal and more recently, Lyall et al. provided a general overview of demographics of veterinary nuclear medicine departments in Australia. Lyall et al. discuss the main clinical applications of nuclear medicine scintigraphy in companion animals; dogs and cats. The aim of this article is to discuss in brief the applications of commonly performed nuclear medicine procedures in humans with respect to veterinary applications. More detailed discussion will also be offered for investigation of pathologies unique to veterinary nuclear medicine or which are more common in animals than humans. Companion animals are living longer today due to advances in both veterinary and human medicine. The problem is, like humans, longevity brings higher incidence of old age morbidity. As a pet owner, one might be initially motivated to extend life expectancy which is followed by the realisation that one also demands quality of life for pets. Early detection through advanced diagnostic tools, like nuclear medicine scintigraphy, allows greater efficacy in veterinary disease. There are limited veterinary nuclear medicine facilities in Australia due to cost and demand. Not surprisingly then, the growth of veterinary nuclear medicine in Australia, and overseas, has been integrally coupled to evaluation of race horses. While these facilities are generally specifically designed for race horses, racing greyhounds, lame family horses and companion animals are being investigated more frequently. In the USA, the American College of Veterinary Radiology (ACVC) is very active clinically and in research. The ACVC journal, Journal of Veterinary Radiology and Ultrasound, is published quarterly and includes a Nuclear Medicine section. Within the ACVR is the Society of Veterinary Nuclear Medicine. Proliferation of veterinary nuclear medicine centres in the USA has been associated with insurance and lifestyle changes

  12. Cardioprotective roles of the Chinese medicinal formula Bao-Xin ...

    African Journals Online (AJOL)

    Background: Bao-Xin-Tang (BXT) is a traditional Chinese medicinal formula used for the treatment of coronary heart disease and known to have favorable therapeutic benefits. The current study was designed to determine whether BXT has a cardioprotective role for acute myocardial infarction. The underlying mechanisms ...

  13. Competing Structure, Competing Views: The Role of Formal and Informal Social Structures in Shaping Stakeholder Perceptions

    OpenAIRE

    Christina Prell; Mark Reed; Liat Racin; Klaus Hubacek

    2010-01-01

    What is social structure, and how does it influence the views and behaviors of land managers? In this paper, we unpack the term "social structure" in the context of current research on institutions, social networks, and their role(s) in resource management. We identify two different kinds of structure, formal and informal, and explore how these link to views of land management and management practice. Formal structures refer to intentionally designed organizations that arise out of larger ins...

  14. Ethical Diversity and the Role of Conscience in Clinical Medicine

    Science.gov (United States)

    Genuis, Stephen J.; Lipp, Chris

    2013-01-01

    In a climate of plurality about the concept of what is “good,” one of the most daunting challenges facing contemporary medicine is the provision of medical care within the mosaic of ethical diversity. Juxtaposed with escalating scientific knowledge and clinical prowess has been the concomitant erosion of unity of thought in medical ethics. With innumerable technologies now available in the armamentarium of healthcare, combined with escalating realities of financial constraints, cultural differences, moral divergence, and ideological divides among stakeholders, medical professionals and their patients are increasingly faced with ethical quandaries when making medical decisions. Amidst the plurality of values, ethical collision arises when the values of individual health professionals are dissonant with the expressed requests of patients, the common practice amongst colleagues, or the directives from regulatory and political authorities. In addition, concern is increasing among some medical practitioners due to mounting attempts by certain groups to curtail freedom of independent conscience—by preventing medical professionals from doing what to them is apparently good, or by compelling practitioners to do what they, in conscience, deem to be evil. This paper and the case study presented will explore issues related to freedom of conscience and consider practical approaches to ethical collision in clinical medicine. PMID:24455248

  15. The Role of Medicinal Cannabis in Clinical Therapy: Pharmacists' Perspectives

    Science.gov (United States)

    2016-01-01

    Background Medicinal cannabis has recently attracted much media attention in Australia and across the world. With the exception of a few countries, cannabinoids remain illegal–known for their adverse effects rather than their medicinal application and therapeutic benefit. However, there is mounting evidence demonstrating the therapeutic benefits of cannabis in alleviating neuropathic pain, improving multiple sclerosis spasticity, reducing chemotherapy induced nausea and vomiting, and many other chronic conditions. Many are calling for the legalisation of medicinal cannabis including consumers, physicians and politicians. Pharmacists are the gatekeepers of medicines and future administrators/dispensers of cannabis to the public, however very little has been heard about pharmacists’ perspectives. Therefore the aim of this study was to explore pharmacists’ views about medicinal cannabis; its legalisation and supply in pharmacy. Methods Semi-structured interviews with 34 registered pharmacists in Australia were conducted. All interviews were audio-recorded, transcribed ad verbatim and thematically analysed using the NVivo software. Results Emergent themes included stigma, legislation, safety and collaboration. Overall the majority of pharmacists felt national legalisation of a standardised form of cannabis would be suitable, and indicated various factors and strategies to manage its supply. The majority of participants felt that the most suitable setting would be via a community pharmacy setting due to the importance of accessibility for patients. Discussion This study explored views of practicing pharmacists, revealing a number of previously undocumented views and barriers about medicinal cannabis from a supply perspective. There were several ethical and professional issues raised for consideration. These findings highlight the important role that pharmacists hold in the supply of medicinal cannabis. Additionally, this study identified important factors, which

  16. The Changing Role of Government and Other Stakeholders in Vocational Education and Training.

    Science.gov (United States)

    International Labour Office, Geneva (Switzerland).

    Historically, the roles of the public and private sectors in VET have been characterized by the following broad stages: (1) unstructured and unregulated VET; (2) supply-driven, state dominated VET; and (3) market-driven VET. More recently, the combined forces of globalization, technological change, and liberalization of markets have forced…

  17. Stakeholder relations and innovation: The role of ethics, trust and sustainability

    OpenAIRE

    Scott, Peter; Moore, Neil; Stokes, Peter

    2016-01-01

    Editorial - special issue As organisations embark on the 21st century it is apparent that there is an ever-increasing need to learn from the events of the recent and distant past in conjunction with the ability to take stock, in real time, of the evermore rapidly transforming present and impending futures. The ability to rethink, reshape, innovate and reconfigure organisational structures, actions, roles and mindsets in manners which embrace agility and flexibility has becom...

  18. The moderating role of stakeholder management and societal characteristics in the relationship between corporate environmental and financial performance.

    Science.gov (United States)

    Dal Maso, Lorenzo; Mazzi, Francesco; Soscia, Manuel; Terzani, Simone

    2018-04-21

    This study contributes to the debate about the moderating factors that affect the relationship between environmental and financial performance. Combining stakeholder theory, stakeholder salience, and legitimacy theory, and based on a large international sample, we demonstrate that stakeholder prioritization and engagement jointly positively moderate the relationship between environmental and financial performance. However, this moderating effect is only found when both formal and informal societal characteristics are strong and support the business environment surrounding the firm and its stakeholders. Contributions and implications for managers and regulators are discussed. Copyright © 2018 Elsevier Ltd. All rights reserved.

  19. The role of narrative medicine in pregnancy after liver transplantation.

    Science.gov (United States)

    Donzelli, Gianpaolo; Paddeu, Erika Maria; D'Alessandro, Francesca; Nanni Costa, Alessandro

    2015-01-01

    Narrative medicine allows professionals from all fields of medical sciences to understand the patient's total experience of illness, and meet his/her needs in an empathetic environment. Narrative medicine helps spread holistic knowledge of a multitude of complex clinical conditions, including transplantation. To underline the role of narrative medicine in women who become pregnant after a liver transplant by using their narrations of this very special experience. We describe our study with narration and listening to the stories of three women expecting their first child after a liver transplant, by analysing the structure and role of narration in the context of relationships between patients and caregivers. The narrations were transcribed verbatim with the main plot analysed in order to address all the aspects of this rare clinical condition and the transition to parenthood. The women narrated this experience in three phases: transplantation, pregnancy and delivery, and post-partum. They described all phases of pregnancy as stressful but satisfying, whereas the fact of becoming a mother was perceived as a victory both as a woman and as a transplant patient. Our results suggest that narrative medicine represents a significant professional tool for caring for transplant patients during pregnancy.

  20. Barriers and Opportunities to Advancing Women in Leadership Roles in Vector Control: Perspectives from a Stakeholder Survey.

    Science.gov (United States)

    Hayden, Mary H; Barrett, Erika; Bernard, Guyah; Toko, Eunice N; Agawo, Maurice; Okello, Amanda M; Gunn, Jayleen K L; Ernst, Kacey C

    2018-03-19

    Increasing the active participation of professional women in vector control (VC) activities may help promote greater gender equity in the workplace and reduce the burden of vector-borne diseases. This stakeholder survey examined the current roles and perspective of professionals employed in the VC sector in Kenya, Indonesia, India, and other countries. The largest barriers that women face in pursuing leadership roles in the VC sector include lack of awareness of career opportunities, limitations based on cultural norms, and the belief that VC is men's work. These barriers could be addressed through improving education and recruitment campaigns, as well as supporting higher education and mentoring programs. Females were almost six times more likely to be encouraged to pursue leadership positions in their organization compared with male respondents (OR = 5.9, P > 0.03, 95% confidence interval: 1.19, 29.42). These findings suggest that once women are recruited into the VC workforce, they face minimal discrimination and have increased leadership opportunities.

  1. Understanding the perceptions, roles and interactions of stakeholder networks managing health-care waste: A case study of the Gaza Strip.

    Science.gov (United States)

    Caniato, M; Tudor, T; Vaccari, M

    2015-01-01

    The sustainable management of waste requires a holistic approach involving a range of stakeholders. What can often be difficult is to understand the manner in which different types of stakeholder networks are composed and work, and how best to enhance their effectiveness. Using social network analysis and stakeholder analysis of healthcare waste management stakeholders in the case study region of the Gaza Strip, this study aimed to understand and examine the manner in which the networks functioned. The Ministry of Health was found to be the most important stakeholder, followed by municipalities and solid waste management councils. Some international agencies were also mentioned, with specific roles, while other local institutions had a limited influence. Finally while health-care facilities had a strong interest in waste management, they were generally poorly informed and had limited links to each other. The manner in which the networks operated was complicated and influenced by differences in perception, sharing of information, access to finance and levels of awareness. The lack of a clear legal framework generated various mistakes about roles and responsibilities in the system, and evidently regulation was not an effective driver for improvement. Finally stakeholders had different priorities according to the waste management issues they were involved with, however segregation at the source was identified as a key requirement by most. Areas for improving the effectiveness of the networks are suggested. The analysis utilized an innovative methodology, which involved a large number of stakeholders. Such an approach served to raise interest and awareness at different levels (public authorities, health providers, supporting actors, others), stimulate the discussion about the adoption of specific policies, and identify the effective way forward. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. Transforming poison into medicine: the role of dualism in psychiatry.

    Science.gov (United States)

    Marinoff, Lou

    2011-09-01

    This article draws attention to a generalizable phenomenon called "transforming poison into medicine," illustrating both literal and figurative applications. The purpose of such illustrations is to support a strong philosophical claim, namely the currently incomplete reduction (if not the ultimate irreducibility) of intentional mind-states - e.g., beliefs, desires, volitions - to electro-chemical brain-states. Such incomplete reduction (or irreducibility) holds profound implications for the ineluctable role of dualism in neuroscience and psychiatry alike.

  3. The role of customers in higher education: Are students active stakeholders?

    Directory of Open Access Journals (Sweden)

    Zoran Mihanović

    2007-07-01

    Full Text Available As the primary subject of research, this paper puts forward the issue of students’ role in Croatian institutions of higher education, taking into consideration the multiplicity of constituents and the complexity of relationships established by an institution of higher education with target groups as potential donors. In order to determine the position of students in higher education in relation to a dependency on the sources of financing, the research includes students as the main target group as well as potential students and the competent Ministry. They are the ones the institution of higher education establishes relations with, while representing a source of financing at the same time. For the purpose of research a model was created and the research carried out in May and June 2006 on a sample that included all public colleges in Croatia (87 of them, with their executives participating as respondents. According to research results, institutions of higher education, whether being largely financed by students or the Ministry, have not focused sufficiently on students or potential students. There are significant differences in the orientation of institutions of higher education to the Ministry. The institutions that are mainly financed by students show a higher degree of orientation toward the Ministry than those financed by the Ministry itself. Both the orientation and development of the relationships with students and potential students depend on the financing sources of institutions of higher education in Croatia. Therefore, students are not recognized as primary/original partners of the Croatian higher education and, in accordance with the mission and objectives of education, they are not adequately taken care of.

  4. Biobanking-Budgets and the Role of Pathology Biobanks in Precision Medicine.

    Science.gov (United States)

    Andry, Chris; Duffy, Elizabeth; Moskaluk, Christopher A; McCall, Shannon; Roehrl, Michael H A; Remick, Daniel

    2017-01-01

    Biobanks have become an important component of the routine practice of pathology. At the 2016 meeting of the Association of Pathology Chairs, a series of presentations covered several important aspects of biobanking. An often overlooked aspect of biobanking is the fiscal considerations. A biobank budget must address the costs of consenting, procuring, processing, and preserving high-quality biospecimens. Multiple revenue streams will frequently be necessary to create a sustainable biobank; partnering with other key stakeholders has been shown to be successful at academic institutions which may serve as a model. Biobanking needs to be a deeply science-driven and innovating process so that specimens help transform patient-centered clinical and basic research (ie, fulfill the promise of precision medicine). Pathology's role must be at the center of the biobanking process. This ensures that optimal research samples are collected while guaranteeing that clinical diagnostics are never impaired. Biobanks will continue to grow as important components in the mission of pathology, especially in the era of precision medicine.

  5. Biobanking—Budgets and the Role of Pathology Biobanks in Precision Medicine

    Directory of Open Access Journals (Sweden)

    Chris Andry MPhil, PhD

    2017-05-01

    Full Text Available Biobanks have become an important component of the routine practice of pathology. At the 2016 meeting of the Association of Pathology Chairs, a series of presentations covered several important aspects of biobanking. An often overlooked aspect of biobanking is the fiscal considerations. A biobank budget must address the costs of consenting, procuring, processing, and preserving high-quality biospecimens. Multiple revenue streams will frequently be necessary to create a sustainable biobank; partnering with other key stakeholders has been shown to be successful at academic institutions which may serve as a model. Biobanking needs to be a deeply science-driven and innovating process so that specimens help transform patient-centered clinical and basic research (ie, fulfill the promise of precision medicine. Pathology’s role must be at the center of the biobanking process. This ensures that optimal research samples are collected while guaranteeing that clinical diagnostics are never impaired. Biobanks will continue to grow as important components in the mission of pathology, especially in the era of precision medicine.

  6. Novel models to improve access to medicines for chronic diseases in South Africa: an analysis of stakeholder perspectives on community-based distribution models.

    Science.gov (United States)

    Magadzire, Bvudzai Priscilla; Marchal, Bruno; Ward, Kim

    2016-01-01

    The rising demand for chronic disease treatment and the barriers to accessing these medicines have led to the development of novel models for distributing medicines in South Africa's public sector, including distribution away from health centres, known as community-based distribution (CBD). In this article, we provide a typology of CBD models and outline perceived facilitators and barriers to their implementation using an adapted health systems framework with a view to analysing how future policy decisions on CBD could impact existing models and the health system as a whole. A qualitative exploratory study comprising in-depth interviews and non-participant observations was conducted between 2012 and 2014 in one province. Study participants consisted of frontline healthcare providers (HCPs) in the public sector and a few policy, supply chain and public health experts. Observations of processes occurred at two CBD sites. We conducted deductive analysis guided by the adapted framework. Models varied in typology ranging from formal (approved by the Department of Health) to informal (demand-driven) and with or without user-fees. Processes and structures also differed, as did HCPs' perceptions of what is appropriate. HCPs perceived that CBD models were largely acceptable to patients and accommodating of their needs. Affordability of services linked to charging of user-fees was a contested issue, requiring further exploration. CBD models operated in the absence of formal policy to guide implementation, and this, coupled with the involvement of non-health professionals, issues regarding medicines handling and storage; and limited patient counselling raised concerns about the quality of pharmaceutical services being delivered. Policy decisions on each of the health system elements will likely affect other elements and ultimately influence the structure and operational modalities of models. In anticipation of a future CBD policy, stakeholders cited the need for a c ontext

  7. Role of nuclear medicine in ischemic heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Hayashida, Kohei; Nishimura, Tsunehiko; Uehara, Toshiisa; Naito, Hiroaki; Omine, Hiromi; Kozuka, Takahiro (National Cardiovascular Center, Suita, Osaka (Japan))

    1982-08-01

    With the progress in gamma camera and computer system, nuclear medicine has been applied for diagnostic tool in ischemic heart disease. There are two devices for cardiac images; (1) Radionuclide angiocardiography (RNA) by in vivo sup(99m)Tc-RBC labeling (2) Myocardial imaging by /sup 201/Tlcl. RNA can evaluate the kinesis of wall motion of left ventricle with gated pool scan and also detect reserve of cardiac function with exercise study. Myocardial imaging at rest can identify myocardial necrosis and the imaging in exercise can detect myocardial ischemia. The elaborateness and reproducibility of cardiac image in nuclear medicine will play the great role to evaluate clinical stage of ischemic heart disease by not only imaging but also functional diagnosis.

  8. Multi-stakeholder Virtual Dialogue

    DEFF Research Database (Denmark)

    Kornum, Niels; Mühlbacher, Hans

    2013-01-01

    This article introduces the special issue on multi-stakeholder virtual dialogue. Research as well as managerial practice in marketing has traditionally focused on single stakeholders and a one-way communication perspective. This special issue takes a novel approach by directing attention to the s......This article introduces the special issue on multi-stakeholder virtual dialogue. Research as well as managerial practice in marketing has traditionally focused on single stakeholders and a one-way communication perspective. This special issue takes a novel approach by directing attention...... success. While marketing literature increasingly recognizes that divers stakeholders have an impact on a company''s success, little is known about how virtual multi-stakeholder dialogue changes marketing research and management. This special issue provides insights on what roles stakeholders may play...

  9. Learning from Stakeholder Pressure and Embeddedness: The Roles of Absorptive Capacity in the Corporate Social Responsibility of Dutch Agribusinesses

    Directory of Open Access Journals (Sweden)

    Paul T. M. Ingenbleek

    2016-10-01

    Full Text Available In spite of much research on corporate social responsibility (CSR responses to secondary stakeholders (i.e., social movements, activists, media, civil society and non-governmental organizations, the debate on how companies learn from pressure and collaboration with these societal groups is still open. Building upon stakeholder and knowledge management theories, this paper analyzes how secondary stakeholder pressure and embeddedness influence agribusiness companies’ absorptive capacity and their CSR strategies. Data are obtained from 152 Dutch agribusiness company managers. The results highlight that, first, absorptive capacity influences companies’ new product innovation, product positioning and organizational innovation to be more oriented towards CSR. Second, stakeholder embeddedness of agribusiness companies triggers absorptive capacity more than pressure from them. Third, stakeholder pressure and embeddedness also have direct (i.e., not mediated by companies’ absorptive capacity yet weaker effects on CSR organizational innovation and product positioning. Findings corroborate the idea that firms develop innovative CSR strategies when they combine internal reflection processes and partnerships with secondary stakeholders.

  10. Investigation of an orbital mass - the role of nuclear medicine

    International Nuclear Information System (INIS)

    Dunlop, R. V.

    2009-01-01

    Full text:A 35 year old male presented, suffering from night sweats, occipital and frontal headaches, blurred vision, nausea and a decrease in appetite. He underwent a CT and MRI scan, which identified a 2.2cm lesion in the left orbit in an intra-conal position. This was suspected to be a cavernous haemangioma, although other tumours, such as Schwannoma could not be ruled out. A nuclear medicine labelled red blood cell study was performed which included initial dynamic images and early statics and 120min delayed images. SPECT/CT was also performed at the later time. The characteristic blood pool mismatch of low early and high delayed concentration of red blood cells confirmed suspicions of a cavernous haemangioma, which, although comprised mainly of blood vessels, has slow flow. Hence there is considerable delay before maximum activity is reached. The lesion was surgically removed. Histology reports confirmed the nuclear medicine results. Nuclear Medicine has the potential to play a significant role in the preoperative diagnosis of an orbital mass.

  11. Potential for social learning in sustainable regional development: analysis of stakeholder interaction with a focus on the role of scientists

    Directory of Open Access Journals (Sweden)

    Jana Dlouhá

    2015-06-01

    Full Text Available This article is concerned with regional development and its dimension of (unsustainability: it analyses conditions for the success or failure of environmental or SD strategies from a social point of view. The authors share their experience acquired within the process of compiling a database of case studies from different regions of the Czech Republic and from abroad, and subsequently provide a brief analytical overview of cases in this special issue. The analytical perspective focuses on the roles of actors in a dialogue about regional sustainability issues within cooperative or conflict situations, and a description of the communication processes at play, especially within the science – policy interface. An analytical tool (actor analysis is employed to explore network characteristics, the relationships of the actors involved and the process of deliberation itself where different approaches to “nature”, “environment”, and/or “sustainable development” were conceived but often not agreed upon. A comparative meta-analysis of different cases helped to formulate several hypotheses: for a successful sustainability transition on a regional level, future visions are necessary and should be discussed and shared by stakeholders. Necessary innovation is often the result of the involvement of experts and might be provided from outside the region. Dialogue should be based on respect for actor diversity and their viewpoints (this is a condition for social learning, as well as a commitment to contribute to the “common good”. Where local actors had only to choose between controversial extant solutions, a deadlock in communication often resulted. The establishment of a communication framework for actor involvement appeared to be beneficial, which is also an opportunity for facilitation of these processes in practice.

  12. Stakeholder confidence in effective safety regulation. A regulator's view on the role of independent research capability

    International Nuclear Information System (INIS)

    Kotra, Janet; Mohanty, Sitakanto

    2006-01-01

    The authors provided a regulator's view on the role of independent research capability and its relationship to stakeholder confidence. They underscored the NRC's commitment to regulatory openness in its Strategic Plan. A number of actions have been adopted to achieve openness: public access to information about risks, safety and licensee performance that is accurate and timely; enhanced awareness of NRC as an independent regulator; fair and timely process for public involvement in NRC's decision-making; and early public involvement and two-way communication to enhance public confidence in NRC's regulatory process. The presentation reviewed the ways through which the NRC seeks to inspire confidence in its process as independent regulator and in future decisions concerning whether to authorize the U.S. DOE to construct the proposed repository at Yucca Mountain. Key to this will be reviewing all information objectively, making open decisions based on sound, scientific judgements about the facts; and maintaining an open and fair public process, and accessing independent R and D. It was noted that among the requirements for the safety review for the Yucca Mountain repository will be extensive technical and scientific analyses, evaluation of expert judgement, and long-range modelling assessments of expected repository performance. NRC requires independent scientific and engineering analyses to develop technical bases for regulations and guidance; evaluate adequacy of DOE's safety case for a potential repository; assist preparation of NRC Safety Evaluation Report; provide technical support for NRC testimony during licensing hearing; and develop effective outreach and communication tools. Confidence in NRC's use of science and engineering will depend upon: competence; independence; open and fair process; regulatory outcomes that are subject to verification and monitoring. To assist, the NRC established the Centre for Nuclear Waste Regulatory

  13. The Role of Stakeholder Relationship Management Crisis Management Processes within the Hotel Industry in a Tourism Context

    Directory of Open Access Journals (Sweden)

    Nicola ZECH

    2015-04-01

    Full Text Available Rates of worldwide environmental, social, technological and other crises are perceived to be constantly increasing - if nothing else due to almost instant broadcasting by media and internet. The Tourism Industry is especially vulnerable to such crises as numerous Stakeholder Groups on the one hand and large numbers of travelers on the other hand are or might be affected. Therefore, Tourism Industry Stakeholder Groups claims regarding transparency can t be denied. This Research Paper focuses on Crisis Management processes from the aspect of the Hotel Industry in a Tourism Context considering a variety of Tourism Market Players. Theoretical foundations combined with empirical research reveal prerequisites, Status Quo as well as opportunities and challenges towards an integrated Crisis Management Model. Finally, key success factors for a Stakeholder Relationship Management based approach are introduced.

  14. Understanding the perceptions, roles and interactions of stakeholder networks managing health-care waste: A case study of the Gaza Strip

    International Nuclear Information System (INIS)

    Caniato, M.; Tudor, T.; Vaccari, M.

    2015-01-01

    Highlights: • We systematically review scientific literature about health-care waste management. • We identify and discuss gaps, trends, efforts, and key-factors. • We suggest areas for improvement and best practices reported in literature. • We include recommendations for policy makers, practitioners and researchers. • We promote a holistic and harmonized approach to health-care waste management. - Abstract: The sustainable management of waste requires a holistic approach involving a range of stakeholders. What can often be difficult is to understand the manner in which different types of stakeholder networks are composed and work, and how best to enhance their effectiveness. Using social network analysis and stakeholder analysis of healthcare waste management stakeholders in the case study region of the Gaza Strip, this study aimed to understand and examine the manner in which the networks functioned. The Ministry of Health was found to be the most important stakeholder, followed by municipalities and solid waste management councils. Some international agencies were also mentioned, with specific roles, while other local institutions had a limited influence. Finally while health-care facilities had a strong interest in waste management, they were generally poorly informed and had limited links to each other. The manner in which the networks operated was complicated and influenced by differences in perception, sharing of information, access to finance and levels of awareness. The lack of a clear legal framework generated various mistakes about roles and responsibilities in the system, and evidently regulation was not an effective driver for improvement. Finally stakeholders had different priorities according to the waste management issues they were involved with, however segregation at the source was identified as a key requirement by most. Areas for improving the effectiveness of the networks are suggested. The analysis utilized an innovative methodology

  15. The Crucial Role of Educational Stakeholders in the Appropriation of Foreign Language Education Policies: A Case Study

    Science.gov (United States)

    Peláez, Oscar; Usma, Jaime

    2017-01-01

    Drawing on the concept of policy appropriation, this study investigates how different education stakeholders in a rural region of Colombia perceive foreign language education policies, and how these perceptions shape the way they recreate these reforms at the ground level. Contributing to the field of language policy analysis in Colombia and…

  16. Limitations on the Role of Stakeholders and the Diverse Effects of Market Conditions: College and University Finances, 1980-2010

    Science.gov (United States)

    Barringer, Sondra N.

    2013-01-01

    In this dissertation I analyze the financial behaviors of public and private nonprofit higher education organizations in the U.S. from 1980 to 2010. The three analyses examine organizational change in the financial behaviors of these institutions and the effects of two sources of organizational interdependencies, stakeholder influence and…

  17. Learning from Stakeholder Pressure and Embeddedness: The Roles of Absorptive Capacity in the Corporate Social Responsibility of Dutch Agribusinesses

    NARCIS (Netherlands)

    Ingenbleek, Paul; Dentoni, Domenico

    2016-01-01

    In spite of much research on corporate social responsibility (CSR) responses to secondary stakeholders (i.e., social movements, activists, media, civil society and non-governmental organizations), the debate on how companies learn from pressure and collaboration with these societal groups is still

  18. The role of intra-organisational stakeholder dynamics in IT-based innovation adoption processes in hospitals

    NARCIS (Netherlands)

    Postema, T.R.F.

    2012-01-01

    The introduction of new information technology in hospitals seems to lead to mixed results in practice; projects are delayed or cost more than budgeted thus severely affecting projected goals of quality or efficiency improvement. A project’s stakeholder environment is in continuous movement, both in

  19. Policy Reforms, Trojan Horses, and Imaginary Friends: The Role of External Stakeholders in Internal Quality Assurance Systems

    Science.gov (United States)

    Rosa, Maria João; Teixeira, Pedro

    2014-01-01

    The governance of higher education has been changing across Europe, most notably in response to the reform agenda that has been pervading many higher education systems. This wave of reforms has given enhanced visibility to external stakeholders, which has been often received with contrasting views. Some regarded it as a factor that would undermine…

  20. Role of Nuclear Medicine in the cardiac resinchronization therapy

    Energy Technology Data Exchange (ETDEWEB)

    Brandao, Simone Cristina Soares, E-mail: simonecordis@yahoo.com.br [Universidade Federal de Pernambuco (UFPE), Recife, PE (Brazil); Giorgi, Maria Clementina Pinto; D' Orio, Silvana Angelina; Meneghetti, Jose Claudio [Instituto do Coracao (InCor/FM/USP), Sao Paulo, SP (Brazil)

    2011-10-15

    Cardiac resynchronization therapy (CRT) emerged as one of the most promising approaches in the treatment of cardiac dyssynchrony in heart failure patients' refractory to medical treatment. However, despite very promising clinical and functional results, individual response analyses show that a significant number of patients do not respond to treatment. The role of nuclear medicine and molecular imaging in the selection of CRT candidates by the assessment of cardiac dyssynchrony, myocardial viability, myocardial perfusion and blood flow and sympathetic cardiac activity has been discussed in this review. The potential utilization of this tool to improve the comprehension of detrimental effects of dyssynchrony on cardiac function and the evaluation and monitoring of the response to CRT were also considered. Other molecular targets that characterize glucose and fatty acid metabolism, apoptosis, angiotensin converting enzyme activity and angiogenesis that can be evaluated with this technique were described. (author)

  1. [Current Status of Community Pharmacies: Expectations as a Health Information Hub, the Enforcement of Revised Pharmaceutical and Medical Device Act, and a New Role as Stakeholders].

    Science.gov (United States)

    Saito, Mitsuo

    2016-01-01

    According to the "Japan Revitalization Strategy" established in June 2013, "the government will promote better contributions of local pharmacies and pharmacists in encouraging self-medication of citizens by making pharmacies the community-based hub for providing information, giving advice on the proper use of non-prescription drugs, etc. and offering consultation and information service concerning health". In addition, the "Demanded Function and Ideal Form of Pharmacy," published in January 2014, requested a change, from pharmacies that specialized in dispensing medicines to pharmacies that serve as whole healthcare stations, providing pharmaceutical care based on patients' medical history, including the intake of dietary supplements. The medication fee was revised in April 2014 to enhance family pharmacy services and the management of pharmaceutical care. At that time, blood testing at a registered pharmacy was officially allowed under strict regulation. Revision of the "Pharmacist Law" in June 2014 included a request to pharmacists to provide pharmaceutical advice in addition to information. For the mitigation of drug-induced tragedies, the "Pharmaceutical Affairs Law" was amended to the "Pharmaceutical and Medical Device Act (PMD Act)" in November 2014, and proper use of medicines was imposed on healthcare professionals and other stakeholders. Patients were also requested to learn and understand the safety and harmful effects of medicines, and were requested to use medicines appropriately. As mentioned above, the status of pharmacies and pharmacists has dramatically changed in the past 2 years, and such changes over time are required.

  2. Roles of contract research organizations in translational medicine

    Directory of Open Access Journals (Sweden)

    Mei-Shu Shih

    2015-04-01

    Full Text Available Transitional medicine/science is shifting the medical research paradigm from compound-based to evidence-based drug/device discovery. It is increasing interdisciplinary collaborations, enhancing usage of advanced technologies, and facilitating therapeutics reaching patients faster. The fundamental theme of evidence-based discovery is to apply what is revealed in preclinical experimentation and to bring the resulting safety and efficacy to clinics. In the medical fields, a contract research organization (CRO works like a hired agent who has corresponding knowledge and experience to conduct and complete tasks for a sponsor. The relationship is business, and the contract is for deliverables. The increasingly high volume of sponsored outsourcing work has made this for-profit business boom in the past decade. Location boundaries are being blurred under globalization in the sciences and cross-border regulatory reviews. Getting from bench to bedside is a winding road with many obstacles and high hurdles. Efficient teamwork becomes essential to materialize ideas and bring them to the market. The professionals within team communities include drug/device makers and CROs. It has become increasingly obvious that CROs play pivotal roles in the chain of discovery/design, developing product to market through in vitro, in vivo, and ex vivo testing during preclinical experimentations and clinical trials. Project management teams are responsible for nurturing the materialization in a collaborative manner and enhancing the productivity of the pipelines. CROs have many functional aspects and specialties, and no one organization is fully capable of serving, i.e., integrated services, with expertise in each step of the chain to the needs of a variety of sponsors. Instead of competition among the CROs themselves, the continuously expanding market demands can be shared by Expertise-Based Integrated Services among allied CROs, in contrast to the few large CROs

  3. Monitoring medicines use: the role of the clinical pharmacologist.

    LENUS (Irish Health Repository)

    Williams, David

    2012-10-01

    Appreciation of the potential of newly marketed medicines to produce both benefit and harm has increased the role of the clinical pharmacologist. Pharmacoepidemiology applies epidemiological reasoning, methods and knowledge to the study of the uses and effects of drugs in human populations. Pharmacovigilence identifies and then responds to safety issues about marketed drugs. Whilst adverse drug reaction (ADR) reporting systems can identify potential problems with drugs, determination of causation requires population-based studies of adverse events (including information from large clinical trials), which attempt to link unequivocally the adverse outcome to the drug in question. Pharmacovigilance is closely linked to postmarketing surveillance and is important for determining issues such as the long-term effects of drugs, identification of low-frequency ADRs, the effectiveness of drugs for their licensed indications or in new indications and other factors which may modify the efficacy and effectiveness of the drug in question. The related field of drug utilization developed in parallel with the study of adverse drug reactions, in recognition of the dramatic increase in the marketing of new drugs, the wide variations in the patterns and extent of drug prescribing, the growing concern about ADRs and the increasing costs of drugs. With the ever increasing number of recognized adverse effects of drugs, prescribing errors, patients\\' expectations concerning drug safety and the need for appropriate new drug appraisal, the clinical pharmacologist will play an important role both in the introduction of new drugs and in improving the safe and effective use of established drugs.

  4. [The role of German official medicines control laboratories in combating counterfeit medicines].

    Science.gov (United States)

    Wiegard, Andrea; Heuermann, Matthias

    2017-11-01

    An official medicines control laboratory (OMCL) provides an important contribution to combat counterfeit and illegal medicines. The OMCL supports the competent authorities in controlling the quality of authorised medicinal products in the legal supply chain. For detecting counterfeit medicines in the legal supply chain, a risk-based approach in choice of products is conducted. Furthermore, the OMCL analyses suspicious medicines from the illegal supply chain for any other authority. The chemical analysis of a suspicious sample is needed to identify such a sample as a counterfeit medicine. The analytical results are fundamental for the evaluation of the legal status of the product and for the assessment of it's inherent hazard to public health. The global market of illegal medicines is rapidly changing. Therefore a good national and international working liaison and co-operation between laboratories and authorities is obligatory to protect public health. The OMCL provides important knowledge of new trends in counterfeit and illegal medicines. Hence, it is an essential part in surveillance of medicinal products. The efficient networking enables prompt official interventions. Thus, risks for the public health by substandard medicines were reduced. Beside the chemical analysis, the OMCL can help to raise public awareness about counterfeit and illegal medicines. In Germany, the risk of counterfeit medicines reaching patients through the legal supply chain is still low, but the possibility cannot be ignored.

  5. Evaluation of the role of risk perception in stakeholder engagement to prevent lead exposure in an urban setting.

    Science.gov (United States)

    Harclerode, Melissa A; Lal, Pankaj; Vedwan, Neeraj; Wolde, Bernabas; Miller, Michael E

    2016-12-15

    Stakeholder engagement is a vital sustainable remediation practice for obtaining useful feedback and identifying societal needs. Evaluating and integrating risk perception of stakeholders into remediation and outreach efforts allows for greater insight, increases the likelihood of success and ultimately, benefits the community by protecting its members from environmental hazards. In this study, we identified risk perception factors that influenced residents' level of concern for mitigating their exposure to elevated concentrations of lead in household paint and historic fill material. Risk perception factors were assessed by an in-person survey conducted in public green spaces. The analysis of survey participants' responses indicated that their perception of risk to exposed lead was mostly influenced by the presence of hazardous materials in close proximity to their residence, the ability to address pollution, and awareness, interest, and individual accountability in mitigating environmental risks. Responses also revealed that residents considered risk of lead and soil pollution as less menacing than the presence of more immediate and perceptible risks posed by factors such as air and water pollution. In addition, the community seemed to exhibit "optimism bias" and did not identify itself at high risk to susceptible and immediate hazards, including lead exposure. This lack of concern over lead exposure created a significant obstacle to community participation in state-led education and outreach programs. By integrating risk perception analysis and increasing stakeholder engagement, we can bring more attention to this issue, educate the public about the threat of lead pollution, and efficiently use financial resources to implement a more sustainable solution. Copyright © 2016. Published by Elsevier Ltd.

  6. The Chief Resident Role in Emergency Medicine Residency Programs

    Directory of Open Access Journals (Sweden)

    Hafner, John W. Jr., MD, MPH

    2010-05-01

    Full Text Available Study Objectives: Although other specialties have examined the role of the chief resident (CR, the role and training of the emergency medicine (EM CR has largely been undefined.Methods: A survey was mailed to all EM CRs and their respective program directors (PD in 124 EM residency programs. The survey consisted of questions defining demographics, duties of the typical CR, and opinions regarding the level of support and training received. Multiple choice, Likert scale (1 strong agreement, 5 strong disagreement and short-answer responses were used. We analyzed associations between CR and PD responses using Chi-square, Student’s T and Mann-Whitney U tests.Results: Seventy-six percent of CRs and 65% of PDs responded and were similar except for age (31 vs. 42 years; p<0.001. CR respondents were most often male, in year 3 of training and held the position for 12 months. CRs and PDs agreed that the assigned level of responsibility is appropriate (2.63 vs. 2.73, p=0.15; but CRs underestimate their influence in the residency program (1.94 vs. 2.34, p=0.002 and the emergency department (2.61 vs. 3.03, p=0.002. The majority of CRs (70% and PDs (77% report participating in an extramural training program, and those CRs who participated in training felt more prepared for their job duties (2.26 vs. 2.73; p=0.03.Conclusion: EM CRs feel they have appropriate job responsibility but believe they are less influential in program and department administration than PD respondents. Extramural training programs for incoming CRs are widely used and felt to be helpful. [West J Emerg Med. 2010; 11(2:120-125.

  7. An Emergency Medicine-Primary Care Partnership to Improve Rural Population Health: Expanding the Role of Emergency Medicine.

    Science.gov (United States)

    Greenwood-Ericksen, Margaret B; Tipirneni, Renuka; Abir, Mahshid

    2017-11-01

    The health of rural America is failing and our traditional approaches have proved ineffective at improving health in rural communities. Rural populations are now a health disparity population, facing higher mortality rates for the 5 leading causes of death compared with their urban counterparts. We must generate novel, rural-specific approaches to solve this challenge-and there is a clear role for the field of emergency medicine. Building on emergency departments' (EDs') expanding role in health care delivery and emergency medicine's increasing involvement in population health, we propose a new health care delivery model for rural population health based on partnership between emergency medicine and primary care that embraces the important role that EDs play in rural areas. Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  8. The role played by stakeholders in the public debate that brought Italy out of the club of nuclear energy producers.

    Science.gov (United States)

    Cantone, Marie Claire; Sturloni, Giancarlo; Brunelli, Giancarlo

    2007-10-01

    In 1964, Italy was the fourth largest world producer of electricity generated by nuclear reactors, second in Europe only to United Kingdom. In subsequent years, various controversial political events contributed towards drastically slowing down the development of the Italian national nuclear program. The 1986 Chernobyl Nuclear Power Plant accident, which caused a public outcry all over Europe, had particularly serious repercussions in Italy. In a controversial referendum, held in November 1987, Italian citizens voted to repeal three laws promoting the installation of nuclear power plants (NPP) on Italian soil and allowing the National Institute for Electrical Energy (ENEL) to participate in the construction of NPP's abroad. This work analyzes the reasons for that decision and the communication strategies of the stakeholders that took part in the public debate on nuclear energy during the weeks following the Chernobyl accident. Drawing from the methodologies used in media studies, a quantitative and qualitative analysis of two leading Italian newspapers was performed. The results reveal that a variety of stakeholders, upholding different values and interests, took part in the debate. There being no tradition of a public dialogue and participation in Italy, the debate was polarized to a "yes/no choice," which eventually caused Italy to abandon the production of nuclear power for civilian use.

  9. Articular cartilage repair and the evolving role of regenerative medicine

    Directory of Open Access Journals (Sweden)

    Pieter K Bos

    2010-10-01

    Full Text Available Pieter K Bos1, Marloes L van Melle1, Gerjo JVM van Osch1,21Department of Orthopaedic Surgery, Erasmus MC, Rotterdam, the Netherlands; 2Department of Otorhinolaryngology, Erasmus MC, Rotterdam, the NetherlandsAbstract: Among the growing applications of regenerative medicine, clinical articular cartilage repair has now been used for 2 decades and forms a successful example of translational medicine. Cartilage is characterized by a limited intrinsic repair capacity following injury. Articular cartilage defects cause symptoms, are not spontaneously repaired, and are generally believed to result in early osteoarthritis. Marrow stimulation techniques, osteochondral transplantation, and cell-based therapies, such as autologous chondrocyte implantation (ACI and use of mesenchymal stem cells (MSCs, are used for tissue regeneration, symptom relief, and prevention of further joint degeneration. The exact incidence of cartilage defects and the natural outcome of joints with these lesions are unclear. Currently available cartilage repair techniques are designed for defect treatment in otherwise healthy joints and limbs, mostly in young adults. The natural history studies presented in this review estimated that the prevalence of cartilage lesions in this patient group ranges from 5% to 11%. The background and results from currently available randomized clinical trials of the three mostly used cartilage repair techniques are outlined in this review. Osteochondral transplantation, marrow stimulation, and ACI show improvement of symptoms with an advantage for cell-based techniques, but only a suggestion that risk for joint degeneration can be reduced. MSCs, characterized by their good proliferative capacity and the potential to differentiate into different mesenchymal lineages, form an attractive alternative cell source for cartilage regeneration. Moreover, MSCs provide a regenerative microenvironment by the secretion of bioactive factors. This trophic activity

  10. What do people really think of generic medicines? A systematic review and critical appraisal of literature on stakeholder perceptions of generic drugs.

    LENUS (Irish Health Repository)

    Dunne, Suzanne S

    2015-07-01

    Considerable emphasis is presently being placed on usage of generic medicines by governments focussed on the potential economic benefits associated with their use. Concurrently, there is increasing discussion in the lay media of perceived doubts regarding the quality and equivalence of generic medicines. The objective of this paper is to report the outcomes of a systematic search for peer-reviewed, published studies that focus on physician, pharmacist and patient\\/consumer perspectives of generic medicines.

  11. Stakeholders in support systems for self-care for chronic illness: the gap between expectations and reality regarding their identity, roles and relationships.

    Science.gov (United States)

    Pumar-Méndez, María J; Mujika, Agurtzane; Regaira, Elena; Vassilev, Ivaylo; Portillo, Mari Carmen; Foss, Christina; Todorova, Elka; Roukova, Poli; Ruud Knutsen, Ingrid A; Serrano, Manuel; Lionis, Christos; Wensing, Michel; Rogers, Anne

    2017-06-01

    The spread of self-care holds the promise of containing chronic illness burden. Falling within the framework of a FP7 collaborative research project, this paper reports the views of key informants from six countries regarding who the main stakeholders are at different levels in the support system for self-care for patients with chronic illness (SSSC) and how they accomplish their role and collaborate. 90 Interviews with purposefully selected key informants from Bulgaria, Greece, the Netherlands, Norway, Spain and United Kingdom were conducted. Interviews involved government and local authorities, politicians, academics, health professionals and private sector representatives. Interviewers followed an expert opinion-based guide. Analysis involved a cross-country examination with thematic analysis and framework method techniques. Key informants described the ideal SSSC as inclusive, interdependent and patient-centred. The following main stakeholders in SSSC were identified: patients, governments, health-care professionals, associations, private companies and the media. In the current SSSCs, collaboration among stakeholders within and across different levels was said to be lacking. Patients were seen as playing a passive subordinate role based on the following: their own attitudes; the paternalistic and medicalized attitudes of the health-care professionals; their misrepresentation by patient associations; and their exposure to the damaging influences of media and industries. Making SSSC patient-centred constitutes the greatest challenge for European authorities. Strategies must be revised for promoting patient participation. They should undergo changes so as to promote industry and media social responsibility and patient association advocacy capacity. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

  12. The role of regional information in the dose rate estimation of biota: from the view point of stakeholder involvement

    International Nuclear Information System (INIS)

    Urabe, Itsumasa

    2008-01-01

    A dose evaluation system developed to judge environmental radiation safety was proposed in order to evaluate the effect on environmental flora and fauna. However, it was noted that large differences exist between biota doses based on the regional data and those determined by the dose evaluation system developed. In order to realize successful mutual communication among stakeholders, information needed for environmental radiation protection has been investigated in various kinds of exposure situations, because the Japanese tend to act following the standards set by them to get the most appropriate results in the situations they are faced with. It became clear from the investigation on beliefs about environmental issues that the Japanese are concerned about regional characteristics of natural environments and biota through which they observe variations in their living conditions. Furthermore, the systematic approach for compilation of the regional environmental parameters and data becomes important to accomplish a social agreement on environmental safety. (author)

  13. Molecular Epidemiology and its Role in Translational Medicine

    Directory of Open Access Journals (Sweden)

    Yeh Lee Yeong

    2016-03-01

    Full Text Available The primary definition of translational medicine is to develop new clinical therapeutic methods for the diagnosis, treatment and prognosis of diseases by the therapeutic mechanism and new pathological cognition obtained in laboratory. Since the 21st century, most developed countries worldwide have made great adjustment in the strategies of translational medicine, but so far, only a few basic research results have been successfully translated into clinical practice. Research of translational medicine requires the team work of interdisciplinary groups, including medical experts, molecular biologists, and epidemiologists. With the rapid development of biological techniques and extensive application of molecular biology, epidemiology has become a real interdisciplinary discipline from conventional population survey, and stepped into genetic and molecular era, an era of molecular epidemiology. Molecular epidemiology not only provides research findings to translational medicine, but also bridges between basic science and medical research, so as to improve the effective translation of basic scientific results. This article, focusing on molecular epidemiology and translational medicine, mainly summarized the history and current status of translational medicine and emphatically interpreted the importance of molecular epidemiology to translational medicine.

  14. The Role of Stakeholders Related to the Management of Ecological Function of Urban Green Open Space. Case Study: City of Depok, Indonesia

    Science.gov (United States)

    Mangopa Malik, Andy Anton

    2017-12-01

    Urban green open space is one of the assets that provide substantial benefits to the urban community. One important function of urban green open space is a function of ecology. This study will provide initial explanation on the various studies related to the ecological function of urban green open space. The study of urban space management approach related to ecological function will explain the extent of the role of stakeholders in the urban areas that will further strengthen the importance of the existence of green open space, especially in city of Depok. With so many problems related to the supply and use of green open space in the city of Depok. This approach was originally applied by the private sector and many applications made a great contribution, so it began to be used by the government in managing public assets there. This study will use descriptive method, at the beginning of the study will explain the existence of the reality of urban green open space as part of the urban space by viewing it from theoretical overview of space, function and role of the various problems that occur in it. The results of this study indicate there are six problems in the management of green open spaces in city of Depok. Using the stages in asset management will provide space for participation of existing stakeholders in the management of green open spaces in city of Depok.

  15. The role of nurses in medicine administration errors.

    Science.gov (United States)

    Wright, Kerri

    This article explores the commonly held belief that nurses are to blame for the high rate of medication administration errors in health care. The article argues for a need to move away from a culture of blame and to consider changes to medicine and the increasing complexity of administration as potential reasons for error. Medicine administration should be viewed within the wider context of health care rather than as an isolated process in order to develop effective solutions to reduce medicine-related errors.

  16. Stakeholder Dissonance

    DEFF Research Database (Denmark)

    Lauesen, Linne Marie

    2013-01-01

    investigate how trust in businesses and institutions can be recovered and which role if any corporate social responsibility plays in it. A study of a process from trust1 breakdown to trust1recovery in the Danish water sector from 2003 till 2013 is revealed, which can be used to inform other kinds of trust......-breakdowns in the aftermath of the global economic crisis such as governance systems in both the public and private sector....

  17. From evidence based medicine to mechanism based medicine : Reviewing the role of pharmacogenetics

    NARCIS (Netherlands)

    Wilffert, Bob; Swen, Jesse; Mulder, Hans; Touw, Daan; Maitland-Van Der Zee, Anke-Hilse; Deneer, Vera

    Aim of the review The translation of evidence based medicine to a specific patient presents a considerable challenge. We present by means of the examples nortriptyline, tramadol, clopidogrel, coumarins, abacavir and antipsychotics the discrepancy between available pharmacogenetic information and its

  18. From evidence based medicine to mechanism based medicine. Reviewing the role of pharmacogenetics

    NARCIS (Netherlands)

    Wilffert, Bob; Swen, Jesse; Mulder, Hans; Touw, Daan; Maitland-Van der Zee, Anke-Hilse; Deneer, Vera

    Aim of the review The translation of evidence based medicine to a specific patient presents a considerable challenge. We present by means of the examples nortriptyline, tramadol, clopidogrel, coumarins, abacavir and antipsychotics the discrepancy between available pharmacogenetic information and its

  19. Unintentional drowning: Role of medicinal drugs and alcohol.

    Science.gov (United States)

    Pajunen, Tuulia; Vuori, Erkki; Vincenzi, Frank F; Lillsunde, Pirjo; Smith, Gordon; Lunetta, Philippe

    2017-05-19

    Alcohol is a well-known risk factor in unintentional drownings. Whereas psychotropic drugs, like alcohol, may cause psychomotor impairment and affect cognition, no detailed studies have focused on their association with drowning. Finland provides extensive post-mortem toxicological data for studies on drowning because of its high medico-legal autopsy rates. Drowning cases, 2000 through 2009, for which post-mortem toxicological analysis was performed, came from the database of the Toxicological Laboratory, Department of Forensic Medicine, University of Helsinki, using the ICD-10 nature-of-injury code T75.1. The data were narrowed to unintentional drowning, using the ICD-10 external-injury codes V90, V92, and W65-74. Each drowning case had its blood alcohol concentration (BAC) and concentrations of other drugs recorded. Evaluation of the contribution of psychotropic drugs to drowning was based on their blood concentration by means of a 6-grade scale. Among victims ≥15 years old, unintentional drownings numbered 1697, of which, 303 (17.9%) were boating-related and 1394 (82.1%) non-boating-related. Among these, 65.0% of boating-related and 61.8% of non-boating-related victims were alcohol-positive (=BAC ≥ 50 mg/dL). The male-to-female ratio in alcohol-positive drownings was 7.3. At least one psychotropic drug appeared in 453 (26.7%) drowning cases, with some victims' bodies showing up to 7 different drugs. Overall 70 different psychotropic drugs were detectable, with 134 (7.9%) cases both alcohol-negative and psychotropic-drug-positive, of these, 59 (3.5%) were graded 4 to 6, indicating a possible to very probable contribution to drowning. Our findings suggest that psychotropic drugs may play a significant role in drowning, in up to 14.5% of cases, independently or in association with alcohol. Psychotropic drugs alone or in association with alcohol may be an overlooked risk factor in drowning, due to their effects on psychomotor function and cognition. Future

  20. The mediating role of environmental innovation in the relationship between environmental management and firm performance in a multi-stakeholder environment

    NARCIS (Netherlands)

    Grekova, E.; Bremmers, H.J.; Trienekens, J.H.; Kemp, R.G.M.; Omta, S.W.F.

    2013-01-01

    Nowadays, firms are increasingly challenged to bridge potentially conflicting economic interests of primary commercial stakeholders and sustainability demands from secondary non-commercial stakeholder groups. While a number of firms view investments in environmental management as disconnected from

  1. Cellular and Molecular Medicine: Its Role in Perioperative Management of Common Anesthetic Complications

    Directory of Open Access Journals (Sweden)

    Ali Dabbagh

    2017-08-01

    Full Text Available Cellular and molecular medicine is expanding its clinical role from day to day. Personalized medicine seems the appropraite response for many unresolved problem and this is why we could rely on this approach more than before. Integrating the techniques of cellular and molecular medicine to our daily anesthesia practice improves not only the quality of care; but also, opens new windows for overcoming challenges that were previously considered as unaccessible fields.

  2. Stakeholder Management of Jakarta’s Light Rail Transit Using Stakeholder Analysis

    Directory of Open Access Journals (Sweden)

    Khrisna Yudi

    2018-01-01

    Full Text Available Stakeholders involvement in infrastructure development c.q. Light Rail Transit (LRT has a significant role since they affect the success of infrastructure management. This paper is primarily aimed to identify key stakeholders and responses that need to be applied to them. On the initial stage, a list of stakeholders was developed using research strategies such as case study and literature review. Sources were then chosen with certain criteria. They were assigned to score each stakeholder on the list. A stakeholder analysis was conducted to obtain a list of key stakeholders that have a significant impact on Jakarta’s LRT.

  3. Stakeholders' views on granting prescribing authority to pharmacists in Nigeria: a qualitative study.

    Science.gov (United States)

    Auta, Asa; Strickland-Hodge, Barry; Maz, Julia

    2016-08-01

    Background In Nigeria, only medical doctors, dentists and some nurses in primary care facilities have the legal right to prescribe medicines to patients. Patients' access to prescription medicines can be seriously affected by the shortage of prescribers leading to longer waiting times in hospitals. Objective This research was carried out to investigate stakeholders' views on granting prescribing authority to pharmacists in Nigeria. Setting The study was conducted in Nigeria. Methods Qualitative, semi-structured interviews were conducted with 43 Nigerian stakeholders including policymakers, pharmacists, doctors and patient group representatives. Transcribed interviews were entered into the QSR NVivo 10 software and analysed using a thematic approach. Main outcome measure Stakeholders' perception on the granting of prescribing authority to pharmacists in Nigeria. Results Three major themes emerged from the interviews: (1) prescribing as a logical role for pharmacists, (2) pharmacist prescribing- an opportunity or a threat and (3) the potential barriers to pharmacist prescribing. Many non-medical stakeholders including pharmacists and patient group representatives supported an extended role for pharmacists in prescribing while the majority of medical doctors including those in policy making were reluctant to do so. Generally, all stakeholders perceived that pharmacist prescribing represents an opportunity to increase patients' access to medicines, reduce doctors' workload and promote the utilisation of pharmacists' skills. However, many stakeholders including pharmacists and doctors commonly identified pharmacists' inadequate skills in diagnosis, medical resistance and shortage of pharmacists as potential barriers to the introduction of pharmacist prescribing in Nigeria. Conclusion The present study showed a split of opinion between participants who were medical doctors and those who were non-doctors in their support for pharmacist prescribing. However, all

  4. An Emerging Role for Polystores in Precision Medicine

    Energy Technology Data Exchange (ETDEWEB)

    Begoli, Edmon [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Christian, J. Blair [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Gadepally, Vijay [Massachusetts Inst. of Technology (MIT), Cambridge, MA (United States); Papadopoulos, Stavros [TileDB, Inc., Cambridge, MA (United States)

    2017-08-26

    Medical data is organically heterogeneous, and it usually varies significantly in both size and composition. Yet, this data is also a key for the recent and promising field of precision medicine, which focuses on identifying and tailoring appropriate medical treatments for the needs of the individual patients, based on their specific conditions, their medical history, lifestyle, genetic, and other individual factors. As we, and a database community at large, recognize that a “one size does not fit all” solution is required to work with such data, we present in this paper our observations based on our experiences, and the applications in the field of precision medicine. Finally, we make the case for the use of polystore architecture; how it applies for precision medicine; we discuss the reference architecture; describe some of its critical components (array database); and discuss the specific types of analysis that directly benefit from this database architecture, and the ways it serves the data.

  5. the natriuretic peptides: an expanding role in clinical medicine

    African Journals Online (AJOL)

    Enrique

    FAST FOOD TRICKS. We all assume that people are getting fatter because they eat too much. But a recent item in New Scientist may suggest otherwise. According to researchers from the International Nutrition Group at the London School of Hygiene and. Tropical Medicine, it may be that our food is too rich. What they are ...

  6. Opinion: redefining the role of the physician in laboratory medicine in the context of emerging technologies, personalised medicine and patient autonomy ('4P medicine').

    Science.gov (United States)

    Orth, Matthias; Averina, Maria; Chatzipanagiotou, Stylianos; Faure, Gilbert; Haushofer, Alexander; Kusec, Vesna; Machado, Augusto; Misbah, Siraj A; Oosterhuis, Wytze; Pulkki, Kari; Twomey, Patrick J; Wieland, Eberhard

    2017-12-22

    The role of clinical pathologists or laboratory-based physicians is being challenged on several fronts-exponential advances in technology, increasing patient autonomy exercised in the right to directly request tests and the use of non-medical specialists as substitutes. In response, clinical pathologists have focused their energies on the pre-analytical and postanalytical phases of Laboratory Medicine thus emphasising their essential role in individualised medical interpretation of complex laboratory results. Across the European Union, the role of medical doctors is enshrined in the Medical Act. This paper highlights the relevance of this act to patient welfare and the need to strengthen training programmes to prevent an erosion in the quality of Laboratory Medicine provided to patients and their physicians. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  7. Narrative medicine's role in graduate nursing curricula: finding and sharing wisdom through story.

    Science.gov (United States)

    Mangino, Heather

    2014-01-01

    Nurses are affected on a personal and professional level by the stories they hear from patients throughout their careers. Nurse educators can help graduate-level nursing students understand how these stories impact their nursing lives by incorporating narrative medicine into graduate nursing curricula. Narrative medicine is "... recognizing, absorbing, interpreting, and being moved by the stories of illness" (Charon, 2006, p. 4). Methods to incorporate narrative medicine into graduate nursing curricula include in-depth text analysis and writing exercises, with opportunities for students to read their work aloud. Narrative medicine's role in nursing must be researched through qualitative and quantitative studies.

  8. Stakeholder perceptions of misoprostol: a qualitative investigation

    Directory of Open Access Journals (Sweden)

    Bazzano AN

    2014-04-01

    Full Text Available Alessandra N Bazzano,1 Lea Jones,1 Thoai D Ngo2 1Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA; 2Research, Monitoring and Evaluation Team, Health System Department, Marie Stopes International, London, UK Abstract: The study aimed to explore perceptions of stakeholders regarding misoprostol use in Cambodia, a setting with high maternal mortality. Semi-structured expert interviews were conducted with 21 participants in the capital, Phnom Penh. The sample included participants involved in providing reproductive health services through international and local health agencies and the pharmaceutical industry. A theme of controversy over the role of misoprostol in the context of reproductive health services emerged, along with a need to reconcile legitimate viewpoints in order to understand the place of misoprostol in the Cambodian reproductive health setting. Understanding stakeholder perspectives on misoprostol can shed light on the drug's role in reproductive health programming where maternal mortality is high and health facilities are still improving. Keywords: maternal mortality, misoprostol, post-partum hemorrhage, medical abortion, unsafe abortion, Cambodia

  9. Towards a More Holistic Stakeholder Analysis Approach

    DEFF Research Database (Denmark)

    Sedereviciute, Kristina; Valentini, Chiara

    2011-01-01

    are identified based on the dimensions of connectivity and the content shared. Accordingly, the study introduces four groups of important actors from social media: unconcerned lurkers, unconcerned influencers, concerned lurkers and concerned influencers and integrates them into the existing Stakeholder Salience...... in finding stakeholders on new environments (social media), where connectivity and relationships play a key role. The argument stems from the need to assess stakeholder presence beyond the dyadic ties. Consequently, the combination of the Stakeholder Salience Model (SSM) and social network analysis (SNA......) is proposed as a more holistic solution for stakeholder identification including those from social media. A process of finding “unknown” but important stakeholders from social media was identified incorporating the content search and the principles of SNA. Consequently, stakeholders from social media...

  10. Unique roles of nanotechnology in medicine and cancer.

    Science.gov (United States)

    Alam, F; Naim, M; Aziz, M; Yadav, N

    2014-01-01

    Here we review the scope of nanotechnology in Medicine and human cancer. The imaging and therapy agents can be co-delivered by same nanoparticle for integrated molecular diagnosis, therapy, and follow-up of cancer or 'cancer theranostics' is implying multimodal use of nanoparticles in cancer care. Nanoparticles are used for passive targeting and in conjugation with ligands for active targeting, to have optimum concentrations of imaging and therapeutic agents in the tumor cells specifically, sparing normal tissue from unwanted side effects. Potential utility of nanoparticles in the nano biosensors, nano fluorescent tag imaging, nano tumor mapping, nano gene profiling, nano molecular delivery, nano chemo-radio therapy, nano thermotherapy, nano photodynamic therapy, etc., is tending to revolutionize medicine particularly personalized cancer care and laboratory. Nanoparticle induced oxidative stress based inflammation reported by few studies; in lung, liver and brain required further investigations.

  11. The role of the anaesthesiologist in air ambulance medicine.

    Science.gov (United States)

    Sollid, Stephen J M; Rehn, Marius

    2017-08-01

    The care administered on air ambulances has become increasing complex. This has led to a discussion among experts as to whether air ambulance travel should be manned by physicians. This review provides evidence in support of anaesthesiologists being the physician-leaders in air ambulance medicine, because of their training in advanced airway management, critical care, and resuscitation. Successful prehospital care requires the ability to perform a complex set of advanced diagnostics and interventions. These include airway management, haemorrhage control, pain management, point-of-care diagnostics, complex interfacility transport, and advanced interventions. This skill set closely mirrors the training and expertise of anaesthesiologists. There are few studies investigating the specific benefit of anaesthesiologists in air ambulance medicine. However, current evidence indicates that their presence does improve patient care and safety. Future studies on this topic should use evidence-based quality indicators and standardized data sets to seek answers to optimal staffing of air ambulance teams.

  12. Unique roles of nanotechnology in medicine and cancer-II.

    Science.gov (United States)

    Alam, F; Naim, M; Aziz, M; Yadav, N

    2015-01-01

    Applications of nanotechnology in medicine and cancer are becoming increasingly popular. Common nanomaterials and devices applicable in cancer medicine are classifiable as liposomes, polymeric-micelles, dendrimers, nano-cantilevers, carbon nanotubes, quantum dots, magnetic-nanoparticles, gold nanoparticles (AuNPs) and certain miscellaneous nanoparticles. Here, we present review of the structure, function and utilities of the various approved, under trial and pretrial nanodevices applicable in the cancer care and medicine. The liposomes are phospholipid-vesicles made use in carrying drugs to the target site minimizing the bio-distribution toxicity and a number of such theranostics have been approved for clinical practice. Newly worked out liposomes and polymeric micelles are under the trail phases for nano-therapeutic utility. A multifunctional dendrimer conjugate with imaging, targeting and drug molecules of paclitaxel has been recently synthesized for cancer theranostic applications. Nano-cantilever based assays are likely going to replace the conventions methods of chemical pathological investigations. Carbon nanotubes are emerging for utility in regenerative and cancer medicine. Quantum dots hold great promise for the micro-metastasis and intra-operative tumor imaging. Important applications of magnetic nanoparticles are in the cardiac stents, photodynamic therapy and liver metastasis imaging. The AuNPs have been employed for cell imaging, computed tomography and cancer therapy. Besides these categories, miscellaneous other nanoparticles are being discovered for utility in the cancer diagnosis and disease management. However, the use of nanoparticles should be cautious since the toxic effects of nanoparticles are not well-known. The use of nanoparticles in the clinical practice and their toxicity profile require further extensive research.

  13. Spirituality: what is its role in pain medicine?

    Science.gov (United States)

    Siddall, Philip J; Lovell, Melanie; MacLeod, Rod

    2015-01-01

    For many years, spirituality has been regarded as an integral aspect of patient care in fields closely allied to pain medicine such as palliative and supportive care. Despite this, it has received relatively little attention within the field of pain medicine itself. Reasons for this may include a lack of understanding of what spirituality means, doubtfulness of its relevance, an uncertainty about how it may be addressed, or a lack of awareness of how addressing spirituality may be of benefit. A review of the literature was conducted to determine the changing conceptual frameworks that have been applied to pain medicine, the emergence of the biopsychospiritual approach and what that means as well as evidence for the benefits of incorporation of this approach for the management of pain. Although the concept of spirituality is broad, there is now greater consensus on what is meant by this term. Many authors and consensus panels have explored the concept and formulated a conceptual framework and an approach that is inclusive, accessible, relevant, and applicable to people with a wide range of health conditions. In addition, there is accumulating evidence that interventions that address the issue of spirituality have benefits for physical and emotional health. Given the firm place that spirituality now holds within other fields and the mounting evidence for its relevance and benefit for people with pain, there is increasing evidence to support the inclusion of spiritual factors as an important component in the assessment and treatment of pain. Wiley Periodicals, Inc.

  14. Project stakeholder management

    CERN Document Server

    Eskerod, Pernille

    2013-01-01

    Carrying out a project as planned is not a guarantee for success. Projects may fail because project management does not take the requirements, wishes and concerns of stakeholders sufficiently into account. Projects can only be successful though contributions from stakeholders. And in the end, it is the stakeholders that evaluate whether they find that the project is a success. To manage stakeholders effectively, you need to know your stakeholders, their behaviours and attitudes towards the project. In Project Stakeholder Management, the authors give guidance on how to adopt an analytical and s

  15. The role of physical examinations and education in prospective medicine

    Science.gov (United States)

    Jones, W. L.; Mockbee, J.; Snow, C. K.; Compton, J. R.

    1978-01-01

    NASA's prospective medicine program, with the principal elements of physical examinations and an educational program for health awareness is described. Participation in the voluntary physical examination program is increasing. In 1976 13,621 employees were given partial or complete examination in NASA Health Units. From the 941 examinations performed at NASA Headquarters in 1976, 522 principal findings were detected. Equipment and techniques in exercise EKG, tonometry, and colonoscopy were partially responsible for this high rate. The health awareness program includes consultations with physicians, training devices and courses, health bulletins, and special screening programs. Epidemiological studies, now underway, will be used to evaluate the health awareness programs.

  16. Why has medicine expanded? The role of consumers.

    Science.gov (United States)

    Zheng, Hui

    2015-07-01

    In the past 50years, the field of medicine has expanded dramatically in many Western societies. Despite substantial improvements in objective health measures, there has not been a commensurate increase in assessments of subjective health. We hypothesize that medical expansion may lower people's subjective health perceptions, leading to an increase in health care utilization, and, in turn, fueling further medical expansion. We use OECD (Organization for Economic Co-operation and Development) Health Data, World Development Indicators, the World Values Survey, and the European Values Study to fit a difference-in-differences model that removes unobserved cross-national heterogeneity and any period trend that is shared across nations. We find that three dimensions of medical expansion at the societal level (medical investment, medical professionalization/specialization, and an expanded pharmaceutical industry) negatively affect individual subjective health. These findings are robust to different model specifications. We conclude by discussing possible explanations for the adverse effect of medical expansion on subjective health, and how this effect may be related to other mechanisms through which medicine expands. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. [Peripheral facial paralysis: the role of physical medicine and rehabilitation].

    Science.gov (United States)

    Matos, Catarina

    2011-12-01

    Peripheral facial paralysis (PFP) is a consequence of the peripheral neuronal lesion of the facial nerve (FN). It can be either primary (Bell`s Palsy) or secondary. The classical clinical presentation typically involves both stages of the hemiface. However, there may be other symptoms (ex. xerophthalmia, hyperacusis, phonation and deglutition changes) that one should recall. Clinical evaluation includes rigorous muscle tonus and sensibility search in the FN territory. Some useful instruments allow better objectivity in the patients' evaluation (House-Brackmann System, Facial Grading System, Functional Evaluation). There are clear referral criteria to Physical Medicine and Rehabilitation. Treatment of Bell`s Palsy may include pharmacotherapy, neuromuscular training (NMT), physical methods and surgery. In the NMT field the several treatment techniques are systematized. Therapeutic strategies should be problem-oriented and adjusted to the patient's symptoms and signs. Physical methods are reviewed. In about 15-20 % of patients permanent sequelae subside after 3 months of evolution. PFP is commonly a multidisciplinary condition. Therefore, it is important to review strategies that Physical Medicine and Rehabilitation may offer.

  18. Managing Diverse Stakeholders

    OpenAIRE

    Pipkin, Erin; Porter, Sean; Clark, Rickie

    2017-01-01

    For every public project, there is a diverse group of stakeholders who need and want information. During this session we outline important stakeholders, how and when to involve them in the planning process, and how targeted messaging might be the key to your project’s success. We also discuss how to identify and manage stakeholders who oppose your project.

  19. Final disposal of spent nuclear fuels - regulations and the roles of different stakeholders during the decision making process

    International Nuclear Information System (INIS)

    2007-05-01

    In November 2006 Swedish Nuclear Fuels Co. applied for a license to build a plant for encapsulation of spent nuclear fuels at Oskarshamn, Sweden. The company also have plans to apply, in 2009, for a license to construct a underground repository for spent nuclear fuels. KASAM arranged a seminar in November 2006 in order to describe and discuss the licensing rules and regulations and the roles of different parties in the decision making. Another objective of the seminar was to point out possible ambiguities in this process. Another interesting question under discussion was in what ways the basic data for the decision should be produced. The seminar covered the part of the process beginning with the application for a license and ending with the government approval/rejection of the application. Most time was spent on the legal aspects of the process

  20. The Politics of Stakeholder Influence in Corporate Environmental Governance

    DEFF Research Database (Denmark)

    Backer, Lise

    2006-01-01

    I contribute in this article to descriptive stakeholder engagement theory by conceptualising a number of new internal influence strategies that engaged secondary stakeholders can use in their new face-to-face interactions with the corporations. These internal stakeholder influence strategies should...... be seen as adding to the list of external stakeholder influence strategies (e.g. Frooman, 1999) that secondary stakeholders can use in their traditional role of operating from the outside....

  1. Utilization of Western Medicine and Traditional Chinese Medicine Services by Physicians and Their Relatives: The Role of Training Background

    Directory of Open Access Journals (Sweden)

    Nicole Huang

    2011-01-01

    Full Text Available Despite extensive efforts to improve the attitude and practice of physicians with respect to complementary and alternative medicine (CAM, the role of training background on physician's own utilization of mainstream Western medicine (WM and CAM remains unclear. We aimed to compare personal utilizations of WM and traditional Chinese medicine (TCM among doctors trained in WM only, TCM only or both. A retrospective population-based study was conducted using the 2004 Taiwan's National Health Insurance data. A total of 103 879 doctors and their relatives and 2 623 658 other adults with equivalent socioeconomic status were analyzed. Ambulatory care utilization of WM and TCM services was compared using the following three measures: probability of any use, number of visits and total annual expenditure. Doctors who were trained in Western medicine only (WMDs had the highest WM use, followed by doctors who were trained in both (WMD-CMDs, while Chinese medicine-trained doctors (CMDs had the lowest use. For TCM use, a reverse pattern was observed. Similar patterns were found among doctors' relatives. Compared with other adults with equivalent socioeconomic status, both the CMDs and WMD-CMDs had a greater use of TCM services. For WM, although the WMDs' probability and frequency of usage were similar to other adults, they incurred considerably higher expenditure. The use of WM and TCM by doctors and their relatives was significantly associated with the training background of the doctors. This highlights the importance of how increasing knowledge and understanding of other medical discipline may influence a practitioner's care-providing behaviors.

  2. How Regenerative Medicine Stakeholders Adapt to Ever-Changing Technology and Regulatory Challenges? Snapshots from the World TERMIS Industry Symposium (September 10, 2015, Boston).

    Science.gov (United States)

    Bayon, Yves; Van Dyke, Mark; Buelher, Robert; Tubo, Ross; Bertram, Tim; Malfroy-Camine, Bernard; Rathman, Michelle; Ronfard, Vincent

    2017-04-01

    Regenerative medicine (RM) is a fascinating area of research and innovation. The huge potential of the field has been fairly underexploited so far. Both TERMIS-AM and TERMIS-EU Industry Committees are committed to mentoring and training young entrepreneurs for more successful commercial translation of upstream research. With this objective in mind, the two entities jointly organized an industry symposium during the past TERMIS World Congress (Boston, September 8-11, 2015) and invited senior managers of the RM industry for lectures and panel discussions. One of the two sessions of the symposium-How to overcome obstacles encountered when bringing products to the commercial phase?-aimed to share the inside, real experiences of leaders from TEI Biosciences (an Integra Company), Vericel (formerly Aastrom; acquirer of Genzyme Regenerative Medicine assets), RegenMedTX (formerly Tengion), Mindset Rx, ViThera Pharmaceuticals, and L'Oreal Research & Innovation. The symposium provided practical recommendations for RM product development, for remaining critical and objective when reviewing progress, for keeping solutions simple, and for remaining relevant and persistent.

  3. The Unique Role of the Survivalist Retail Entrepreneur in Job Creation and Poverty Reduction. Implications for Active Stakeholder Participation

    Directory of Open Access Journals (Sweden)

    Chux Gervase Iwu

    2016-08-01

    Full Text Available This is an applied study endeavour with the aim of exploring the specific role of survivalist retail entrepreneurship in job creation and poverty reduction. Two hundred (200 subjects were sampled using snowballing technique. Structured questionnaires as well as semi-structured interviews were employed to collect data. 182 usable questionnaires were analysed with the help of SPSS version 23. The results indicate that retail entrepreneurship is evolving in Khayelitsha, especially when one does not only focus on spaza shops, but looks at the entire survivalist retail industry. This sector is capable of creating jobs, reducing poverty and aiding economic growth of the country even more, should measures to boost motivation levels and self-efficacy of the entrepreneurs emerge. These measures, among others could include support programmes for survivalist entrepreneurial ventures that present greater potential for growth and job creation. Part of the support programmes should include business skills training (such as simple bookkeeping practices and human resource management. Importantly, this study is the first of its kind in the community of Khayelitsha; an emerging black-populated township in South Africa, indicating a new vista for retail entrepreneurship research.

  4. Role of Nutrition in Children Growth in View of Traditional Medicine.

    Science.gov (United States)

    Farsani, Gholamreza Mohammadi; Movahhed, Mina

    2016-05-01

    Growth and development are the basic science in pediatric medicine. Growth disorder in children is one of the important health problems in the world, especially in developing countries. Regardless of the underlying disease, as the main cause of growth disorders, assessment and correction of nutritional status of these children are very important. Given the fundamental importance of this issue and ascending tendency to use complementary medicine in the world, this article discusses the traditional Iranian philosopher's views on the role of nutrition in child development. This study reviews textbooks of traditional medicine, particularly in the field of pediatric medicine with a focus on Canon of Medicine of Avicenna. Temperament is the physiological concept of the human body in traditional medicine and has an important role in health, diagnosis, and treatment of disease. Generally, children are born with warm and wet temperament that provides the best condition for growth. However, the personal temperament of each child determines growth, the need for a variety of food groups, and even physical activity. Different appetite and food preferences in children show temperamental variation. Therefore, children need special management regarding special temperament. In Iranian traditional medicine, special lifestyle orders are discussed in detail according to these differentiations and nutritional management is the most important factor considered. In spite of advances in classical medicine in the prevention and treatment of many diseases, there are still a lot of therapeutic challenges in many health problems. Temperamental approach to the human body in traditional medicine provides a different perspective on the medicine. Reflecting on temperamental view in child development may lead to a better understanding of the diagnosis and treatment of diseases. On the other hand, further research studies based on the reform of nutrition with respect to temperament should be

  5. Integrative Medicine in Preventive Medicine Education

    Science.gov (United States)

    Jani, Asim A.; Trask, Jennifer; Ali, Ather

    2016-01-01

    During 2012, the USDHHS’s Health Resources and Services Administration funded 12 accredited preventive medicine residencies to incorporate an evidence-based integrative medicine curriculum into their training programs. It also funded a national coordinating center at the American College of Preventive Medicine, known as the Integrative Medicine in Preventive Medicine Education (IMPriME) Center, to provide technical assistance to the 12 grantees. To help with this task, the IMPriME Center established a multidisciplinary steering committee, versed in integrative medicine, whose primary aim was to develop integrative medicine core competencies for incorporation into preventive medicine graduate medical education training. The competency development process was informed by central integrative medicine definitions and principles, preventive medicine’s dual role in clinical and population-based prevention, and the burgeoning evidence base of integrative medicine. The steering committee considered an interdisciplinary integrative medicine contextual framework guided by several themes related to workforce development and population health. A list of nine competencies, mapped to the six general domains of competence approved by the Accreditation Council of Graduate Medical Education, was operationalized through an iterative exercise with the 12 grantees in a process that included mapping each site’s competency and curriculum products to the core competencies. The competencies, along with central curricular components informed by grantees’ work presented elsewhere in this supplement, are outlined as a roadmap for residency programs aiming to incorporate integrative medicine content into their curricula. This set of competencies adds to the larger efforts of the IMPriME initiative to facilitate and enhance further curriculum development and implementation by not only the current grantees but other stakeholders in graduate medical education around integrative medicine

  6. Why Stakeholder Engagement will not be Tweeted

    DEFF Research Database (Denmark)

    Castello, Itziar; Etter, Michael

    We analyze the role of power transforming stakeholder engagement practices under the conditions of the network society. We look at how Global Health (pseudonym) managers navigate between two competing logics of stakeholder engagement: the current (influence logic) and the new logic underlying...... social media (logic of community). With a longitudinal study of 26 months we find that managers are able to integrate symbolic and substantive elements of the new logic but elements of the conditions of authority and hierarchy remain unchanged constraining new forms of stakeholder engagement. We relate...... our results to the current conceptualization of stakeholder engagement as firm centered....

  7. The role of metabolomics in neonatal and pediatric laboratory medicine.

    Science.gov (United States)

    Mussap, Michele; Antonucci, Roberto; Noto, Antonio; Fanos, Vassilios

    2013-11-15

    Metabolomics consists of the quantitative analysis of a large number of low molecular mass metabolites involving substrates or products in metabolic pathways existing in all living systems. The analysis of the metabolic profile detectable in a human biological fluid allows to instantly identify changes in the composition of endogenous and exogenous metabolites caused by the interaction between specific physiopathological states, gene expression, and environment. In pediatrics and neonatology, metabolomics offers new encouraging perspectives for the improvement of critically ill patient outcome, for the early recognition of metabolic profiles associated with the development of diseases in the adult life, and for delivery of individualized medicine. In this view, nutrimetabolomics, based on the recognition of specific cluster of metabolites associated with nutrition and pharmacometabolomics, based on the capacity to personalize drug therapy by analyzing metabolic modifications due to therapeutic treatment may open new frontiers in the prevention and in the treatment of pediatric and neonatal diseases. This review summarizes the most relevant results published in the literature on the application of metabolomics in pediatric and neonatal clinical settings. However, there is the urgent need to standardize physiological and preanalytical variables, analytical methods, data processing, and result presentation, before establishing the definitive clinical value of results. © 2013 Elsevier B.V. All rights reserved.

  8. The Role of Patients' Stories in Emergency Medicine Triage.

    Science.gov (United States)

    Roscoe, Lori A; Eisenberg, Eric M; Forde, Colin

    2016-09-01

    Emergency medicine is a communicative activity, and characteristics such as incomplete information, time pressure, and the potentially serious consequences of errors complicate effective communication and decision making. The present study examined the triage process as an interpretive activity driven in part by the patient's story. Of four identified communication processes in the emergency department (ED), the "handoff" of patients between shifts has been identified as especially problematic since missing contextual details from patients' stories increased the probability of errors. The problematic nature of patient handoffs led to our interest in triage, the initial site of interpretation and decision making. Triage distinguishes patients with emergent medical conditions requiring immediate care from those who can more safely wait for medical attention. We report results from 110 hours of observing the triage process and semistructured interviews with 16 triage nurses in a Level I Trauma Center in an urban teaching hospital in the southeastern United States. Field notes and interview transcripts were analyzed and coded to explore decision rules and information sources used in triage decision making. Triage nurses generally discounted patients' stories in favor of information from visual cues and vital signs. Patients' stories tended to influence the triage process only in certain cases when the story contained information that was not readily apparent, such as a recent organ transplant. Triage nurses' reliance on "gut feeling," however, might be a kind of narrative sense-making that combines observable and measurable clinical facts with the narrative competence to utilize intuition and past experience.

  9. Role of primary health care in ensuring access to medicines.

    Science.gov (United States)

    Sambala, Evanson Z; Sapsed, Susan; Mkandawire, Mercy L

    2010-06-01

    To examine ways of ensuring access to health services within the framework of primary health care (PHC), since the goal of PHC to make universal health care available to all people has become increasingly neglected amid emerging themes of globalization, trade, and foreign policy. From a public health point of view, we argue that the premise of PHC can unlock barriers to health care services and contribute greatly to determining collective health through the promotion of universal basic health services. PHC has the most sophisticated and organized infrastructure, theories, and political principles, with which it can deal adequately with the issues of inequity, inequality, and social injustice which emerge from negative economic externalities and neo-liberal economic policies. Addressing these issues, especially the complex social and political influences that restrict access to medicines, may require the integration of different health initiatives into PHC. Based on current systems, PHC remains the only conventional health delivery service that can deal with resilient public health problems adequately. However, to strengthen its ability to do so, we propose the revitalization of PHC to incorporate scholarship that promotes human rights, partnerships, research and development, advocacy, and national drug policies. The concept of PHC can improve access; however, this will require the urgent interplay among theoretical, practical, political, and sociological influences arising from the economic, social, and political determinants of ill health in an era of globalization.

  10. Stakeholders in One Health.

    Science.gov (United States)

    Mazet, J A K; Uhart, M M; Keyyu, J D

    2014-08-01

    The stakeholders in One Health include the ultimate beneficiaries (i.e. animals, people and the environment) and the organisations that work to protect them (i.e. research institutes, government ministries, international organisations and professional bodies). However, identifying these stakeholders who will contribute to One Health activities and develop solutions to complex health problems can be difficult, as these problems often affect all sectors of society. In addition, evolving concepts about health and its dependence on environmental resilience necessitate the inclusion of ministries, organisations and disciplines that may not have been traditionally considered to be related to health. The multilateral organisations with greatest responsibilities in the global health arena have recognised that the best way to protect health security and promote overall global well-being is to work together across disciplinary and jurisdictional boundaries. Permanent regional networks and ad hoc networks created to tackle specific issues (both of which require donor investment) are also facilitating improved disease surveillance and collaborative approaches to synchronised interventions across country borders. These networks necessarily involve the key ministries for One Health, those of health, agriculture/livestock, and natural resources/environment. Ministries play a critical role in the formulation and implementation of policies for the promotion of health and disease control. They contribute to all stages of the One Heath process, as do universities, which engage by generating knowledge and capacity through teaching, research and extension services. Similarly, non-governmental organisations have a key role in stewardship; resource mobilisation; generation of knowledge; capacity development; intervention design; and implementation. Finally, communities, including rural and indigenous peoples, particularly those that are in close proximity to natural areas, are at the

  11. Why Stakeholder Engagement will not be Tweeted

    DEFF Research Database (Denmark)

    Castello, Itziar; Etter, Michael

    We analyze the role of power transforming stakeholder engagement practices under the conditions of the network society. We look at how Global Health (pseudonym) managers navigate between two competing logics of stakeholder engagement: the current (influence logic) and the new logic underlying...

  12. Smart Mobility Stakeholders - Curating Urban Data & Models

    Energy Technology Data Exchange (ETDEWEB)

    Sperling, Joshua [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

    2017-09-01

    This presentation provides an overview of the curation of urban data and models through engaging SMART mobility stakeholders. SMART Mobility Urban Science Efforts are helping to expose key data sets, models, and roles for the U.S. Department of Energy in engaging across stakeholders to ensure useful insights. This will help to support other Urban Science and broader SMART initiatives.

  13. Understanding Processes of Multi-Stakeholder Brand-Interessement

    DEFF Research Database (Denmark)

    von Wallpach, Sylvia; Hemetsberger, Andrea; Kornum, Niels

    2013-01-01

    The new “stakeholder-focus brand era” (Merz, He, & Vargo 2009, p.337) puts stakeholders and their role in brand co-creation center stage. Yet, insights into the dynamics of multi-stakeholder brand co-creation are still sparse. Applying a network theory approach, this article advances stakeholder......-oriented branding theory by investigating into discursive strategies multiple stakeholders use to engage in and mobilize brand networks on social media sites. An empirical investigation into two prominent online LEGO sites uncovers the role of social media sites as actors, and the interests and respective...... discursive strategies of stakeholders involved in co-creating the brand LEGO....

  14. The role of complementary and alternative medicine in the treatment of eating disorders: A systematic review.

    Science.gov (United States)

    Fogarty, Sarah; Smith, Caroline A; Hay, Phillipa

    2016-04-01

    This systematic review critically appraises the role of complementary and alternative medicine in the treatment of those with an eating disorder. Sixteen studies were included in the review. The results of this review show that the role of complementary and alternative medicine in the treatment of those with an eating disorder is unclear and further studies should be conducted. A potential role was found for massage and bright light therapy for depression in those with Bulimia Nervosa and a potential role for acupuncture and relaxation therapy, in the treatment of State Anxiety, for those with an eating disorder. The role of these complementary therapies in treating eating disorders should only be provided as an adjunctive treatment only. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Stakeholder Relationships in Higher Education

    Science.gov (United States)

    Kettunen, Juha

    2015-01-01

    The purpose of this study is to develop a stakeholder map to describe the most important stakeholders and the process of stakeholder relationships in higher education. According to the perspective of the balanced scorecard, the classification of stakeholders integrates stakeholders into strategic management. Stakeholder maps are essential in…

  16. The role of corruption and unethical behaviour in precluding the placement of industry sponsored clinical trials in sub-Saharan Africa: Stakeholder views

    Directory of Open Access Journals (Sweden)

    Efe Egharevba

    2016-08-01

    More discussion around corruption with all relevant stakeholders is required in order for progress to be made and to enable greater involvement of sub-Saharan African countries in the conduct of industry sponsored clinical trials.

  17. Corporate Stakeholding and Globalism

    DEFF Research Database (Denmark)

    Lauesen, Linne Marie

    2016-01-01

    , the global warming, the disasters of global consumerism in terms of the collapse of the Rana Plaza factory in the fashion industry, are examples of how the stakeholder concept cannot continue to be defined as narrow as corporations usually does. The butterfly effect of globalism has shown to be – yes, global...... how to revise the stakeholder concept according to corporate responsibility, company stakeholding and globalism. It points to shortcomings in various global trade systems such as banking, fashion and IT markets, and through these it suggests and discusses a new way of defining the stakeholder concept...

  18. The roles of clinical pharmacologists in formulating medicines policy locally

    Science.gov (United States)

    Reynolds, D John M; Barker, Charlotte I S

    2012-01-01

    Specialists in Clinical Pharmacology and Therapeutics (CPT) can add value in day-to-day NHS activities in several ways. They provide a breadth of expertise that is not organ-based or disease-specific and that is based on an intimate knowledge and understanding of the effectiveness, safety and cost-effectiveness of pharmacological interventions. More than any other professional group, they can address the growing need for undergraduate and postgraduate teaching to be based on ‘thoughtful therapeutics’, not just the mechanics of prescribing. CPT specialists can and do take the lead in making local and national policy decisions relating to drug usage and they should be involved in local commissioning decisions. Because of the breadth of experience embraced by CPT, many clinical pharmacologists have taken on local and national senior clinical leadership roles. CPT needs to demonstrate to the NHS, and in particular to trainees, that a CPT post in the NHS is a legitimate and rewarding career path, where they can use their hard earned CPT skills and expertise to the benefit of the NHS as a whole. PMID:22360513

  19. [Personalized medicine in otology. The role of genetic diagnostics in patients with hearing impairment].

    Science.gov (United States)

    Friese, N; Braun, K; Müller, M; Tropitzsch, A

    2015-06-01

    Classification of diseases on the molecular level is the basis for personalized medicine. Personalized medicine proposes to improve efficiency and quality of care, to reduce side effects and to increase long-term cost-effectiveness. This paper is concerned with the role of genetic diagnostics in patients with a cochlear implant. A selective literature search in PubMed was performed. Genetic diagnosis allows ruling out syndromic hearing loss and thus prevents follow-up studies. It allows genetic counseling, prognosis and advice on family planning and targeted prevention. Due to its minimal invasiveness, it is suitable for evaluation of factors accounting for hearing loss in children. Molecular medicine plays a major role in the treatment of sensorineural hearings loss with cochlear implants.

  20. Strategies for Increasing the Role of Family Medicine in Mexican Health Care Reform

    NARCIS (Netherlands)

    Aranda, J.M. Ramirez; Weel, C. van; Goodyear-Smith, F.

    2017-01-01

    There is little or no role for primary care and family medicine in current health reforms in Mexico. However, robust evidence shows that primary care helps prevent morbidity and mortality and increases health equity. Mexico has participated in several international meetings sponsored by the World

  1. the healing hand: the role of women in ancient medicine 1 ...

    African Journals Online (AJOL)

    See for example the list of female painters in Pliny, Historia Naturalis xxxv.40. 6. Much research has already been done on the role of women in medicine in the. Middle Ages; see Green (1989); Benedek (1975); Greilsammer (1991). On the uphill battle of women in later ages to gain access to academic institutions, see.

  2. cardioprotective roles of the chinese medicinal formula bao-xin-tang ...

    African Journals Online (AJOL)

    Background: Bao-Xin-Tang (BXT) is a traditional Chinese medicinal formula used for the treatment of coronary heart disease and known to have favorable therapeutic benefits. The current study was designed to determine whether BXT has a cardioprotective role for acute myocardial infarction. The underlying mechanisms ...

  3. The role and behaviour of the experts and how to expose the experts' value system in order to gain stakeholder confidence

    International Nuclear Information System (INIS)

    Andersson, Kjell

    2006-01-01

    The author discussed the role and behaviour of experts in the context of gaining stakeholder confidence. The author underscored the many reasons to make explicit experts' values. Complex policy issues often involve many challenges, factual issues with uncertainties, values, emotions and vested interests. All of these factors should be exposed to policy makers and the public before decisions are made. Experts may set the agendas too narrowly, there may be mistrust in expertise and authorities, and there may be low awareness in the political system. Excessively narrow framing of the issues can result in frustration and inability to solve important societal problems. It was noted further, that in a democratic society decisions are based not on expert values, but on citizen values. Democracy implies accountability and requires awareness and transparency. Modern society is demanding higher levels of transparency and public participation dialogue and incorporation of public values. The author reviewed some of the models which have been advanced for awareness building with transparency and participation within frameworks of representative democracy. The RISKOM model was discussed, as was the VALDOC model, both of which invoke the practice of 'stretching' - inviting questions to be raised from new angles through challenges from society. Another key element of the RISKOM model is 'intelligence' - understanding future developments and outside forces, as well as studying and planning for the future. Crucial aspects of the VALDOC methodology include the authenticity of the approach itself, its identity in awareness and transparency, fairness in process setting and ensure neutral venues for hearings and transparency arenas. The presentation highlighted some applications of these models in a variety of industries in Sweden. The presentation reviewed a number of arenas in which experts' value systems may be exposed. Within the expert arena, it was

  4. Modelling with stakeholders - Next generation

    Science.gov (United States)

    Voinov, Alexey; Kolagani, Nagesh; McCall, Michael K; Glynn, Pierre D.; Kragt, Marit E; Ostermann, Frank O; Pierce, Suzanne A; Ramu, Palaniappan

    2016-01-01

    This paper updates and builds on ‘Modelling with Stakeholders’ Voinov and Bousquet, 2010 which demonstrated the importance of, and demand for, stakeholder participation in resource and environmental modelling. This position paper returns to the concepts of that publication and reviews the progress made since 2010. A new development is the wide introduction and acceptance of social media and web applications, which dramatically changes the context and scale of stakeholder interactions and participation. Technology advances make it easier to incorporate information in interactive formats via visualization and games to augment participatory experiences. Citizens as stakeholders are increasingly demanding to be engaged in planning decisions that affect them and their communities, at scales from local to global. How people interact with and access models and data is rapidly evolving. In turn, this requires changes in how models are built, packaged, and disseminated: citizens are less in awe of experts and external authorities, and they are increasingly aware of their own capabilities to provide inputs to planning processes, including models. The continued acceleration of environmental degradation and natural resource depletion accompanies these societal changes, even as there is a growing acceptance of the need to transition to alternative, possibly very different, life styles. Substantive transitions cannot occur without significant changes in human behaviour and perceptions. The important and diverse roles that models can play in guiding human behaviour, and in disseminating and increasing societal knowledge, are a feature of stakeholder processes today.

  5. Role of medicinal plants on growth performance and immune status in fish.

    Science.gov (United States)

    Awad, Elham; Awaad, Amani

    2017-08-01

    Disease outbreaks increase proportionally with increases in intensive aquaculture. Natural products including medicinal plants have been known from thousands of years for treating some human diseases. It is well known that many active compounds are responsible for potential bio-activities. For that reason, there has been considerable interest in the use of medicinal plants in aquaculture with a view to providing safe and eco-friendly compounds for replacing antibiotics and chemical compounds as well as to enhance immune status and control fish diseases. This article describes a wide range of medicinal plants such as herbs, seeds, and spices with different forms such as crude, extracts, mixed and active compounds, used as immunostimulants and resulting in a marked enhancement in the immune system of fish to prevent and control microbial diseases. Moreover, different activity was recorded from plant parts like seeds, roots, flowers and leaves. The mode of action of medicinal plants was stimulation of the cellular and humoral immune response which was monitored through elevation in immune parameters. Various levels of immune stimulation have been shown by medicinal plants at different concentrations through injection or immersion or oral administration. However, it is critically important to determine the optimal dose to enhance the immune system of fish and avoid the risk of immunosuppression. Some medicinal plants have been used to replace the protein in fishmeal as a cheap source of protein and proved to be efficient in this respect. Medicinal plants can act as a growth promoter and immunomodulator at the same time. Further investigations should be carried out to examine the influence of those plants on fish health (including physiological and histological parameters) as a preliminary step for use in large scale in aquaculture. The current review describes the role of medicinal plants and their derivatives on innate and adaptive immune status as well as growth

  6. The Role of Nuclear Medicine in The Diagnosis and Management of Solitary Pulmonary Nodules

    Directory of Open Access Journals (Sweden)

    Farzaneh Shariati

    2013-10-01

    Full Text Available   Solitary pulmonary nodule (SPN is a frequent finding on the chest x-ray and computed tomography. Nuclear medicine techniques play an important role in the diagnosis and management of SPN. In the current review, we briefly will explain the different nuclear medicine modalities in this regard including positron emission tomography (PET using 18-F-FDG, and 11-C-Methionine, and single photon emission computerized tomography (SPECT using somatostatin receptor scintigraphy, 201-Thallium, and 99m-Tc-MIBI.  

  7. Discussion of "The New Role of Biomedical Informatics in the Age of Digital Medicine".

    Science.gov (United States)

    Al-Shorbaji, Najeeb; Bellazzi, Riccardo; Gonzalez Bernaldo de Quiros, Fernan; Koch, Sabine; Kulikowski, Casimir A; Lovell, Nigel H; Maojo, Victor; Park, Hyeoun-Ae; Sanz, Ferran; Sarkar, Indra N; Tanaka, Hiroshi

    2016-10-17

    This article is part of a For-Discussion-Section of Methods of Information in Medicine about the paper "The New Role of Biomedical Informatics in the Age of Digital Medicine" written by Fernando J. Martin-Sanchez and Guillermo H. Lopez-Campos [1]. It is introduced by an editorial. This article contains the combined commentaries invited to independently comment on the paper of Martin-Sanchez and Lopez-Campos. In subsequent issues the discussion can continue through letters to the editor.

  8. India: using stakeholder analysis to forecast success.

    Science.gov (United States)

    Kumar, Y; Chaudhury, N R; Vasudev, N

    1999-01-01

    This article presents the use of stakeholder analysis to examine the efficacy of health reform programs in India. Stakeholder analysis assists planners in identifying groups affected by proposed activities, their reactions to prospective changes, and the roles they might play in supporting or opposing them. Such information is then used to develop strategies involving national and local officials and communities in reform. Stakeholder analysis was used by the US Agency for International Development (USAID) for the proposed Women's and Children's Health (WACH) project. It involved interviews among major stakeholders regarding their views on the effectiveness of the current health system, the new roles that health care organizations and individuals would have after changes in service delivery under WACH, and their institutional capacity to handle new roles. In addition to stakeholder analysis, three other tools are available to policy managers and health sector reform teams to help them manage and influence the process of health sector reform: 1) institutional mapping, which involves identification and analysis of an organization's structure; 2) political mapping through graphic display of sources and degrees of political support and opposition; and 3) interest mapping, a combination of stakeholder analysis and political mapping. With the use of stakeholder analysis, USAID was provided with crucial information for the evaluation of community support and success capability of the WACH project.

  9. Combining Human Resource and Stakeholder Management Perspectives

    DEFF Research Database (Denmark)

    Ravazzani, Silvia; Mormino, Sara

    2015-01-01

    This paper explores collaborative learning activities involving HR and external stakeholders that organizations decide to plan and implement in order to obtain benefits in terms of knowledge sharing, stakeholder understanding and value creation. The increasing uncertainty and multiplicity...... of competitive pressures and stakeholder demands (Harrison, St. John, 1996) require organizations, and in particular HR, to take on a more strategic role aimed to build new capability and support the overarching business strategy (Ulrich, Beatty 2001). This study draws on Strategic Human Resource Management......, Strategic Human Resource Development and Stakeholder Management studies and, on this basis, investigates the case of an Italian bank to understand the nature and characteristics of collaborative learning activities towards external stakeholders. The investigation supports the proposition that HR development...

  10. Co-creating Stakeholder and Brand Identities

    DEFF Research Database (Denmark)

    von Wallpach, Sylvia; Voyer, Benjamin; Kastanakis, Minas

    2017-01-01

    important role in ongoing interactive identity development processes of stakeholders. The special section contributes to deepening the understanding of this reciprocal co-creation of stakeholder and brand identities, through a series of conceptual and empirical articles. The Introduction reviews four......This article introduces the special section on reciprocal co-creation of stakeholder and brand identities. Branding research and practice traditionally focus on the managerial creation and implementation of brand identity. Based on recent paradigmatic shifts from managerial to co-creative branding...... and from consumer to multi-stakeholder approaches in marketing, this special section develops a dynamic, process-oriented perspective on brand identity. Brand identity continuously emerges as a dynamic outcome of social processes of stakeholder interaction. Reciprocally, brand identity plays a potentially...

  11. A dynamic perspective in Freeman’s stakeholder model

    OpenAIRE

    Y. FASSIN

    2011-01-01

    Stakeholder literature has acknowledged the need to complement the extant theory on stakeholder management by more dynamic perspectives. This article makes use of the recent terminology of stakewatcher and stakeseeker to illustrate the dynamic aspect of stakeholder theory transposed in the graphical representation of Freeman’s stakeholder model. Presenting a few selected case studies, it applies the scheme on the concept of value responsibility chain; it exemplifies the role of stakeseekers i...

  12. The New Role of Biomedical Informatics in the Age of Digital Medicine.

    Science.gov (United States)

    Martin-Sanchez, Fernando J; Lopez-Campos, Guillermo H

    2016-10-17

    To reflect on the recent rise of Digital Medicine, as well as to analyse main research opportunities in this area. Through the use of several examples, this article aims to highlight the new role that Biomedical Informatics (BMI) can play to facilitate progress in research fields such as participatory and precision medicine. This paper also examines the potential impact and associated risks for BMI due to the development of digital medicine and other recent trends. Lastly, possible strategies to place BMI in a better position to face these challenges are suggested. The core content of this article is based on a recent invited keynote lecture delivered by one of the authors (Martin-Sanchez) at the Medical Informatics Europe conference (MIE 2015) held in Madrid in May 2015. Both authors (Lopez-Campos and Martin-Sanchez) have collaborated during the last four years in projects such as the ones described in section 3 and have also worked in reviewing relevant articles and initiatives to prepare this talk. Challenges for BMI posed by the rise of technologically driven fields such as Digital Medicine are explored. New opportunities for BMI, in the context of two main avenues for biomedical and clinical research (participatory and precision medicine) are also emphasised. Several examples of current research illustrate that BMI plays a key role in the new area of Digital Medicine. Embracing these opportunities will allow academic groups in BMI to maintain their leadership, identify new research funding opportunities and design new educational programs to train the next generation of BMI scientists.

  13. Role of Iranian Traditional Medicine in the Prevention of Respiratory Infectious Diseases.

    Science.gov (United States)

    Soroushzadeh, Sayed Mohammad Ali; Khiveh, Ali; Gerayelimalek, Valiollah

    2016-05-01

    In order to define appropriate plans for respiratory infectious diseases, in accordance with Iranian traditional medicine, one should cover the topic of "havae vabai". "Havae vabai" is related to the epidemics of respiratory infectious diseases. This study is a review of the role of Iranian traditional medicine in the prevention of respiratory infectious diseases .Resources of traditional medicine with the keyword "havae vabai" were reviewed in Noor digital library. The perspective of traditional medicine for the prevention of disease in "havae vabai" is based on self-recuperation and air modification. Items that are mentioned are; refine the surrounding air, move to a proper space, live in a house with no source of water like fountains and limited flow of air, air-drying, use air freshener, smell fruit sticks, use in-house plants, and place a cloth soaked with vinegar in front of the nose. For self-recuperation, reducing body moisture with proper foods and drugs or with vomiting, diarrhea, phlebotomy, wet-cupping, reduction in food and drink intake, avoiding sexual intercourse, bathing, heavy exercise, inactivity, overeating, hunger, thirst, milk, sweets, fish, fatty foods, fruits especially juicy fruits are recommended. The food that tends to have a sour taste, eating meat cooked with sour taste like vinegar is suggested. The use of the solutions offered in traditional medicine to control air is helpful as it can reduce epidemics, such as influenza; that yearly kills many patients with a heavy financial burden.

  14. Medical students' perspective about role-plays as a teaching strategy in community medicine.

    Science.gov (United States)

    Manzoor, Iram; Mukhtar, Fatima; Hashmi, Noreen Rahat

    2012-04-01

    To assess the students' perspective about role-plays conducted as a teaching methodology in community medicine. A quasi-experimental study. Department of Community Medicine at Fatima Memorial College of Medicine and Dentistry from July to November 2010. A probability technique of simple random sampling was used to collect 63 students from the third and fourth year MBBS who were randomly distributed in five sub-groups. They were variously ascribed the roles of obsceners, participants and helpers. A questionnaire was distributed to collect student's responses. The data was analyzed on SPSS version 17 to compare the responses. Chi-square test was applied and p-value was fixed at students were selected as participants of this study in which 46 belonged to the fourth year MBBS class (73%) and 17 were third year MBBS students (27%). There were 13 male (20.6%) and 50 female (79.4%) students. Role-plays were identified as most effective method of teaching (n = 25, 37.9%) followed by lectures (n = 17, 25.8%, p = 0.054). Fifty-two students (78.5%) admitted that role-plays improved their knowledge of the subject, 55 (84.6%) said that it will help them in their clinical performance. Fifty-nine participants (89.4%) found role-plays interesting and 49 (74.2%) wanted to incorporate role-plays as a part of curriculum. Fifty-six of the participants (88.9%) agreed that role-plays improved their communication skills. Twenty-one participants (31.8%) believed that it helped them in making acquaintance with the local situation. Forty-six students (76.7%) identified role-plays as a feasible way of andragogy (p = 0.005) and 48 (76.2%) said that it provoked critical thinking about the subject (p = 0.038). Fifty-four students (85.7%) admitted that their attention span was better in role-plays as compared to lectures (p = 0.047). Role-plays were well accepted by the students as an effective teaching methodology and can be incorporated as a part of teaching strategies in Community Medicine.

  15. THE ROLE OF THE PREVENTIVE MEDICINE IN SUSTAINABLE DEVELOPMENT. A STUDY CASE ON THE PRIVATE MEDICINE SECTOR IN ORADEA

    Directory of Open Access Journals (Sweden)

    Unita Lucian

    2011-12-01

    Full Text Available The concerns with respect to healthy life styles, preventive medical approaches, safe environment, and early warning systems represents the Millennium Development Goals, the United Nations Organization's so called Decade for Education for Sustainable Development, the European Union's sustainability strategy, the Global Environmental Outlook of the United Nations Environment Programme (UNEP and the ten Principles of the UN Global Compact, all aiming to attain the sustainable global health, which is possible only through collective multilevel efforts for the sake of human wellbeing, equity, livelihood, and worldwide sustainable development and stability. Romania, as an EU Member States, have to take into consideration the fact that health is a precondition for economic growth and sustainable development, and this way, it has to promote the EU common approaches to health policy. Between these approaches, the prevention plays a key role when addressing to the global health challenges such as the pandemics control, and the rising tide of non-communicable diseases. For these purposes, preventive strategies need to include promoting polices that foster a healthy environment, healthy life styles and equitable access to health care and information, so, it is necessary to meet the requests towards sustainable global health. From this perspective, for the empirical research pursued in this paper, we have considered the Global Challenge Index, which focuses on seven global challenges of the new millennium, and on this basis, we have compared Romania with the other EU Member States. Then, we have computed the index for Oradea and its neighbour region, including the framework of a comprehensive analysis of political, economic and social target system. The key issues we have considered in this context were referring to lifestyles, life care and education for lifelong well-being, partnerships for health, institutions and related policy areas, alternative

  16. [Historical Archives of Italian Nephrology: The role of women in the history of Medicine and Nephrology].

    Science.gov (United States)

    Timio, M

    2002-01-01

    The aim of the present survey of the history of medicine is to provide a series of succinct assessments of the role of women in the development of nephrology. The inadequate role played by women in some areas of medicine underlines the trend that considers health history as part of external history modulating the branches of science. If "external" or social history considers women's role as marginal in many segments of society, no wonder they play a marginal role in the history of medicine. Nonetheless, when women are offered the opportunity to map out new medical paths or handle new health systems they have always been excellent. Tratula, a doctor from Salerno's medical school, is just an example. Women have been excellent in nursing and popular medicine. Florence Nightingale (1823-1910), an English woman of rare ability and humanitarian enthusiasm, was the first to understand the role of women in organising nursing. In this area she had such a striking success that her method contributed to the founding of the first school of nursing in England and in the world. On the other hand, women doctors have had many difficulties in the medical area. The first modern woman to take her degree in medicine was Elisabeth Blackwell, who graduated from the Geneva Medical School of Western New York in 1849. She managed to open a private dispensary, which within a few years developed into a great hospital and training school for women. In the nephrology area a great Australian woman entered the universal history of medicine, Priscilla Kincaid-Smith. Her outstanding contribution was to improve the diagnosis and treatment of glomerulonephritis. Her positive attitude and the novelty of a woman being on the same scientific level as men, combined to secure her unique reputation in both her own country and the world. We hope that new social trends will develop in which women with scientific ideas will be able to completely express their medical ability and the tendency to eliminate the

  17. The role of stakeholders in Murray-Darling Basin water management: How do irrigators make water use decisions and how can this influence water policy?

    Science.gov (United States)

    Douglas, E. M.; Wheeler, S. A.; Smith, D. J.; Gray, S.; Overton, I. C.; Crossman, N. D.; Doody, T.

    2014-12-01

    their communities and appreciated for their role in the sustainability of the Basin. The mental modelling approach used in this research could be used to educate all stakeholders in differences in perspectives and common goals and bridge the gap into how to implement sustainable management practices.

  18. Stakeholder Attitudes EBM

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The National Marine Fisheries Service (NMFS) conducted a survey of fisheries stakeholders on the Gulf and East Coasts of the United States seeking their views on...

  19. The Role of MicroRNAs in Natural Tissue Development and Application in Regenerative Medicine

    DEFF Research Database (Denmark)

    Andersen, Morten Østergaard; Dillschneider, Philipp; Kjems, Jørgen

    2013-01-01

    will revolutionise regenerative medicine. This chapter will introduce miRNA biology and their role in controlling pluripotency, stem cell differentiation, proliferation, senescence, survival, inflammation and angiogenesis. There are several strategies by which miRNA-modulating technologies can be used...... to specifically target tissue engineering and repair, either in culture or in association with implanted cells and/or implants. We will here summarise these methods providing examples from present literature. Based on previous results, we will also predict more advanced technologies that may deliver mi......RNA in a spatial/temporally regulated manner that may imitate natural miRNA expression. Furthermore, exogenous miRNAs, carried between cells in secreted vesicles, have recently been characterised and may further increase the role and potential of miRNA in relation to regenerative medicine....

  20. Engaging stakeholder networks

    Energy Technology Data Exchange (ETDEWEB)

    Svendsen, A. [CoreRelation Consulting Inc., Delta, BC (Canada)]|[Simon Fraser Univ., Burnaby, BC (Canada); Laberge, M. [Simon Fraser Univ., Burnaby, BC (Canada)

    2004-07-01

    Management philosophies concerning stakeholder engagement were reviewed. This presentation provided guidelines for managers working from a sustainability value creation framework who wish to develop more effective ways to engage with stakeholders and high stakes issues that cross political, social and organizational boundaries. It was suggested that conflicts over resources, the demand for participation and the increasing power of Non-Governmental Organizations have all contributed to the increased need for stakeholder engagement. A review of different types of stakeholders was provided. Earlier strategies of managing stakeholders were examined, in which externalities such as environmental cost were not accounted for. By contrast, the emerging management philosophy presented here stressed a recognition that long term survival relied on the good health of external and internal environments. Core business strategies were discussed with reference to core values. It was suggested that a longer term focus, inclusiveness, and integration were beneficial to businesses as a whole. A case study of Clayoquot Sound was presented. The concept of social capital was examined. Individual and collective learning were evaluated. A model for engaging stakeholder networks was presented as well as a step by step procedural guide, which included the creation of a solid foundation; organizational alignment; strategy; the importance of asking questions; trust building; evaluation; and renewal. Challenges to stakeholder engagement included finding resources; ensuring consistency; patience; a tendency in business to measure success in short term payoffs; and maintaining a stakeholder perspective. It was concluded that the benefits of a sustainability value creation framework for businesses far outweighed any initial disadvantages. refs., tabs., figs.

  1. Stakeholders: theory and practice

    National Research Council Canada - National Science Library

    Friedman, Andrew L; Miles, Samantha

    2006-01-01

    ... of the concept on practice and policy. However, as the concept has become more popular, the path has become tangled with the many different ways the concept has been used. For example, different practices have come to be called stakeholder activities, particularly by those seeking to use the label to legitimize their actions. Also, a range of different definitions as to what a stakeholder is has emerged. Concentrating on these issues encourages a view of a second future path of the stake...

  2. Combining Human Resource and Stakeholder Management Perspectives

    DEFF Research Database (Denmark)

    Ravazzani, Silvia; Mormino, Sara

    2015-01-01

    of competitive pressures and stakeholder demands (Harrison, St. John, 1996) require organizations, and in particular HR, to take on a more strategic role aimed to build new capability and support the overarching business strategy (Ulrich, Beatty 2001). This study draws on Strategic Human Resource Management......, Strategic Human Resource Development and Stakeholder Management studies and, on this basis, investigates the case of an Italian bank to understand the nature and characteristics of collaborative learning activities towards external stakeholders. The investigation supports the proposition that HR development...... and corporate learning in a stakeholder-oriented perspective can play a strategic role in supporting business strategy, providing organizations the resources to meet internal and external needs (Wilson, 2005) and to interconnect with their value network....

  3. The role of silicon in physiology of the medicinal plant (Lonicera japonica L.) under salt stress

    OpenAIRE

    Gengmao, Zhao; Shihui, Li; Xing, Sun; Yizhou, Wang; Zipan, Chang

    2015-01-01

    Silicon(Si) is the only element which can enhance the resistance to multiple stresses. However, the role of silicon in medicinal plants under salt stress is not yet understood. This experiment was conducted to study the effects of silicon addition on the growth, osmotic adjustments, photosynthetic characteristics, chloroplast ultrastructure and Chlorogenic acid (CGA) production of Honeysuckle plant (Lonicera japonica L.) under salt-stressed conditions. Salinity exerted an adverse effect on th...

  4. COMMUNICATION STRATEGY ABOUT BUSINESS MODELS: STAKEHOLDERS PERSPECTIVE

    Directory of Open Access Journals (Sweden)

    Bojoagă Alexandru

    2013-07-01

    Full Text Available Organizations inform stakeholders about their current and future activities, processes, created value, strategic intentions, and other information that may influence the established relationships. Organizations choose to communicate with stakeholders by different means and in varied ways. The annual report represents a way of communicating between companies and their stakeholders, and it is offering comprehensive information about how companies operates and creates value. The business model is an emerging concept in management literature and practice. The concept describes the logic by which a organization creates, maintains and delivers value for its stakeholders. Through annual reports organisations can communicate to stakeholders information about their business models.We investigated how information about business models is explicitly communicated through annual reports, and how this information is reffering to stakeholders. Our paper aims to reveal which stakeholders are more often mentioned when organizations are communicating about business models through annual reports. This approach shows the attention degree given by organizations to stakeholders. We perceived this from a strategic point of view, as a strategic signal. Thus, we considered if the stakeholder is mentioned more frequent in the communicated message it has a greater role in communication strategy about business model. We conducted an exploratory research and have realized a content analysis.The analysed data consist in over a thousand annual reports from 96 organizations. We analysed the informations transmitted by organizations through annual reports. The annual reports were for a time period of 12 years. Most of the selected companies are multi-business, and are operating in different industries. The results show the stakeholder’s hierarchy based on how often they were mentioned in the communicated messages about business models through annual reports. Based on our

  5. The role of RD and D for stakeholder confidence as seen by non-institutional actors. The Perspective of a Municipality

    International Nuclear Information System (INIS)

    Aahagen, Harald

    2006-01-01

    The author set the context for his presentation by profiling the geographic location and history of Oskarshamn including the feasibility study and the council's 2002 unanimous vote to accept site investigation with 13 conditions and clarifications. The municipality's policy places an emphasis on ensuring safety first, providing information on the table from all parties at all times, and ensuring active engagement and influence. Working groups were established by the municipality to follow the safety issues and ensure that the 13 conditions are fulfilled, require investigations enhance citizens' competence; collect and forward questions and issues; and draw experience from local participation in other national programmes. Reaching informed consent in siting depends upon many factors, a key factor of which is RD and D. The author identified two components that he believes to be key to achieving informed stakeholder consent: first a need to build local competence on local terms, allowing the municipality to have the capacity to independently judge the project. The second challenge is to achieve consent - a conclusion by a majority that the repository can be accepted and is compatible with the broader visions for the municipality. R and D, together with parameters from site investigations form the basic safety case for repository siting. It was noted that evaluations of safety also are based on assumptions and value judgements. The author underscored that the public has a much better understanding of R and D than most experts are aware of, and that implementers should have faith in the public and trust the public's ability to absorb the facts and follow the issues. Citizens understand the quality aspects of R and D, including the role for peer reviews. The public is also aware that facts change over time and that scientists may hold different opinions. The presentation emphasized the importance of capacity-building at the local level. Stable local

  6. Reflections on the consensus process: a leadership role for emergency medicine in educational scholarship and practice across health care.

    Science.gov (United States)

    Gordon, James A

    2012-12-01

    In just a few decades, emergency medicine (EM) has assumed a leadership role in medical education across many academic medical centers. This rapid evolution suggests medical education as a natural priority area for EM scholarship. This year's Academic Emergency Medicine consensus conference provides an ideal forum to focus on educational research as a core element of the specialty's academic portfolio. © 2012 by the Society for Academic Emergency Medicine.

  7. Current role of the radiographers in imaging diagnostics, nuclear medicine and radiotherapy in modern departments

    International Nuclear Information System (INIS)

    Karidova, S.; Velkova, K.; Panamska, K.; Petkova, K.

    2006-01-01

    Full text: In the communication we set out to focus the attention of the medical staff and the public on the place and the constantly growing role (relative burden) of the radiographers in imaging diagnostics, nuclear medicine and radiotherapy in the field of modern medicine. The advanced radiographers level and rapid development of the contemporary equipment and apparatuses used in imaging diagnostics, nuclear medicine and radiotherapy, as well as the methods of their utilization, presuppose very good and constantly improving theoretical and practical training of the imaging technician. The radiographer fulfills responsible tasks under the guidance of the physician or independently and bears specific responsibilities. Having mastered the fundamentals of radiation protection, the imaging technician protects both himself and the patient from the impact of ionizing radiation. To be able to fulfill his/her constantly increasing duties and obligations, the imaging radiographer has acquired wide knowledge of general education subjects, subjects of general medicine and special subjects. The radiographer has a good knowledge of Latin and a modern foreign language, and he is also computer literate so as to be able to cope with the widely spread visualizing methods. The radiographer acquires additional post-graduate training to work in narrowly specialized fields as well as to improve his/her qualifications

  8. Role of international organizations in promoting nuclear medicine in the developing countries

    International Nuclear Information System (INIS)

    Nofal, M.

    1992-01-01

    Today, because of the diversity of its applications - radiation and radionuclides for medical and biological purposes are used in more countries and in more laboratories than any other application of atomic energy. International organizations, mainly the IAEA and the WHO, have played a significant role in the spread of this nuclear technology in developing countries. There are altogether 112 member states of the Agency, about 71 of them can be classified as developing countries. Out of them, nearly 56 have some kind of nuclear medicine. By that I mean there is some medical use of radioisotopes, be it imaging, radioimmunoassay or the old thyroid uptake. In most of these countries, the personnel working in nuclear medicine has been trained abroad. Training can be as short as few weeks abroad in the form of attendance at one of the four or six week training courses offered by an international organization. Occasionally it is through a fellowship offered by the same organizations. In terms of technology and training, Nuclear Medicine, in its present form, can thus be considered a high technology imported medicine in many of these countries

  9. Training for Leadership Roles in Academic Medicine: Opportunities for Psychologists in the AAMC LEAD Program.

    Science.gov (United States)

    LaPaglia, Donna; Thompson, Britta; Hafler, Janet; Chauvin, Sheila

    2017-06-01

    Psychologists' roles within academic medicine have expanded well beyond research and scholarship. They are active as providers of patient care, medical education, and clinical supervision. Although the number of psychologists in academic health centers continues to grow, they represent a small portion of total medical school faculties. However, with the movement toward collaborative care models, emphasis on interprofessional teams, and increased emphasis on psychological science topics in medical curricula, psychologists are well-positioned to make further contributions. Another path through which psychologists can further increase their contributions and value within academic health centers is to aspire to leadership roles. This article describes the first author's reflections on her experiences in a two-year, cohort-based, educational leadership development certificate program in academic medicine. The cohort was comprised largely of physicians and basic scientists, and a small number of non-physician participants of which the first author was the only clinical psychologist. The insights gained from this experience provide recommendations for psychologists interested in leadership opportunities in academic medicine.

  10. Stakeholder engagement for improved school policy: development and implementation.

    Science.gov (United States)

    2010-01-01

    The health and education departments of government share a responsibility for promoting the health of children through policies in the school setting. These policies can be enhanced through the involvement of such stakeholders as school personnel, students, parents or caregivers, health professionals, the non-profit sector and industry. Although there is little evidence-based literature on the roles of stakeholders in school policy development and implementation, stakeholder involvement appears to be critical throughout the policy process. This article discusses stakeholder involvement in the development and implementation of school policies that promote and support healthy eating and physical activity. Canadian examples illustrate stakeholder engagement in this context.

  11. The role of podiatric medicine in the health-care team. A paradigm shift.

    Science.gov (United States)

    Levy, Leonard A

    2015-03-01

    As physicians, podiatric medical doctors should not define themselves as medical professionals who treat the foot and ankle but rather as medical professionals who prevent, diagnose, and treat people who have foot and ankle problems. Patients who come to see podiatric physicians often have other health-care issues, and because of the education and training that doctors of podiatric medicine receive, they are uniquely qualified to identify and respond to findings not only related to the pedal extremity but also that may affect overall health, have a major effect on quality of life, and even help reduce overall health-care costs. The role of podiatric medicine as a truly integrated branch of medical care needs to be reassessed.

  12. Erasmus of Rotterdam (1466-1536): renaissance advocate of the public role of medicine.

    Science.gov (United States)

    Albury, W R; Weisz, G M

    2003-08-01

    The great Renaissance scholar Erasmus of Rotterdam was a pioneering advocate of the importance of medicine for social as well as individual welfare. Erasmus' "Oration in praise of the art of medicine" (1518) illustrates his literary approach to this topic. Although the original version of his text did not address the state's role in promoting the health of the populace, Erasmus inserted new material on this topic into the "Oration" for a 1529 edition. This new material and references in some of his other writings from the same period indicate that it was in the 1520s that Erasmus first became a strong advocate of government intervention in public health matters. It is suggested that medical events in Erasmus' own life-his experiences both as a patient and as an observer of diseases-may explain why his interest in public health legislation increased significantly around this time.

  13. Listed Firm's Level of Stakeholder Transparency

    DEFF Research Database (Denmark)

    Rose, Caspar

    2015-01-01

    This article analyzes how Danish listed firms comply with the Danish Corporate Governance Code's recommendations regarding the categories: Role of shareholders, role of stakeholders and transparency. It is shown that the number of recommendations can be explained by six different underlying facto...

  14. IMPLICATIONS OF CSR ON CORPORATE STAKEHOLDERS

    Directory of Open Access Journals (Sweden)

    Crisan Catalina

    2015-07-01

    Full Text Available Companies’ strategies and values must be in accordance to stakeholders’ expectations and needs because their role and influences on companies’ activity are decisive for companies future development. Corporate Social Responsibility is a meaningful way through which companies can pursue sustainable development by having a coherent economical, social and environmental perspective on how the business should be managed. CSR must become an integral part of corporate management system, because it has a major role in distressing the relation between company and major stakeholders, both internally and externally. CSR is a global phenomenon, which draws the attention of a growing number of partisans, from public private and social sector. To demonstrate the applicability of the theoretical approaches deduced from the existing literature, the authors recourse to an empirical qualitative research, conducted through a questionnaire implemented to top managers, HR managers and heads of CSR departments within large companies that operate in Romania. The research is based on the analysis of a number of 87 questionnaires and aims to highlight major stakeholders and finding how companies’ responsible activities can influence stakeholders. This study is designed to highlight how prioritization of stakeholders influences CSR initiatives within large companies that operate in Romania, and to present a perspective of company’s approach towards shared value influence major stakeholders. The conclusions drawn have a greater relevance both theoretically and especially practically because provides insights on how large companies perceive CSR and how stakeholders influence responsible initiatives in emergent country like Romania where stereotypes are difficult to manage.

  15. The role of the Therapeutic Goods Administration and the Medicine and Medical Devices Safety Authority in evaluating complementary and alternative medicines in Australia and New Zealand

    International Nuclear Information System (INIS)

    Ghosh, Dilip; Skinner, Margot; Ferguson, Lynnette R.

    2006-01-01

    Currently, the regulation of complementary and alternative medicines and related health claims in Australia and New Zealand is managed in a number of ways. Complementary medicines, including herbal, minerals, nutritional/dietary supplements, aromatherapy oils and homeopathic medicines are regulated under therapeutic goods/products legislation. The Therapeutic Goods Administration (TGA), a division of the Commonwealth Department of Health and Ageing is responsible for administering the provisions of the legislation in Australia. The New Zealand Medicines and Medical Devices Safety Authority (Medsafe) administers the provision of legislation in New Zealand. In December 2003 the Australian and New Zealand governments signed a Treaty to establish a single, bi-national agency to regulate therapeutic products, including medical devices prescription, over-the-counter and complementary medicines. A single agency will replace the Australian TGA and the New Zealand Medsafe. The role of the new agency will be to safeguard public health through regulation of the quality, safety and efficacy or performance of therapeutic products in both Australia and New Zealand. The major activities of the new joint Australia New Zealand therapeutic products agency are in product licensing, specifying labelling standards and setting the advertising scheme, together with determining the risk classes of medicines and creating an expanded list of ingredients permitted in Class I medicines. A new, expanded definition of complementary medicines is proposed and this definition is currently under consultation. Related Australian and New Zealand legislation is being developed to implement the joint scheme. Once this legislation is passed, the Treaty will come into force and the new joint regulatory scheme will begin. The agency is expected to commence operation no later than 1 July 2006 and will result in a single agency to regulate complementary and alternative medicines

  16. An international comparison of stakeholder motivation to implement liver cancer control.

    Science.gov (United States)

    Bridges, John F P; Joy, Susan M; Blauvelt, Barri M; Yan, Weili; Marsteller, Jill A

    2015-06-01

    The World Health Organization offers clear guidance on the development of national cancer control programmes based on a country's level of resources, yet the motivation to implement such programmes may be driven by factors other than resources. To compare stakeholder motivation to implement a national liver cancer control programme and assess if variation in motivation was associated with stakeholder characteristics or with national indicators of need and resources. Relevant stakeholders were purposively selected from 13 countries (Australia, China, France, Germany, Italy, Japan, Nigeria, South Korea, Spain, Taiwan, Thailand, Turkey and USA) to participate in a structured survey on liver cancer control. Respondents included 12 individuals working in clinical, 5 in policy and 3 in advocacy roles from each country. Stakeholders' motivation was measured using a scale grounded in expectancy theory and knowledge gained during previous qualitative interviews. Comparisons across countries and respondent characteristics were conducted using hierarchical regression. Country level motivation scores, holding constant individual level covariates, were correlated with indicators of need and resources and tested using Pearson's correlation coefficients. In total, 260 stakeholders, equally drawn from the study countries, completed the survey (45% response rate). At the national level, motivation was highest in Nigeria, Thailand and China (P stakeholders working at the international level relative to the local level (P = 0.017). Motivation was positively associated with a country's relative burden of liver cancer (P = 0.015) and negatively associated with their level of resources (P = 0.018). This study provides the first empirical evidence on the motivation of stakeholders to implement national cancer control programmes. Furthermore, we demonstrate that motivation is more clearly associated with a country's cancer control needs rather than resources. Published by Oxford

  17. Mapping the Views of Adolescent Health Stakeholders.

    Science.gov (United States)

    Ewan, Lindsay A; McLinden, Daniel; Biro, Frank; DeJonckheere, Melissa; Vaughn, Lisa M

    2016-01-01

    Health research that includes youth and family stakeholders increases the contextual relevance of findings, which can benefit both the researchers and stakeholders involved. The goal of this study was to identify youth and family adolescent health priorities and to explore strategies to address these concerns. Stakeholders identified important adolescent health concerns, perceptions of which were then explored using concept mapping. Concept mapping is a mixed-method participatory research approach that invites input from various stakeholders. In response to prompts, stakeholders suggested ways to address the identified health conditions. Adolescent participants then sorted the statements into groups based on content similarity and rated the statements for importance and feasibility. Multidimensional scaling and cluster analysis were then applied to create the concept maps. Stakeholders identified sexually transmitted infections (STIs) and obesity as the health conditions they considered most important. The concept map for STIs identified 7 clusters: General sex education, support and empowerment, testing and treatment, community involvement and awareness, prevention and protection, parental involvement in sex education, and media. The obesity concept map portrayed 8 clusters: Healthy food choices, obesity education, support systems, clinical and community involvement, community support for exercise, physical activity, nutrition support, and nutrition education. Ratings were generally higher for importance than for feasibility. The concept maps demonstrate stakeholder-driven ideas about approaches to target STIs and obesity in this context. Strategies at multiple social ecological levels were emphasized. The concept maps can be used to generate discussion regarding these topics and to identify interventions. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  18. Salt and its Role in Health and Disease Prevention from the Perspectives of Iranian Medicine and Modern Medicine.

    Science.gov (United States)

    Mokhtari, Masoud; Vahid, Hamide

    2016-05-01

    Salt in Iranian medical sources is mentioned as Malh and has a special place in people's nutrition. The purpose of this study was to investigate the effect of correct use of salt on health and disease prevention in the context of Iranian medicine and its comparison with modern medicine. This article reviews Iranian medicine references on the usage of salt and its benefits. Additionally, modern medicine references were searched to identify the dos and don'ts of salt consumption. Then the results from both approaches were compared and analyzed. The main application salt in Iranian medical resources includes usage in latif supplier, solvent, dryer, laxative of phlegm and melancholy, slimy moisture body repellent, opening obstruction of liver and spleen, aid in digestion, beneficial for seeds and corruption of foods, appetizing, cold foods reformer and improving the flavor of foods. On the other hand, the major benefits of salt according to modern medicine resources are; aiding the balance of electrolytes and fluids, carry nutrients into cells, regulation of acid-base balance, support transfer of nerve impulses, regulate blood pressure, and secretion of gastric acid. According to the Iranian medicine, the amount and type of salt to maintain health and prevent diseases is determined based on factors such as temperament, age, health and disease, season, and location. While a unique approach is not prescribed for every individual, in modern medicine resources, a fixed set of guidelines is recommended for all healthy individuals. Consequently, the modern medicine pays less attention to physiological, structural, and genetic issues. Considering the importance of salt and its undeniable impact on human health, it is apparent that additional research is required to determine factors affecting the actual amount of salt per person.

  19. Role of Stress in Burnout among Students of Medicine and Dentistry – A Study in Ljubljana, Slovenia, Faculty of Medicine

    OpenAIRE

    Krokter Kogoj, Tina; Čebašek Travnik, Zdenka; Zaletel Kragelj, Lijana

    2014-01-01

    Medical education is challenging, but for some students it can be very stressful. Studies suggest that stress during medical education can have a negative impact on students’ mental health and that burnout is frequent among medical school students. The aim of this study was to measure burnout among students of medicine/dentistry (M/D) at the Faculty of Medicine, University of Ljubljana, Slovenia, in relation to their perception of stress, so as to enable planning preventative activities for s...

  20. The role of prudent love in the practice of clinical medicine.

    Science.gov (United States)

    Marcum, James A

    2011-10-01

    Virtues are an important component in the practice of clinical medicine. Prudence or wisdom and charity or love are often viewed as crucial for virtuous practice. Generally, the two virtues are discussed separately, with no connection between them; however, a synergy exists between the two virtues as a compound virtue of prudent love in which the properties of the compound virtue transcend those of the individual virtues. To examine the nature of prudent love and to discuss its role in the practice of clinical medicine. Philosophical and conceptual analyses. Prudent love exhibits properties, which are the result of a synergistic interaction between the two individual virtues. Succinctly, prudent love synergism is an outcome of a particular structural relationship between the two virtues in which motivational love prompts the prudent clinician to acquire and utilize clinical competence, which then allows the loving clinician to take care of an individual patient's health care needs. In turn, the virtuous clinician's ability to meet those needs successfully feedbacks onto the motivation to satisfy them initially, thereby encouraging and enhancing the clinician to fulfil them even more prudently and lovingly, not only for the individual patient but also for other patients. The compound virtue of prudent love provides a comprehensive approach to practising medicine that meets not only the needs of patients but also fulfils the physician's sense as healer. Although challenges face teaching virtues in the medical curriculum, strategies are available for incorporating training in virtues into the curriculum. © 2011 Blackwell Publishing Ltd.

  1. The role of civil society organizations in the institutionalization of indigenous medicine in Bolivia.

    Science.gov (United States)

    Babis, Deby

    2014-12-01

    December 2013 marked a significant shift in Bolivia with the enactment of a law for the inclusion of indigenous doctors in the National Health System. This article traces the constellation of forces that led to the institutionalization of indigenous medicine in Bolivia. It identifies three factors contributing to this health policy change. The first factor is the crystallization of a strong indigenous movement fighting for the recognition of cultural rights through the foundation of civil society organizations. Second is the rise to power of Evo Morales, the first Latin American president of indigenous origin, who has promoted multicultural policies, formally supported through the promulgation of a new constitution. Lastly is the influence of the global acceptance of alternative medicine. Indigenous doctor organizations in Bolivia have been highly involved throughout the entire process of institutionalization and have played a crucial role in it. An analysis of the relationship between these civil society organizations and the Bolivian government reveals a strong partnership. This dynamic can be described in terms of Interdependence Theory, as each party relied on the other in the promotion and practice of the law to achieve the integration of indigenous medicine as part of the Bolivian Health System. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. Microfoundations for stakeholder theory: Managing stakeholders with heterogeneous motives

    NARCIS (Netherlands)

    Bridoux, F.; Stoelhorst, J.W.

    2014-01-01

    Instrumental stakeholder theory proposes a positive relationship between fairness toward stakeholders and firm performance. Yet, some firms are successful with an arms-length approach to stakeholder management, based on bargaining power rather than fairness. We address this puzzle by relaxing the

  3. Public Participation Guide: Stakeholder Interviews

    Science.gov (United States)

    Interviews with stakeholders are one-to-one conversations about a specific topic or issue. The primary purpose of these interviews is to obtain project-relevant information and elicit stakeholder reactions and suggestions.

  4. The Role of Pavlov's Theory in North Korea in the Late 1950s: Ideological Struggle in Medicine and Scientification of Traditional Medicine.

    Science.gov (United States)

    Han, Sun-Hee; Kim, Ock-Joo

    2013-12-01

    This paper deals with Pavlov theory in North Korea in the late 1950s, focusing on its role in ideological struggle in medicine and in reinterpretation of traditional medicine. In North Korean Ministry of Health found Pavlov theory to have rich resources which could be used in the construction of the North Korea's socialist medicine. First of all, Pavlov theory provided the North Korean Communist Party with a powerful ideological weapon against capitalist medical thoughts, representing superior socialist medicine based upon Marx-Leninism and dialectical materialism. This paper examines the contents of Pavlov theory introduced in the North Korea from the Soviet Union in the late 1950s. Pavlov theory in the North Korea was not merely a political slogan but a unified medical system of thought, ranging from biological theory on the organism and pathogenesis to clinical theory. Nonetheless, Pavlov theory became Pavlov doctrine in the ideological struggle in healthcare field initiated by Kim Il Sung and the Communist Party. In the process of the ideological struggle, the abducted surgeon Kim Si-Chang was accused and purged of counter-revolutionary and refusal to conform to Pavlov doctrines by the Communist Party in 1959. Interestingly, Pavlov theory was used in reinterpretation of Traditional Medicine in North Korea from unscientific practice to a rich and scientific complementary medicine by connecting the two with common theoretical components such as Pavlov's typology. By the enthusiastic Communist Party members, Pavlov doctrine was introduced, transformed and exploited to build monolithic ideology system in medicine in North Korea in the late 1950s.

  5. STAKEHOLDER LINKAGES FOR SUSTAINABLE LAND ...

    African Journals Online (AJOL)

    Osondu

    This paper presents stakeholder types involved in sustainable land management (SLM), their interests and ... (DAs), and Rural Kebele Administration (RKA) offices were major stakeholders involved in SLM activities in the ... Key words: Stakeholders; farmer-expert linkages; resource management; Ethiopia. Introduction.

  6. Theory-Based Stakeholder Evaluation

    Science.gov (United States)

    Hansen, Morten Balle; Vedung, Evert

    2010-01-01

    This article introduces a new approach to program theory evaluation called theory-based stakeholder evaluation or the TSE model for short. Most theory-based approaches are program theory driven and some are stakeholder oriented as well. Practically, all of the latter fuse the program perceptions of the various stakeholder groups into one unitary…

  7. Safety Outreach and Incident Response Stakeholder Strategy

    Energy Technology Data Exchange (ETDEWEB)

    Rosewater, David Martin [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Conover, David [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-06-01

    The objective of this document is to set out a strategy to reach all stakeholders that can impact the timely deployment of safe stationary energy storage systems in the built environment with information on ESS technology and safety that is relevant to their role in deployment of the technology.

  8. Stakeholders and quality assurance in higher education

    NARCIS (Netherlands)

    Leisyte, Liudvika; Westerheijden, Donald F.; Eggins, Heather

    2014-01-01

    The various changes in post-bureaucratic organising, which are moving towards network approaches, coupled with the managerial agenda of corporate governance, have redefined the roles of various internal and external stakeholders in the governance of higher education institutions (Leisyte and Dee,

  9. Human Genetic Variation, Sport and Exercise Medicine, and Achilles Tendinopathy: Role for Angiogenesis-Associated Genes.

    Science.gov (United States)

    Rahim, Masouda; El Khoury, Louis Y; Raleigh, Stuart M; Ribbans, William J; Posthumus, Michael; Collins, Malcolm; September, Alison V

    2016-09-01

    Sport and Exercise Medicine is one of the important subspecialties of 21st century healthcare contributing to improving the physical function, health, and vitality of populations while reducing the prevalence of lifestyle-related diseases. Moreover, sport and exercise are associated with injuries such as Achilles tendinopathy, which is a common tendon injury. The angiogenesis-associated signaling pathway plays a key role in extracellular matrix remodeling, with increased levels of angiogenic cytokines reported after cyclic stretching of tendon fibroblasts. We investigated the variants in angiogenesis genes in relation to the risk of Achilles tendinopathy in two population samples drawn independently from South Africa (SA) and the United Kingdom (UK). The study sample comprised 120 SA and 130 UK healthy controls, and 108 SA and 87 UK participants with Achilles tendinopathy. All participants were genotyped for five functional polymorphisms in the vascular endothelial growth factor, A isoform (VEGFA) (rs699947, rs1570360, rs2010963) and kinase insert-domain receptor (KDR) genes (rs1870377, rs2071559). The VEGFA A-G-G inferred haplotype was associated with an increased risk of Achilles tendinopathy in the SA group (15% in controls vs. 20% in cases, p = 0.048) and the combined SA+UK group (14% in controls vs. 20% in cases, p = 0.009). These new findings implicate the VEGFA gene with Achilles tendinopathy risk, while highlighting the potential biological significance of the angiogenesis signaling pathway in the etiology of Achilles tendinopathy. The evidence suggesting a genetic contribution to the susceptibility of sustaining a tendon injury is growing. We anticipate that high-throughput and multi-omics approaches, building on genomics, proteomics, and metabolomics, may soon uncover the pathophysiology of many diseases in the field of Sports and Exercise Medicine, as a new frontier of global precision medicine.

  10. Strengthening stakeholder-engaged research and research on stakeholder engagement.

    Science.gov (United States)

    Ray, Kristin N; Miller, Elizabeth

    2017-06-01

    Stakeholder engagement is an emerging field with little evidence to inform best practices. Guidelines are needed to improve the quality of research on stakeholder engagement through more intentional planning, evaluation and reporting. We developed a preliminary framework for planning, evaluating and reporting stakeholder engagement, informed by published conceptual models and recommendations and then refined through our own stakeholder engagement experience. Our proposed exploratory framework highlights contexts and processes to be addressed in planning stakeholder engagement, and potential immediate, intermediate and long-term outcomes that warrant evaluation. We use this framework to illustrate both the minimum information needed for reporting stakeholder-engaged research and the comprehensive detail needed for reporting research on stakeholder engagement.

  11. Shareholder, stakeholder-owner or broad stakeholder maximization

    DEFF Research Database (Denmark)

    Mygind, Niels

    2004-01-01

    including the shareholders of a company. Although it may be the ultimate goal for Corporate Social Responsibility to achieve this kind of maximization, broad stakeholder maximization is quite difficult to give a precise definition. There is no one-dimensional measure to add different stakeholder benefits...... by other stakeholders' interests. These constraints vary for dif-ferent stakeholder owners and new standards for Corporate Social Responsibility and more active political consumers will strengthen these constraints.......With reference to the discussion about shareholder versus stakeholder maximization it is argued that the normal type of maximization is in fact stakeholder-owner maxi-mization. This means maximization of the sum of the value of the shares and stake-holder benefits belonging to the dominating...

  12. The Role of Chinese Medicine in Cancer Care—a Critical Review

    Directory of Open Access Journals (Sweden)

    Dan Jiang

    2016-01-01

    Full Text Available Traditional Chinese medicine (TCM has been widely used in China and other East Asian countries for helping cancer patients. However, it is unavailable to most patients who are treated in NHS in UK, due to there is not enough evidence in using TCM in cancer patients, To try to establish the evidence base for using TCM in cancer patients management, the author reviewed the current available clinical reports to TCM treatment of cancer patients, mainly those of randomly assigned and controlled clinical trials (RCTs with bigger samples, from maintaining the quality of life, enhancing immune system, remedying the side effects from radiotherapy and chemotherapy respectively, and to propose a role of TCM as an assistant therapy to the main therapies. We then concluded that TCM holds its unique value in maintaining good quality of life, and to help the patients through the operation, chemotherapy and radiotherapy to achieve better outcomes.

  13. The role of pediatricians as key stakeholders in influencing immunization policy decisions for the introduction of meningitis B vaccine in Canada: The Ontario perspective

    Science.gov (United States)

    Yamashiro, Hirotaka; Cutcliffe, Nora; Dobson, Simon; Fisman, David; Gold, Ronald

    2015-01-01

    As key stakeholders in immunization policy decisions, the Pediatricians of Ontario held an accredited conference on January 18, 2014, to discuss prevention of invasive meningococcal disease. Five key recommendations were put forth regarding immunization strategies to protect children from meningococcal serogroup B disease. The recently approved four-component meningococcal B (4CMenB) vaccine should be recommended and funded as part of Ontario’s routine immunization schedule and should also be mandated for school attendance. Public funding for 4CMenB immunization is justified based on current MenB epidemiology, vaccine coverage, cost effectiveness and acceptability, as well as legal, political and ethical considerations related to 4CMenB immunization, particularly because routine recommendations and funding are currently in place for vaccination against meningococcal serogroups that cause significantly less disease in Canada than MenB. Broadly, the goals are to assist individual practitioners in advocating the benefits of 4CMenB vaccination to parents, and to counterbalance recommendations from the National Advisory Committee on Immunization and the Canadian Paediatric Society. PMID:26361485

  14. AN INSIGHT INTO STAKEHOLDER-LED CSR COMMUNICATION

    Directory of Open Access Journals (Sweden)

    Olesia Mihai

    2012-11-01

    Full Text Available Although companies have always been engaged in communicating strategically with the main stakeholders, recent developments have shown that the corporate communication function has been redefined as a complex activity of communicating with both internal and external stakeholders. The authors use stakeholder theory to provide insight into CSR on-line communication by analyzing the content available to the general public of three major Romanian companies. The analysis shows that Romanian companies have adopted mainly the engagement rhetoric, one of the explanations being the fact that many domestic stakeholders still fail to understand the key role of CSR in developing corporate identity and reputation via on-line communication.

  15. Complementary Role of Herbal Medicine and Exercise in Cardiovascular Disease Prevention and Management: A Review of Evidence.

    Science.gov (United States)

    Veluswamy, Sundar Kumar; Babu, Abraham Samuel; Sundar, Lakshmi Manickavasagam

    2017-01-01

    Cardiovascular disease (CVD) is the leading cause of death worldwide. Herbal medicine and exercise interventions have individually been shown to be effective in the prevention and management of CVD. However, the complementary roles of herbal medicine and exercise interventions for CVD prevention and management have not been adequately reported. 1. Identify studies analysing complementary roles of herbal medicine and exercise intervention in CVD prevention and management, 2. Identify herbs and exercise strategies that have been reported to exhibit complementary roles in CVD prevention and management, and 3. Summarize evidence of complementary roles of herbal medicine and exercise interventions for CVD prevention and management. PubMed, CINAHL and Web of Science were searched with a customised search strategy in May 2015. Two reviewers screened the search results for inclusion using pre-specified criteria. Data were extracted from full text of selected abstracts in a predetermined template by two reviewers and verified by the third reviewer when needed. A total of 35 titles were identified for full texts review after screening 827 abstracts. Data were extracted from 23 titles, representing 12 human studies and six animal studies. This review identified effects of 14 different herbs and 10 exercise strategies on over 18 CVD risk factors and markers. Complementary roles of herbal medicine and exercise were reported from five studies. Evidence of complementary role of herbal medicine and exercise is emerging from animal studies. More robust clinical studies on proven risk factors are needed before they can be recommended for clinical practice. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  16. The influence of age and educational qualification on stakeholders ...

    African Journals Online (AJOL)

    Policy makers, teachers, students and members of the society are normally referred to as major stakeholders in education. The role of stakeholders in facilitating decisions that affect educational policies cannot be undermined. Although technology is considered a veritable platform for enhancing the teaching-learning ...

  17. The Politics of Stakeholder Influence in Corporate Environmental Governance

    DEFF Research Database (Denmark)

    Backer, Lise

    2006-01-01

    I contribute in this article to descriptive stakeholder engagement theory by conceptualising a number of new internal influence strategies that engaged secondary stakeholders can use in their new face-to-face interactions with the corporations. These internal stakeholder influence strategies should...... environmental governance practices. The Shell top management is to this end appearing sincere in the way they monitor (Meyer and Rowan, 1977) the progress in giving secondary stakeholders (Clarkson, 1995) access to environmental information and to environmental decision-making in Shell. Based on the Shell case...... be seen as adding to the list of external stakeholder influence strategies (e.g. Frooman, 1999) that secondary stakeholders can use in their traditional role of operating from the outside....

  18. The Politics of Stakeholder Influence in Corporate Environmental Governance

    DEFF Research Database (Denmark)

    Backer, Lise

    I contribute in this article to descriptive stakeholder engagement theory by conceptualising a number of new internal influence strategies that engaged secondary stakeholders can use in their new face-to-face interactions with the corporations. These internal stakeholder influence strategies should...... environmental governance practices. The Shell top management is to this end appearing sincere in the way they monitor (Meyer and Rowan, 1977) the progress in giving secondary stakeholders (Clarkson, 1995) access to environmental information and to environmental decision-making in Shell. Based on the Shell case...... be seen as adding to the list of external stakeholder influence strategies (e.g. Frooman, 1999) that secondary stakeholders can use in their traditional role of operating from the outside....

  19. E-health stakeholders experiences with clinical modelling and standardizations.

    Science.gov (United States)

    Gøeg, Kirstine Rosenbeck; Elberg, Pia Britt; Højen, Anne Randorff

    2015-01-01

    Stakeholders in e-health such as governance officials, health IT-implementers and vendors have to co-operate to achieve the goal of a future-proof interoperable e-health infrastructure. Co-operation requires knowledge on the responsibility and competences of stakeholder groups. To increase awareness on clinical modeling and standardization we conducted a workshop for Danish and a few Norwegian e-health stakeholders' and made them discuss their views on different aspects of clinical modeling using a theoretical model as a point of departure. Based on the model, we traced stakeholders' experiences. Our results showed there was a tendency that stakeholders were more familiar with e-health requirements than with design methods, clinical information models and clinical terminology as they are described in the scientific literature. The workshop made it possible for stakeholders to discuss their roles and expectations to each other.

  20. Stakeholder Relations Office

    CERN Multimedia

    2013-01-01

    Scientists, politicians, the public, school children, our neighbours, you. All of these groups of people have a stake in CERN, and all are important to us.   The list of stakeholders in an organisation as large and complex as CERN is a long and ever lengthening one. Each group has its own specific interests and needs in terms of what kind of information it requires from CERN and how we should engage. It’s important, therefore, for us to ensure that we’re communicating optimally with everyone we care about and who cares about us. This is something that CERN has always taken seriously. The CERN Courier, for example, was first published in 1959 and we had a pro-active public information office right from the start. Today, our stakeholder relations are spread between several groups and teams, reflecting the nature of CERN today. But while we’re already doing a good job, I think we can do better by exploiting the synergies between these teams, and that’s wh...

  1. Role of stress in burnout among students of medicine and dentistry--a study in Ljubljana, Slovenia, Faculty of Medicine.

    Science.gov (United States)

    Kogoj, Tina Krokter; Cebašek-Travnik, Zdenka; Zaletel-Kragelj, Lijana

    2014-09-01

    Medical education is challenging, but for some students it can be very stressful. Studies suggest that stress during medical education can have a negative impact on students' mental health and that burnout is frequent among medical school students. The aim of this study was to measure burnout among students of medicine/dentistry (M/D) at the Faculty of Medicine, University of Ljubljana, Slovenia, in relation to their perception of stress, so as to enable planning preventative activities for students at risk. The data were collected in a cross-sectional study, carried out in spring 2008 among the total population of MID students of 1St, 3rd, 4th and 6th year, using a self-administered online questionnaire. Oldenburg Burnout Inventory (OLBI) instrument was used. Separate burnout scores were calculated for the exhaustion and disengagement dimensions of burnout, and related to students'perception of stress. Multiple linear regression method was carried out to adjust the association estimates for several potential confounders (gender, study program, relationship status, and grade). The overall response rate was 47.2%, and a total of 476 students participated. Students scored higher on exhaustion than on disengagement dimension--the mean value of burnout scores on the exhaustion dimension scale was -1.68, while it was -4.58 on the disengagement dimension scale. The results showed a statistically significant difference between high and low risk-for-stress groups of students in both burnout dimensions (average value of burnout scores on the exhaustion scale: high risk-for-stress group -3.69, low risk-for-stress group 0.19, pburnout scores on the disengagement scale: high risk-for-stress group -5.57, low risk-for-stress group -3.65, pburnout subscales remained almost unchanged. Results confirmed our hypothesis that M/D students of Ljubljana Faculty of Medicine who frequently experience stress (especially those with poor coping mechanisms), exhibit higher degree of burnout.

  2. Women in senior post-graduate medicine career roles in the UK: a qualitative study.

    Science.gov (United States)

    Curtis, Anthony; Eley, Lizzie; Gray, Selena; Irish, Bill

    2016-01-01

    This qualitative study sought to elicit the views, experiences, career journeys and aspirations of women in senior post-graduate medical education roles to identify steps needed to help support career progression. In-depth semi-structured telephone interviews. UK. Purposive sample of 12 women in a variety of senior leadership roles in post-graduate medical education in the UK. Self reported motivating influences, factors that helped and hindered progress, key branch points, and key educational factors and social support impacting on participants' career in postgraduate medicine. Respondents often reported that career journeys were serendipitous, rather than planned, formal or well structured. Senior women leaders reported having a high internal locus of control, with very high levels of commitment to the NHS. All reported significant levels of drive, although the majority indicated that they were not ambitious in the sense of a strong drive for money, prestige, recognition or power. They perceived that there was an under-representation of women in senior leadership positions and that high-quality female mentorship was particularly important in redressing this imbalance. Social support, such a spouse or other significant family member, was particularly valued as reaffirming and supporting women's chosen career ambition. Factors that were considered to have hindered career progression included low self-confidence and self-efficacy, the so-called glass ceiling and perceived self-limiting cultural influences. Factors indirectly linked to gender such as part-time versus working full time were reportedly influential in being overlooked for senior leadership roles. Implications of these findings are discussed in the paper. Social support, mentorship and role modelling are all perceived as highly important in redressing perceived gender imbalances in careers in post-graduate medical education.

  3. A position paper of the EFLM Committee on Education and Training and Working Group on Distance Education Programmes/E-Learning: developing an e-learning platform for the education of stakeholders in laboratory medicine.

    Science.gov (United States)

    Gruson, Damien; Faure, Gilbert; Gouget, Bernard; Haliassos, Alexandre; Kisikuchin, Darya; Reguengo, Henrique; Topic, Elizabeta; Blaton, Victor

    2013-04-01

    The progress of information and communication technologies has strongly influenced changes in healthcare and laboratory medicine. E-learning, the learning or teaching through electronic means, contributes to the effective knowledge translation in medicine and healthcare, which is an essential element of a modern healthcare system and for the improvement of patient care. E-learning also represents a great vector for the transfer knowledge into laboratory practice, stimulate multidisciplinary interactions, enhance continuing professional development and promote laboratory medicine. The European Federation of Laboratory Medicine (EFLM) has initiated a distance learning program and the development of a collaborative network for e-learning. The EFLM dedicated working group encourages the organization of distance education programs and e-learning courses as well as critically evaluate information from courses, lectures and documents including electronic learning tools. The objectives of the present paper are to provide some specifications for distance learning and be compatible with laboratory medicine practices.

  4. The role of veterinarians in equestrian sport: a comparative review of ethical issues surrounding human and equine sports medicine.

    Science.gov (United States)

    Campbell, Madeleine L H

    2013-09-01

    Veterinarians have a key role in providing medical care for sports horses during and between competitions, but the standard client:veterinarian relationship that exists in companion and production animal medicine is distorted by the involvement of third parties in sports medicine, resulting in distinct ethical dilemmas which warrant focused academic attention. By comparing the existing literature on human sports medicine, this article reviews the ethical dilemmas which face veterinarians treating equine athletes, and the role of regulators in contributing to or resolving those dilemmas. Major ethical dilemmas occur both between and during competitions. These include conflicts of responsibility, conflicts between the need for client confidentiality and the need to share information in order to maximise animal welfare, and the need for an evidence base for treatment. Although many of the ethical problems faced in human and equine sports medicine are similar, the duty conferred upon a veterinarian by the licensing authority to ensure the welfare of animals committed to his or her care requires different obligations to those of a human sports medicine doctor. Suggested improvements to current practice which would help to address ethical dilemmas in equine sports medicine include an enhanced system for recording equine injuries, the use of professional Codes of Conduct and Codes of Ethics to establish acceptable responses to common ethical problems, and insistence that treatment of equine athletes is evidence-based (so far as possible) rather than economics-driven. Copyright © 2013 The Author. Published by Elsevier Ltd.. All rights reserved.

  5. The role of silicon in physiology of the medicinal plant (Lonicera japonica L.) under salt stress

    Science.gov (United States)

    Gengmao, Zhao; Shihui, Li; Xing, Sun; Yizhou, Wang; Zipan, Chang

    2015-08-01

    Silicon(Si) is the only element which can enhance the resistance to multiple stresses. However, the role of silicon in medicinal plants under salt stress is not yet understood. This experiment was conducted to study the effects of silicon addition on the growth, osmotic adjustments, photosynthetic characteristics, chloroplast ultrastructure and Chlorogenic acid (CGA) production of Honeysuckle plant (Lonicera japonica L.) under salt-stressed conditions. Salinity exerted an adverse effect on the plant fresh weight and dry weight, whilst 0.5 g L-1 K2SiO3·nH2O addition obviously improved the plant growth. Although Na+ concentration in plant organs was drastically increased with increasing salinity, higher levels of K+/Na+ ratio was obtained after K2SiO3·nH2O addition. Salinity stress induced the destruction of the chloroplast envelope; however, K2SiO3·nH2O addition counteracted the adverse effect by salinity on the structure of the photosynthetic apparatus. K2SiO3·nH2O addition also enhanced the activities of superoxide dismutase and catalase. To sum up, exogenous Si plays a key role in enhancing its resistance to salt stresses in physiological base, thereby improving the growth and CGA production of Honeysuckle plant.

  6. The role and place of medicinal plants in the strategies for disease ...

    African Journals Online (AJOL)

    Medicinal plants have been used in healthcare since time immemorial. Studies have been carried out globally to verify their efficacy and some of the findings have led to the production of plant-based medicines. The global market value of medicinal plant products exceeds $100 billion per annum. This paper discusses the ...

  7. Stakeholder analysis methodologies resource book

    Energy Technology Data Exchange (ETDEWEB)

    Babiuch, W.M.; Farhar, B.C.

    1994-03-01

    Stakeholder analysis allows analysts to identify how parties might be affected by government projects. This process involves identifying the likely impacts of a proposed action and stakeholder groups affected by that action. Additionally, the process involves assessing how these groups might be affected and suggesting measures to mitigate any adverse effects. Evidence suggests that the efficiency and effectiveness of government actions can be increased and adverse social impacts mitigated when officials understand how a proposed action might affect stakeholders. This report discusses how to conduct useful stakeholder analyses for government officials making decisions on energy-efficiency and renewable-energy technologies and their commercialization. It discusses methodological issues that may affect the validity and reliability of findings, including sampling, generalizability, validity, ``uncooperative`` stakeholder groups, using social indicators, and the effect of government regulations. The Appendix contains resource directories and a list of specialists in stakeholder analysis and involvement.

  8. Stakeholder Salience in ERP Projects

    OpenAIRE

    Salhotra, Eashan

    2014-01-01

    The aim of this study is to examine stakeholder involvement in an Enterprise Resource Planning (ERP) System project that involves implementation and improvement of the implemented system. The study targets stakeholders, their classification, and their degree of importance during different phases of an ERP project life cycle, i.e. planning, implementation, stabilisation and improvement. The study shows that stakeholder involvement and their salience vary along the ERP project life cycle a...

  9. Shareholder, stakeholder-owner or broad stakeholder maximization

    DEFF Research Database (Denmark)

    Mygind, Niels

    2004-01-01

    including the shareholders of a company. Although it may be the ultimate goal for Corporate Social Responsibility to achieve this kind of maximization, broad stakeholder maximization is quite difficult to give a precise definition. There is no one-dimensional measure to add different stakeholder benefits...

  10. Female role models in medicine: a medical student’s perspective

    Directory of Open Access Journals (Sweden)

    DIYA KAPILA

    2018-01-01

    Full Text Available The importance of role models in medical education cannot be understated. They allow for professional development, aid in career motivation and inspire and educate through example. Unfortunately, I cannot admit knowing more than three female role models throughout my time at medical school, and now as a final year student, I am more disappointed than ever for this deficit. My admiration and respect for doctors remains sky high, but from the age of 15, I remember being put off and discouraged from a career in medicine. My first work experience placement was met with disgruntled medical students and doctors warning me to ‘steer clear’ of this career choice. Notably, female doctors would state their reservations about whether they could adequately bring up a stable family together with the demands of this profession. This was an extremely frustrating resolution for me to see as a young, inspired medic- who passionately felt I would work hard to do both. I sought to find out more about the challenges for women in medicine. There lies no dispute that having a stable family life and successful career is no easy feat for women. Yet, the mere choice between a family and/or career is far more intricate than it may seem; it is really a question exploring personal life priorities, resolute character traits and, most importantly, equal gender opportunities and the necessity for greater support for women with families (1. Gender equity and empowerment are inextricably linked to a woman’s entitlement and contribution to the workplace. Evidently, the endless unpaid hours of bringing up a family need greater recognition- arguably a full time job in itself; some people still don’t deem the demanding work of a mother as a career- illustrated by Catherine Deveny’s Guardian article (2. Women are often invited to defend their life choices, or fulfil gender expectations. Maybe, as women we need to alter our own insight into what it means to be a successful

  11. Clinical governance and clinical competence to support new scenarios and role of internal medicine

    Directory of Open Access Journals (Sweden)

    Antonino Mazzone

    2015-11-01

    Full Text Available The complex patient, who has often multiple, chronic and progressive disorders, who has undergone polytherapy, should be evaluated totally with respect not only to medical side, but also to psychological and clinical side. The shortage of specialists in disciplines that require technical skills, obtained by training and performing a sufficient number of annual procedures, contributes to the need for reorganizing health care; in this background the Internist devolves less time to charitable activities in favor of competences related to the processes. The knowledge of the clinical governance (CG should be the common heritage of all the actors of the health system, that need to be made up of professionals able to coordinate and make easy the implementation and the spread the CG culture. At least initially we propose to focus the testing strictly on the medical department. As already mentioned above, the natural Internist predisposition, cultural and training, leads him to a multidisciplinary vision of medicine that allows acquiring more easily the tools that make up the structure of CG, being able to facilitate the application. The acquisitions of professional competence and clinical governance play a key role in the Internist culture. The purpose of an Internist with professional skills and managerial capacity, is to act within the department to facilitate and simplify the horizontal interaction among other similar corporate structures and to help the Management to improve structural and clinical appropriateness in Hospital and to better the relations between hospital and territory, identifying the critical issues and the possible solutions.

  12. Emerging roles of hyaluronic acid bioscaffolds in tissue engineering and regenerative medicine.

    Science.gov (United States)

    Hemshekhar, Mahadevappa; Thushara, Ram M; Chandranayaka, Siddaiah; Sherman, Larry S; Kemparaju, Kempaiah; Girish, Kesturu S

    2016-05-01

    Hyaluronic acid (HA), is a glycosaminoglycan comprised of repeating disaccharide units of N-acetyl-D-glucosamine and D-glucuronic acid. HA is synthesized by hyaluronan synthases and reaches sizes in excess of 2MDa. It plays numerous roles in normal tissues but also has been implicated in inflammatory processes, multiple drug resistance, angiogenesis, tumorigenesis, water homeostasis, and altered viscoelasticity of extracellular matrix. The physicochemical properties of HA including its solubility and the availability of reactive functional groups facilitate chemical modifications on HA, which makes it a biocompatible material for use in tissue regeneration. HA-based biomaterials and bioscaffolds do not trigger allergies or inflammation and are hydrophilic which make them popular as injectable dermal and soft tissue fillers. They are manufactured in different forms including hydrogels, tubes, sheets and meshes. Here, we review the pathophysiological and pharmacological properties and the clinical uses of native and modified HA. The review highlights the therapeutic applications of HA-based bioscaffolds in organ-specific tissue engineering and regenerative medicine. Copyright © 2016 Elsevier B.V. All rights reserved.

  13. Human Trafficking: The Role of Medicine in Interrupting the Cycle of Abuse and Violence.

    Science.gov (United States)

    Macias-Konstantopoulos, Wendy

    2016-10-18

    Human trafficking, a form of modern slavery, is an egregious violation of human rights with profound personal and public health implications. It includes forced labor and sexual exploitation of both U.S. and non-U.S. citizens and has been reported in all 50 states. Victims of human trafficking are currently among the most abused and disenfranchised persons in society, and they face a wide range of negative health outcomes resulting from their subjugation and exploitation. Medicine has an important role to play in mitigating the devastating effects of human trafficking on individuals and society. Victims are cared for in emergency departments, primary care offices, urgent care centers, community health clinics, and reproductive health clinics. In addition, they are unknowingly being treated in hospital inpatient units. Injuries and illnesses requiring medical attention thus represent unique windows of opportunity for trafficked persons to receive assistance from trusted health care professionals. With education and training, health care providers can recognize signs and symptoms of trafficking, provide trauma-informed care to this vulnerable population, and respond to exploited persons who are interested and ready to receive assistance. Multidisciplinary response protocols, research, and policy advocacy can enhance the impact of antitrafficking health care efforts to interrupt the cycle of abuse and violence for these victims.

  14. Part seven: The role of narrative in the everyday practice of medicine developing narrative competence.

    Science.gov (United States)

    Vannatta, Jerry; Schleifer, Ronald; Crow, Sheila

    2009-10-01

    It has been the thesis of this symposium that medicine is a narrative enterprise. We have presented our case that the work in is largely narrative. If that is true, then one of the goals of medical education should be to create methods of improving the narrative competencies in learners and practitioners of medicine. This final paper will explore the field of Narrative Medicine and briefly discuss methods currently in use in American Medical Education and conclude with the experience at the University of Oklahoma College of Medicine over the past ten years.

  15. Understanding the role of farm dams in the Murray-Darling Basin in Australia through hydrological analysis coupled with stakeholder interviews

    Science.gov (United States)

    Kuil, Linda; Winnubst, Madelinde; van Dijk, Albert

    2013-04-01

    Climate predictions suggest that surface water availability in the Murray-Darling Basin (MDB) in Australia is more likely to decline than to increase in the next decades. In 2000, farm dams were first recognized as a significant risk to future flows in the MDB and have since been the subject of hydrological research. This study was conducted to provide insight into the role of farm dams in the Yass catchment, which is a subcatchment of the MDB close to Canberra, in order to indentify obstacles for integrated water management. The role of farm dams was investigated from both a hydrological and social perspective. Model prediction and data inference were used to estimate the impact of farm dams on streamflow. The density of farm dams in the catchment was estimated at 5.7 dams km-2. The impact on the Yass River was simulated to be in the order of 20 percent of mean annual streamflow. To understand why farm dams are used, semi-structured interviews were conducted to capture views and opinions of land holders. Research found that farm dams play a very important role in terms of individuals' water supply, although other systems are also used. Furthermore, land holders are responsible for their own water supply for drinking and agricultural water needs. Water rights are based on a right to rainfall or groundwater that is present on an individual's property. This means that landholders have both a need and a right to collect and store runoff. Current legislation put in place by the New South Wales government to restrict the amount of rain water to be captured does not seem to affect most people. If additional policy to minimize the impact of farm dams on streamflow were to be introduced, this has to be based on well-thought-out arguments based on a long term vision as the interview results indicate that farm dams are deeply embedded in Australian rural culture.

  16. MO-C-BRB-04: The role of the NIH in funding innovations in science and medicine

    Energy Technology Data Exchange (ETDEWEB)

    Pettigrew, R. [NIH/NIBIB (United Kingdom)

    2015-06-15

    between medical physicists, radiologists, oncologists, industry representatives, and other stakeholders. The mission of QIBA is to improve the accuracy and practicality of quantitative image-based biomarkers by increasing precision across devices, patients, and time, an essential step in incorporating quantitative imaging biomarkers into radiology practice. Validated quantitative imaging biomarkers are necessary to support precision medicine initiatives, multimodality / multiparametric applications in medicine, treatment planning and response assessment, and radiogenomics applications. Current applications in the QIBA portfolio extend to cancer diagnosis and treatment, pulmonary diseases, and neurological disorders. The overall goal of this symposium is to illustrate the bidirectional exchange between medical research and clinical practice. Revitalizing scientific excellence in clinical medical physics challenges practitioners to identify clinical limitations, which then drive research innovation; research funded by the NIH and other agencies develops technological solutions to these limitations, which are translated to the care environment to ultimately improve clinical practice in radiology and radiation oncology.

  17. MO-C-BRB-04: The role of the NIH in funding innovations in science and medicine

    International Nuclear Information System (INIS)

    Pettigrew, R.

    2015-01-01

    between medical physicists, radiologists, oncologists, industry representatives, and other stakeholders. The mission of QIBA is to improve the accuracy and practicality of quantitative image-based biomarkers by increasing precision across devices, patients, and time, an essential step in incorporating quantitative imaging biomarkers into radiology practice. Validated quantitative imaging biomarkers are necessary to support precision medicine initiatives, multimodality / multiparametric applications in medicine, treatment planning and response assessment, and radiogenomics applications. Current applications in the QIBA portfolio extend to cancer diagnosis and treatment, pulmonary diseases, and neurological disorders. The overall goal of this symposium is to illustrate the bidirectional exchange between medical research and clinical practice. Revitalizing scientific excellence in clinical medical physics challenges practitioners to identify clinical limitations, which then drive research innovation; research funded by the NIH and other agencies develops technological solutions to these limitations, which are translated to the care environment to ultimately improve clinical practice in radiology and radiation oncology

  18. The Role of Nutrition and Edible Medicinal Plants in the Treatment of Chronic Wounds Based on the Principles of Iranian Traditional Medicine.

    Science.gov (United States)

    Shirbeigi, Leila; Mohebbi, Mina; Karami, Soodeh; Nejatbakhsh, Fatemeh

    2016-05-01

    Skin is the body's first defense against stressful factors. Skin wounds are caused by the loss of connection in the skin and recovery requires cellular and biochemical reactions. Chronic wounds arise from the lack of physiological processes and the disease due to complications (e.g. infection and amputation) has devastating consequences on societies. According to the principles of Iranian traditional medicine (ITM), these disorders can be treated in a step-by-step procedure. This is a systematic review study that involved gathering data from three traditional medical textbooks, namely Canon of Medicine, Tib-e-Akbari and Exir-e-Azam with the keyword "chronic wound" or "ghorha". In the next step, few tables were developed for nutrition measures as well as edible and topical medicinal herbs. Electronic databases such as PubMed, Scopus, Web of Science, and Cochrane library were searched for relevant articles and those related to effective medicinal herbs in the treatment of wounds were obtained. Depending on appearance and secretions, wounds are divided into two categories, namely simple and compound wounds. The prognostic factors are based on the age, weight, accompanied disease, as well as the quality and quantity of the wound secretions. Wound treatments include medical nutrition therapy, edible medications, and manipulation therapies. Patient's diet is very important and oral medications have a major role in the whole body detoxification. Topical medications are used together with the above-mentioned treatments; noting that without detoxification, these medications are not effective entirely. Wound healing requires physiological processes within the body. From the perspective of ITM, body detoxification is the first medical step, after which topical medications could lead to a better wound healing result.

  19. Stakeholder relations and financial performance

    NARCIS (Netherlands)

    Scholtens, B.; Zhou, Y.

    2008-01-01

    We analyze how shareholder performance can be associated with stakeholder relations. As such, we try to find out whether there is an association between financial performance and stakeholder relations with respect to different theoretical notions about the firm. Financial performance is

  20. Collaborative Stakeholder Engagement. Special Report

    Science.gov (United States)

    Jordan, Matt; Chrislip, David; Workman, Emily

    2016-01-01

    Stakeholder engagement and collaboration are essential to the development of an effective state plan. Engaging a diverse group of stakeholders tasked with working together to create education policies that will have a positive, lasting impact on students is not as easy as it sounds. Experts in the field argue that the traditional stakeholder…

  1. Online Company-stakeholder Communication

    DEFF Research Database (Denmark)

    Eriksen, Rikke Augustinus; Morsing, Mette

    Based on a systematic data collection we study one of the first pioneering company-stakeholder communication campaigns in social media: the case of energy company Vattenfall A/S’s pan-European campaign ‘The Climate Manifesto’. Our findings challenge the general assumption, that stakeholder intera...

  2. Integrating Environmental and Stakeholder Management

    DEFF Research Database (Denmark)

    Madsen, Henning; Ulhøi, John Parm

    2001-01-01

    relationships with various stakeholders, companies need to be able to identify these stakeholders and assess their influence. The first part of this paper will discuss the relevant theory and introduce a model to analyse and identify the most significant stakeholder groups and their influence on corporate...... behaviour. Based on a recent survey of Danish compa-nies, the second part of the paper will report on the success of a variety of stakeholders in forc-ing companies to introduce environment-related initiatives. The results will then be discussed in light of the theory and other reported results. The paper......Regulation has been an important instrument in pushing the business community towards im-proved environmental performance. However, there has also been increasing pressure from a growing number of stakeholders, including employees, customers, neighbours and NGOs, etc. In order to improve corporate...

  3. Concepts on social services. The role of public administration authorities and other stakeholders in the organization and development of social services for people in difficult situations

    Directory of Open Access Journals (Sweden)

    Ludmila PROCA

    2015-12-01

    Full Text Available This article is devoted to social services, which are tackled as a form of social as¬sistance, as a result of the continuous objectives of National Program on creating the integrated social system for 2008- 2013, the strategy of social inclusion of persons with disabilities. As a result of the ratification of the UN Convention on the Rights of Persons with Disabilities by Law nr. 166- XVIII of July 9, 2010, which has marked 5 years since its ratification, in the period from 5 to 10 July 2015, within the framework of International Scientific- practical conference on the topic ,,Five years after the ratification of the UN Convention on the Rights of Persons with Disabilities. Practical and Judicial aspects’ analysis.’’ At this time, the creation and development of new community social services is a ceaseless process, alternative institutionalized social services (residential for children and adults, which are considered more efficient and less expensive for this system. They are meant to keep people or families in difficulty in an organizational propinquity to the community, having as a main objective the marginalization’s prevention, social ex¬clusion and facilitating the integration of beneficiaries in the family and community for improving their quality of life. The role of the organization, operation and development of social services reverts to: Ministry of Labor, Social Protection and Family and other Ministries, local public ad¬ministration authorities of level I and II, territorial structures of social assistance and their subdivisions with other social actors, associations, foundations, non-profit pri¬vate institutions, registered and accredited in accordance with the legislation in force, with the activity in the social sphere.

  4. Talent development: linking the stakeholders to the process.

    Science.gov (United States)

    Pankhurst, Anne; Collins, Dave; Macnamara, Áine

    2013-01-01

    The three stakeholders (coaches, parents and the National Governing Body) in Talent Identification and Development (TID) are important factors in athlete development. How each of them perceive the key constructs of Talent Identification and Development (i.e. sport specialisation and selection, practice, athlete development, junior and adult success, and the role of the stakeholders), and the coherence of that understanding is not well understood. This study focuses on junior performance tennis and investigates the perceptions of coaches, parents and sports organisations (a National Governing Body) of the five key constructs of Talent Identification and Development. We were interested in examining (a) the extent to which stakeholder perceptions relate to research, (b) the coherence of each stakeholder's perceptions and (c) the extent to which there is coherence between what stakeholders understand each other thinks. Seventy-five coaches, parents, and National Governing Body staff completed a questionnaire that asked participants to rate their degree of agreement/disagreement with researched 'principles' of Talent Identification and Development. The results suggest that stakeholders do not strongly agree with the research supporting principles of Talent Identification and Development. Furthermore, a significant lack of coherence of stakeholder perceptions was evident. This lack of coherence was also evident in each group's understanding of what the other stakeholders believed. The impact of these results on the Talent Identification and Development process is discussed.

  5. Managing stakeholders in transformational government

    DEFF Research Database (Denmark)

    Reinwald, Anja Kaldahl; Kræmmergaard, Pernille

    2012-01-01

    ). This paper contributes to this literature by reporting the findings from a case study in a Danish local government who has reached the stage of transformational government. Using a grounded theory approach, information about the local government was initially collected and further analyzed within...... a stakeholder perspective. The paper reports how they succeeded in involving the most important stakeholders in the process of reaching transformational government. Finally the paper offers six lessons learned, based on the case study, about how to manage the involved stakeholders to reach transformational...

  6. Stakeholder Thinking in Sustainability Management

    DEFF Research Database (Denmark)

    Gjerdrum Pedersen, Esben Rahbek; Hove Henriksen, Morten; Frier, Claus

    2013-01-01

    Purpose – The objective of the paper is to describe and discuss how the biotech company Novozymes integrates stakeholder thinking into everyday sustainability practices. Design/methodology/approach – The paper is based on first-hand experiences as well as secondary information from Novozymes...... to make sense of stakeholder thinking. Originality/value – The contribution of this paper is to provide a detailed analysis of how various stakeholder relations management methods can be used in practice to integrate sustainability in an organisation....

  7. Stakeholder research study : summary

    International Nuclear Information System (INIS)

    2001-10-01

    The Canadian Energy Pipeline Association (CEPA) commissioned Ipsos-Reid to conduct a telephone survey to obtain an independent assessment of the level of knowledge and attitudes of four pipeline industry stakeholder groups in relation to Canada's pipeline industry and the individual member companies of CEPA. Included in the survey, which was conducted in the summer and fall of 2001, were 1000 people from the general population across Canada, 1,372 landowners who have CEPA member pipelines crossing their land, 400 adjacent landowners who own land within 2.5 km of a CEPA member pipeline, and 50 news media personnel. The survey revealed that there is a much higher level of knowledge than expected, and a positive attitude towards the energy pipeline industry. Results indicated that more than 80 per cent of landowners, adjacent landowners and the general public agree that Canadians can trust pipelines to safely transport oil and natural gas products across the country. A very strong percentage (88 to 97 per cent) of landowners agree that pipeline operators are generally good neighbours, that local pipeline companies are environmentally responsible and that the pipeline industry is necessary to transport energy products such as oil and natural gas across the country. 82 per cent of the adjacent landowners agree that pipeline companies make significant investments to maintain pipelines in Canada. As far as the general public is concerned, 95 per cent agree that the energy pipeline industry is important to the Canadian economy and 92 per cent believe pipeline incidents occur rarely or occasionally. 96 per cent of media also believe the economic impact of the pipeline industry is important to Canada and to local regions. CEPA's strategy is to raise awareness about pipeline safety, environmental performance and community involvement of the industry. The topics that survey respondents wanted to learn more about were: the economic impact of the energy pipeline industry

  8. Fat on sale: role of adipose-derived stem cells as anti-fibrosis agent in regenerative medicine

    OpenAIRE

    Gupta, Manoj K.; Ajay, Amrendra Kumar

    2015-01-01

    The potential use of stem cells for cell-based tissue repair and regeneration offers alternative therapeutic strategies for various diseases. Adipose-derived stem cells (ADSCs) have emerged as a promising source of stem cells suitable for transplantation in regenerative medicine and wound repair. A recent publication in Stem Cell Research & Therapy by Zhang and colleagues reports a new finding about the anti-fibrosis role of ADSCs and conditioned media derived from them on hypertrophic scar f...

  9. Smart medicine: how the changing role of doctors will revolutionize health care

    National Research Council Canada - National Science Library

    Hanson, William, M.D

    2011-01-01

    .... In Smart Medicine, William Hanson brings to life the fascinating true world of doctors and nurses and reveals the revolutionary changes that will soon be sweeping through the medical community...

  10. Protecting the Force - Occupational Medicine's Expanded Role in Future Theaters of Operation

    National Research Council Canada - National Science Library

    Stover, William

    1998-01-01

    .... Other aspects of health service support that are not so closely tied to the hospital like medical intelligence and preventive medicine must also be considered and included for in the operational planning process...

  11. Antiviral and immunoregulatory role against PCV2 in vivo of Chinese herbal medicinal ingredients

    Directory of Open Access Journals (Sweden)

    Yang Haifeng

    2017-12-01

    Full Text Available Introduction: The aim of the research was to investigate the antiviral and immunoregulatory effects of saikosaponin A, saikosaponin D, Panax notoginseng saponins, notoginsenoside R1, and anemoside B4 saponins commonly found in Chinese herbal medicines.

  12. Perspectives of Indian traditional and allopathic professionals on religion/spirituality and its role in medicine: basis for developing an integrative medicine program.

    Science.gov (United States)

    Ramakrishnan, P; Dias, A; Rane, A; Shukla, A; Lakshmi, S; Ansari, B K M; Ramaswamy, R S; Reddy, A R; Tribulato, A; Agarwal, A K; Bhat, J; SatyaPrasad, N; Mushtaq, A; Rao, P H; Murthy, P; Koenig, H G

    2014-08-01

    Allopathic medical professionals in developed nations have started to collaborate with traditional, complementary, and alternative medicine (TCAM) to enquire on the role of religion/spirituality (r/s) in patient care. There is scant evidence of such movement in the Indian medical community. We aim to understand the perspectives of Indian TCAM and allopathic professionals on the influence of r/s in health. Using RSMPP (Religion, Spirituality and Medicine, Physician Perspectives) questionnaire, a cross-sectional survey was conducted at seven (five TCAM and two allopathic) pre-selected tertiary care medical institutes in India. Findings of TCAM and allopathic groups were compared. Majority in both groups (75% of TCAM and 84.6% of allopathic practitioners) believed that patients' spiritual focus increases with illness. Up to 58% of TCAM and allopathic respondents report patients receiving support from their religious communities; 87% of TCAM and 73% of allopaths believed spiritual healing to be beneficial and complementary to allopathic medical care. Only 11% of allopaths, as against 40% of TCAM, had reportedly received 'formal' training in r/s. Both TCAM (81.8%) and allopathic (63.7%) professionals agree that spirituality as an academic subject merits inclusion in health education programs (p = 0.0003). Inclusion of spirituality in the health care system is a need for Indian medical professionals as well as their patients, and it could form the basis for integrating TCAM and allopathic medical systems in India.

  13. Stakeholder expectation and satisfaction in road maintenance

    NARCIS (Netherlands)

    Hietbrink, M.; Hartmann, Andreas; Dewulf, Geert P.M.R.

    2012-01-01

    Understanding the process of stakeholder satisfaction is a prerequisite for successful stakeholder management. The expectancy disconfirmation model describes the process of stakeholder satisfaction by relating customers’ satisfaction with a product or service to discrepancy between the perceived

  14. Value Perspective of Project Stakeholders

    Science.gov (United States)

    Cekic, Z.; Surlan, N.; Kosic, T.

    2017-11-01

    When starting a construction project, one assumes, mostly through experience, what is the value the project will bring to investors, consultants, contractors and other stakeholders. However, the value of the project greatly depends on the perspective of the observer and which stakeholder is considering it. So, how is value perceived on the construction project? The purpose of this research is to obtain construction project value parameters utilizing the Delphi technique.

  15. Corporate communications and stakeholder management

    Directory of Open Access Journals (Sweden)

    Đorđević Mira

    2010-01-01

    Full Text Available Corporate communications represent a modern communications discipline used by businesses across the globe to communicate with key stakeholders. Chief executive officers and executive management teams strive to create, protect and advance corporate reputation through corporate communications. Further, by communicating with key stakeholders the company adequately prepares for good news and future problems. With the benefit of technology and greater transparency, corporations of the future will continue to use corporate communications approaches to advance their business. Company's reputation derives from the way stakeholders perceive the organization, how they think, feel or act towards it. It is therefore vital that organizations interested in developing and building their reputational capital; pay careful attention to the way they are perceived and that they manage the relationships with their various stakeholders like a strategic resource. Stakeholders represent both opportunity and threat for the organizations. For instance, if an institution has a good reputation with stakeholders they may provide the organization more latitude to operate. On the other hand a poor reputation may result in creating the legislative that can make it more difficult for an institution to operate.

  16. A successful effort to involve stakeholders in a facility siting decision using LIPS with stakeholder involvement

    International Nuclear Information System (INIS)

    Merkhofer, L.; Conway, R.; Anderson, B.

    1995-01-01

    Local public opposition to federal bureaucratic decisions has resulted in public agencies rethinking the role of stakeholders in decision making. Efforts to include stakeholders directly in the decision-making process are on the increase. Unfortunately, many attempts to involve members of the public in decisions involving complex technical issues have failed. A key problem has been defining a meaningful role for the public in the process of arriving at a technical decision. This paper describes a successful effort by Sandia National Laboratories (SNL) in New Mexico to involve stakeholders in an important technical decision associated with its Environmental Restoration (ER) Project. The decision was where to locate a Corrective Action Management Unit (CAMU), a facility intended to consolidate and store wastes generated from the cleanup of hazardous waste sites. A formal priority setting process known as the Laboratory Integration Prioritization System (LIPS) was adapted to provide an approach for involving the public. Although rarely applied to stakeholder participation, the LIPS process proved surprisingly effective. It produced a consensus over a selected site and enhanced public trust and understanding of Project activities

  17. Identifying potential academic leaders: Predictors of willingness to undertake leadership roles in an academic department of family medicine.

    Science.gov (United States)

    White, David; Krueger, Paul; Meaney, Christopher; Antao, Viola; Kim, Florence; Kwong, Jeffrey C

    2016-02-01

    To identify variables associated with willingness to undertake leadership roles among academic family medicine faculty. Web-based survey. Bivariate and multivariable analyses (logistic regression) were used to identify variables associated with willingness to undertake leadership roles. Department of Family and Community Medicine at the University of Toronto in Ontario. A total of 687 faculty members. Variables related to respondents' willingness to take on various academic leadership roles. Of all 1029 faculty members invited to participate in the survey, 687 (66.8%) members responded. Of the respondents, 596 (86.8%) indicated their level of willingness to take on various academic leadership roles. Multivariable analysis revealed that the predictors associated with willingness to take on leadership roles were as follows: pursuit of professional development opportunities (odds ratio [OR] 3.79, 95% CI 2.29 to 6.27); currently holding at least 1 leadership role (OR 5.37, 95% CI 3.38 to 8.53); a history of leadership training (OR 1.86, 95% CI 1.25 to 2.78); the perception that mentorship is important for one's current role (OR 2.25, 95% CI 1.40 to 3.60); and younger age (OR 0.97, 95% CI 0.95 to 0.99). Willingness to undertake new or additional leadership roles was associated with 2 variables related to leadership experiences, 2 variables related to perceptions of mentorship and professional development, and 1 demographic variable (younger age). Interventions that support opportunities in these areas might expand the pool and strengthen the academic leadership potential of faculty members.

  18. The medicine selection process in four large university hospitals in Brazil: Does the DTC have a role?

    Directory of Open Access Journals (Sweden)

    Elisangela da Costa Lima-Dellamora

    2015-03-01

    Full Text Available Knowledge about evidence-based medicine selection and the role of the Drug and Therapeutics Committee (DTC is an important topic in the literature but is scarcely discussed in Brazil. Our objective, using a qualitative design, was to analyze the medicine selection process performed in four large university hospitals in the state of Rio de Janeiro. Information was collected from documents, interviews with key informants and direct observations. Two dimensions were analyzed: the structural and organizational aspects of the selection process and the criteria and methods used in medicine selection. The findings showed that the DTC was active in two hospitals. The structure for decision-making was weak. DTC members had little experience in evidence-based selection, and their everyday functions did not influence their participation in DTC activities. The methods used to evaluate evidence were inadequate. The uncritical adoption of new medicines in these complex hospital facilities may be hampering pharmaceutical services, with consequences for the entire health system. Although the qualitative approach considerably limits the extent to which the results can be extrapolated, we believe that our findings may be relevant to other university hospitals in the country.

  19. Improving access to medicines in low and middle income countries: corporate responsibilities in context.

    Science.gov (United States)

    Leisinger, Klaus Michael; Garabedian, Laura Faden; Wagner, Anita Katharina

    2012-12-01

    More than two billion people in low- and middle-income countries (LMIC) lack adequate access to essential medicines. In this paper, we make strong public health, human rights and economic arguments for improving access to medicines in LMIC and discuss the different roles and responsibilities of key stakeholders, including national governments, the international community, and non-governmental organizations (NGOs). We then establish a framework of pharmaceutical firms' corporate responsibilities - the "must," the "ought to," and the "can" dimensions - and make recommendations for actionable business strategies for improving access to medicines. We discuss controversial topics, such as pharmaceutical profits and patents, with the goal of building consensus around facts and working towards a solution. We conclude that partnerships and collaboration among multiple stakeholders are urgently needed to improve equitable access to medicines in LMIC.

  20. How can stakeholders promote environmental and social responsibility in the shipping industry?

    DEFF Research Database (Denmark)

    Parviainen, Tuuli; Lehikoinen, Annukka; Kuikka, Sakari

    2017-01-01

    as well as safe shipping industry practices. Limited attention has been paid on the role of stakeholders such as consumers, employees, NGOs, and academia in pressuring the shipping industry towards greater environmental and social responsibility. Here, by applying stakeholder theory and drawing...... on examples of already materialized stakeholder actions and multistakeholder initiatives, we study the potential ways that stakeholders can promote CSR in the shipping industry: we explore the resource dependencies between stakeholders, the stakeholder influence strategies, and the importance of multi-stakeholder...... pressure. We show that stakeholders can gain more power by using indirect strategies such as working via and/or in alliances with NGOs, trade unions, banks and financers, and/or different national or international regulatory bodies, as well as with the industry itself. Our results reveal the potential...

  1. Evaluation of a support worker role, within a nurse delegation and supervision model, for provision of medicines support for older people living at home: the Workforce Innovation for Safe and Effective (WISE) Medicines Care study.

    Science.gov (United States)

    Lee, Cik Yin; Beanland, Christine; Goeman, Dianne; Johnson, Ann; Thorn, Juliet; Koch, Susan; Elliott, Rohan A

    2015-10-06

    Support with managing medicines at home is a common reason for older people to receive community nursing services. With population ageing and projected nurse shortages, reliance on nurses may not be sustainable. We developed and tested a new workforce model: 'Workforce Innovation for Safe and Effective (WISE) Medicines Care', which enabled nurses to delegate medicines support home visits for low-risk clients to support workers (known as community care aides [CCAs]). Primary study aims were to assess whether the model increased the number of medicines support home visits conducted by CCAs, explore nurses', CCAs' and consumers' experiences with the CCAs' expanded role, and identify enablers and barriers to delegation of medicines support. A prospective before-after mixed-methods study was conducted within a community nursing service that employed a small number of CCAs. The CCAs' main role prior to the WISE Medicines Care model was personal care, with a very limited role in medicines support. CCAs received training in medicines support, and nurses received training in assessment, delegation and supervision. Home visit data over two three-month periods were compared. Focus groups and interviews were conducted with purposive samples of nurses (n = 27), CCAs (n = 7) and consumers (n = 28). Medicines support visits by CCAs increased from 43/16,863 (0.25 %) to 714/21,552 (3.3 %) (p delegating to CCAs sometimes eliminated the need for duplicate nurse and CCA visits (for people requiring personal care plus medicines support) and enabled them to visit people with more complex needs. CCAs enjoyed their expanded role and were accepted by clients and/or carers. Nurses and CCAs reported effective communication when medicine-related problems occurred. No medication incidents involving CCAs were reported. Barriers to implementation included the limited number of CCAs employed in the organisation and reluctance from some nurses to delegate medicines support to CCAs

  2. Roles of Chinese herbal medicines in ischemic heart diseases (IHD) by regulating oxidative stress.

    Science.gov (United States)

    Wang, Dawei; Wang, Jin; Liu, Yuntao; Zhao, Zhen; Liu, Qing

    2016-10-01

    Ischemic heart disease (IHD) basing on atherosclerosis (AS) is known as a top killer for decades. Oxidative stress, representing excessive oxidation and insufficient elimination, has been proved to be a critical molecular mechanism of IHD and accompanying myocardium dysfunction. Therefore, anti-oxidation therapy may be efficient. Chinese herbal medicine, including extractive compounds, decoctions, patent drugs, and injections, has shown its enormous potential in prevention and treatment of IHD as an effective antioxidant in experimental studies. The aim of this review is to highlight recent studies of Chinese herbal medicine in regulating oxidative stress in IHD. These studies represent recent progress of IHD treatment and indicate the possible pathways and target spots of Chinese herbal medicine. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  3. Psychosomatic medicine and biodefense preparedness--a new role for the American Psychosomatic Society.

    Science.gov (United States)

    Locke, Steven E

    2006-01-01

    Biodefense preparations in the United States have focused mostly on improving biosurveillance and hospital surge capacity in the event of an outbreak or a weapons of mass destruction (WMD) event. However, what if an invisible bioweapon or dirty bomb was released in a major population center, or if avian flu took hold with sustained human to human transmission? Suddenly, we need to combine efforts from psychosomatic medicine and general medicine with public health practice to triage nonexposed patients with somatic symptoms from those with medical sequelae resulting from hazardous exposures. This would better enable the limited acute care resources to be directed to those most in need of urgent medical care. Furthermore, psychosomatic medicine experts are potentially important players in biodefense planning related to risk communication and health education strategies in a WMD scenario or outbreak in which individuals must make informed choices about their need for immediate medical attention.

  4. Precision medicine in oncology: New practice models and roles for oncology pharmacists.

    Science.gov (United States)

    Walko, Christine; Kiel, Patrick J; Kolesar, Jill

    2016-12-01

    Three different precision medicine practice models developed by oncology pharmacists are described, including strategies for implementation and recommendations for educating the next generation of oncology pharmacy practitioners. Oncology is unique in that somatic mutations can both drive the development of a tumor and serve as a therapeutic target for treating the cancer. Precision medicine practice models are a forum through which interprofessional teams, including pharmacists, discuss tumor somatic mutations to guide patient-specific treatment. The University of Wisconsin, Indiana University, and Moffit Cancer Center have implemented precision medicine practice models developed and led by oncology pharmacists. Different practice models, including a clinic, a clinical consultation service, and a molecular tumor board (MTB), were adopted to enhance integration into health systems and payment structures. Although the practice models vary, commonalities of three models include leadership by the clinical pharmacist, specific therapeutic recommendations, procurement of medications for off-label use, and a research component. These three practice models function as interprofessional training sites for pharmacy and medical students and residents, providing an important training resource at these institutions. Key implementation strategies include interprofessional involvement, institutional support, integration into clinical workflow, and selection of model by payer mix. MTBs are a pathway for clinical implementation of genomic medicine in oncology and are an emerging practice model for oncology pharmacists. Because pharmacists must be prepared to participate fully in contemporary practice, oncology pharmacy residents must be trained in genomic oncology, schools of pharmacy should expand precision medicine and genomics education, and opportunities for continuing education in precision medicine should be made available to practicing pharmacists. Copyright © 2016 by the

  5. The role of Aloe vera in various fields of medicine and dentistry

    Directory of Open Access Journals (Sweden)

    Andey Venkata Subhash

    2014-01-01

    Full Text Available Aloe vera is a cactus like plant that actually is part of the lily family. There are more than 300 varieties of the Aloe plant, but the Aloe barbadensis variety exhibits the best medicinal properties. It has strong antiseptic, antibacterial, fungicidal and virucidal properties. It promotes cell growth and is neurologically calming and acts as a detoxifying agent. Others provide nutritional support and some increase the regenerative potential of tissues while others act with anti-inflammatory responses. This article reviews the uses of the plant in different fields of medicine and dentistry.

  6. Environmental Assessments and Stakeholder Involvement

    International Nuclear Information System (INIS)

    Wesolowski, Cassandra

    2006-01-01

    Directives and legislation on EIA and SEA need to provide more guidance on how and when public participation should be used. There are now several examples of how well public participation can be performed and the methods are becoming more proactive and innovative. By increasing the role of public participation within the Environmental Assessment process, plans, programmes and projects will become more publicly acceptable. There does need to be a balance as to where public participation is performed in the system, as too much can be a stress on resources and time, as well as producing ineffective results. Key stages such as scoping, preparing the environmental statement or report and decision-making need to be highlighted for the benefits public participation can have. The Aarhus Convention is certainly making a difference in the UK; however it is difficult to judge exactly how much difference yet. It was only fully implemented in the UK in 2005 although some Authorities were applying the three pillars prior to implementation. It is not clear how aware the general public are of the Convention and their rights. Empowering communities in the UK. will communities for decision-making in Environmental Assessments? Providing the public with resources to enable them to fully engage in the process will improve the participation and increase their confidence, but how will this increase their influence within the decision-making process? Ultimately, should the stakeholders and public just influence the incremental decisions made in Environmental Assessments or have more responsibility within the major decisions taken? It will be interesting to see how these issues are addressed over the coming years

  7. An evaluation of the role of nuclear medicine imaging in the diagnosis of periprosthetic infections of the hip

    International Nuclear Information System (INIS)

    Trevail, C.; Ravindranath-Reddy, P.; Sulkin, T.; Bartlett, G.

    2016-01-01

    Aim: To validate the role of nuclear medicine (NM) imaging in hip periprosthetic joint infection (PJI) of hip arthroplasties. Materials and methods: This was a retrospective study of 235 consecutive patients referred to NM for investigation of a symptomatic hip prosthesis. Imaging comprised Tc-99m bone scintigraphy, In-111 white cell scintigraphy, and bone marrow scintigraphy if required. Imaging findings were compared with intraoperative microbiology and histology, clinical findings and follow up for ≥24 months. Results: There were 14 exclusions. Of the 221 remaining patients, there were 16 true positives, one false positive, 200 true negatives, and four false negatives. The algorithm used at this centre demonstrated an accuracy of 97.7% with high specificity of 99.5% and sensitivity of 80%. Conclusion: When modern NM techniques and accurate reporting criteria are used, scintigraphy is an effective tool for diagnosing PJI of the hip. NM is only given a marginal role in the recent American Association of Orthopedic Surgeons guidelines, and the orthopaedic community should reconsider their evaluation of this technique. - Highlights: • Nuclear Medicine can accurately diagnose periprosthetic infection. • NM has an integral role in the rational management of periprosthetic infection. • SPECT CT has a potential role in improving accuracy.

  8. Innovative pharmaceutical pricing agreements in five European markets: A survey of stakeholder attitudes and experience.

    Science.gov (United States)

    Dunlop, William C N; Staufer, Alexandra; Levy, Pierre; Edwards, Guy J

    2018-03-08

    Innovative pricing agreements for medicines have been used in European markets for more than 20 years, and offer an opportunity for payers and pharmaceutical companies to align on value, optimise speed to patients, and share risk. Developing successful agreements requires alignment between key stakeholders, yet there is a lack of summative data on how current innovative agreements are used in the real-world (e.g. the level of realised access to medicines, and rebates and discounts, which are often non-transparent). This research used a web-based survey of payer stakeholders to determine what kinds of innovative agreements are currently used, anticipated future usage, attitudes, and drivers of adoption. Participants included national and regional payers (or former payers) and hospital-level decision makers. Sixty-six payers completed the survey. Respondents expected that the use of innovative pricing agreements will remain the same or increase in the future. Overall, they felt there is a positive attitude towards new schemes, and that innovative agreements are likely to be used when they reduce total costs or reduce uncertainty. Given payer expectations, pharmaceutical companies should continue to take a role in ensuring that they have sufficient capacity to support payers in the design and implementation of innovative pricing agreements. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

  9. Ontario Energy Board 2005 survey of stakeholders

    International Nuclear Information System (INIS)

    2006-01-01

    A survey was conducted among members of the Ontario Energy Board's (OEB) various stakeholder groups in order to measure the Board's performance and to help the Board identify areas for improvement in the way it operates. The survey included telephone interviews with consumer groups, advocacy groups, the energy sector, electricity and gas distributors, financial organizations as well as other stakeholders. The topics addressed in the survey were key energy issues and priority issues; the perceived role of the OEB; the OEB strengths and weaknesses; the importance of various OEB functions; the overall performance of the OEB; an evaluation of OEB communication with industry and consumers; an evaluation of service quality; and, awareness and participation in regulatory policy initiatives. Respondents used a 10-point scale in their evaluation. This report presented the main findings and their interpretations. Major stakeholders identified electricity supply issues and the price of electricity as being the most important energy issues facing Ontario. This report also presented the detailed findings for questions regarding the lack of generator capacity, policy stability, the coal phase out program, electricity blackouts, conservation, electricity restructuring and investment. The major finding of the survey was an overall increase in satisfaction with the OEB's performance. It was suggested that the OEB can improve in timeliness and providing consumer information. The major areas of strength were found to be its professionalism in conducting hearings and the fairness of the Board's decisions and regulations. tabs

  10. From Metabonomics to Pharmacometabonomics: The Role of Metabolic Profiling in Personalised Medicine

    Directory of Open Access Journals (Sweden)

    Jeremy Everett

    2016-09-01

    Full Text Available Variable patient responses to drugs are a key issue for medicine and for drug discovery and development. Personalised medicine, that is the selection of medicines for subgroups of patients so as to maximise drug efficacy and minimise toxicity, is a key goal of 21st century healthcare. Currently, most personalised medicine paradigms rely on clinical judgement based on the patient’s history, and on the analysis of the patients’ genome to predict drug effects i.e. pharmacogenomics. However, variability in patient responses to drugs is dependent upon many environmental factors to which human genomics is essentially blind. A new paradigm for predicting drug responses based on individual pre-dose metabolite profiles has emerged in the past decade: pharmacometabonomics, which is defined as ‘the prediction of the outcome (for example, efficacy or toxicity of a drug or xenobiotic intervention in an individual based on a mathematical model of pre-intervention metabolite signatures’. The new pharmacometabonomics paradigm is complementary to pharmacogenomics but has the advantage of being sensitive to environmental as well as genomic factors. This review will chart the discovery and development of pharmacometabonomics, and provide examples of its current utility and possible future developments.

  11. ROLE OF THE INTERNATIONAL ORGANIZATIONS IN PREVENTING THE COUNTERFEIT MEDICINES ENTRY INTO THE WORLD MARKETS.

    Science.gov (United States)

    Stukina, Valeryia; Dohnal, Jiri; Saloun, Jan

    2016-09-01

    30 years have passed since Conference of Experts on the Rational Use of Drugs was held in Nairobi, Kenya, from 25 to 29 November 1985, where the problem of counterfeit medicines was mentioned as the international for the first time. The problem of counterfeit medicines is not only a major threat to public health and national and private economy, but also it is of great interest for key decision-making actors at the international level. The authors analyzed what has been done since that time by international organizations. Combating the counterfeiting of medicines cannot be successfully achieved by the health sector alone - World Health Organization (WHO), - so the efforts of the other United Nations (UN) organizations relevant to counterfeiting were in need and were studied in the article: World Intellectual Property Organization (WIPO), World Trade Organization (WTO), World Customs Organization (WCO), United Nations Office on Drugs and Crime (UNODC), etc. Today WHO is unable to coordinate all their activities, so the few existing proposals for establishing a new mechanism of international cooperation have been examined. Will the MEDICRIME Convention that will enter into force on January 1, 2016 be the start of the new era in the combating with the counterfeit medicines? - the authors offered their vision on the international developments.

  12. A review of the role of African traditional medicine in the ...

    African Journals Online (AJOL)

    Background: Poverty, inadequacy of health services, shortage of health workers, infectious diseases scourges, rampant shortage of drugs and equipment in existing health facilities make traditional medicine an important component of healthcare in Africa, especially in oral health care. This review was done to document the ...

  13. the healing hand: the role of women in ancient medicine 1 ...

    African Journals Online (AJOL)

    In contrast with the struggle of 19th and 20th century women all over the world to be admitted to medical schools, women in ancient Greece and Rome were apparently increasingly at liberty to practise medicine from the 4th century BC onwards. The available evidence offers conclusive proof of this more tolerant attitude.

  14. The healing hand: the role of women in Graeco-Roman medicine ...

    African Journals Online (AJOL)

    In contrast with the struggle of 19th and 20th century women all over the world to be admitted to medical schools, women in ancient Greece and Rome were apparently increasingly at liberty to practise medicine from the 4th century BC onwards. The available evidence offers conclusive proof of this more tolerant attitude.

  15. Stakeholder views on the impact of nurse prescribing on dermatology services.

    Science.gov (United States)

    Carey, Nicola; Stenner, Karen; Courtenay, Molly

    2010-02-01

    To explore stakeholder views on the impact of nurse prescribing on dermatology services. Nurse led care enhances the services that dermatology patients receive. Research indicates that care delivered by nurse prescribers can improve efficiency and access to medicines. There is no evidence exploring the impact of nurse prescribing on the configuration of dermatology services. Case study. A collective case study of 10 practice settings across England where nurses prescribed medicines for dermatology patients. A thematic analysis of semi-structured interview data collected during 2006 and 2007. Participants were qualified nurse prescribers, administrative staff, doctors and non-nurse prescribers. Nurse prescribing was reported to support and facilitate the modernisation of dermatology services. It enabled nurses to make effective use of their knowledge and skills, overcome delays in treatment and provide faster access to medicines. However several organisational issues restricted the success of the initiative. Nurse prescribing is successfully being used to support and deliver a range of services to dermatology patients. Stakeholders reported that both patients and staff had benefited by the adoption of this role by nurses. However issues over support and access to CPD and capacity of the workforce were identified as potential barriers which could affect the contribution of nurse prescribing to dermatology patients. Nurse prescribing contributes to the services provided to dermatology patients; Nurse supplementary prescribing contributes to the ability of dermatology nurse specialists to work in teams and prescribe complex medicines; Provision of adequate support and strategic planning are essential if the impact of nurse prescribing is to be fully realised.

  16. Stakeholder involvement - a japanese perspective

    International Nuclear Information System (INIS)

    Kobayashi, S.

    2004-01-01

    Traditional societal and cultural background of Japanese in general indicates the intrinsic difficulty in involving the public as stakeholders in the process of any type of decision making in policy matters. It is characterized by the long-taught virtue of harmonization and obedience to others. In addition, characteristic system of Japanese traditional industrial society, such as lifetime employment, seniority-based wage system, and enterprise-based labour union, encourages the loyalty to the employer/company, but not to the public. The public or ordinary citizens would seldom come out as stakeholders and express their true feelings or real opinions, even though younger generation is notably getting out from such a trend. On the other hand, it is a common practice in Japanese society for any business or administrative transactions to try to obtain 'consensus' among relevant parties concerned (stakeholders) by negotiations behind the curtain prior to the formal discussion. In this sense, 'stakeholders involvement' is accepted and practised as a matter of course, but mostly for actions between parties of equivalently influential status levels or between 'directly relevant' parties such as those between the different government agencies, between regulators and industries. The concept of 'Involving the public in decision making as stakeholders' is not yet fully understood nor accepted in Japan both by regulators and by the public so far as the issue of radiation protection is concerned. These situations are explained with some examples. (author)

  17. The role of government and community leaders in domestication ...

    African Journals Online (AJOL)

    The shea tree is very important to people of its area of distribution. The significance of the shea tree results from its excellent ecological role in the ecosystems which support it. It also serves a multiplicity of uses for a variety of stakeholders ranging from the socio-cultural, nutritional, medicinal and the economic.

  18. Stakeholder Involvement Throughout the Life Cycle of Nuclear Facilities

    International Nuclear Information System (INIS)

    2011-01-01

    This report demonstrates the importance of stakeholder involvement throughout the life cycle of all nuclear facilities; including operating reactors, temporary spent fuel storage facilities and final radioactive waste repositories and follows what is defined in the IAEA Safety Standards GS-R-3 where the stakeholders' expectations (identified as 'interested parties' in GS-R-3) shall be taken into consideration 'in the activities and interactions in the processes of the management system, with the aim of enhancing the satisfaction of interested parties while at the same time ensuring that safety is not compromised'. This report explains how involving stakeholders in decision making processes, even for those stakeholder groups that do not have a direct role in making those decisions, can enhance public confidence in the application of nuclear science and technology. In addition, this report presents general guidance on stakeholder involvement. It does not provide detailed procedures for developing and implementing stakeholder involvement programmes, and specifics regarding stakeholder involvement for particular types of nuclear facilities. However, this publication references reports that provide such details. This publication provides assistance to those responsible for planning, designing, constructing, operating or decommissioning a nuclear facility. In addition, regulatory organizations and other authorities overseeing nuclear activities or managing nuclear facility licensing processes are often seen as the main source of independent information for the general public; therefore, stakeholder involvement can demonstrate capability and trustworthiness of regulatory organizations as well. The role of stakeholder involvement at different stages of a facility's life cycle is discussed, with suggestions on developing the components of a comprehensive stakeholder involvement plan. Included is guidance on focusing communication with certain stakeholders, applying various

  19. Role of the multi-modality image archival and communication system in nuclear medicine

    International Nuclear Information System (INIS)

    Bela Kari; Adam Mester; Erno Mako; Zoltan Gyorfi; Bela Mihalik; Zsolt; Hegyi

    2004-01-01

    algorithm design. The complete PACS system with the Internet based telecommunication part according to the clinical requirements has been created and is continuously upgraded with the support and collaboration of three domestic companies. Currently 3 modalities - CT, nuclear medicine (NM), digitised mammography - are available and can be accessed in our institute from more than 15 workstations. Additionally, other extemal institutes -Dept. of Neurology, Dept. of Orthopaedics, 1st Surgical Clinic, Budapest University of Technology and Economics, Dept. of Measurement and Informatics System- are connected to our central archives and can access the necessary and/or available modalities for both routine clinical applications and research purposes according to the access rights rule. The created system works more than a year continuously under the described circumstances and participates intensively in the research (advisory systems for non-invasive studies), education, and daily clinical routine activities. Nowadays, the simultaneous presentation and post processing of the functional and morphological images plays more and more important role in order to make more reliable and quick clinical decision by non-invasive way (both functional and morphological modalities are developing very rapidly). This technology is outstandingly effective in the fields of consultation (even if it is combined by MMS), post processing and tele-evaluation as well as education. eRAD ImageMedical TM created in Palo Alto (USA, CA) a training real patient database with various digital radiological images in their PACS in order to learn and test the feasibility of the system. (authors)

  20. The Role of Nuclear Medicine in the Staging and Management of Human Immune Deficiency Virus Infection and Associated Diseases.

    Science.gov (United States)

    Ankrah, Alfred O; Glaudemans, Andor W J M; Klein, Hans C; Dierckx, Rudi A J O; Sathekge, Mike

    2017-06-01

    Human immune deficiency virus (HIV) is a leading cause of death. It attacks the immune system, thereby rendering the infected host susceptible to many HIV-associated infections, malignancies and neurocognitive disorders. The altered immune system affects the way the human host responds to disease, resulting in atypical presentation of these disorders. This presents a diagnostic challenge and the clinician must use all diagnostic avenues available to diagnose and manage these conditions. The advent of highly active antiretroviral therapy (HAART) has markedly reduced the mortality associated with HIV infection but has also brought in its wake problems associated with adverse effects or drug interaction and may even modulate some of the HIV-associated disorders to the detriment of the infected human host. Nuclear medicine techniques allow non-invasive visualisation of tissues in the body. By using this principle, pathophysiology in the body can be targeted and the treatment of diseases can be monitored. Being a functional imaging modality, it is able to detect diseases at the molecular level, and thus it has increased our understanding of the immunological changes in the infected host at different stages of the HIV infection. It also detects pathological changes much earlier than conventional imaging based on anatomical changes. This is important in the immunocompromised host as in some of the associated disorders a delay in diagnosis may have dire consequences. Nuclear medicine has played a huge role in the management of many HIV-associated disorders in the past and continues to help in the diagnosis, prognosis, staging, monitoring and assessing the response to treatment of many HIV-associated disorders. As our understanding of the molecular basis of disease increases nuclear medicine is poised to play an even greater role. In this review we highlight the functional basis of the clinicopathological correlation of HIV from a metabolic view and discuss how the use of

  1. The role of nuclear medicine in the staging and management of human immune deficiency virus infection and associated diseases

    Energy Technology Data Exchange (ETDEWEB)

    Ankrah, Alfred O.; Sathekge, Mike [Dept. of Nuclear Medicine, University of Pretoria and Steve Biko Academic Hospital, Pretoria (South Africa); Glaudemans, Andor W. J. M.; Klein, Hans; Dierckx, Rudi A. J. O. [University of Groningen, University Medical Centre Groningen, Groningen (Netherlands)

    2017-06-15

    Human immune deficiency virus (HIV) is a leading cause of death. It attacks the immune system, thereby rendering the infected host susceptible to many HIV-associated infections, malignancies and neurocognitive disorders. The altered immune system affects the way the human host responds to disease, resulting in atypical presentation of these disorders. This presents a diagnostic challenge and the clinician must use all diagnostic avenues available to diagnose and manage these conditions. The advent of highly active antiretroviral therapy (HAART) has markedly reduced the mortality associated with HIV infection but has also brought in its wake problems associated with adverse effects or drug interaction and may even modulate some of the HIV-associated disorders to the detriment of the infected human host. Nuclear medicine techniques allow non-invasive visualisation of tissues in the body. By using this principle, pathophysiology in the body can be targeted and the treatment of diseases can be monitored. Being a functional imaging modality, it is able to detect diseases at the molecular level, and thus it has increased our understanding of the immunological changes in the infected host at different stages of the HIV infection. It also detects pathological changes much earlier than conventional imaging based on anatomical changes. This is important in the immunocompromised host as in some of the associated disorders a delay in diagnosis may have dire consequences. Nuclear medicine has played a huge role in the management of many HIV-associated disorders in the past and continues to help in the diagnosis, prognosis, staging, monitoring and assessing the response to treatment of many HIV-associated disorders. As our understanding of the molecular basis of disease increases nuclear medicine is poised to play an even greater role. In this review we highlight the functional basis of the clinicopathological correlation of HIV from a metabolic view and discuss how the use of

  2. The role of nuclear medicine in the staging and management of human immune deficiency virus infection and associated diseases

    International Nuclear Information System (INIS)

    Ankrah, Alfred O.; Sathekge, Mike; Glaudemans, Andor W. J. M.; Klein, Hans; Dierckx, Rudi A. J. O.

    2017-01-01

    Human immune deficiency virus (HIV) is a leading cause of death. It attacks the immune system, thereby rendering the infected host susceptible to many HIV-associated infections, malignancies and neurocognitive disorders. The altered immune system affects the way the human host responds to disease, resulting in atypical presentation of these disorders. This presents a diagnostic challenge and the clinician must use all diagnostic avenues available to diagnose and manage these conditions. The advent of highly active antiretroviral therapy (HAART) has markedly reduced the mortality associated with HIV infection but has also brought in its wake problems associated with adverse effects or drug interaction and may even modulate some of the HIV-associated disorders to the detriment of the infected human host. Nuclear medicine techniques allow non-invasive visualisation of tissues in the body. By using this principle, pathophysiology in the body can be targeted and the treatment of diseases can be monitored. Being a functional imaging modality, it is able to detect diseases at the molecular level, and thus it has increased our understanding of the immunological changes in the infected host at different stages of the HIV infection. It also detects pathological changes much earlier than conventional imaging based on anatomical changes. This is important in the immunocompromised host as in some of the associated disorders a delay in diagnosis may have dire consequences. Nuclear medicine has played a huge role in the management of many HIV-associated disorders in the past and continues to help in the diagnosis, prognosis, staging, monitoring and assessing the response to treatment of many HIV-associated disorders. As our understanding of the molecular basis of disease increases nuclear medicine is poised to play an even greater role. In this review we highlight the functional basis of the clinicopathological correlation of HIV from a metabolic view and discuss how the use of

  3. Performance satisfaction, shareholder and stakeholder orientations: Managers´ perceptions in three countries across continents

    Directory of Open Access Journals (Sweden)

    Georgios Angelopoulos

    2013-05-01

    Full Text Available Managers working in South Africa, Peru and the United States were classified as stakeholder- and/or shareholder-oriented along the Perceived Role of Ethics and Social Responsibility (PRESOR scale. The relationship between stakeholder/shareholder orientation and perceptions of organisational performance was further explored. In South Africa and overall, respondents with both high stakeholder and low shareholder orientations reported the greatest performance satisfaction. In Peru, managers with a high stakeholder orientation reported the greatest satisfaction with organisational performance. A significant link between stakeholder or shareholder orientation and performance satisfaction was not found in the United States, however. Directions for future research are outlined.

  4. Effective stakeholder management for medical practitioners

    OpenAIRE

    E Zigiriadis; A Nicolaides

    2014-01-01

    The importance of organizational-stakeholder relationships is highlighted in most organizational studies literature. This article investigates the relationship between medical practices and their stakeholders and has been developed to provide guidance on stakeholder engagement and communication. It is intended to provide a useful reference point for all medical practices concerning stakeholder engagement activities. Direction is provided on how to identify and ul...

  5. Analysis of evidence supporting the Federation of Bosnia and Herzegovina reimbursement medicines lists: role of the WHO Essential Medicines List, Cochrane systematic reviews and technology assessment reports.

    Science.gov (United States)

    Mahmić-Kaknjo, Mersiha; Marušić, Ana

    2015-07-01

    We compared recently introduced Basic Medicines Lists of the Federation of Bosnia and Herzegovina (BH) (FBH Basic Lists (FBLs)) with the World Health Organization (WHO) Essential Medicines List (EML) and the evidence supporting the inclusion of additional medicines on FBLs. The sources of data included the 18th edition of the EML and the following FBLs: 2013 Hospital List, 2013 A List in Outpatient Setting, and 2012 List financed by the Federal Solidarity Fund. For medicines found on FBLs but not on EML, we searched the Cochrane Database of Systematic Reviews (CSR) and public health technology assessment (HTA) reports for evidence. FBLs had 134 medicines and 17 combinations that were not on EML, as well as 9 medicines deleted and 4 rejected from EML. EML had 82 medicines and 10 combinations of medicines not included in FBLs. Out of 125 medicines on FBLs but not on EML, 52 (42%) had good CSR evidence supporting their inclusion (n = 38) or exclusion (n = 14). For the rest (n = 74), we found 24 favourable HTA reports. For the total of 89 medicines (27%) listed on FBLs, we found no evidence (EML, CSR, HTA reports) good enough to justify their inclusion in FBLs. In circumstances of scarce financial resources, greater reliance on well-established, proven list is crucial. Independent, unbiased, high-quality evidence such as WHO EML, CSR and HTA reports (national or international with local adaptations) should be used when deciding on medicine reimbursement.

  6. ANALISIS STAKEHOLDER PENGELOLAAN TAMAN NASIONAL BANTIMURUNG BULUSARAUNG, PROPVINSI SULAWESI SELATAN (Stakeholder Analysis of Bantimurung Bulusaraung National Park Management, South Sulawesi Province

    Directory of Open Access Journals (Sweden)

    Abd. W Kadir

    2013-03-01

    Full Text Available ABSTRAK Para pihak (stakeholder yang terkait dalam pengelolaan TN Babul memiliki kepentingan dan pengaruh yang beragam sehingga harus dapat dikelola dengan baik dalam mencapai tujuan pengelolaan TN Babul. Penelitian ini bertujuan untuk mengidentifikasi stakeholder dalam pengelolaan TN Babul, mendapatkan penjelasan tentang kepentingan dan pengaruh setiap stakeholder dalam pengelolaan TN Babul, serta peran stakeholder dalam mengakomodir kepentingan masyarakat sekitar TN Babul. Penelitian ini dilaksanakan di Kabupaten Maros pada Kawasan TN Babul, Propinsi Sulawesi Selatan. Pengumpulan data dilakukan melalui observasi dan wawancara kepada sejumlah informan kunci. Data dianalisis dengan teknik analisis deskriptif kualitatif. Hasil analisis stakeholder menunjukkan bahwa stakeholder primer dalam pengelolaan TN Babul terdiri dari Balai TN Babul, Masyarakat sekitar TN Babul, PDAM Maros, Disparbud Maros, Lembaga Pengelola Air Desa. Sedangkan stakeholder sekunder terdiri dari Dishutbun Maros, Dinas Pertanian Maros, Pemerintah desa dan kecamatan, BP2KP Maros, BPN Maros, PNPM Mandiri, LSM, dan Perguruan Tinggi dan lembaga penelitian. Keberadaan stakeholder tersebut dapat memberikan pengaruh positif dan negatif terhadap kawasan TN Babul. Peran yang dapat dilakukan oleh stakeholder dalam mengakomodir kepentingan masyarakat dapat berupa fungsi kontrol, bantuan fisik, bantuan teknis, dan dukungan penelitian. Pengelolaan kolaborasi dapat menjadi alternatif model pengelolaan TN Babul dalam mengakomodir kepentingan stakeholder yang beragam.   ABSTRACT Stakeholders involved in management of the Babul National Park have diverse interest and power that must be managed well in achieving Babul National Park management objectives. This study aims to identify the stakeholders in Babul National Park management, an explanation of the intersest and power of each stakeholder, and the role of stakeholders in accommodating the interests of communities around Babul National

  7. Transformational Leadership and Stakeholder Management in Library Change

    Directory of Open Access Journals (Sweden)

    Dolores Sucozhañay

    2014-11-01

    Full Text Available This article aims to analyse the role of library managers as change agent when implementing Library 2.0, using transformational leadership and stakeholder management approaches. To do so, a case study in a Latin American academic library was performed. The experiences acquired for a period of six years were analysed, during which three library managers were involved in managing change. Qualitative data from documents, interviews, and observations were collected, and qualitative analysis methods were used to obtain in-depth understanding of the change process. Results show that lack of transformational leadership and stakeholder management contribute to delayed implementation and limited adoption of innovations. Although library managers recognized the importance of different stakeholders to implement changes, they did not apply systematic and proactive strategies to define and manage them. All in all, library managers should be trained as change agents, with emphasis on transformational leadership and stakeholder management skills.

  8. Stakeholder Engagement Through Social Media

    DEFF Research Database (Denmark)

    Etter, Michael; Castello, Itziar

    The introduction of new information and communication technologies such social media platforms in organizations results in a new emerging logic of stakeholder engagement around sustainable development issues. We investigate how middle managers of a pharmaceutical corporation navigate between two...... competing logics of stakeholder engagement: the current (influence logic) and the new logic underlying social media (logic of community). With a longitudinal study of 26 months we observe how engagements failed since managers were not able to integrate certain symbolic and substantive elements of the new...... introduced by social media....

  9. The "Century of Biology" and the Evolving Role of Medicinal Chemists in Neuroscience.

    Science.gov (United States)

    Doller, Dario

    2017-01-18

    Society expects that the wave of contemporary new discoveries in biological sciences will soon lead to novel treatments for human diseases, including many devastating brain disorders. Historically, medicinal chemists have contributed to drug discovery teams in ways that synergize with those from their partner sciences, and help transform new knowledge into the ultimate tangible asset: a new drug. The optimal balance of resources and the right strategy to minimize the risk of late clinical failure may differ for different therapeutic indications. Recent progress in the oncology and neuroscience therapeutic areas is compared and contrasted, in particular looking at the biological target space and functional attributes of recently FDA-approved drugs and those in the late clinical pipeline. Medicinal chemists are poised to have major influence in neuroscience drug research, and examples of areas of potential impact are presented, together with a discussion of the soft skills they bring to their project teams and why they have been so impactful.

  10. Focal nodular hyperplasia of the liver: The role of Nuclear Medicine

    International Nuclear Information System (INIS)

    Von Wenzel, K.S.; Ellmann, A.; Rubow, S.M.

    2002-01-01

    Focal nodular hyperplasia (FNH) is a rare benign hepatic tumour of unknown etiology. Clinically it is described in middle aged females, but it can occur at any age and has been described in children and males. Usually these tumours are asymptomatic and are detected incidentally during ultrasonographic or other diagnostic examinations or at autopsy. FNH may however present with vague or even severe abdominal pain. Histologically a FNH is composed of Kupffer cells, hepatocytes, bile duct elements and fibrous connective tissue. Other types of benign hepatic tumours like hepatic adenomas (HA) need to be distinguished from FNH, as their management differs. Two patients recently presented at Windhoek Hospital with abdominal pain. In both cases Nuclear Medicine investigations, namely Tc-99m colloid liver scintigraphy and hepatobiliary scanning with Tc-99m DISIDA, aided in the diagnosis of focal nodular hyperplasia. This poster will demonstrate the value of Nuclear Medicine investigations in the evaluation of patients with focal nodular hyperplasia

  11. Role of Medicinal Plants and Natural Products on Osteoporotic Fracture Healing

    Directory of Open Access Journals (Sweden)

    Mohd Azri Abd Jalil

    2012-01-01

    Full Text Available Popularly known as “the silent disease” since early symptoms are usually absent, osteoporosis causes progressive bone loss, which renders the bones susceptible to fractures. Bone fracture healing is a complex process consisting of four overlapping phases—hematoma formation, inflammation, repair, and remodeling. The traditional use of natural products in bone fractures means that phytochemicals can be developed as potential therapy for reducing fracture healing period. Located closely near the equator, Malaysia has one of the world’s largest rainforests, which are homes to exotic herbs and medicinal plants. Eurycoma longifolia (Tongkat Ali, Labisia pumila (Kacip Fatimah, and Piper sarmentosum (Kaduk are some examples of the popular ethnic herbs, which have been used in the Malay traditional medicine. This paper focuses on the use of natural products for treating fracture as a result of osteoporosis and expediting its healing.

  12. Role of medicinal plants and natural products on osteoporotic fracture healing.

    Science.gov (United States)

    Abd Jalil, Mohd Azri; Shuid, Ahmad Nazrun; Muhammad, Norliza

    2012-01-01

    Popularly known as "the silent disease" since early symptoms are usually absent, osteoporosis causes progressive bone loss, which renders the bones susceptible to fractures. Bone fracture healing is a complex process consisting of four overlapping phases-hematoma formation, inflammation, repair, and remodeling. The traditional use of natural products in bone fractures means that phytochemicals can be developed as potential therapy for reducing fracture healing period. Located closely near the equator, Malaysia has one of the world's largest rainforests, which are homes to exotic herbs and medicinal plants. Eurycoma longifolia (Tongkat Ali), Labisia pumila (Kacip Fatimah), and Piper sarmentosum (Kaduk) are some examples of the popular ethnic herbs, which have been used in the Malay traditional medicine. This paper focuses on the use of natural products for treating fracture as a result of osteoporosis and expediting its healing.

  13. Being human: The role of pluripotent stem cells in regenerative medicine and humanizing Alzheimer's disease models.

    Science.gov (United States)

    Sproul, Andrew A

    2015-01-01

    Human pluripotent stem cells (PSCs) have the capacity to revolutionize medicine by allowing the generation of functional cell types such as neurons for cell replacement therapy. However, the more immediate impact of PSCs on treatment of Alzheimer's disease (AD) will be through improved human AD model systems for mechanistic studies and therapeutic screening. This review will first briefly discuss different types of PSCs and genome-editing techniques that can be used to modify PSCs for disease modeling or for personalized medicine. This will be followed by a more in depth analysis of current AD iPSC models and a discussion of the need for more complex multicellular models, including cell types such as microglia. It will finish with a discussion on current clinical trials using PSC-derived cells and the long-term potential of such strategies for treating AD. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Nuclear Medicine Practice in Kenya

    International Nuclear Information System (INIS)

    Ndrirangu, T.T.

    2017-01-01

    Nuclear medicine is a medical specialty that relies on the use of nuclear technology in the diagnosis and treatment (therapy) of diseases. Nuclear medicine uses the principle that a certain radiopharmaceutical (tracer) will at a certain point in time have a preferential uptake by a particular body, tissue or cell. Unlike other radiation applications for medical use, nuclear medicine uses open (unsealed) sources of radiation. The tracer is introduced into the body of the patient through several routes (oral, intravenous, percutaneous, intradermally, inhalation, intracapsular etc) and s/he becomes the source of radiation. Early diagnosis of diseases coupled with associated timely therapeutic intervention will lead to better prognosis. In a country with an estimated population of 42 million in 2017, Kenya has only two (2) nuclear medicine facilities (units) that is Kenyatta National Hospital - Public facility and Aga Khan University Hospital which is a Private facility. Being a relatively new medical discipline in Kenya, several measures have been taken by the clinical nuclear medicine team to create awareness at various levels. Kenya does not manufacture radiopharmaceuticals. We therefore have to import them from abroad and this makes them quite expensive, and the process demanding. There is no local training in nuclear medicine and staff have to be sent abroad for training, making this quite expensive and cumbersome and the IAEA has been complimenting in this area. With concerted effort by all stakeholders at the individual, national and international level, it is possible for Kenya to effectively sustain clinical nuclear medicine service not only as a diagnostic tool in many disease entities, but also play an increasingly important role in therapy

  15. The seminal role played by Pierre Marie in Neurology and Internal Medicine

    Directory of Open Access Journals (Sweden)

    Gustavo M Almeida

    2015-10-01

    Full Text Available The authors review the most important contributions of Pierre Marie to the elucidation and description of several neurological diseases, such as Charcot-Marie-Tooth’s disease and hereditary cerebellar ataxia, as well as his contributions to Internal Medicine, including his pioneering studies on acromegaly, ankylosing spondylitis, and hypertrophic pulmonary osteoarthropathy. His works led to incontestable advances in the medical sciences that transcended his time.

  16. The role of EQA in harmonization in laboratory medicine – a global effort

    OpenAIRE

    Jones, Graham R.D.

    2017-01-01

    There are many activities currently being undertaken in the field of laboratory medicine under the broad heading of ?harmonization?. These include traceability of results to international reference standards, processes to align results from assays where traceability has not been achieved (analytical harmonization) and international or national clinical guidelines based on studies from many parts of the world. Many of these issues are global in nature, with clinical evidence derived from studi...

  17. Grief narratives: The role of medicine in the policing of grief

    OpenAIRE

    Walter, Tony

    2000-01-01

    Drawing largely on already published literature, this article examines the hypothesis, derived from Frank, that the current proliferation of first-person accounts of grief represents an attempt by mourners to recover their voice in the face of grief's medicalisation. The extent of medicine's colonisation of grief is found to be limited. Though some mourners make a point of rejecting semi-psychiatric terms, others use such terms to structure their accounts of grief. A broader analysis shows th...

  18. A pharmacy student's role as a teaching assistant in an undergraduate medicinal chemistry course - Implementation, evaluation, and unexpected opportunities for educational outreach.

    Science.gov (United States)

    DellaVecchia, Matthew J; Claudio, Alyssa M; Fairclough, Jamie L

    2017-11-01

    To describe 1) a pharmacy student's teaching assistant (TA) role in an undergraduate medicinal chemistry course, 2) an active learning module co-developed by the TA and instructor, and 3) the unexpected opportunities for pharmacy educational outreach that resulted from this collaboration. Medicinal Chemistry (CHM3413) is an undergraduate course offered each fall at Palm Beach Atlantic University (PBA). As a TA for CHM3413, a pharmacy student from the Gregory School of Pharmacy (GSOP) at PBA co-developed and implemented an active learning module emphasizing foundational medicinal chemistry concepts as they pertain to performance enhancing drugs (PEDs). Surveys assessed undergraduate students' perceived knowledge of medicinal chemistry concepts, PEDs, and TA involvement. Students' (total n = 60, three fall semesters) perceived confidence in knowledge of medicinal chemistry concepts and PEDs increased significantly (p medicinal chemistry course. An advanced pharmacy practice experience elective in sports pharmacy (based on Ambrose's model) begins Fall 2017. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Librarians in Evidence-Based Medicine Curricula: A Qualitative Study of Librarian Roles, Training, and Desires for Future Development.

    Science.gov (United States)

    Maggio, Lauren A; Durieux, Nancy; Tannery, Nancy H

    2015-01-01

    This study aims to describe librarians' roles in evidence-based medicine (EBM) from the librarian perspective, identify how librarians are trained to teach, and highlight preferences for professional development. A multiinstitution qualitative study was conducted. Nine medical librarians identified by their faculty as integrated into EBM training were interviewed. Participants' descriptions indicated that they were active in curriculum development, deployment (including teaching activities), and assessment to support EBM. Participants identified direct experience and workshop participation as primary methods of learning to teach. Participants desired continuing development as teachers and requested opportunities for in-person workshops, shadowing physicians, and online training.

  20. The role of nuclear medicine in the evaluation of the patient with acquired immune deficiency syndrome (AIDS)

    International Nuclear Information System (INIS)

    Mali, Mrinal; Freeman, L.M.

    1991-01-01

    The Acquired Immuno-deficiency Syndrome (AIDS) was first recognized in the spring of 1981 in New York and California by the centers for Disease Control (CDC). Subsequently there have been numerous invasive and non-invasive methods proposed for the early diagnosis and treatment of this usually fatal disorder. This article reviews the ongoing role of nuclear medicine in the diagnosis of HIV infection and HIV related diseases over the last decade as well as some recently introduced radionuclide investigations that are still in the realm of 'work in progress'. (author). 49 refs.; 4 figs.; 2 tabs

  1. Potential role for psychological skills training in emergency medicine: Part 1 - Introduction and background.

    Science.gov (United States)

    Lauria, Michael J; Rush, Stephen; Weingart, Scott D; Brooks, Jason; Gallo, Isabelle A

    2016-10-01

    Psychological skills training (PST) is the systematic acquisition and practice of different psychological techniques to improve cognitive and technical performance. This training consists of three phases: education, skills acquisition and practice. Some of the psychological skills developed in this training include relaxation techniques, focusing and concentration skills, positive 'self-suggestion' and visualisation exercises. Since the middle of the 20th century, PST has been successfully applied by athletes, performing artists, business executives, military personnel and other professionals in high-risk occupations. Research in these areas has demonstrated the breadth and depth of the training's effectiveness. Despite the benefits realised in other professions, medicine has only recently begun to explore certain elements of PST. The present paper reviews the history and evidence behind the concept of PST. In addition, it presents some aspects of PST that have already been incorporated into medical training as well as implications for developing more comprehensive programmes to improve delivery of emergency medical care. © 2016 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  2. The role of EQA in harmonization in laboratory medicine – a global effort

    Science.gov (United States)

    Jones, Graham R.D.

    2017-01-01

    There are many activities currently being undertaken in the field of laboratory medicine under the broad heading of “harmonization”. These include traceability of results to international reference standards, processes to align results from assays where traceability has not been achieved (analytical harmonization) and international or national clinical guidelines based on studies from many parts of the world. Many of these issues are global in nature, with clinical evidence derived from studies performed in all parts of the world and multinational diagnostic companies providing assays worldwide. As with all aspects of medicine, progress can only be assured where these is evidence of effectiveness of the activities. External Quality Assurance (EQA) programs are designed to meet this need. Currently EQA processes have significant limitations in meeting the global needs of the laboratory medicine community. This paper aims to identify the steps that can be taken to allow current and future EQA programs to provide information on global variation in results. It is only by being aware of result differences that steps can be taken to improve performance. PMID:28392723

  3. The role of EQA in harmonization in laboratory medicine - a global effort.

    Science.gov (United States)

    Jones, Graham R D

    2017-02-15

    There are many activities currently being undertaken in the field of laboratory medicine under the broad heading of "harmonization". These include traceability of results to international reference standards, processes to align results from assays where traceability has not been achieved (analytical harmonization) and international or national clinical guidelines based on studies from many parts of the world. Many of these issues are global in nature, with clinical evidence derived from studies performed in all parts of the world and multinational diagnostic companies providing assays worldwide. As with all aspects of medicine, progress can only be assured where these is evidence of effectiveness of the activities. External Quality Assurance (EQA) programs are designed to meet this need. Currently EQA processes have significant limitations in meeting the global needs of the laboratory medicine community. This paper aims to identify the steps that can be taken to allow current and future EQA programs to provide information on global variation in results. It is only by being aware of result differences that steps can be taken to improve performance.

  4. One Health stakeholder and institutional analysis in Kenya

    Science.gov (United States)

    Kimani, Tabitha; Ngigi, Margaret; Schelling, Esther; Randolph, Tom

    2016-01-01

    Introduction One Health (OH) can be considered a complex emerging policy to resolve health issues at the animal–human and environmental interface. It is expected to drive system changes in terms of new formal and informal institutional and organisational arrangements. This study, using Rift Valley fever (RVF) as a zoonotic problem requiring an OH approach, sought to understand the institutionalisation process at national and subnational levels in an early adopting country, Kenya. Materials and methods Social network analysis methodologies were used. Stakeholder roles and relational data were collected at national and subnational levels in 2012. Key informants from stakeholder organisations were interviewed, guided by a checklist. Public sector animal and public health organisations were interviewed first to identify other stakeholders with whom they had financial, information sharing and joint cooperation relationships. Visualisation of the OH social network and relationships were shown in sociograms and mathematical (degree and centrality) characteristics of the network summarised. Results and discussion Thirty-two and 20 stakeholders relevant to OH were identified at national and subnational levels, respectively. Their roles spanned wildlife, livestock, and public health sectors as well as weather prediction. About 50% of national-level stakeholders had made significant progress on OH institutionalisation to an extent that formal coordination structures (zoonoses disease unit and a technical working group) had been created. However, the process had not trickled down to subnational levels although cross-sectoral and sectoral collaborations were identified. The overall binary social network density for the stakeholders showed that 35 and 21% of the possible ties between the RVF and OH stakeholders existed at national and subnational levels, respectively, while public health actors’ collaborations were identified at community/grassroots level. We recommend

  5. The role of discounts and loss leaders in medicine procurement in Austrian hospitals - a primary survey of official and actual medicine prices.

    Science.gov (United States)

    Vogler, Sabine; Zimmermann, Nina; Habl, Claudia; Mazag, Jan

    2013-07-04

    Knowledge about the prices of medicines used in hospitals, particularly the actually achieved ones, is scant. There are indications of large discounts and the provision of medicines cost-free to Austrian hospitals. The study aims to survey the official and actual prices of medicines procured by Austrian hospitals and to compare them to the out-patient prices. Primary price collection of the official hospital list prices and the actually achieved prices for 12 active ingredients as of the end of September 2009 in five general hospitals in Austria and analysis of the 15 most commonly used presentations. The official hospital list prices per unit differed considerably (from 1,500 Euro for an oncology medicine to 0.20 Euro for a generic cardiovascular medicine). For eight on-patent medicines (indications: oncology, anti-inflammatory, neurology-multiple sclerosis and blood) actual hospital medicine prices equaled the list prices (seven medicines) or were lower (one medicine) in four hospitals, whereas one hospital always reported higher actual prices due to the application of a wholesale mark-up. The actual hospital prices of seven medicines (cardiology and immunomodulation) were below the official hospital prices in all hospitals; of these all cardiovascular medicines were provided free-of-charge. Hospital prices were always lower than out-patient prices (pharmacy retail price net and reimbursement price). The results suggest little headroom for hospitals to negotiate price reductions for "monopoly products", i.e. medicines with no therapeutic alternative. Discounts and cost-free provision (loss leaders) appear to be granted for products of strategic importance for suppliers, e.g. cardiovascular medicines, whose treatment tends to be continued in primary care after discharge of the patient.

  6. Proceedings of the DOE workshop on the role of a high-current accelerator in the future of nuclear medicine

    International Nuclear Information System (INIS)

    Moody, D.C.; Peterson, E.J.

    1989-05-01

    The meeting was prompted by recent problems with isotope availability from DOE accelerator facilities; these difficulties have resulted from conflicting priorities between physics experiments and isotope production activities. The workshop was a forum in which the nuclear medicine community, isotope producers, industry, and other interested groups could discuss issues associated with isotope availability (including continuous supply options), the role of DOE and industry in isotope production, and the importance of research isotopes to the future of nuclear medicine. The workshop participants endorsed DOE's presence in supplying radioisotopes for research purposes and recommended that DOE should immediately provide additional support for radionuclide production in the form of personnel and supplies, DOE should establish a policy that would allow income from sales of future ''routine'' radionuclide production to be used to support technicians, DOE should obtain a 70-MeV, 500-/mu/A variable-energy proton accelerator as soon as possible, and DOE should also immediately solicit proposals to evaluate the usefulness of a new or upgraded high-energy, high-current machine for production of research radionuclides. This proceedings volume is a summary of workshop sessions that explored the future radionuclide needs of the nuclear medicine community and discussed the DOE production capabilities that would be required to meet these needs

  7. The Role and Characteristics of Collections of Folk Recepies in the Folk and Traditional Medicine of Bosnia and Herzegovina.

    Science.gov (United States)

    Skrbo, Armin; Masic, Izet

    2017-09-01

    Folk medicine represents part of the folk culture, when we first think about the rural culture with characteristic of the rural population in the pre-industrial period. The difference between official and folk medicine is manifested in the education, knowledge and social status of those practicing folk medicine as well as their patients. The most common ways of treating were the treatment by use of herbs, magic and treatments based on religious beliefs. So, it is of no surprise that folk medicine was the main form of treatment for the inhabitants of Bosnia and Herzegovina (B&H) in the past. In addition to many herbalists, quacks and religious officials who treated the patients with records, there were also spells, i.e. women who, by pronouncing various magic formulas, treated the patients. Each village had at least one person who practiced this type of treatment. Numerous, original documents and records have been stored in the archives of the monastery throughout B&H, including very valuable literature in the field of medicine and pharmacy, which testifies of the very important role of Franciscans in the treatment of the population in Bosnia and Herzegovina. The most extensive health service of the Franciscans since their arrival in Bosnia in 1291 was the decadent era of Turkish rule, mostly from the 17 th century until the Austro-Hungarian occupation of Bosnia and Herzegovina in 1978. In the sources of national thought, and on the basis of professional medical books, the Franciscans created recipes for the treatment of certain diseases, which they then collected in so-called "Ljekaruse" (Collections of folk recipes), and over time there was a lot of them. Most of the ljekarusa are hand-printed booklets, for some it is known the time and place of creation, and less often the author of the text. Ljekarusa is a very important source of information about our medical past. Some of them were processed and recorded, while a significant part of these manuscripts remained

  8. The role and tasks of industrial hygienists in occupational and environmental medicine and their code of ethics

    Directory of Open Access Journals (Sweden)

    Jan Grzesik

    2012-12-01

    Full Text Available The paper considers changes in occupational medicine in the last fifty years, describes industrial hygienists tasks and the reasons why their activities grew in importance. Also the needs of compliance with their own professional Code of Ethics are discussed. The Universal Declaration of Human Rights, voted and accepted by the United Nations in 1948 changed the strategic target of occupational medicine. Since then the most important task became prevention of health damage caused by work, which should enable the employees to stay healthy throughout the whole period of professional activity. Before that the main target was to restore the health of employees injured by work. To make the used preventive measures to be effective, they must be selected appropriately to professional harmfulness posing threat to employees health. This requires to reveal all factors potentially harmful to health, which occur in the work-environment, to measure their concentrations or intensity, to determine the employees exposure to those factors and to estimate the level of the health risk, caused by this complex exposure. Contemporarily occupational medicine service encompass with its preventive supervision the municipal environments, because they become seriously polluted due to emission of harmful industrial pollutants what brings about a negative impact to health of exposed dwellers. Those activities, being to a large extent outside the scope of competence and tasks of doctors – specialists of occupational medicine, are performed by industrial hygienists, who the required knowledge and skills acquired during university studies on technical and natural faculties. This caused a substantial increase of the role of industrial hygienists in the present activity of occupational medicine service and simultaneously took into consideration the ethical aspects of the work of these professionals. Evaluation of the backbone and the scope of work drew attention not only to the

  9. Stakeholders and Radiation Protection in Today's World

    International Nuclear Information System (INIS)

    Rick Jones, C.; Lochard, J.; Lazo, T.

    2006-01-01

    In looking forward the C.R.P.P.H.(Nea 's Committee on radiation protection and public health) identified three influences that will condition the way we address emerging issues, and will alter how we address ongoing issues. These are the involvement of stakeholders in decision making processes, the evolution of radiological protection science and its changing place in risk assessment and management, and the experience gained in implementing the current system of radiological protection. First among there is the growing importance of stakeholder involvement in radiation protection decision making. This has affected the way that the principles of justification, optimization and limitation are viewed, the way the role of the radiation protection professional in risk assessment and management is viewed, and the relative importance of case specific circumstances in relation to harmonized, internationally accepted criteria. In the wake of this change, the international system of radiological protection is being updated by the ICRP, and discussions of the most appropriate direction to take are nearing their end. Second, radiological protection science continues to identify specific aspects that do not fit the conventional linear non threshold model, and which us to consider that, at the very least, the risks from different exposures and exposure situations may not be as simply and universally comparable assumed. This will affect the way that risks are managed, and all relevant stakeholder involvement processes. In addition, decisions relating to public, worker and environmental health and safety are increasingly seen as judgement social choices. Although such choices must be guided by an understanding of state-of-the-art scientific and its uncertainties, the final, choice will generally be made by society, not scientists. Third, since the issuance of ICRP Publication 60 in 1990, and the International Basic Safety Standards in 1996, extensive experience has been amassed in

  10. Linking environmental and stakeholder management

    DEFF Research Database (Denmark)

    Madsen, Henning; Ulhøi, John Parm

    1999-01-01

    Regulation has been an important instrument in pushing the business community towards a more sustainable way of conduct. But recently an increasing pressure from a growing number of stakeholders including employees, customers, neighbours, NGO's etc has been observed. The purpose of this paper...

  11. Corporate responses to stakeholder activism

    DEFF Research Database (Denmark)

    Uldam, Julie; Krause Hansen, Hans

    2017-01-01

    Corporations are increasingly expected to act responsibly. The purpose of this paper is to examine two types of corporate responses to these expectations: overt and covert responses. Specifically, it examines oil companies’ involvement in multi-stakeholder initiatives and sponsorships (overt...... responses) and their monitoring of critics, including non-governmental organisations (NGOs) and activist organisations (covert responses)....

  12. Willingness to Consult a Veterinarian on Physician's Advice for Zoonotic Diseases: A Formal Role for Veterinarians in Medicine?

    Science.gov (United States)

    Speare, Rick; Mendez, Diana; Judd, Jenni; Reid, Simon; Tzipori, Saul; Massey, Peter D

    2015-01-01

    Physicians appear to find zoonotic diseases a challenge and consider that this topic belongs more to the veterinary profession. However, veterinarians have no formal role in clinical medicine. Data were collected as part of the Queensland Social Survey 2014 to determine the willingness of the public, if diagnosed with a zoonotic disease, to consult a veterinarian on the advice of a physician. Self-reported willingness to consult with a veterinarian at the respondent's own expense was 79.8% (95% CI: 81.96%-77.46%) (976/1223). If the cost was funded by Medicare, the Australian public health insurance scheme, 90.7% (95% CI: 92.18%-88.92%) (1109/1223) would be willing to consult a veterinarian. Therefore, a large majority of Australian residents would be willing to consult with a veterinarian on the advice of their physician if they had a zoonotic disease. Does this indicate a possible new role for veterinarians under Clinical One Health?

  13. Effecting Change in an Evidence-Based Medicine Curriculum: Librarians' Role in a Pediatric Residency Program.

    Science.gov (United States)

    Zeblisky, Kathy; Birr, Rebecca A; Sjursen Guerrero, Anne Marie

    2015-01-01

    Librarians for the joint Phoenix Children's Hospital/Maricopa Medical Center Pediatric Residency Program were asked to assist on the Evidence-Based Medicine (EBM) Subcommittee for the program. Faculty was open to recommendations for revising and improving the curriculum and desired librarian assistance in completing the task. The annual program review and conference evaluations revealed a gap between the objectives of the EBM curriculum and the residents' perceived abilities to integrate knowledge into meaningful literature searches. This column demonstrates how librarians can collaborate with their residency programs to revise and improve processes to effect change in their program's EBM curriculum.

  14. Science communication in regenerative medicine: Implications for the role of academic society and science policy

    Directory of Open Access Journals (Sweden)

    Ryuma Shineha

    2017-12-01

    Full Text Available It is essential to understand the hurdles, motivation, and other issues affecting scientists' active participation in science communication to bridge the gap between science and society. This study analyzed 1115 responses of Japanese scientists regarding their attitudes toward science communication through a questionnaire focusing on the field of stem cell and regenerative medicine. As a result, we found that scientists face systemic issues such as lack of funding, time, opportunities, and evaluation systems for science communication. At the same time, there is a disparity of attitudes toward media discourse between scientists and the public.

  15. The Role of Clinical Records in Narrative Medicine: A Discourse of Message.

    Science.gov (United States)

    Murphy, John W; Choi, Jung Min; Cadeiras, Martin

    This article is designed to unite theory and practice. The focus of attention is the impact of narrative medicine on clinical records. Specifically important is that records are created through dialogue, whereby patients are able to grow the record through their ability to offer critiques and alternative explanations. Merely allowing patients to peruse their records, through advances in technology, is not sufficient to facilitate this aim. Various theoretical and practical considerations are discussed that may facilitate patient involvement and the creation of more accurate and relevant patient records.

  16. The role of integrative medicine and Kampo treatment in an aging society: experience with Kampo treatment during a natural disaster.

    Science.gov (United States)

    Takayama, Shin; Numata, Takehiro; Iwasaki, Koh; Kuroda, Hitoshi; Kagaya, Yutaka; Ishii, Tadashi; Yaegashi, Nobuo

    2014-01-01

    After the Great East Japan Earthquake, elderly individuals, who are particularly vulnerable during natural disasters, experienced difficulty while evacuating the area. This report discusses the Kampo treatments provided to elderly individuals in the disaster areas, and the role of integrative medicine and Kampo treatment. The changes in symptoms and Kampo treatment contents were summarized using the medical records of treatments provided in the evacuation centers until 10 weeks after the earthquake. Infectious diseases, the common cold and hypothermia were frequently observed in most patients for first two weeks after the disaster. Allergies increased two weeks later, and mental distress was commonly observed six weeks later. We prescribed several Kampo formulas to treat the individual symptoms. Many elderly individuals were treated using Western medications, but the symptoms persisted; however, after Kampo formulas were included in the treatment, the symptoms of many patients improved. Unlike Western medications, Kampo formulas warmed the bodies of elderly individuals who often had a reduced basal metabolism and low body temperatures due to exposure to the cold tsunami waters. Therefore, the Kampo formulas may have improved the immunity of those who were under psychological and physical stress because they had spent several days in the evacuation centers. Many studies have reported the effectiveness of Kampo formulas. Therefore, the combined usage of both Western and Kampo medicine may be used in a mutually complementary manner, and these combination treatments may play an important role in preserving the victims overall health after natural disasters.

  17. Stakeholder challenges in purchasing medical devices for patient safety.

    Science.gov (United States)

    Hinrichs, Saba; Dickerson, Terry; Clarkson, John

    2013-03-01

    This study identifies the stakeholders who have a role in medical device purchasing within the wider system of health-care delivery and reports on their particular challenges to promote patient safety during purchasing decisions. Data was collected through observational work, participatory workshops, and semi-structured qualitative interviews, which were analyzed and coded. The study takes a systems-based and engineering design approach to the study. Five hospitals took part in this study, and the participants included maintenance, training, clinical end-users, finance, and risk departments. The main stakeholders for purchasing were identified to be staff from clinical engineering (Maintenance), device users (Clinical), device trainers (Training), and clinical governance for analyzing incidents involving devices (Risk). These stakeholders display varied characteristics in terms of interpretation of their own roles, competencies for selecting devices, awareness and use of resources for purchasing devices, and attitudes toward the purchasing process. The role of "clinical engineering" is seen by these stakeholders to be critical in mediating between training, technical, and financial stakeholders but not always recognized in practice. The findings show that many device purchasing decisions are tackled in isolation, which is not optimal for decisions requiring knowledge that is currently distributed among different people within different departments. The challenges expressed relate to the wider system of care and equipment management, calling for a more systemic view of purchasing for medical devices.

  18. A new taxonomy for stakeholder engagement in patient-centered outcomes research.

    Science.gov (United States)

    Concannon, Thomas W; Meissner, Paul; Grunbaum, Jo Anne; McElwee, Newell; Guise, Jeanne-Marie; Santa, John; Conway, Patrick H; Daudelin, Denise; Morrato, Elaine H; Leslie, Laurel K

    2012-08-01

    Despite widespread agreement that stakeholder engagement is needed in patient-centered outcomes research (PCOR), no taxonomy exists to guide researchers and policy makers on how to address this need. We followed an iterative process, including several stages of stakeholder review, to address three questions: (1) Who are the stakeholders in PCOR? (2) What roles and responsibilities can stakeholders have in PCOR? (3) How can researchers start engaging stakeholders? We introduce a flexible taxonomy called the 7Ps of Stakeholder Engagement and Six Stages of Research for identifying stakeholders and developing engagement strategies across the full spectrum of research activities. The path toward engagement will not be uniform across every research program, but this taxonomy offers a common starting point and a flexible approach.

  19. Stakeholder Involvement in Japan. Appendix IX.3

    International Nuclear Information System (INIS)

    2016-01-01

    The Government of Japan, especially the Ministry of the Environment, is responsible for implementing the decontamination activities in the areas contaminated by radioactive materials discharged by the accident at Fukushima Daiichi nuclear power plant operated by the Tokyo Electric Power Company (TEPCO). To promptly reduce the impacts of the contamination on human health and the living environment, the Act on Special Measures Concerning the Handling of Environmental Pollution by Radioactive Materials Discharged by the Nuclear Power Station Accident Associated with the Tohoku District — Off the Pacific Ocean Earthquake that Occurred on March 11, 2011 (the Act) came into force on 1 January 201220. The Act clarifies the roles and responsibility of the national and local governments, TEPCO, relevant stakeholders (e.g. landowners) and the public as follows: (a) National government: Implement any necessary measures in considering its social responsibility associated with the promotion of nuclear energy; (b) Local governments: Carry out their roles depending on their natural and social conditions, in cooperation with the national government; (c) TEPCO: Implement any necessary measures in good faith, while assisting the national and local governments; (d) Relevant stakeholders (e.g. landowners) and the public: Cooperate with the national and local governments

  20. [The role of health regulations in the rational use of medicines].

    Science.gov (United States)

    Arriola-Peñalosa, Mikel Andoni

    2015-01-01

    The Federal Commission for the Protection against Sanitary Risk (COFEPRIS by its initials in Spanish) is the state body responsible for transversely regulating various sectors of the Mexican economy, among them health services and inputs. Both cases are related to the rational use of medicines. The pharmaceutical policy of the Mexican Government is to prevent health risks by strengthening the effective and timely access to a market supplied with safe, effective, and quality products at the lowest possible prices. To date, the regulatory mechanisms used by COFEPRIS to ensure access to medicines and quality health services have been effective. With the implemented measures, self-medication has been reduced and medical services provided by pharmaceutical clinics comply with the best practices. Finally, the regulatory framework has been strengthened to fight the illegal drug market and "miracle" products. So far, the present administration has increased seizures of illegal substances and, as of today, all advertising guidelines for health-related products comply with the regulations.

  1. The International Finance Facility for Immunisation: stakeholders' perspectives.

    Science.gov (United States)

    Crocker-Buque, Tim; Mounier-Jack, Sandra

    2016-09-01

    To evaluate stakeholders' understanding and opinions of the International Finance Facility for Immunisation (IFFIm); to identify factors affecting funding levels; and to explore the future use of IFFIm. Between July and September 2015, we interviewed 33 individuals from 25 organizations identified as stakeholders in IFFIm. In total 22.5 hours of semi-structured interviews were recorded, transcribed and analysed using a framework method. Stakeholders' understanding of IFFIm's financing mechanism and its outcomes varied and many stakeholders wanted more information. Participants highlighted that the change in the macro-economic environment following the 2008 financial crisis affected national policy in donor countries and subsequently the number of new commitments IFFIm received. Since Gavi is now seen as a successful and mature organization, participants stated that donors prefer to donate directly to Gavi. The pharmaceutical industry valued IFFIm for providing funding stability and flexibility. Other stakeholders valued IFFIm's ability to access funds early and enable Gavi to increase vaccine coverage. Overall, stakeholders thought IFFIm was successful, but they had divergent views about IFFIm's on-going role. Participants listed two issues where bond financing mechanisms may be suitable: emergency preparedness and outcome-based time-limited interventions. The benefit of pledging funds through IFFIm needs to be re-evaluated. There are potential uses for bond financing to raise funds for other global health issues, but these must be carefully considered against criteria to establish effectiveness, with quantifiable pre-defined outcome indicators to evaluate performance.

  2. Nuclear regulatory organisations: Learning from stakeholders to enhance communication

    International Nuclear Information System (INIS)

    Lorin, Aurelie

    2015-01-01

    Since its creation 15 years ago, the NEA Committee on Nuclear Regulatory Activities (CNRA) Working Group on Public Communication of Nuclear Regulatory Organisations (WGPC) has been addressing a broad range of communication issues, with two reports recently issued on Nuclear Regulatory Organisations, the Internet and Social Media: The What, How and Why of Their Use as Communication Tools and on Nuclear Regulatory Organisations and Communication Strategies. After the Fukushima Daiichi nuclear power plant accident in 2011, nuclear regulatory organisations around the world reaffirmed the need to strengthen stakeholder outreach and communication, and to create more robust avenues for stakeholder involvement in regulatory matters. The WGPC proposed a means for stakeholders to play a more active role in the group by holding one-day workshops in conjunction with regular meetings. These workshops offer a platform for stakeholder exchange with communication experts from nuclear regulatory organisations (NROs). The objective is to stimulate co-operation and improve communication by better understanding stakeholder perceptions, needs and expectations, and by discussing how to use traditional and social media more effectively. While nuclear regulatory organisations may have a common willingness to improve their communication methods and to build constructive relationships with stakeholders, every country has its own practices and cultural background, and thus its own challenges. Following the first workshop in Paris, which brought together European stakeholders, and the second in North America, the NEA is now organising a third workshop in Asia (Japan) to be held in April 2016. This third workshop will enable the NEA to gather stakeholder views from a third continent. A report on the workshops' findings will be issued after the completion of this third workshop, thus giving a broader idea of how to improve the overall communication methods of nuclear regulatory

  3. Ecosystem Services Flows: Why Stakeholders' Power Relationships Matter.

    Science.gov (United States)

    Felipe-Lucia, María R; Martín-López, Berta; Lavorel, Sandra; Berraquero-Díaz, Luis; Escalera-Reyes, Javier; Comín, Francisco A

    2015-01-01

    The ecosystem services framework has enabled the broader public to acknowledge the benefits nature provides to different stakeholders. However, not all stakeholders benefit equally from these services. Rather, power relationships are a key factor influencing the access of individuals or groups to ecosystem services. In this paper, we propose an adaptation of the "cascade" framework for ecosystem services to integrate the analysis of ecological interactions among ecosystem services and stakeholders' interactions, reflecting power relationships that mediate ecosystem services flows. We illustrate its application using the floodplain of the River Piedra (Spain) as a case study. First, we used structural equation modelling (SEM) to model the dependence relationships among ecosystem services. Second, we performed semi-structured interviews to identify formal power relationships among stakeholders. Third, we depicted ecosystem services according to stakeholders' ability to use, manage or impair ecosystem services in order to expose how power relationships mediate access to ecosystem services. Our results revealed that the strongest power was held by those stakeholders who managed (although did not use) those keystone ecosystem properties and services that determine the provision of other services (i.e., intermediate regulating and final services). In contrast, non-empowered stakeholders were only able to access the remaining non-excludable and non-rival ecosystem services (i.e., some of the cultural services, freshwater supply, water quality, and biological control). In addition, land stewardship, access rights, and governance appeared as critical factors determining the status of ecosystem services. Finally, we stress the need to analyse the role of stakeholders and their relationships to foster equal access to ecosystem services.

  4. Role of medicinal plants, herbs, and spices in protecting human health.

    Science.gov (United States)

    Balentine, D A; Albano, M C; Nair, M G

    1999-09-01

    The body of knowledge about plants, herbs, and spices and their respective and collective roles in promoting human health is modest. Flavonoids in tea and anthocyanins in tart cherries were presented as examples of how to move forward in understanding active compounds. Dietary compounds, their roles in maintaining human health, and their interactions with established nutrients were determined to be short-term research priorities.

  5. DEVISING STRATEGIES FOR RECLAMATION OF DERELICT SITES DUE TO MINING OF RESIDUAL SOIL (“SAIBRO” AT UBATUBA, NORTH COAST OF SÃO PAULO STATE, BRAZIL: THE VIEWS AND ROLES OF THE STAKEHOLDERS

    Directory of Open Access Journals (Sweden)

    Cláudio José Ferreira

    2005-05-01

    Full Text Available Between the late 60's and early 90's intensive exploitation of residual soil for civil construction took place in the municipality of Ubatuba, North Coast of São Paulo State. Tropical climatic conditions associated with a hilly landscape bordered by the Atlantic Ocean gave rise to thick (10-30m weathering profiles derived from Precambrian granitic-gneissic rocks. Exploitation of large volumes of this material required only very simple technology, which on the other hand has caused highly adverse environmental impacts, such asdeforestation, soil erosion, land instability hazards, scenic eterioration, pollution and disturbance of local water flow regime. This paper deals with the devising of strategies thus identifying stakeholders and describing their roles both on the dereliction and reclamation processes related with residual soil exploitation. The evaluation approach focused on the analysis of the regulatory framework and its practical implications and issues in terms of licensing for mining operations, commercialization of construction materials, and the relations of such mining activities with regional and urban planning. A survey of stakeholderviewpoints was successfully achieved through a two-day workshop. The attendance included decision-makers, officials and representatives of governmental and regulatory bodies (Federal, State and Municipal, environmental research institutions, private miners (entrepreneurs and consultants, public attorney, and NGOs. The outcomes have ndicated that State and local authorities properly managed to stop illegal exploitation of residual soil in the early 90´s. However no land reclamation was undertaken until present. One of the main problems would be related with the procedures for mining and environmental licensing that were considered to be too complex and long (usually involving up to seven decisional instances and 2,5 years in average. Other key issues and needs identified included: aorganization of a

  6. [Team approach to improve the quality of perioperative medicine and the role of anesthesiologists: preface and comments].

    Science.gov (United States)

    Nishino, Takashi

    2012-03-01

    Surgeons, anesthesiologists, nurses and paramedical staffs constitute a team dedicated to the welfare of the surgical patients. We have to understand that good results depend on good teamwork. Thus, we, anesthesiologists, have to know precisely the roles and works of other members of the team. In this special issue, the topic of team approach to improve the quality of perioperative medicine including the roles of anesthesiologists is featured. Seven subtopics; (1) usefulness and problems of pre- and post-operative anesthesia evaluation clinic, (2) communication at the time of the operating room emergency outbreak, (3) cooperative structures in blood transfusion departments for massive intraoperative hemorrhage, (3) collaboration between anesthesiologists and psychiatrists in the management of modified electroconvulsive therapy (mECT), (5) the role of the pharmacist in the management of the operating room, (6) the importance of perioperative oral care, and (7) anesthesiologists playing a pivotal role in the enhanced recovery after surgery program, are presented and discussed in detail. It should be emphasized that good teamwork arises from mutual respect.

  7. [Integrative medicine in the management of functional dyspepsia. Role of the herbal preparation STW5].

    Science.gov (United States)

    Sebastián-Domingo, Juan J

    2014-04-01

    Functional dyspepsia is defined as a group of symptoms, whether related or unrelated to intake, localized in the upper abdomen, that manifest in the form of discomfort or epigastric pain, postprandial fullness and early satiety, in the absence of any demonstrable organic or structural anomaly. The etiopathogenesis and physiopathology of the process are unknown but factors that may be involved include gastric motility disorders, visceral hypersensitivity, psychological and genetic factors, Helicobacter pylori infection, and gastric acid hypersecretion. There is still no etiological treatment and consequently treatment is empirical and based on symptoms. This article reviews the main therapeutic options currently available, with special emphasis on the use of certain phytoceuticals (STW 5), in an attempt to integrate with traditional scientific medicine. This article also proposes an integrative therapeutic algorithm. Copyright © 2013 Elsevier España, S.L. and AEEH y AEG. All rights reserved.

  8. Role of Some Medicinal Herbs Plants (Anise and Chamomile) in Male Rats Intoxicated with Metacide Pesticide

    International Nuclear Information System (INIS)

    Afifi, E.A.A.; Ali, S.E.; Hafez, S.E.

    2011-01-01

    This present study was undertaken to evaluate the effect of some medicinal herbs plants such as anise and chamomile (300 mg/kg b.wl) for five weeks on some biochemical changes induced in rats administrated daily oral dose of organophosphorus pesticide metacide at level of 1.4 mg/kg b.wt for live weeks. The data showed that the metacide pesticides caused disturbance in liver and kidney function revealed as significant increased in serum total lipids, triglycerides, total free amino, biliburine, total cholesterol, creatinine, urea and uric acid. Moreover, a significant decreased in total proteins. Also thyroxine hormone (T4) was increased while triiodothyronine (T 3) was decreased. The results also revealed that both anise and chamomile exhibited an improvement and highly affective in attenuation of metacide pesticide caused oxidative damage, disturbance and injury induced in liver, kidney and thyroid hormone function

  9. [The role of the Constitutional Court on the analysis of contracts of prepaid medicine programs].

    Science.gov (United States)

    Quintana-Cepeda, Anamaría

    2016-01-01

    Since 1991, when the current Colombian Constitution came into force and the Constitutional Court was appointed as its guardian and protector, constitutional values have permeated all subjects and areas of law, even those that were previously considered as private matters. Prepaid medicine contracts are a good example of this phenomenon, since the Colombian Constitutional Court has limited individual freedom of contract to private parties -prepaid medical companies- for the benefit of final users of this service through "acción de tutela", in order to protect the right to healthcare and to prevent some behaviors that violate the principle of good faith. The Court has demanded private companies to assess the health condition of patients and has prohibited pre-existent and exclusion clauses that diminish the responsibilities of said companies. Nevertheless, there is a gap in the law regarding the duties of good faith that concern the user, which will be addressed in this paper.

  10. Remote Control of Cellular Functions: The Role of Smart Nanomaterials in the Medicine of the Future.

    Science.gov (United States)

    Genchi, Giada Graziana; Marino, Attilio; Grillone, Agostina; Pezzini, Ilaria; Ciofani, Gianni

    2017-05-01

    The remote control of cellular functions through smart nanomaterials represents a biomanipulation approach with unprecedented potential applications in many fields of medicine, ranging from cancer therapy to tissue engineering. By actively responding to external stimuli, smart nanomaterials act as real nanotransducers able to mediate and/or convert different forms of energy into both physical and chemical cues, fostering specific cell behaviors. This report describes those classes of nanomaterials that have mostly paved the way to a "wireless" control of biological phenomena, focusing the discussion on some examples close to the clinical practice. In particular, magnetic fields, light irradiation, ultrasound, and pH will be presented as means to manipulate the cellular fate, due to the peculiar physical/chemical properties of some smart nanoparticles, thus providing realistic examples of "nanorobots" approaching the visionary ideas of Richard Feynman. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  11. Combating slavery in the 21st century: the role of emergency medicine.

    Science.gov (United States)

    Chisolm-Straker, Makini; Richardson, Lynne D; Cossio, Tania

    2012-08-01

    Human trafficking (HT) victims may present to emergency departments (ED) as patients, but are infrequently identified. To address this issue, we developed and piloted a training intervention for emergency providers on HT and how to identify and treat these patients. Included in the intervention participants were emergency medicine residents, ED attendings, ED nurses, and hospital social workers. Prior to the intervention, 4.8% felt some degree of confidence in their ability to identify and 7.7% to treat a trafficked patient. After the 20-minute intervention, 53.8% felt some degree of confidence in their ability to identify and 56.7% care for this patient population. Because this problem is global, we created a Website that includes an instructive toolkit and an interactive course for self-learning and/or assessment. This intervention will give ED providers the tools they need to assess and treat a patient who might be a victim of human trafficking.

  12. [The role of ancient astrology in preparation for a secular natural science and medicine].

    Science.gov (United States)

    Geller, Markham J

    2011-01-01

    The Persian period in the Near East (from c. 500 BCE) represented the first example of globalisation, during which advanced cultural centres from Egypt to Afghanistan were united under a single rule and common language. Paul Unschuld has drawn attention to a scientific revolution in the late first millennium BC, extending from Greece to China, from Thales to Confucius, which saw natural law replace the divine law in scientific thinking. This paper argues for new advances in astronomy as the specific motor which motivated changes in scientific thinking and influenced other branches of science, including medicine, just as the new science of astrology, which replaced divination, fundamentally changed the nature of medical prognoses. The secularisation of science was not universally accepted among ancient scholars, and the irony is that somewhat similar reservations accompanied the reception of modern quantum physics.

  13. Effectiveness of resident as teacher curriculum in preparing emergency medicine residents for their teaching role.

    Science.gov (United States)

    Hosein Nejad, Hooman; Bagherabadi, Mehdi; Sistani, Alireza; Dargahi, Helen

    2017-01-01

    Over the past 30 years, recognizing the need and importance of training residents in teaching skills has resulted in several resident-as-teacher programs. The purpose of this study was to explore the impact of this teaching initiative and investigate the improvement in residents' teaching skills through evaluating their satisfaction and perceived effectiveness as well as assessing medical students' perception of the residents' teaching quality. This research is a quasi-experimental study with pre- and post-tests, continuing from Dec 2010 to May 2011 in Imam Hospital, Tehran University of Medical Sciences. In this survey, Emergency Medicine Residents (n=32) participated in an 8-hour workshop. The program evaluation was performed based on Kirkpatrick's model by evaluation of residents in two aspects: self-assessment and evaluation by interns who were trained by these residents. Content validity of the questionnaires was judged by experts and reliability was carried out by test re-test. The questionnaires were completed before and after the intervention. Paired sample t-test was applied to analyze the effect of RAT curriculum and workshop on the improvement of residents' teaching skills based on their self-evaluation and Mann-Whitney U test was used to identify significant differences between the two evaluator groups before and after the workshop. The results indicated that residents' attitude towards their teaching ability was improved significantly after participating in the workshop (pTeacher for emergency medicine residents resulted in favorable outcomes in the second evaluated level of Kirkpatrick's model, i.e. it showed measurable positive changes in the self-assessments of medical residents about different aspects of teaching ability and performance. However, implementing training sessions for resident physicians, although effective in improving their confidence and self-assessment of their teaching skills, seems to cause no positive change in the third

  14. The role of cultural diversity climate in recruitment, promotion, and retention of faculty in academic medicine.

    Science.gov (United States)

    Price, Eboni G; Gozu, Aysegul; Kern, David E; Powe, Neil R; Wand, Gary S; Golden, Sherita; Cooper, Lisa A

    2005-07-01

    Ethnic diversity among physicians may be linked to improved access and quality of care for minorities. Academic medical institutions are challenged to increase representation of ethnic minorities among health professionals. To explore the perceptions of physician faculty regarding the following: (1) the institution's cultural diversity climate and (2) facilitators and barriers to success and professional satisfaction in academic medicine within this context. Qualitative study using focus groups and semi-structured interviews. Nontenured physicians in the tenure track at the Johns Hopkins University School of Medicine. Focus groups and interviews were audio-taped, transcribed verbatim, and reviewed for thematic content in a 3-stage independent review/adjudication process. Study participants included 29 faculty representing 9 clinical departments, 4 career tracks, and 4 ethnic groups. In defining cultural diversity, faculty noted visible (race/ethnicity, foreign-born status, gender) and invisible (religion, sexual orientation) dimensions. They believe visible dimensions provoke bias and cumulative advantages or disadvantages in the workplace. Minority and foreign-born faculty report ethnicity-based disparities in recruitment and subtle manifestations of bias in the promotion process. Minority and majority faculty agree that ethnic differences in prior educational opportunities lead to disparities in exposure to career options, and qualifications for and subsequent recruitment to training programs and faculty positions. Minority faculty also describe structural barriers (poor retention efforts, lack of mentorship) that hinder their success and professional satisfaction after recruitment. To effectively manage the diversity climate, our faculty recommended 4 strategies for improving the psychological climate and structural diversity of the institution. Soliciting input from faculty provides tangible ideas regarding interventions to improve an institution's diversity

  15. Role of Suez Canal University, Faculty of Medicine in Egyptian Medical Education Reform

    Directory of Open Access Journals (Sweden)

    Somay Hosny

    2016-06-01

    Full Text Available There are currently 22 public and 2 private medical schools in Egypt, which graduate around 10,000 physicians annually. While Kasr Al-Eini (Cairo University is the oldest one; established in 1827, the Suez Canal Faculty of Medicine (FOM/SCU is the first to adopt an integrated, student centered, problem- and community-based curriculum since its inauguration in 1978. Apart from Port Said medical school, which was established in 2013, the remaining medical schools either generally adopt the conventional teacher-centered and subject-based curricula or starting to introduce changes in their curricula in order to fulfill the National Academic Reference Standards (NARS, published in 2008 by the National Authority of Quality Assurance and Accreditation in Education (NAQAAE. This authority was established in 2006 as part of the reform agenda of the education system in Egypt. All institutes are mandated to comply with the set national standards and apply to NAQAAE for national accreditation. FOM/SCU was the first higher education institute in Egypt to obtain national accreditation in 15 May 2010 and also the first to be re-accredited in August 2015. The principal reason for this achievement is the implementation of innovative strategies by FOM/SCU that perfectly match the NARS, which were issued 30 years after the inception of FOM/SCU. Many traditional schools are now trying to implement some of these strategies, and these trials are applied either as separate parallel innovative programs (Mansoura, Ain Shams, and Menoufia, integrated modules (Zagazig, Armed Forces College of Medicine, or new curriculum (Alexandria. FOM/SCU, through its WHO collaborating center in the field of medical education and its department of medical education, offers help to all schools in Egypt in this regard. In parallel, FOM/SCU members have also offered training and consultations to numerous medical schools in other countries, including Syria, Libya, Yemen, Sudan, Somalia, and

  16. Specialty Choice Among Sexual and Gender Minorities in Medicine: The Role of Specialty Prestige, Perceived Inclusion, and Medical School Climate.

    Science.gov (United States)

    Sitkin, Nicole A; Pachankis, John E

    2016-12-01

    Sexual and gender minorities (SGMs) in medicine experience unique stressors in training. However, little is known about SGM specialty choice. This study examined predictors of SGM specialty choice, associations between specialty prestige and perceived SGM inclusion, and self-reported influences on specialty choice. Medical trainees and practitioners (358 SGM, 1528 non-SGM) were surveyed online. We operationalized specialty choice at the individual level as respondents' specialty of practice; at the specialty level, as a percentage of SGM respondents in each specialty. We examined specialty prestige, perceived SGM inclusivity, and medical school climate as predictors of SGM specialty choice, and we compared additional influences on specialty choice between SGM and non-SGM. The percentage of SGM in each specialty was inversely related to specialty prestige (P = 0.001) and positively related to perceived SGM inclusivity (P = 0.01). Prestigious specialties were perceived as less SGM inclusive (P gender identity strongly influenced specialty choice (P role models, and work-life balance as strong influences on specialty choice. Exposure as a medical student to SGM faculty did not predict specialty prestige among SGM. Specialty prestige and perceived inclusivity predict SGM specialty choice. SGM diversity initiatives in prestigious specialties may be particularly effective by addressing SGM inclusion directly. Further research is needed to inform effective mentorship for SGM medical students. Exposure to SGM in medical training reduces anti-SGM bias among medical professionals, and SGM in medicine often assume leadership roles in clinical care, education, and research regarding SGM health. Supporting and promoting SGM diversity across the spectrum of medical specialties, therefore, represents a critical avenue to improve the care delivered to SGM populations and addresses the role of providers in the health disparities experienced by SGM.

  17. Not Missing the Future: A Call to Action for Investigating the Role of Regenerative Medicine Therapies in Pediatric/Adolescent Sports Injuries.

    Science.gov (United States)

    Best, Thomas M; Caplan, Arnold; Coleman, Michael; Goodrich, Laurie; Hurd, Jason; Kaplan, Lee D; Noonan, Ben; Schoettle, Philip; Scott, Christopher; Stiene, Henry; Huard, Johnny

    In August 2016, a group including sport medicine clinicians, researchers, and a bioethicist met in Vail, Colorado to discuss regenerative medicine and its potential role in youth sports injuries. There was consensus that a call to action is urgently needed to understand the current evidence base, the risks and rewards, and future directions of research and clinical practice for regenerative medicine therapies in youth sports. We present here a summary of our meeting, which was supported by the National Youth Sports Health and Safety Institute (NYSHSI), a partnership between the American College of Sports Medicine (ACSM) and Sanford Health. The group's goal is to educate practitioners and the public, and to pioneer a means of accumulating meaningful clinical data on regenerative medicine therapies in pediatric and adolescent athletes.

  18. A systematic review of stakeholder engagement in comparative effectiveness and patient-centered outcomes research.

    Science.gov (United States)

    Concannon, Thomas W; Fuster, Melissa; Saunders, Tully; Patel, Kamal; Wong, John B; Leslie, Laurel K; Lau, Joseph

    2014-12-01

    We conducted a review of the peer-reviewed literature since 2003 to catalogue reported methods of stakeholder engagement in comparative effectiveness research and patient-centered outcomes research. We worked with stakeholders before, during and after the review was conducted to: define the primary and key research questions; conduct the literature search; screen titles, abstracts and articles; abstract data from the articles; and analyze the data. The literature search yielded 2,062 abstracts. The review was conducted on 70 articles that reported on stakeholder engagement in individual research projects or programs. Reports of stakeholder engagement are highly variable in content and quality. We found frequent engagement with patients, modestly frequent engagement with clinicians, and infrequent engagement with stakeholders in other key decision-making groups across the healthcare system. Stakeholder engagement was more common in earlier (prioritization) than in later (implementation and dissemination) stages of research. The roles and activities of stakeholders were highly variable across research and program reports. To improve on the quality and content of reporting, we developed a 7-Item Stakeholder Engagement Reporting Questionnaire. We recommend three directions for future research: 1) descriptive research on stakeholder-engagement in research; 2) evaluative research on the impact of stakeholder engagement on the relevance, transparency and adoption of research; and 3) development and validation of tools that can be used to support stakeholder engagement in future work.

  19. Stakeholder orientation vs. shareholder value

    DEFF Research Database (Denmark)

    Rose, Caspar

    2003-01-01

    Abstract: This article analyzes the conflict of interests between shareholders andother stakeholders, including when such conflicts of interests may arise. It is arguedthat shareholder value cannot be justified simply by referring to any prerogativeproperty rights of the shareholders. Instead, sh...... cautious the legal systemshould use a doctrine based on the `company's interests'. In addition, the notion of afirm's social responsibility is critically evaluated together with the associated pitfallsof accepting this concept....

  20. A Nurse Associate in a Department of Family Medicine: Developing a Role Definition

    OpenAIRE

    1981-01-01

    The activities of a nurse associated with a family practice were documented and categorized into functional activities to give a role description. Over two years, the mean distribution of her time has spent in well child care (28.6%), pre- and postnatal care (14.7%), health education and counselling (9.6%), liaison (2.6%), student education (23.7%) and practice management (20.8%). Two important conclusions are that her major role is in preventive care and health promotion, complementary to th...

  1. A stakeholder dialogue on European vulnerability

    NARCIS (Netherlands)

    Vega-Leinert, de la A.C.; Schröter, D.; Leemans, R.; Fritsch, U.; Pluimers, J.C.

    2008-01-01

    A stakeholder dialogue was embedded in the ATEAM project to facilitate the development and dissemination of its European-wide vulnerability assessment of global change impacts. Participating stakeholders were primarily ecosystem managers and policy advisers interested in potential impacts on

  2. How We Engage Our Pesticide Stakeholders

    Science.gov (United States)

    The success of EPA's pesticide program is directly connected to our efforts to engage all stakeholders. In addition to meetings on pesticide-specific actions, we sponsor advisory committees that include diverse, independent stakeholders.

  3. When democratic principles are not enough:Tensions and temporalities of dialogic stakeholder engagement

    OpenAIRE

    Passetti, Emilio; Bianchi, Lara; Battaglia, Massimo; Frey, Marco

    2017-01-01

    Stakeholder engagement and dialogue have a central role in defining the relations between organisations and their internal and external interlocutors. Drawing upon the analysis of dialogic motifs, power-conflict dynamics and socio-political perspectives, and based on a set of interviews with the stakeholders of a consumer-owned co-operative, the research explores the dialogic potential of stakeholder engagement. The analysis revealed a fragmented picture where the co-design and co-implementat...

  4. The role of forensic medicine and forensic dentistry in estimating the chronological age of living individuals in Hamburg, Germany.

    Science.gov (United States)

    Mansour, Hussam; Fuhrmann, Andreas; Paradowski, Ioana; van Well, Eilin Jopp; Püschel, Klaus

    2017-03-01

    Age estimation represents one of the primary responsibilities of forensic medicine and forensic dentistry. It is an integral procedure aiming to estimate the chronological age of an individual, whose age is either unknown or doubtful, by means of assessing the stage of dental, skeletal, and physical development. The present publication reviews the methods and procedures used in estimating the age of young living individuals as well as the experiences of the Institute of Legal Medicine in Hamburg-Eppendorf, Germany, during the last 25 years. From 1990 to 2015, 4223 age estimations were carried out in Hamburg. During this time, forensic age estimation was requested by different concerned authorities including courts, the foreigners' registration office (Zentrale Ausländerbehörde), and the state office of education and consultation (Landesbetrieb Erziehung und Beratung). In the context of judicial proceedings, orthopantomograms, as well as X-ray examinations of both the left hand and the medial clavicular epiphyses were carried out in accordance with AGFAD recommendations. For investigations not associated with judicial proceedings, orthopantomogram examinations play a key role in the process of age estimation, due to their high diagnostic value and low radiation exposure. Since 2009, mainly unaccompanied young refugees were examined for age estimation. Orthopantomograms and clinical-physical examinations have been used as essential steps in this context to determine whether an individual is 18 years or less. Additional X-ray examinations of the left hand and the medial clavicular epiphyses have been used less frequently.

  5. Implicit bias against sexual minorities in medicine: cycles of professional influence and the role of the hidden curriculum.

    Science.gov (United States)

    Fallin-Bennett, Keisa

    2015-05-01

    Despite many recent advances in rights for sexual and gender minorities in the United States, bias against lesbian, gay, bisexual, and transgender (LGBT) people still exists. In this Commentary, the author briefly reviews disparities with regard to LGBT health, in both health care and medical education, and discusses the implications of Burke and colleagues’ study of implicit and explicit biases against lesbian and gay people among heterosexual first-year medical students, published in this issue of Academic Medicine. Emphasis is placed on the ways in which physicians’ implicit bias against LGBT people can create a cycle that perpetuates a professional climate reinforcing the bias. The hidden curriculum in academic health centers is discussed as both a cause of this cycle and as a starting point for a research and intervention agenda. The findings from Burke and colleagues’ study, as well as other evidence, support raising awareness of LGBT discrimination, increasing exposure to LGBT individuals as colleagues and role models in academic health centers, and modifying medical education curricula as methods to break the cycle of implicit bias in medicine.

  6. Exploring the role of medicinal plant-based immunomodulators for effective therapy of leishmaniasis

    Directory of Open Access Journals (Sweden)

    Garima eChouhan

    2014-05-01

    Full Text Available Leishmaniasis is a pestilent affliction that importunately needs better therapeutics necessitated by absence of effective vaccine, emergence as HIV co-infection and the dread of debilitating chemotherapy. The Leishmania parasites incapacitate host macrophages by preventing the formation of phagolysosomes, impeding antigen presentation to T cells, leading to suppression of cell-mediated immunity. An ideal approach to cure leishmaniasis includes administration of antileishmanial compounds that can concomitantly establish an effective Th1 response via restoration of requisite signaling between macrophages and T cells, for subsequent activation of macrophages to eliminate intracellular amastigotes. Plants have provided an opulent treasure of biomolecules that have fuelled the discovery of antileishmanial drugs. Modulation of immune functions using medicinal plants and their products has emerged as an effective therapeutic strategy. Herein, we review the plant extracts and natural products that have resulted in therapeutic polarization of host immunity to cure leishmaniasis. These immunostimulatory phytochemicals as source of potential antileishmanials may provide new strategies to combat leishmaniasis, alone or as adjunct modality.

  7. The role and rationale of nuclear medicine procedures in the differential diagnosis of renovascular hypertension

    Energy Technology Data Exchange (ETDEWEB)

    Blaufox, M.D. (Albert Einstein Coll. of Medicine, Bronx, NY (United States))

    1991-01-01

    The use of radionuclides in the differential diagnosis of renovascular hypertension has gone through many periods of enthusiasm and of disappointment. Regardless of the problems with the routine renogram, the availability of gamma camera renal evaluation makes possible meaningful preintervention of screening. The use of the test as a follow-up procedure is an extremely important but often overlooked application of radionuclides in the evaluation of renovascular hypertension. The radionuclide technique is a sensitive and accurate method of evaluating the results of percutaneous angioplasty or surgery or renal function in the affected kidney of patients with renovascular disease. A major change in our approach to the nuclear medicine diagnosis of renovascular hypertension has been the introduction of captopril renography. Although there is still a great deal of work to be done and many investigators are actively studying captopril renography, the potential of the test is clear. Captopril renography should include a baseline renogram, followed by the administration of 25 mg of captopril and a repeat study. Specificity and sensitivity data on this test probably will not be available for several years, but preliminary results are encouraging enough to justify routine use at this time in clinics in which screening for renovascular hypertension is carried out. (author).

  8. A Role for Complementary and Integrative Medicine in Alzheimer's Disease Prevention.

    Science.gov (United States)

    Ashford, J Wesson; Mahoney, Louise; Burkett, Tim

    2015-01-01

    Complementary and Integrative Medicine has been maturing as a field to support treatment for a variety of medical conditions. The approaches, including yoga, meditation, acupuncture, and dietary supplements, may assist patients in a variety of ways, though clear explanations for their mechanisms of action or measurements of their possible benefit are in most cases elusive. In this issue of the Journal of Alzheimer's Disease, Khalsa examines the use of meditation as a stress-reduction technique and provides an argument that with a specific technique such stress reduction can be provided efficiently, with relatively little interference in daily activities, and might decrease Alzheimer risk. This thorough review provides some evidence of physiological benefit of meditation to brain function. While any actual effect of meditation on Alzheimer pathophysiology is only conjectural, meditation has received considerable attention as a tool that may have positive psychological and medical benefits. Consequently, this review is welcome. What is less certain is whether the recommended meditation approach is of specific benefit for Alzheimer's disease or any other condition above and beyond what might be provided by many other types of exercises (like singing in a chorus or doing cross-word puzzles) or physical activities (like swimming or yoga).

  9. The role of Balint group training in the professional and personal development of family medicine residents.

    Science.gov (United States)

    Player, Marty; Freedy, John R; Diaz, Vanessa; Brock, Clive; Chessman, Alexander; Thiedke, Carolyn; Johnson, Alan

    2018-01-01

    This paper presents a study based on the participation of PGY2 and PGY3 family medicine residents in Balint seminars that occurred twice monthly for 24 months. Balint groups were cofacilitated by leader pairs experienced with the Balint method. Prior to residency graduation, 18 of 19 eligible resident physicians (94.5%) completed 30- to 60-min semistructured interviews conducted by a research assistant. Resident physicians were told that these individual interviews concerned "…how we teach communication in residency." The deidentified transcripts from these interviews formed the raw data that were coded for positive (n = 9) and negative (n = 3) valence themes by four faculty coders utilizing an iterative process based on grounded theory. The consensus positive themes included several elements that have previously been discussed in published literature concerning the nature of Balint groups (e.g., being the doctor that the patient needs, reflection, empathy, blind spots, bonding, venting, acceptance, perspective taking, and developing appreciation for individual experiences). The negative themes pointed to ways of possibly improving future Balint offerings in the residency setting ( repetitive, uneasiness, uncertain impact). These findings appear to have consistency with seminal writings of both Michael and Enid Balint regarding the complex nature of intrapsychic and interpersonal skills required to effectively manage troubling doctor-patient relationships. The implications of findings for medical education (curriculum) development as well as future research efforts are discussed.

  10. What should medical practitioners know about the role of alternative medicines in cardiovascular disease management?

    Science.gov (United States)

    Whayne, Thomas F

    2010-04-01

    Alternative medications as a term call up many different meanings, significance, and perceptions to various medical practitioners. Some are good; others are bad. A wide range of alternative medications with relevance or connection to cardiovascular (CV) disease have been considered. While many are worthless, others have definite benefit, and at least one, chelation therapy, is associated with definite harm, significant risk, no benefit, and enrichment of the practitioners who prescribe it. The issues concerning alternative therapies will likely never be studied with randomized clinical trials due to the lack of a profit motive on the part of pharmaceutical companies--only rarely do other institutions, such as the National Institutes of Health, support medicinal studies. Basic knowledge of alternative therapies is essential for the CV specialist and other practicing physicians and other practitioners, since at least a few of their patients will take these medications regardless of medical advice. The result is that a number of these alternative medications will then interact with conventional CV medications, many times unfavorably.

  11. The continuing important role of radionuclide generator systems for nuclear medicine

    International Nuclear Information System (INIS)

    Knapp, F.F. Jr.; Mirzadeh, S.

    1994-01-01

    In this review, the continuing importance and status of development of radionuclide generator systems for nuclear medicine are discussed. Radioisotope costs and availability are two important factors, and both nuclear reactors and accelerator facilities are required for production of the parent radioisotopes. Radionuclide generator research is currently focused on the development of generators which provide radioisotopes for positron emission tomography (PET) applications and daughter radioisotopes for various therapeutic applications which decay primarily by particle emission. Generator research continues to be influenced by developments and requirements of complementary technologies, such as the increasing availability of PET. In addition, the availability of a wide spectrum of tumor-specific antibodies, fragments, and peptides for radioimmunodiagnosis and radioimmunotherapy has stimulated the need for generator-derived radioisotopes. The advantages of treatment of arthritis of the synovial joints with radioactive particles (radiation synovectomy) may be expected to be of increasing importance as the elderly population increases, and many of these agents are prepared using generator-derived radioisotopes such as yttrium-90 and rhenium-188. Therapeutic use of the ''in vivo generator'' is a new approach, where the less radiotoxic parent radioisotope is used to prepare tissue-speciic therapeutic agents. Following in vivo site localization, decay of the parent provides the daughter for therapy at the target site. The principal foundation of most diagnostic agents will continue to require technetium-99m from the molybdenum-99/technetium-99m (''Moly'') generator. (orig./VHE)

  12. Stakeholder Orientation in Cruise Lines’ Mission Statements

    Directory of Open Access Journals (Sweden)

    Lara Penco

    2017-11-01

    Full Text Available Consistent with the extant management literature, mission statements are crucial for the sustainability and growth of any firms and have been considered to be a tool for the strategic management process. Despite the considerable attention awarded to this theme, the role of the mission statement in the strategic management of tourism firms has not been sufficiently highlighted. The present paper tries to bridge this literature gap and aims to (i analyze the content of mission statements; and (ii investigate the stakeholder orientation of cruise line mission statements. We apply a content analysis method to analyze the mission statements of 44 cruise lines, employing three different perspectives: (1 the inclusion of stakeholder groups; (2 mentions of specific “mission” components; (3 reference to four goals usually assigned to mission statements. The analysis was performed using the software package QDA-Miner. The results suggest that it is possible to identify four clusters of firms that present similar content in their mission statements, and that cruise companies tend to reserve a major attention to customers. This contribution presents some valuable research implications mainly useful for researchers and academics, but also maybe of benefit to professionals and investors.

  13. CSR Model Implementation from School Stakeholder Perspectives

    Science.gov (United States)

    Herrmann, Suzannah

    2006-01-01

    Despite comprehensive school reform (CSR) model developers' best intentions to make school stakeholders adhere strictly to the implementation of model components, school stakeholders implementing CSR models inevitably make adaptations to the CSR model. Adaptations are made to CSR models because school stakeholders internalize CSR model practices…

  14. 40 CFR 155.52 - Stakeholder engagement.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Stakeholder engagement. 155.52 Section... REGISTRATION STANDARDS AND REGISTRATION REVIEW Registration Review Procedures § 155.52 Stakeholder engagement... Agency may meet with stakeholders regarding a forthcoming or ongoing registration review. For example...

  15. Info avond Go&Learn stakeholders

    OpenAIRE

    Brabant, Karen

    2014-01-01

    De infoavond licht de stakeholders in over de planning en invulling van de circuits en de praktische organisatie ervan. De stakeholders worden ingelicht over de huidige realisaties binnen het project, zowel op nationaal als internationaal niveau. Het geeft aan de stakeholders eveneens de kans om te netwerken.

  16. Physician social capital and the reported adoption of evidence-based medicine: exploring the role of structural holes.

    Science.gov (United States)

    Mascia, Daniele; Cicchetti, Americo

    2011-03-01

    The present study explores the role that professional networks play in the propensity of hospital physicians to adopt and implement evidence-based medicine (EBM) into clinical practice. Using attributional and relational data collected from a sample of 207 physicians in six Italian National Health Service hospitals, social network techniques were used to analyze the structure of the networks representing professional interactions among the surveyed hospital physicians. Ordinal logistic regression was applied to analyze the association between the structural features of physicians' networks and their self-reported propensity to implement EBM into daily practice. Physicians who were highly constrained in their interpersonal networks were less likely to report adopting EBM, suggesting that the cohesion induced by social interactions may hamper, rather than foster, the diffusion of scientific information within professional groups. We discuss the implications of the observed interaction patterns for hospital administrators and policy makers. Copyright © 2011 Elsevier Ltd. All rights reserved.

  17. CARDIOPROTECTIVE ROLES OF THE CHINESE MEDICINAL FORMULA BAO-XIN-TANG ON ACUTE MYOCARDIAL INFARCTION IN RATS.

    Science.gov (United States)

    Wang, Yang; Wang, Weihao; Peng, Weijun; Liu, Weiping; Cai, Weijun; Xia, Zian; Zhang, Honggeng; Xing, And Zhihua

    2017-01-01

    Bao-Xin-Tang (BXT) is a traditional Chinese medicinal formula used for the treatment of coronary heart disease and known to have favorable therapeutic benefits. The current study was designed to determine whether BXT has a cardioprotective role for acute myocardial infarction. The underlying mechanisms were also explored. The Sprague-Dawley rat model of acute myocardial infarction was established by occluding the left anterior descending branch of the coronary artery. After a 3-h ischemic period, we determined the myocardial infarction size, inflammatory components, and antioxidant activities. The data showed that BXT could reduce the infarction size and lower the levels of C-reactive protein, interleukin-6, and myeloperoxidase, and increase the activities of superoxide dismutase and the anti-inflammatory cytokine, interleukin-10. These results indicate that administration of BXT, following acute myocardial infarction, could reduce infarct size. The effects of BXT may be related to its anti-inflammatory and anti-oxidative properties.

  18. Restoring Faculty Vitality in Academic Medicine When Burnout Threatens.

    Science.gov (United States)

    Shah, Darshana T; Williams, Valerie N; Thorndyke, Luanne E; Marsh, E Eugene; Sonnino, Roberta E; Block, Steven M; Viggiano, Thomas R

    2017-11-21

    Increasing rates of burnout-with accompanying stress and lack of engagement-among faculty, residents, students, and practicing physicians have caused alarm in academic medicine. Central to the debate among academic medicine's stakeholders are oft-competing issues of social accountability; cost containment; effectiveness of academic medicine's institutions; faculty recruitment, retention, and satisfaction; increasing expectations for faculty; and mission-based productivity.The authors propose that understanding and fostering what contributes to faculty and institutional vitality is central to preventing burnout during times of change. They first look at faculty vitality and how it is threatened by burnout, to provide a framework for a greater understanding of faculty well-being. Then they draw on higher education literature to determine how vitality is defined in academic settings and what factors affect faculty vitality within the context of academic medicine. Next, they propose a model to explain and examine faculty vitality in academic medicine, followed by a discussion of the need for a greater understanding of faculty vitality. Finally, the authors offer conclusions and propose future directions to promote faculty vitality.The authors encourage institutional decision makers and other stakeholders to focus particular attention on the evolving expectations for faculty, the risk of extensive faculty burnout, and the opportunity to reduce burnout by improving the vitality and resilience of these talented and crucial contributors. Faculty vitality, as defined by the institution, has a critical role in ensuring future institutional successes and the capacity for faculty to thrive in a complex health care economy.

  19. CarlSnet II : Strengthening the Caribbean ICT Virtual Stakeholders ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    CarlSnet I arose out of the recognition that the Caribbean ICT Stakeholders Virtual Community (CIVIC) needed some form of animation if it were to fulfill its role as a regional mechanism to promote and support the use of information and communication technology for development (ICT4D). CarlSnet I was funded under the ...

  20. Perception of Stakeholders to the Proposed Ban on Cow Hide ...

    African Journals Online (AJOL)

    User

    173. Perception of Stakeholders to the Proposed Ban on Cow Hide Consumption in. Ogun State, Nigeria. Http://dx.doi.org/10.4314/jae.v20i1.15. Tijani S.A. ... of manure and draught power and fulfills cultural roles in livestock farming ... which is brown in colour, is prepared by subjecting the animal hide to an amount of.

  1. Business-NGO interactions in a multi-stakeholder context

    NARCIS (Netherlands)

    Huijstee, M.M. van; Glasbergen, P.

    2010-01-01

    The main purpose of this paper is to contribute to our understanding of the conditions under which Business– nongovernmental organization (NGO) interactions lead to improvements in corporate social responsibility (CSR), by assessing the role that the stakeholder context of the firm plays in the

  2. What constitutes an effective community pharmacy?--development of a preliminary model of organizational effectiveness through concept mapping with multiple stakeholders.

    Science.gov (United States)

    Scahill, S L; Harrison, J; Carswell, P

    2010-08-01

    To develop a multi-constituent model of organizational effectiveness for community pharmacy. Using Concept Systems software, a project with 14 stakeholders included a three stage process: (i) face to face brainstorming to generate statements describing what constitutes an effective community pharmacy, followed by (ii) statement reduction and approval by participants, followed by (iii) sorting of the statements into themes with rating of each statement for importance. Primary care in a government-funded, national health care system. A multi-constituent group representing policy-makers and health care providers including; community pharmacy, professional pharmacy organizations, primary health care funders and policy-makers, general practitioners and general practice support organizations. Statement clusters included: 'has safe and effective workflows', 'contributes to the safe use of medicines', 'manages human resources and has leadership', 'has a community focus', 'is integrated within primary care', 'is a respected innovator', 'provides health promotion and preventative care', 'communicates and advocates'. These clusters fit into a quadrant model setting stakeholder focus against role development. The poles of stakeholder focus are 'internal capacity' and 'social utility'. The poles of role development are labelled 'traditional safety roles' and 'integration and innovation'. Organizational effectiveness in community pharmacy includes the internal and external focus of the organization and role development. Our preliminary model describes an effective community pharmacy and provides a platform for investigation of the factors that may influence the organizational effectiveness of individual community pharmacies now and into the future.

  3. A systematic review of the role of proprietary and patent medicine vendors in healthcare provision in Nigeria.

    Directory of Open Access Journals (Sweden)

    Naomi Beyeler

    Full Text Available Interventions to reduce the burden of disease and mortality in sub-Saharan Africa increasingly recognize the important role that drug retailers play in delivering basic healthcare services. In Nigeria, owner-operated drug retail outlets, known as patent and proprietary medicine vendors (PPMVs, are a main source of medicines for acute conditions, but their practices are not well understood. Greater understanding of the role of PPMVs and the quality of care they provide is needed in order to inform ongoing national health initiatives that aim to incorporate PPMVs as a delivery mechanism.This paper reviews and synthesizes the existing published and grey literature on the characteristics, knowledge and practices of PPMVs in Nigeria. We searched published and grey literature using a number of electronic databases, supplemented with website searches of relevant international agencies. We included all studies providing outcome data on PPMVs in Nigeria, including non-experimental studies, and assessed the rigor of each study using the WHO-Johns Hopkins Rigor scale. We used narrative synthesis to evaluate the findings.We identified 50 articles for inclusion. These studies provided data on a wide range of PPMV outcomes: training; health knowledge; health practices, including drug stocking and dispensing, client interaction, and referral; compliance with regulatory guidelines; and the effects of interventions targeting PPMVs. In general, PPMVs have low health knowledge and poor health treatment practices. However, the literature focuses largely on services for adult malaria, and little is known about other health areas or services for children.This review highlights several concerns with the quality of the private drug retail sector in Nigeria, as well as gaps in the existing evidence base. Future research should adopt a more holistic view of the services provided by PPMV shops, and evaluate intervention strategies that may improve the services provided in

  4. The Evolving Role of Open Source Software in Medicine and Health Services

    Directory of Open Access Journals (Sweden)

    Sevket Seref Arikan

    2013-01-01

    Full Text Available The past five decades have witnessed immense coevolution of methods and tools of information technology, and their practical and experimental application within the medical and healthcare domain. Healthcare itself continues to evolve in response to change in healthcare needs, progress in the scientific foundations of treatments, and in professional and managerial organization of affordable and effective services, in which patients and their families and carers increasingly participate. Taken together, these trends impose highly complex underlying challenges for the design, development, and sustainability of the quality of supporting information services and software infrastructure that are needed. The challenges are multidisciplinary and multiprofessional in scope, and they require deeper study and learning to inform policy and promote public awareness of the problems health services have faced in this area for many years. The repeating pattern of failure to live up to expectations of policy-driven national health IT initiatives has proved very costly and remains frustrating and unproductive for all involved. In this article, we highlight the barriers to progress and discuss the dangers of pursuing a standardization framework devoid of empirical testing and iterative development. We give the example of the openEHR Foundation, which was established at University College London (UCL in London, England, with members in 80 countries. The Foundation is a not-for-profit company providing open specifications and working for generic standards for electronic records, informed directly by a wide range of implementation experience. We also introduce the Opereffa open source framework, which was developed at UCL based on these specifications and which has been downloaded in some 70 countries. We argue that such an approach is now essential to support good discipline, innovation, and governance at the heart of medicine and health services, in line with the

  5. A feasibility study exploring the role of Chinese herbal medicine in the treatment of endometriosis.

    Science.gov (United States)

    Flower, Andrew; Lewith, George T; Little, Paul

    2011-08-01

    Endometriosis is a common and disabling gynecologic condition affecting between 5% and 15% of women of childbearing age. Conventional medical intervention has unpleasant side-effects, and symptoms frequently return after treatment. Preliminary evidence suggests Chinese herbal medicine (CHM) may contribute to the treatment of endometriosis. The aims of this study were to test the feasibility of a novel methodology for investigating individualized decoctions of CHM rigorously and to gather preliminary data on the treatment effect of CHM for a larger definitive trial. This was a 16-week prospective, double blinded, randomized controlled trial of 40 women with laparoscopically confirmed endometriosis. The trial was conducted at a private CHM clinic in Hove (U.K.) and at a National Health Service outpatient clinic in London (U.K.). Participants were initially randomized to either wait-list control (WLC) or treatment groups to receive either individualized CHM decoctions or a therapeutically inert placebo decoction. Four 10-cm visual analogue scales (VAS) were used to measure menstrual pain, daily pain, and pain on intercourse and bowel movement; these measurements were recorded weekly. The Endometriosis Health Profile-30 (EHP-30) endometriosis-specific quality-of-life questionnaire was completed at the beginning and at the end of the trial. The Measure Yourself Medical Outcomes Profile (MYMOP) a patient-centered health questionnaire was completed monthly. Liver and renal function was measured at 0, 4, 8, and 16 weeks. Twenty-eight (28) women completed the trial. High dropout rates led to the suspension of the WLC. Randomization, double blinding, and allocation concealment was achieved successfully. Adjusted mean differences favored the active treatment in the EHP-30 and MYMOP scores. VAS scores favored the active treatment for relief of menstrual pain and the placebo group for reduction of daily pain. the methodology successfully allowed individualized CHM decoctions to

  6. Regulation of advanced therapy medicinal products in Europe and the role of academia.

    Science.gov (United States)

    Pearce, Kim F; Hildebrandt, Martin; Greinix, Hildegard; Scheding, Stefan; Koehl, Ulrike; Worel, Nina; Apperley, Jane; Edinger, Matthius; Hauser, Andrea; Mischak-Weissinger, Eva; Dickinson, Anne M; Lowdell, Mark W

    2014-03-01

    Advanced therapy medicinal products (ATMP) are gene therapy, somatic cell therapy or tissue-engineered products regulated under (EC) No. 1394/2007 to ensure their free movement within the European Union while guaranteeing the highest level of health protection for patients. Academic good manufacturing practice (GMP) centers are major contributors in the development of ATMPs and this study assessed the impact of regulations on them. European academic and non-industrial facilities (n = 747) were contacted, and a representative sample of 50 replied to a detailed questionnaire. Experienced centres were further selected in every Member State (MS) for semi-structured interviews. Indicators of ATMP production and development success were statistically assessed, and opinions about directive implementation were documented. Facilities experienced in manufacturing cell therapy transplant products are the most successful in developing ATMPs. New centres lacking this background struggle to enter the field, and there remains a shortage of facilities in academia participating in translational research. This is compounded by heterogeneous implementation of the regulations across MS. GMP facilities successfully developing ATMPs are present in all MS. However, the implementation of regulations is heterogeneous between MS, with substantial differences in the definition of ATMPs and in the approved manufacturing environment. The cost of GMP compliance is underestimated by research funding bodies. This is detrimental to development of new ATMPs and commercialization of any that are successful in early clinical trials. Academic GMP practitioners should strengthen their political visibility and contribute to the development of functional and effective European Union legislation in this field. Copyright © 2014 International Society for Cellular Therapy. All rights reserved.

  7. The role of complementary and alternative medicine (CAM in Germany – A focus group study of GPs

    Directory of Open Access Journals (Sweden)

    Rosemann Thomas

    2008-06-01

    Full Text Available Abstract Background There has been a marked increase in the use of complementary and alternative medicine (CAM in recent years worldwide. In Germany, apart from 'Heilpraktiker' (= state-licensed, non-medical CAM practitioners, some general practitioners (GPs provide CAM in their practices. This paper aims to explore the attitudes of GPs about the role of CAM in Germany, in relation to the healthcare system, quality of care, medical education and research. Furthermore, experiences of GPs integrating CAM in their daily practice were explored. Methods Using a qualitative methodological approach 3 focus groups with a convenience sample of 17 GPs were conducted. The discussions were transcribed verbatim and analysed using qualitative content analysis. Results The majority of the participating GPs had integrated one or more CAM therapies into their every-day practice. Four key themes were identified based on the topics covered in the focus groups: the role of CAM within the German healthcare system, quality of care, education and research. Within the theme 'role of CAM within the healthcare system' there were five categories: integration of CAM, CAM in the Statutory Health Insurance, modernisation of the Statutory Health Insurance Act, individual healthcare services and 'Heilpraktiker'. Regarding quality of care there were two broad groups of GPs: those who thought patients would benefit from standardizing CAM and those who feared that quality control would interfere with the individual approach of CAM. The main issues identified relating to research and education were the need for the development of alternative research strategies and the low quality of existing CAM education respectively. Conclusion The majority of the participating GPs considered CAM as a reasonable complementary approach within primary care. The study increased our understanding of GPs attitudes about the role of CAM within the German healthcare system and the use of

  8. Stakeholders, responsabilidad social en ecuador Stakeholders, social responsibility in ecuador

    Directory of Open Access Journals (Sweden)

    Christian Morán

    2016-11-01

    Full Text Available La importancia de la responsabilidad social empresarial (RSE radica en el involucramiento y el compromiso de la empresa hacia los diferentes grupos de interés que interactúan. Algunos grupos son afectados a causa de las actividades operacionales de las organizaciones, generando impactos en dimensiones sociales, económicas y ambientales. El enfoque central de la investigación es la determinación de la incidencia de la RSE en los patrones de vida de los grupos que intervienen en la cadena de valor ecuatoriana. En adelante estos son llamados stakeholders. Se precisa como antesala, los hechos y precedentes que marcaron la evolución y participación del modelo de negocio en los diferentes países de Latinoamérica. Sobre esta base, se realiza una revisión conceptual de la responsabilidad social en las empresas, la ISO 26000 y la posición de los stakeholders. El estudio se fundamenta en un análisis comparativo de países como: Chile, Colombia y Ecuador; identificando similitudes de su entorno, particularidades, fortalezas y debilidades en materia de RSE.

  9. Self reported involvement in emergency medicine among GPs in Norway.

    Science.gov (United States)

    Hjortdahl, Magnus; Zakariassen, Erik; Halvorsen, Peder A

    2018-04-10

    To examine general practitioners' (GPs') perception of their role in emergency medicine and participation in emergency services including ambulance call outs, and the characteristics of the GPs and casualty clinics associated with the GPs' involvement in emergency medicine. Cross-sectional online survey. General practice. General practitioners in Norway (n = 1002). Proportion of GPs perceiving that they have a large role in emergency medicine, regularly being on call, and the proportion of ambulance callouts with GP participation. Forty six percent of the GPs indicated that they play a large role in emergency medicine, 63 percent of the GPs were regularly on call, and 28 percent responded that they usually took part in ambulance call outs. Multivariable logistic regression analyses indicated that these outcomes were strongly associated with participation in multidisciplinary training. Furthermore, the main outcomes were associated with traits commonly seen at smaller casualty clinics such as those with an absence of nursing personnel and extra physicians, and based on the distance to the hospital. Our findings suggest that GPs play an important role in emergency medicine. Multidisciplinary team training may be important for their continued involvement in prehospital emergencies. Key Points   Health authorities and other stakeholders have raised concerns about general practitioner's (GPs) participation in emergency medicine, but few have studied opinions and perceptions among the GPs themselves.   • Norwegian GPs report playing a large role in emergency medicine, regularly being on call, and taking part in selected ambulance call outs.   • A higher proportion of GPs who took part in team training perceived themselves as playing a large role in emergency medicine, regularly being on call, and taking part in ambulance call outs.   • These outcomes were also associated with attributes commonly seen at smaller casualty clinics.

  10. [Role of nuclear medicine in the diagnosis and treatment of macroscopic metastases].

    Science.gov (United States)

    Chatal, L F

    1997-01-01

    The efficacy of internal radiotherapy of metastases of differentiated thyroid carcinoma is optimal when the lesions are small or microscopic in size, but decreases rapidly when the metastatic mass exceeds several grams. In this last situation the role of internal radiotherapy should be discussed relative to surgery (when possible) and external radiotherapy. When metastases do not take up iodine-131 (about a third of cases) and are not visualized by conventional imaging techniques, several radiopharmaceutical agents with relative tumor specificity can facilitate their visualization and guide surgical strategy. None of the radiopharmaceutical agents currently under evaluation have demonstrated a clear superiority for this purpose.

  11. The municipality as a stakeholder

    International Nuclear Information System (INIS)

    Palmqvist, Roland

    2006-01-01

    The author explains how local politicians look upon the dialogue regarding nuclear installations in their municipalities. As seen from the map of European reactors there is a lot of local districts affected by nuclear operations. What has a mayor from such a community to say about the shut-down phase of such operations and especially about the need for communication between stakeholders when closing and decommissioning a nuclear power reactor? To answer this question the author has structured his presentation into 4 parts as follows: 1. The European municipalities ? some characteristics; 2. The siting of NPPs (nuclear power plants) in Europe; 3. The shutdown, decommissioning and the dismantling phases; 4. Lessons learnt

  12. National stakeholder workshop summary report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-06-01

    This is a summary of the plenary sessions and small group discussion sessions from the fourth National Stakeholder Workshop sponsored by the DOE Office of Worker and Community Transition held in Atlanta, Georgia on March 13--15, 1996. Topics of the sessions included work force planning and restructuring, worker participation in health and safety, review of actions and commitments, lessons learned in collective bargaining agreements, work force restructuring guidance, work force planning, update on community transition activities. Also included are appendices listing the participants and DOE contacts.

  13. Early detection of ovarian cancer in FB&H - role of family medicine team

    Directory of Open Access Journals (Sweden)

    Dž. Ljuca

    2007-08-01

    Full Text Available Assessment of problems with ovarian malignancy in the Federation B&H requires a comprehensive and precise analysis of the population characteristics with particular focus on risk factors such as age, parity, hereditary factors, menstrual cycle characteristics (short cycle, early menarche, late menopause. A retrospective study of medical documentation involving 272 patients with ovarian cancer within the Federation of BiH in the period from 1996 to 2000 was conducted. Usual statistical methods were used (T- test, 2 -Test, Fisher exact test. The research showed that the disease was in most cases diagnosed too late, in the stages III and IV (60% whereas histology of the tissue showed epithelial cancer in 88,6% cases, most frequently between the age of 55 to 70. Out of 272 patients null-parity was recorded in 16,9 %, whereas 19,8 % of patients had just one pregnancy. Menstrual cycle duration shorter than 21 days was recorded in 26,5% cases. Approximately 1,8% patients had close relatives that suffered of cancer of breast, ovary or colon. Prerequisites for application of algorhithms in diagnostic procedures would be met by identification of risk groups consisting of those with one or more risk factors in their history. Bearing in mind the role of the family doctors in the future health system reform, it can be concluded that they could have an important role in the process.

  14. Stakeholder involvement in CSR strategy-making?

    DEFF Research Database (Denmark)

    Trapp, Leila

    2014-01-01

    listening to others in the strategy-making process rather than directly involving others in decision-making. Also, because non-stakeholders, such as paid-for consultants, are found to be note-worthy influencers in the CSR strategy-making process, it is concluded that the process is not only a stakeholder......A given characteristic of successful corporate social responsibility (CSR) programs is that they reflect stakeholder expectations and preferences for corporate behavior. This study examines the process by which this alignment is sought by CSR managers in the CSR strategy-making process. Through...... reliance on stakeholder management theories, and with a particular focus on how and why managers communicate with stakeholders, the extent to which the company-stakeholder alignment process in CSR strategy-making reflects modern, enlightened approaches to stakeholder relations is assessed. This assessment...

  15. Lessons learnt from stakeholder engagement in the UK Environment Agency

    International Nuclear Information System (INIS)

    Chandler, Steve

    2004-01-01

    The Environment Agency has many reasons and occasions for engaging with stakeholders and does so very frequently. Many of these are relatively formal, often statutory, consultations which are part of the determination of regulatory permits. Other consultations are part of the Agency's role as developer, for example in the construction of flood defence schemes. The Agency also consults nationally on its significant policies, such as the stocking of salmon fisheries. This paper gives some examples of lessons learnt from the Agency's own stakeholder engagements and also from our participation in those led by other organizations. In the next section it also describes the Agency's current approach to stakeholder consultation and engagement. (author)

  16. Stakeholders involvement by HTA Organisations: why is so different?

    Science.gov (United States)

    Cavazza, Marianna; Jommi, Claudio

    2012-05-01

    To investigate stakeholder involvement by Health Technology Assessment Organisations (HTAOs) in France, Spain, England and Wales, Germany, Sweden, and The Netherlands and to examine whether this involvement depends on (i) the administrative tradition and the relevant conception of the relationship between state and society (contractarian and corporative vs. organic), (ii) the general structure of the healthcare system (HCS) (Bismarckian vs. Beveridgian system), and (iii) the role of Health Technology Assessment (HTA) and HTAOs in the HCS. Given the exploratory nature of the study, we considered interviews based on semi-structured questionnaires the most appropriate data-gathering technique. The interviews were administered to 16 key personnel in the HTAOs concerned. We have also carried out a literature review on HTAOs and stakeholders (1999-2011) using PubMed, Ebsco, JSTOR and Wiley Science. In contractarian and (to a lesser extent) Bismarckian models, stakeholders are more involved. The administrative tradition and the HCS appear less important when the HTA is binding and used for regulatory purposes. In such situations, stakeholders are more intensively involved because their participation provides an opportunity for HTAOs to achieve consensus and legitimacy in advance. Despite the limitations of the research (we did not conduct multiple interviews for each HTAO, and key informants were not always available) and its exploratory nature, we can conclude that models of stakeholders involvement cannot easily be transferred from one country to another due to the importance of national administrative traditions and the characteristics of HCSs. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  17. Multi-Stakeholder Process Strengthens Agricultural Innovations and Sustainable Livelihoods of Farmers in Southern Nigeria

    Science.gov (United States)

    Bisseleua, D. H. B.; Idrissou, L.; Olurotimi, P.; Ogunniyi, A.; Mignouna, D.; Bamire, S. A.

    2018-01-01

    Purpose: In this paper, we explore the strategic role of Multi-stakeholder processes (MSP) in agricultural innovations and how it has impacted livelihood assets' (LAs) capital dynamics of stakeholders in platforms in West Africa. Design/Methodology/Approach: We demonstrate how LA capitals and socio-economic dynamics induced by MSP can enhance…

  18. Scenarios of Quality Assurance of Stakeholder Relationships in Finnish Higher Education Institutions

    Science.gov (United States)

    Lyytinen, Anu; Kohtamäki, Vuokko; Kivistö, Jussi; Pekkola, Elias; Hölttä, Seppo

    2017-01-01

    Although the role and significance of the external stakeholders of higher education institutions has grown in recent years, quality assurance of stakeholder relationships remains a new phenomenon in the management practices of higher education institutions and in higher education research. Based on interviews and expert panel data, this article…

  19. Identifying Key Stakeholders in Blended Tertiary Environments: Experts' Perspectives

    Science.gov (United States)

    Tuapawa, Kimberley

    2017-01-01

    Although key stakeholders in blended tertiary environments (BTEs) fulfil an extraordinary role in higher education, significant gaps in knowledge about their identities may be impeding the provision of stakeholder support, limiting their ability to promote effective learning and teaching. As online growth intensifies, it is critical that tertiary…

  20. Role of sport medicine professionals in addressing psychosocial aspects of sport-injury rehabilitation: professional athletes' views.

    Science.gov (United States)

    Arvinen-Barrow, Monna; Massey, William V; Hemmings, Brian

    2014-01-01

    Research from the sport medicine professional's (SMP's) perspective indicates that SMPs are often required to address psychosocial aspects of injuries during treatment. However, only a few authors have investigated injured athletes' experiences with these concerns. To explore injured professional athletes' views on the role of SMPs in the psychosocial aspects of sport-injury rehabilitation. Design : Qualitative study. Professional association football and rugby union clubs. Ten professional, male football (n = 4; 40%) and rugby union (n = 6; 60%) players (age = 22.4 ± 3.4 years). Data Collection and Analysis : We collected data using a semistructured interview guide, and the data were then transcribed and analyzed following the interpretative phenomenological analysis guidelines. We peer reviewed and triangulated the established emergent themes to establish trustworthiness. Athletes in our study viewed injuries as "part and parcel" of their sports. Despite normalizing sport injuries, athletes reported frequent feelings of frustration and self-doubt throughout the rehabilitation process. However, athletes' perceived the role of SMPs in injury rehabilitation as addressing physical concerns; any intervention aimed at psychosocial outcomes (eg, motivation, confidence) needed to be subtle and indirect. The SMPs working with injured athletes need to understand the psychosocial principles that underpin athletes' sport-injury processes and the effect psychosocial reactions can have on athletes. Moreover, SMPs must understand the self-regulatory processes that may take place throughout injury rehabilitation and be able to apply psychological principles in natural and subtle ways to aid athletes' self-regulatory abilities.

  1. Willingness to Consult a Veterinarian on Physician’s Advice for Zoonotic Diseases: A Formal Role for Veterinarians in Medicine?

    Science.gov (United States)

    Speare, Rick; Mendez, Diana; Judd, Jenni; Reid, Simon; Tzipori, Saul; Massey, Peter D

    2015-01-01

    Physicians appear to find zoonotic diseases a challenge and consider that this topic belongs more to the veterinary profession. However, veterinarians have no formal role in clinical medicine. Data were collected as part of the Queensland Social Survey 2014 to determine the willingness of the public, if diagnosed with a zoonotic disease, to consult a veterinarian on the advice of a physician. Self-reported willingness to consult with a veterinarian at the respondent’s own expense was 79.8% (95% CI: 81.96%-77.46%) (976/1223). If the cost was funded by Medicare, the Australian public health insurance scheme, 90.7% (95% CI: 92.18%-88.92%) (1109/1223) would be willing to consult a veterinarian. Therefore, a large majority of Australian residents would be willing to consult with a veterinarian on the advice of their physician if they had a zoonotic disease. Does this indicate a possible new role for veterinarians under Clinical One Health? PMID:26237399

  2. Willingness to Consult a Veterinarian on Physician's Advice for Zoonotic Diseases: A Formal Role for Veterinarians in Medicine?

    Directory of Open Access Journals (Sweden)

    Rick Speare

    Full Text Available Physicians appear to find zoonotic diseases a challenge and consider that this topic belongs more to the veterinary profession. However, veterinarians have no formal role in clinical medicine. Data were collected as part of the Queensland Social Survey 2014 to determine the willingness of the public, if diagnosed with a zoonotic disease, to consult a veterinarian on the advice of a physician. Self-reported willingness to consult with a veterinarian at the respondent's own expense was 79.8% (95% CI: 81.96%-77.46% (976/1223. If the cost was funded by Medicare, the Australian public health insurance scheme, 90.7% (95% CI: 92.18%-88.92% (1109/1223 would be willing to consult a veterinarian. Therefore, a large majority of Australian residents would be willing to consult with a veterinarian on the advice of their physician if they had a zoonotic disease. Does this indicate a possible new role for veterinarians under Clinical One Health?

  3. Developing a stakeholder engagement strategy

    International Nuclear Information System (INIS)

    Nixon, J.A.

    2004-01-01

    Shell Canada's social performance plan was outlined in this presentation. Stakeholder engagement is a key strategy in the company's response to the concerns and broader priorities of different groups and individuals affected by their operations. A review of the business and societal values of stakeholder engagement was presented. Key benefits include greater profitability; protection of the environment; effective resource management; community benefits; and the delivery of value to customers. It was suggested that a continuous engagement process helps companies to assess impacts and work on strategies to avoid and mitigate negative impacts. A framework for social performance management was presented. It was noted that accountability and transparency are key components of Shell's progress towards sustainable development, and their direct and indirect contributions to the communities and societies where they operate. The social impact of core business operations is now a focus of the company. Key concerns of the social performance plan include environmental and health impacts; land use and changes in local economies; cultural concerns; and infrastructure impacts. An outline of Shell's Listening and Responding Program was also provided. refs., tabs., figs

  4. The role of the internal medicine specialist in the management of infective complications in general surgical wards

    Directory of Open Access Journals (Sweden)

    Patrizia Zoboli

    2013-05-01

    Full Text Available BACKGROUND Internal medicine specialists are often asked to evaluate a patient before surgery. Perioperative risk evaluation for elderly patients is important, because complications increase with age. The increasing age of the general population increases the probabilities of surgery in the older patients. The manifestation of a surgical problem, is more likely to be severe and complicated in the elderly patients. In fact, emergency surgery treatment occurs more frequently in the elderly (e.g., it is much more common to see intestinal obstruction complicating colorectal cancer in the elderly compared with a younger population. Old age is an independent factor for long hospital stay after surgery. The role of the preoperative medical consultant is to identify and evaluate a patient’s current medical status and provide a clinical risk profile, in order to decide whether further tests are indicated prior to surgery, and to optimise the patient’s medical condition in the attempt of reducing the risk of complications. The medical consultant must know which medical condition could eventually influence the surgery, achieve a good contact and communication between the medical and surgical team, in order to obtain the best management planning. AIM OF THE STUDY This paper focuses on the rational use of antibiotic prophylaxis and on the treatment of the complications of post-surgery infections (e.g., pulmonary complication, peritonitis, intra-abdominal infection. Specific aspects of pre-operative risk evaluation and peri and post-operative management are discussed. CONCLUSIONS The internal medicin specialist in collaboration with the surgical team is necessary in the peri and post-surgery management.

  5. The Role of Endophytic Microorganisms of Medicinal Plants in the Adaptation of Host Plant

    Directory of Open Access Journals (Sweden)

    Zhivetev M.A.

    2015-09-01

    Full Text Available Cultures of microorganisms were isolated from endosphere of Lake Baikal littoral zone plants: Veronica chamaedrys L., Alchemilla subscrenata Buser, Achillea asiatica Serg., Taraxacum officinale Wigg., Plantago major L. Morphology and biochemical properties of isolated bacteria were studied. For the majority of the endophytic bacterial cultures cellulolitic and proteolytic activity has been shown, which necessary for the effective colonization of plant tissue. For many cultures revealed ability in varying degrees to form a biofilm to improve survival in a vegetative organism. Their potencial role in adaptation of plant-hosts under conditions of climat Baikal region was shown. In particular, 9 of cultures demonstrated ability to act as nitrogen retainer. The vast majority of bacterial cultures did not have phytotoxicity or demonstrated its low level, reflecting and minimum negative effects of them on plant. Moreover, culture with encryption P3, isolated from Plantago major in August, showed a stimulatory effect in experiments on phytotoxicity. This same culture possessed the highest ability to secrete sugars as at +26°С and at +4°С.

  6. The roles of non-coding RNAs in cardiac regenerative medicine

    Directory of Open Access Journals (Sweden)

    Oi Kuan Choong

    2017-06-01

    Full Text Available The emergence of non-coding RNAs (ncRNAs has challenged the central dogma of molecular biology that dictates that the decryption of genetic information starts from transcription of DNA to RNA, with subsequent translation into a protein. Large numbers of ncRNAs with biological significance have now been identified, suggesting that ncRNAs are important in their own right and their roles extend far beyond what was originally envisaged. ncRNAs do not only regulate gene expression, but are also involved in chromatin architecture and structural conformation. Several studies have pointed out that ncRNAs participate in heart disease; however, the functions of ncRNAs still remain unclear. ncRNAs are involved in cellular fate, differentiation, proliferation and tissue regeneration, hinting at their potential therapeutic applications. Here, we review the current understanding of both the biological functions and molecular mechanisms of ncRNAs in heart disease and describe some of the ncRNAs that have potential heart regeneration effects. Keywords: Non-coding RNAs, Cardiac regeneration, Cardiac fate, Proliferation, Differentiation, Reprograming

  7. Role of gold and silver nanoparticles in cancer nano-medicine.

    Science.gov (United States)

    Chugh, Heerak; Sood, Damini; Chandra, Ishita; Tomar, Vartika; Dhawan, Gagan; Chandra, Ramesh

    2018-03-13

    Development of nanoparticles (NPs) as a part of cancer therapeutics has given rise to a new field of research - cancer nanomedicine. In comparison to traditional anti-cancer drugs, NPs provide a targeted approach which prevents undesirable effects. In this communication, we have reviewed the role of gold and silver NPs (AgNPs) in the cancer nanomedicine. The preparation of gold NPs (AuNPs) and AgNPs can be grouped into three categories - physical, chemical and biological. Among the three approaches, the biological approach is growing and receiving more attention due to its safe and effective production. In this review, we have discussed important methods for synthesis of gold and AgNPs followed by techniques employed in characterization of their physicochemical properties, such as UV-visible spectroscopy, electron microscopy (TEM and SEM) and size and surface analysis (DLS). The mechanism of formation of these NPs in an aqueous medium through various stages - reduction, nucleation and growth has also been reviewed briefly. Finally, we conclude our review with the application of these NPs as anti-cancer agents and numerous mechanisms by which they render cancer cell toxicity.

  8. Insights into the key roles of proteoglycans in breast cancer biology and translational medicine.

    Science.gov (United States)

    Theocharis, Achilleas D; Skandalis, Spyros S; Neill, Thomas; Multhaupt, Hinke A B; Hubo, Mario; Frey, Helena; Gopal, Sandeep; Gomes, Angélica; Afratis, Nikos; Lim, Hooi Ching; Couchman, John R; Filmus, Jorge; Sanderson, Ralph D; Schaefer, Liliana; Iozzo, Renato V; Karamanos, Nikos K

    2015-04-01

    Proteoglycans control numerous normal and pathological processes, among which are morphogenesis, tissue repair, inflammation, vascularization and cancer metastasis. During tumor development and growth, proteoglycan expression is markedly modified in the tumor microenvironment. Altered expression of proteoglycans on tumor and stromal cell membranes affects cancer cell signaling, growth and survival, cell adhesion, migration and angiogenesis. Despite the high complexity and heterogeneity of breast cancer, the rapid evolution in our knowledge that proteoglycans are among the key players in the breast tumor microenvironment suggests their potential as pharmacological targets in this type of cancer. It has been recently suggested that pharmacological treatment may target proteoglycan metabolism, their utilization as targets for immunotherapy or their direct use as therapeutic agents. The diversity inherent in the proteoglycans that will be presented herein provides the potential for multiple layers of regulation of breast tumor behavior. This review summarizes recent developments concerning the biology of selected proteoglycans in breast cancer, and presents potential targeted therapeutic approaches based on their novel key roles in breast cancer. Copyright © 2015 Elsevier B.V. All rights reserved.

  9. Role of ABC transporters in veterinary medicine: pharmaco-toxicological implications.

    Science.gov (United States)

    Virkel, Guillermo; Ballent, Mariana; Lanusse, Carlos; Lifschitz, Adrian

    2018-01-31

    Unlike physicians, veterinary practitioners must deal with a number of animal species with crucial differences in anatomy, physiology and metabolism. Accordingly, the pharmacokinetic behaviour, the clinical efficacy and the adverse or toxic effects of drugs may differ across domestic animals. Moreover, the use of drugs in food-producing species may impose a risk for humans due to the generation of chemical residues in edible products, a major concern for public health and consumer's safety. As is clearly known in human beings, the ATP binding cassette (ABC) of transport proteins may influence the bioavailability and elimination of numerous drugs and other xenobiotics in domestic animals as well. A number of drugs, currently available in the veterinary market, are substrates of one or more transporters. Therefore, significant drug-drug interactions among ABC substrates may have unpredictable pharmaco-toxicological consequences in different species of veterinary interest. In this context, different investigations revealed the major relevance of P-gp and other transport proteins, like breast cancer resistance protein (BCRP) and multidrug resistance-associated proteins (MRPs), in both companion and livestock animals. Undoubtedly, the discovery of the ABC transporters and the deep understanding of their physiological role in the different species introduced a new paradigm into the veterinary pharmacology. This review focus on the expression and function of the major transport proteins expressed in species of veterinary interest, and their impact in drug disposition, efficacy and toxicity. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  10. Eight essential foods in Iranian traditional medicine and their role in health promotion and well-being

    Directory of Open Access Journals (Sweden)

    Mehrdad Zeinalian

    2017-01-01

    Full Text Available Eight essential foods (EEF described in Iranian traditional medicine (ITM have a determinant role to balance human temperament insuring health and well-being. EEF included oral, imaginary, auditory, visual, olfactory, touch, sexual, and familiarity food. Oral foods should be halal, compatible with individual temper, consumed up twice a day, and compatible with different seasons and geographic conditions. Imaginary food consists of the individual thought content which is directly related to mental and physical fitness. It helps to balance temperament if be free of negative thoughts such as suspicion and distrust to others. Auditory food includes all sounds surrounding us, some of which are sedative and help to balance temperaments, such as natural sounds, and spiritual and beautiful words. Visual food includes everything in the range of human vision which is impressive on his/her thought. Natural beautiful scenes have almost a warm temper and help to balance human temperament. Olfactory food includes odors which stimulate the smell. Touch food includes all materials in direct contact with body skin, like clothes, which have a determinant role in temper moderation in the case of being natural. Sexual food complies with the human need to express his/her love and/or is loved, so its fulfillment could prevent human mal-temperament. Familiarity food can be provided by companion with friends and family members and has a significant role to insure well-being. Given the comprehensiveness of EEF in ITM which covers all human health-related aspects, we can insure health and well-being among our population by promoting and public educating of these principles.

  11. Eight Essential Foods in Iranian Traditional Medicine and their Role in Health Promotion and Well-being.

    Science.gov (United States)

    Zeinalian, Mehrdad; Eshaghi, Mehdi; Hadian, Mahdi; Naji, Homayoun; Marandi, Sayed Mohammad Masoud; Asgary, Sedigheh

    2017-01-01

    Eight essential foods (EEF) described in Iranian traditional medicine (ITM) have a determinant role to balance human temperament insuring health and well-being. EEF included oral, imaginary, auditory, visual, olfactory, touch, sexual, and familiarity food. Oral foods should be halal, compatible with individual temper, consumed up twice a day, and compatible with different seasons and geographic conditions. Imaginary food consists of the individual thought content which is directly related to mental and physical fitness. It helps to balance temperament if be free of negative thoughts such as suspicion and distrust to others. Auditory food includes all sounds surrounding us, some of which are sedative and help to balance temperaments, such as natural sounds, and spiritual and beautiful words. Visual food includes everything in the range of human vision which is impressive on his/her thought. Natural beautiful scenes have almost a warm temper and help to balance human temperament. Olfactory food includes odors which stimulate the smell. Touch food includes all materials in direct contact with body skin, like clothes, which have a determinant role in temper moderation in the case of being natural. Sexual food complies with the human need to express his/her love and/or is loved, so its fulfillment could prevent human mal-temperament. Familiarity food can be provided by companion with friends and family members and has a significant role to insure well-being. Given the comprehensiveness of EEF in ITM which covers all human health-related aspects, we can insure health and well-being among our population by promoting and public educating of these principles.

  12. Effective stakeholder management for medical practitioners

    Directory of Open Access Journals (Sweden)

    E Zigiriadis

    2014-01-01

    Full Text Available The importance of organizational-stakeholder relationships is highlighted in most organizational studies literature. This article investigates the relationship between medical practices and their stakeholders and has been developed to provide guidance on stakeholder engagement and communication. It is intended to provide a useful reference point for all medical practices concerning stakeholder engagement activities. Direction is provided on how to identify and ultimately engage with stakeholders. It should hopefully further develop the effectiveness of engagement efforts that are undertaken between a medical practice and its stakeholders. The ability of a medical practice to cultivate and sustain strong relationships with its prominent stakeholder groups greatly enhances the likelihood that the relationship will endure. Medical practitioners in South Africa are generally in urgent need of pursuing new ways of delivering quality health care through developing new service models that have been developed with the help of relevant stakeholders. Since stakeholder relationship management is critical for corporate sustainability, medical practice management should seek strategic direction by investigating the relative competitive threat and relative supportive value of each stakeholder and then classify them accordingly.

  13. Development and testing of a community stakeholder park audit tool.

    Science.gov (United States)

    Kaczynski, Andrew T; Stanis, Sonja A Wilhelm; Besenyi, Gina M

    2012-03-01

    Parks are valuable community resources, and auditing park environments is important for understanding their influence on physical activity and health. However, few tools exist that engage citizens in this process. The purpose of this study was to develop a user-friendly tool that would enable diverse stakeholders to quickly and reliably audit community parks for their potential to promote physical activity. A secondary aim was to examine community stakeholders' reactions to the process of developing and using the new tool. The study employed a sequential, multiphase process including three workshops and field testing to ensure the new instrument was the product of input and feedback from a variety of potential stakeholders and was psychometrically sound. All study stages, including data collection and analysis, occurred in 2010. Stakeholder recommendations were combined with reviews of existing instruments to create the new Community Park Audit Tool (CPAT). The CPAT contains four sections titled Park Information, Access and Surrounding Neighborhood, Park Activity Areas, and Park Quality and Safety. Inter-rater analyses demonstrated strong reliability for the vast majority of the items in the tool. Further, stakeholders reported a range of positive reactions resulting from their engagement in the project. The CPAT provides a reliable and user-friendly means of auditing parks for their potential to promote physical activity. Future use of the CPAT can facilitate greater engagement of diverse groups in evaluating and advocating for improved parks and overall healthy community design. Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  14. Simulating stakeholder behavior in a marine setting: Integrated coastal zone planning and the influential power of selected stakeholders in Frøya, Norway

    Directory of Open Access Journals (Sweden)

    Rachel Gjelsvik Tiller

    2015-11-01

    Full Text Available Aquaculture expansion is a political priority in Norway, despite simmering conflicts and competing claims. We expand on this hypothesis and analyze the Norwegian governance system by adding stakeholder theory in case of a simulated model of the effects of municipal coastal zone planning in the municipality of Frøya, Norway. One cannot analyze the governance system in Norway without fully comprehending the perspectives of the stakeholders involved. Different stakeholders will react and respond differently and have conflicting presumptions basing their actions towards the planning process for coastal areas. They will also have different levels of power and abilities to influence the system. The article presents the interdisciplinary, first generation development of an agent based simulation model that mimics the outcomes of coastal zone planning for a stakeholder groups, the commercial fishers and the aquaculture industry, based on qualitative input from legislation, regulations and stakeholder workshops. We proceed with verifying the applicability of this simulator in light of the key actors involved, namely the commercial fishers. We found that the simulator had two outcomes for the commercial fishers that were consistently recurring, namely collapse and stability, based on the simulated occurrences of complaints by the stakeholders, with the latter being the de facto perceptions of actuality by the commercial fishers. Using stakeholder theory, we argue that the aquaculture industry’s role has the saliency of an Important Stakeholder in Frøya has steered the commercial fishers, who has the role of Dependent Stakeholders according to stakeholder theory, to no longer see any legitimacy in the process in that their complaints were never upheld because of their lack of the attribute Power.

  15. Defining the Stakeholder Concept for Political Marketing

    DEFF Research Database (Denmark)

    Ormrod, Robert

    The concept of a ‘stakeholder’ is often misused in the academic literature; stakeholders can range from the few actors with which the organisation has a direct interaction (Carroll 1993), to anything that can exert some form of influence over the organisation, including nature, the deceased...... and the unborn (Starik 1995). It is therefore necessary to provide a precise definition of the stakeholder concept to maintain academic rigour. However, a specification of the nature of the stakeholder concept is generally missing in political marketing literature. This paper addresses this issue by discussing...... how the stakeholder concept is understood, and then applies the stakeholder concept to the political marketing context, proposing a definition of the stakeholder concept for political marketing research....

  16. Stakeholders in the Political Marketing Context

    DEFF Research Database (Denmark)

    Ormrod, Robert

    /strategic and broad/narrow dimensions. Building on the assumption that ‘political marketing is different’, the paper argues that stakeholders can be considered as direct or indirect depending on which of the three interaction marketplaces of the political exchange triad the political actor-stakeholder interaction......Stakeholders influence the ability of organisations to achieve their aims, but little work has been carried out into understanding the stakeholder concept as applied to the political marketing context. This paper first discusses the contextual nature of stakeholders using normative...... occurs in. Finally, it is proposed that in the political marketing context, the stakeholder concept can be defined as ‘context-specific actors that directly or indirectly influence or are influenced by the political actor’....

  17. Stakeholder confidence and radioactive waste disposal

    International Nuclear Information System (INIS)

    2000-01-01

    Any significant decisions regarding geologic disposal of radioactive waste will need a comprehensive public review and a thorough involvement of all relevant stakeholders, such as waste generators, waste management agencies, regulatory authorities, local communities and elected officials. The participation of non-technical stakeholders will become increasingly important as more countries move towards siting and implementing geologic repositories. The decision-making process and avenues for stakeholder involvement differ from country to country. It is important to identify similarities and differences, understand the key concerns of the various stakeholders, and develop means to interact effectively. The Nuclear Energy Agency recently set up a Forum on Stakeholder Confidence charged with distilling the lessons that can be learnt from national and international experience. These proceedings of the Forums first workshop held in August 2000 provide an overview of OECD countries' experience in the field of stakeholder confidence and radioactive waste disposal. (author)

  18. Defining the Stakeholder Concept for Political Marketing

    DEFF Research Database (Denmark)

    Ormrod, Robert

    The concept of a ‘stakeholder’ is often misused in the academic literature; stakeholders can range from the few actors with which the organisation has a direct interaction (Carroll 1993), to anything that can exert some form of influence over the organisation, including nature, the deceased and t...... how the stakeholder concept is understood, and then applies the stakeholder concept to the political marketing context, proposing a definition of the stakeholder concept for political marketing research....... and the unborn (Starik 1995). It is therefore necessary to provide a precise definition of the stakeholder concept to maintain academic rigour. However, a specification of the nature of the stakeholder concept is generally missing in political marketing literature. This paper addresses this issue by discussing...

  19. Determinants of stakeholders' attitudes towards biodiesel.

    Science.gov (United States)

    Amin, Latifah; Hashim, Hasrizul; Mahadi, Zurina; Ibrahim, Maznah; Ismail, Khaidzir

    2017-01-01

    Concern about the inevitable depletion of global energy resources is rising and many countries are shifting their focus to renewable energy. Biodiesel is one promising energy source that has garnered much public attention in recent years. Many believe that this alternative source of energy will be able to sustain the need for increased energy security while at the same time being friendly to the environment. Public opinion, as well as proactive measures by key players in industry, may play a decisive role in steering the direction of biodiesel development throughout the world. Past studies have suggested that public acceptance of biofuels could be shaped by critical consideration of the risk-benefit perceptions of the product, in addition to the impact on the economy and environment. The purpose of this study was to identify the relevant factors influencing stakeholders' attitudes towards biodiesel derived from crops such as palm oil for vehicle use, as well as to analyse the interrelationships of these factors in an attitude model. A survey of 509 respondents, consisting of various stakeholder groups in the Klang Valley region of Malaysia, was undertaken. The results of the study have substantiated the premise that the most important direct predictor of attitude to biodiesel is the perceived benefits ( β  = 0.80, p  < 0.001). Attitude towards biodiesel also involves the interplay between other factors, such as engagement to biotechnology, trust of key players, attitude to technology, and perceived risk. Although perceived benefit has emerged as the main predictor of public support of biodiesel, the existence of other significant interactions among variables leads to the conclusion that public attitude towards biodiesel should be seen as a multi-faceted process and should be strongly considered prior to its commercialisation.

  20. Stakeholder management from the business perspective

    OpenAIRE

    Krstić Nataša

    2014-01-01

    In an increasingly global and highly competitive business world of today, the business sector pays meticulous attention to stakeholders - groups or individuals, which affect or are affected by business decisions. The paper examines the methodology of identifying key stakeholders, demonstrates the process of their various mapping models, as well as the manner in which stakeholders, in cooperation with a corporation, create the opportunity to be engaged at an early stage of a project, activity ...

  1. THE ROLE OF THE N.V. SKLIFOSOVSKY RESEARCH INSTITUTE FOR EMERGENCY MEDICINE IN THE CREATION OF DISASTER MEDICINE IN THE COUNTRY

    Directory of Open Access Journals (Sweden)

    M. S. Khubutiya

    2016-01-01

    Full Text Available The occurrence  of large-scale emergencies with great  human  losses  and the  absence of a unified authority  of the country health  system which would manage  its medical and sanitary consequences required  the  creation  of special  units to provide emergency  health  services (EHS in mass injuries. The disaster  medicine  became  attractive for the N.V. Sklifosovsky Research  Institute  for Emergency Medicine in the 70s of the last century. Originally, the Department for Disaster Medicine was established at the  Institute  in 1987. At the  Department, the  extensive  work was performed  to shorten  a time gap between the delivery of medical care and the beginning  of a disaster  as much as possible. It was based  on a created  concept  for organization of medical  assistance and evacuation,  methods of its expertise and the  development of technical  means  for phased  medical  and evacuatiol  support of victims. The organizational and medical-diagnostic specificity of EHS in emergencies and its delivery were analyzed  in order to reduce  the severity of consequences. The health  care experience in emergencies has been  enriched  by the staff of the Institute  (who were not employees  of the Department  actively involved in the management of mass injuries and poisonings via air ambulance at the accident site and in the treatment of victims admitted to the Institute  from sites of emergencies. Consequently, the N.V. Sklifosovsky Research Institute  for Emergency Medicine developed and offered the  scientific and organizational basis  for EHS in emergencies which made  a significant  practical contribution to the creation  of public services for disaster  medicine in the country.

  2. The role of evidence in the decision-making process of selecting essential medicines in developing countries: the case of Tanzania.

    Science.gov (United States)

    Mori, Amani Thomas; Kaale, Eliangiringa Amos; Ngalesoni, Frida; Norheim, Ole Frithjof; Robberstad, Bjarne

    2014-01-01

    Insufficient access to essential medicines is a major health challenge in developing countries. Despite the importance of Standard Treatment Guidelines and National Essential Medicine Lists in facilitating access to medicines, little is known about how they are updated. This study aims to describe the process of updating the Standard Treatment Guidelines and National Essential Medicine List in Tanzania and further examines the criteria and the underlying evidence used in decision-making. This is a qualitative study in which data were collected by in-depth interviews and document reviews. Interviews were conducted with 18 key informants who were involved in updating the Standard Treatment Guidelines and National Essential Medicine List. We used a thematic content approach to analyse the data. The Standard Treatment Guidelines and National Essential Medicine List was updated by committees of experts who were recruited mostly from referral hospitals and the Ministry of Health and Social Welfare. Efficacy, safety, availability and affordability were the most frequently utilised criteria in decision-making, although these were largely based on experience rather than evidence. In addition, recommendations from international guidelines and medicine promotions also influenced decision-making. Cost-effectiveness, despite being an important criterion for formulary decisions, was not utilised. Recent decisions about the selection of essential medicines in Tanzania were made by committees of experts who largely used experience and discretionary judgement, leaving evidence with only a limited role in decision-making process. There may be several reasons for the current limited use of evidence in decision-making, but one hypothesis that remains to be explored is whether training experts in evidence-based decision-making would lead to a better and more explicit use of evidence.

  3. The economic role of the Emergency Department in the health care continuum: applying Michael Porter's five forces model to Emergency Medicine.

    Science.gov (United States)

    Pines, Jesse M

    2006-05-01

    Emergency Medicine plays a vital role in the health care continuum in the United States. Michael Porters' five forces model of industry analysis provides an insight into the economics of emergency care by showing how the forces of supplier power, buyer power, threat of substitution, barriers to entry, and internal rivalry affect Emergency Medicine. Illustrating these relationships provides a view into the complexities of the emergency care industry and offers opportunities for Emergency Departments, groups of physicians, and the individual emergency physician to maximize the relationship with other market players.

  4. Stakeholder engagement in dredged material management decisions.

    Science.gov (United States)

    Collier, Zachary A; Bates, Matthew E; Wood, Matthew D; Linkov, Igor

    2014-10-15

    Dredging and disposal issues often become controversial with local stakeholders because of their competing interests. These interests tend to manifest themselves in stakeholders holding onto entrenched positions, and deadlock can result without a methodology to move the stakeholder group past the status quo. However, these situations can be represented as multi-stakeholder, multi-criteria decision problems. In this paper, we describe a case study in which multi-criteria decision analysis was implemented in a multi-stakeholder setting in order to generate recommendations on dredged material placement for Long Island Sound's Dredged Material Management Plan. A working-group of representatives from various stakeholder organizations was formed and consulted to help prioritize sediment placement sites for each dredging center in the region by collaboratively building a multi-criteria decision model. The resulting model framed the problem as several alternatives, criteria, sub-criteria, and metrics relevant to stakeholder interests in the Long Island Sound region. An elicitation of values, represented as criteria weights, was then conducted. Results show that in general, stakeholders tended to agree that all criteria were at least somewhat important, and on average there was strong agreement on the order of preferences among the diverse groups of stakeholders. By developing the decision model iteratively with stakeholders as a group and soliciting their preferences, the process sought to increase stakeholder involvement at the front-end of the prioritization process and lead to increased knowledge and consensus regarding the importance of site-specific criteria. Published by Elsevier B.V.

  5. Engaging stakeholders on complex, and potentially contested, science

    International Nuclear Information System (INIS)

    Holmes, John; Atherton, Elizabeth; Tweed, Cherry

    2014-01-01

    is built at an interpersonal level between those involved in the process. - Honest brokers: Can play an important role, mediating between the people and organisations involved, and interpreting the science and its significance for decisions. - Stakeholders as 'scientists': Involving stakeholders in the generation and interpretation of scientific knowledge promotes ownership and helps ensure that it is socially robust. - Communicating about uncertainty: Establishing uncertainty as an inherent feature of science, and discussing uncertainties in a way which is helpful to stakeholders while remaining true to the science. - Protected spaces: Creating spaces in which productive dialogue can take place between scientists and stakeholders, where issues and questions can be explored in a process of honest enquiry. For RWMD the scientific uncertainties inherent in evaluating the performance of a geological disposal facility into the far future present a challenge of engaging productively with stakeholders on the science. The stakeholders who are fundamentally opposed to disposal will focus on remaining uncertainties as just cause for their position. Whatever the process of stakeholder engagement on science that is eventually developed, it will be important to build in evaluation and learning, together with the flexibility to adjust the process as experience is gained. Its development should also keep one eye on the planning and legal framework to ensure that synergies, rather than pitfalls, are built in. (authors)

  6. Management of sustainable tourism destination through stakeholder cooperation

    Directory of Open Access Journals (Sweden)

    Božena Krce Miočić

    2016-12-01

    Full Text Available Destination presents a set of different organizations and individuals who can work towards realising the same objectives or their objectives can be diametrically opposed. Harmonisation of such objectives in a unique strategic development of the entire destination is usually taken over by destination management organization (DMO established to accomplish the mentioned objective. The opposed interests in such a system as complex as tourism result in the degradation of space and society in which tourism takes place. Therefore sustainable development in tourism represents a primary concept of development today. Tourism is a fast growing phenomenon and its sustainable development represents a necessity. Besides the positive economic outputs of tourism, we should also mention its negative impact on the particular destination, the environmental degradation to some extent, as well as socio-economic elements of local community. Accordingly, multi-stakeholder concept in destination management should include all interest and influential groups in tourism development planning. Such integrated destination management connects all stakeholders independent from influence or interest powers to participate directly or indirectly in creating and implementing the quality tourism development. This concept’s basic function is connecting and coordinating stakeholders with different interests within a tourism destination, in order to create quality product and a recognizable destination image, and to achieve a long-term sustainable competitiveness on the market. However, based on the stakeholder approach, the most emphasized issue in sustainable tourism development concept is the government that holds a key role in socio-economic development. In this paper, we analysed current involvement of stakeholders in Zadar County tourism development and examined their interest in future involvement in sustainable destination development. Based on the analysis of focus group

  7. Evaluating stakeholder management performance using a stakeholder report card: the next step in theory and practice.

    Science.gov (United States)

    Malvey, Donna; Fottler, Myron D; Slovensky, Donna J

    2002-01-01

    In the highly competitive health care environment, the survival of an organization may depend on how well powerful stakeholders are managed. Yet, the existing strategic stakeholder management process does not include evaluation of stakeholder management performance. To address this critical gap, this paper proposes a systematic method for evaluation using a stakeholder report card. An example of a physician report card based on this methodology is presented.

  8. The role of global traditional and complementary systems of medicine in the treatment of mental health disorders.

    Science.gov (United States)

    Gureje, Oye; Nortje, Gareth; Makanjuola, Victor; Oladeji, Bibilola D; Seedat, Soraya; Jenkins, Rachel

    2015-02-01

    Traditional and complementary systems of medicine include a broad range of practices, which are commonly embedded in cultural milieus and reflect community beliefs, experiences, religion, and spirituality. Two major components of this system are discernible: complementary alternative medicine and traditional medicine, with different clientele and correlates of patronage. Evidence from around the world suggests that a traditional or complementary system of medicine is commonly used by a large number of people with mental illness. Practitioners of traditional medicine in low-income and middle-income countries fill a major gap in mental health service delivery. Although some overlap exists in the diagnostic approaches of traditional and complementary systems of medicine and conventional biomedicine, some major differences exist, largely in the understanding of the nature and cause of mental disorders. Treatments used by providers of traditional and complementary systems of medicine, especially traditional and faith healers in low-income and middle-income countries, might sometimes fail to meet widespread understandings of human rights and humane care. Nevertheless, collaborative engagement between traditional and complementary systems of medicine and conventional biomedicine might be possible in the care of people with mental illness. The best model to bring about that collaboration will need to be established by the needs of the extant mental health system in a country. Research is needed to provide an empirical basis for the feasibility of such collaboration, to clearly delineate its boundaries, and to test its effectiveness in bringing about improved patient outcomes. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Stakeholder views of superfund sites

    International Nuclear Information System (INIS)

    English, M.R.

    1992-01-01

    Nearly ten years have passed since the enactment of the federal Comprehensive Response, Compensation, and Liability Act (CERCLA), usually referred to as open-quotes Superfundclose quotes. Nearly four years have passed since CERCLA's major overhaul through the Superfund Amendments and Reauthorization Act (SARA). Although much still remains to be done under Superfund, there is now enough experience to assess how effectively it is working. A study being undertaken by the University of Tennessee's Waste Management Research and Education Institute will supply a portion of that assessment. The study was completed in the fall of 1990. Our study examines two related issues: the resources that will be needed in the coming years to fulfill the mandate of Superfund and other hazardous waste remediation programs, and the site-level experience to date in implementing CERCLA and SARA. This chapter discusses only the open-quotes site-level experienceclose quotes effort, and only its methodological approach. The purpose of the open-quotes site-level experienceclose quotes effort is to explore what counts as a open-quotes successfulclose quotes site in the eyes of different stakeholders in a Superfund cleanup - e.g., the affected community, the potentially responsible parties (PRPs), state and local officials, and the US Environmental Protection Agency (EPA)

  10. The menace of tuberculosis and the role of nuclear medicine in tackling it. Now its time to tighten the loose strings.

    Science.gov (United States)

    Gupta, Vijay

    2009-01-01

    Tuberculosis is a global medical problem. The radioisotopes have played an important role in the diagnosis and treatment of many problems including various cancers. In the early period after the discovery of radioactivity, isotopes or radionuclides like radium were used for the treatment of tuberculosis (TB) but they failed completely. Later, nuclear medicine has developed techniques for sensitive and rapid detection of TB. Many of the currently applied molecular biology techniques of nuclear medicine find applications in diagnostic research of TB. Still, the detection of lesions of unknown origin, the differentiation of active from inactive TB lesions and also the response to treatment, especially in cases of drug resistant TB are the main fields that need better approaches for identification by nuclear medicine techniques.

  11. How Do Stakeholders Matter in Product Innovation?

    NARCIS (Netherlands)

    Driessen, P.H.; Hillebrand, B.

    2015-01-01

    This study investigates how stakeholder orientation affects product innovation and takes the incorporation of green (ecological) issues as a specific context to study this question. The authors borrow insights from three streams of literature: (1) insights from stakeholder theory, combined with (2)

  12. Organising stakeholder workshops in research and innovation

    DEFF Research Database (Denmark)

    Nielsen, Morten Velsing; Bryndum, Nina; Bedsted, Bjørn

    2017-01-01

    , the article illustrates the challenges of applying theory to five European stakeholder workshops co-organised by the authors. The illustration highlights the difficult interaction between theory and practice. The article concludes that while theoretical perspectives can provide general guidance, practical...... experience is essential when dealing with the trade-offs that are an intrinsic part of organising stakeholder workshops....

  13. Improving Urban Freight Governance and Stakeholder Management

    DEFF Research Database (Denmark)

    Gammelgaard, Britta; Bech Godskesen Andersen, Christina; Figueroa, Maria J.

    2017-01-01

    Urban freight transport is a complex field characterised by many actors and stakeholders and thus many rationalities are at stake. This paper contributes to literature on urban freight governance by approaching the field with social system theory combined with the concepts of relationship platforms...... of value creation among stakeholders through this process is key to implementation of new urban freight solutions....

  14. Accountability in Community Colleges Using Stakeholder Theory

    Science.gov (United States)

    Pitcher, Paula R.

    2012-01-01

    The purpose of the present study is to analyze stakeholder theory and its applicability to community college accountability. Community colleges have been using strategic planning as a management approach that includes the process of strategic action, and many organizations claim that they collaborate with their stakeholders during this process.…

  15. DG CONNECT’s stakeholder engagement strategy

    NARCIS (Netherlands)

    Verheyden, M.; Glidden, J.; Shahin, J.

    2013-01-01

    How do we ensure that public policy represents the interests of all, rather than a select few? How will we ensure it draws upon the best insights and talents of key stakeholders? The European Commission’s DG CONNECT recently announced the results of its Stakeholder Engagement Survey, which is

  16. STAKEHOLDER PERCEPTION OF CORPORATE SOCIAL RESPONSIBILITY

    OpenAIRE

    Petra F.A. Dilling

    2011-01-01

    As corporate social responsibility receives increased attention by company stakeholders, researchers are also increasingly exploring corporate social responsibility, its causes and implications. However little is known about the perception of corporate social responsibility. This study explores the link between stakeholder perception of corporate social responsibility and its relationship with underlying factors. The findings suggest that age of the corporation, community involvement, and cul...

  17. Stakeholders' perceptions about recreational events within Marine ...

    African Journals Online (AJOL)

    ... to achievelong-term conservation of marine resources. The promulgation of laws regarding MPAs in South Africa has triggered various responses from stakeholders affected by their declaration. This study focused on perceptions of stakeholders from recreational activity providers such as fishing and scuba diving within ...

  18. Perceptions of European stakeholders of pulse fishing

    NARCIS (Netherlands)

    Kraan, M.L.; Trapman, B.K.; Rasenberg, M.M.M.

    2015-01-01

    This research project examines the concerns and questions of European stakeholders about pulse fishing, in order to assess to what extent the knowledge agenda on pulse fishing covers these issues. To get a first impression of the concerns about pulse fishing, and to get an idea of the stakeholders

  19. Stakeholders' Perceptions of School Counselling in Singapore

    Science.gov (United States)

    Low, Poi Kee

    2015-01-01

    This article reports on a qualitative study that set out to understand stakeholders' perception of the school counselling service in Singapore. Using semi-structured interviews, this study explored the perceptions of three main stakeholder groups, namely teachers and counsellors working within the schools and those working in the communities.…

  20. An Online Discursive Inquiry into the Social Dynamics of Multi-stakeholder Brand Meaning Co-creation

    DEFF Research Database (Denmark)

    Vallaster, Christine; von Wallpach, Sylvia

    2013-01-01

    Brand research increasingly recognizes the active role of multiple stakeholders in co-creating brand meaning and the importance of new social media supporting stakeholders in their co-creation efforts. However, empirical insights into the social process of online multi-stakeholder brand meaning co......-creation are so far missing. This study contributes to existing research by illuminating the social dynamics that characterize multi-stakeholder brand meaning co-creation in a virtual environment. The authors undertake an online discursive inquiry focusing on stakeholders’ textual interactions regarding the UK...... Gate Gourmet brand crisis. The empirical study aggregates online stakeholder texts to illustrate (a) relationships between salient stakeholders and (b) discursive strategies and resources stakeholders apply to co-create brand meaning. The article concludes that brand meaning results from simultaneous...

  1. Stakeholder Risk Management in Ethical Decision Making

    DEFF Research Database (Denmark)

    Lauesen, Linne Marie

    Stakeholder management has for the last three decades been concerned either with strategic business management or business ethics, values and quality. Many models have been developed, but recently the literature asks for more dynamic models instead of the staticism that characterizes some models....... This paper offers an ‘Organic Stakeholder Model’ based on decision making theory, risk assessment and adaption to a rapidly changing world combined with appropriate stakeholder theory for ethical purposes in decision making processes in businesses. The ‘Organic Stakeholder Model’ is based on empirical...... evidence from hybrid organizations as Publicly Owned Enterprises (POEs) mixed of private corporations and political administration. The model offers a new way of combining risk management with ethical decisionmaking processes by the inclusion of multiple stakeholders. Not only does the model apply...

  2. Transformational Leadership and Stakeholder Management in Library Change

    OpenAIRE

    Dolores Sucozhañay; Lorena Siguenza-Guzman; Cristian Zhimnay; Dirk Cattrysse; Guido Wyseure; Karel De Witte; Martin Euwema

    2014-01-01

    This article aims to analyse the role of library managers as change agent when implementing Library 2.0, using transformational leadership and stakeholder management approaches. To do so, a case study in a Latin American academic library was performed. The experiences acquired for a period of six years were analysed, during which three library managers were involved in managing change. Qualitative data from documents, interviews, and observations were collected, and qualitative analysis metho...

  3. Corporate Reputation Management: Reaching Out to Financial Stakeholders

    OpenAIRE

    Wang, Yijing

    2013-01-01

    textabstractCorporate reputation is important for firms’ long-term performance and competitive advantages. This dissertation sets out to understand the relationship between corporate reputation and a company’s attractiveness to financial stakeholders from different angles. Specifically, I examine the role of corporate reputation in the context of the agency problem to explain the causal chain through which the uncertainties and risks are mitigated for investors. This dissertation contributes ...

  4. Essential Medicines in a High Income Country: Essential to Whom?

    Science.gov (United States)

    Duong, Mai; Moles, Rebekah J; Chaar, Betty; Chen, Timothy F

    2015-01-01

    To explore the perspectives of a diverse group of stakeholders engaged in medicines decision making around what constitutes an "essential" medicine, and how the Essential Medicines List (EML) concept functions in a high income country context. In-depth qualitative semi-structured interviews were conducted with 32 Australian stakeholders, recognised as decision makers, leaders or advisors in the area of medicines reimbursement or supply chain management. Participants were recruited from government, pharmaceutical industry, pharmaceutical wholesale/distribution companies, medicines non-profit organisations, academic health disciplines, hospitals, and consumer groups. Perspectives on the definition and application of the EML concept in a high income country context were thematically analysed using grounded theory approach. Stakeholders found it challenging to describe the EML concept in the Australian context because many perceived it was generally used in resource scarce settings. Stakeholders were unable to distinguish whether nationally reimbursed medicines were essential medicines in Australia. Despite frequent generic drug shortages and high prices paid by consumers, many struggled to describe how the EML concept applied to Australia. Instead, broad inclusion of consumer needs, such as rare and high cost medicines, and consumer involvement in the decision making process, has led to expansive lists of nationally subsidised medicines. Therefore, improved communication and coordination is needed around shared interests between stakeholders regarding how medicines are prioritised and guaranteed in the supply chain. This study showed that decision-making in Australia around reimbursement of medicines has strayed from the fundamental utilitarian concept of essential medicines. Many stakeholders involved in medicine reimbursement decisions and management of the supply chain did not consider the EML concept in their approach. The wide range of views of what stakeholders

  5. Essential Medicines in a High Income Country: Essential to Whom?

    Directory of Open Access Journals (Sweden)

    Mai Duong

    Full Text Available To explore the perspectives of a diverse group of stakeholders engaged in medicines decision making around what constitutes an "essential" medicine, and how the Essential Medicines List (EML concept functions in a high income country context.In-depth qualitative semi-structured interviews were conducted with 32 Australian stakeholders, recognised as decision makers, leaders or advisors in the area of medicines reimbursement or supply chain management. Participants were recruited from government, pharmaceutical industry, pharmaceutical wholesale/distribution companies, medicines non-profit organisations, academic health disciplines, hospitals, and consumer groups. Perspectives on the definition and application of the EML concept in a high income country context were thematically analysed using grounded theory approach.Stakeholders found it challenging to describe the EML concept in the Australian context because many perceived it was generally used in resource scarce settings. Stakeholders were unable to distinguish whether nationally reimbursed medicines were essential medicines in Australia. Despite frequent generic drug shortages and high prices paid by consumers, many struggled to describe how the EML concept applied to Australia. Instead, broad inclusion of consumer needs, such as rare and high cost medicines, and consumer involvement in the decision making process, has led to expansive lists of nationally subsidised medicines. Therefore, improved communication and coordination is needed around shared interests between stakeholders regarding how medicines are prioritised and guaranteed in the supply chain.This study showed that decision-making in Australia around reimbursement of medicines has strayed from the fundamental utilitarian concept of essential medicines. Many stakeholders involved in medicine reimbursement decisions and management of the supply chain did not consider the EML concept in their approach. The wide range of views of

  6. Sex-Divergent Clinical Outcomes and Precision Medicine: An Important New Role for Institutional Review Boards and Research Ethics Committees.

    Science.gov (United States)

    Segarra, Ignacio; Modamio, Pilar; Fernández, Cecilia; Mariño, Eduardo L

    2017-01-01

    The efforts toward individualized medicine have constantly increased in an attempt to improve treatment options. These efforts have led to the development of small molecules which target specific molecular pathways involved in cancer progression. We have reviewed preclinical studies of sunitinib that incorporate sex as a covariate to explore possible sex-based differences in pharmacokinetics and drug-drug interactions (DDI) to attempt a relationship with published clinical outputs. We observed that covariate sex is lacking in most clinical outcome reports and suggest a series of ethic-based proposals to improve research activities and identify relevant different sex outcomes. We propose a deeper integration of preclinical, clinical, and translational research addressing statistical and clinical significance jointly; to embed specific sex-divergent endpoints to evaluate possible gender differences objectively during all stages of research; to pay greater attention to sex-divergent outcomes in polypharmacy scenarios, DDI and bioequivalence studies; the clear reporting of preclinical and clinical findings regarding sex-divergent outcomes; as well as to encourage the active role of scientists and the pharmaceutical industry to foster a new scientific culture through their research programs, practice, and participation in editorial boards and Institutional Ethics Review Boards (IRBs) and Research Ethics Committees (RECs). We establish the IRB/REC as the centerpiece for the implementation of these proposals. We suggest the expansion of its competence to follow up clinical trials to ensure that sex differences are addressed and recognized; to engage in data monitoring committees to improve clinical research cooperation and ethically address those potential clinical outcome differences between male and female patients to analyze their social and clinical implications in research and healthcare policies.

  7. The role of librarians in teaching evidence-based medicine to pediatric residents: a survey of pediatric residency program directors.

    Science.gov (United States)

    Boykan, Rachel; Jacobson, Robert M

    2017-10-01

    The research sought to identify the general use of medical librarians in pediatric residency training, to define the role of medical librarians in teaching evidence-based medicine (EBM) to pediatric residents, and to describe strategies and curricula for teaching EBM used in pediatric residency training programs. We sent a 13-question web-based survey through the Association of Pediatric Program Directors to 200 pediatric residency program directors between August and December 2015. A total of 91 (46%) pediatric residency program directors responded. Most (76%) programs had formal EBM curricula, and more than 75% of curricula addressed question formation, searching, assessment of validity, generalizability, quantitative importance, statistical significance, and applicability. The venues for teaching EBM that program directors perceived to be most effective included journal clubs (84%), conferences (44%), and morning report (36%). While 80% of programs utilized medical librarians, most of these librarians assisted with scholarly or research projects (74%), addressed clinical questions (62%), and taught on any topic not necessarily EBM (58%). Only 17% of program directors stated that librarians were involved in teaching EBM on a regular basis. The use of a librarian was not associated with having an EBM curriculum but was significantly associated with the size of the program. Smaller programs were more likely to utilize librarians (100%) than were medium (71%) or large programs (75%). While most pediatric residency programs have an EBM curriculum and engage medical librarians in various ways, librarians' expertise in teaching EBM is underutilized. Programs should work to better integrate librarians' expertise, both in the didactic and clinical teaching of EBM.

  8. Nuclear Medicine

    Science.gov (United States)

    ... Parents/Teachers Resource Links for Students Glossary Nuclear Medicine What is nuclear medicine? What are radioactive tracers? ... funded researchers advancing nuclear medicine? What is nuclear medicine? Nuclear medicine is a medical specialty that uses ...

  9. US spending on complementary and alternative medicine during 2002-08 plateaued, suggesting role in reformed health system.

    Science.gov (United States)

    Davis, Matthew A; Martin, Brook I; Coulter, Ian D; Weeks, William B

    2013-01-01

    Complementary and alternative medicine services in the United States are an approximately $9 billion market each year, equal to 3 percent of national ambulatory health care expenditures. Unlike conventional allopathic health care, complementary and alternative medicine is primarily paid for out of pocket, although some services are covered by most health insurance. Examining trends in demand for complementary and alternative medicine services in the United States reported in the Medical Expenditure Panel Survey during 2002-08, we found that use of and spending on these services, previously on the rise, have largely plateaued. The higher proportion of out-of-pocket responsibility for payment for services may explain the lack of growth. Our findings suggest that any attempt to reduce national health care spending by eliminating coverage for complementary and alternative medicine would have little impact at best. Should some forms of complementary and alternative medicine-for example, chiropractic care for back pain-be proven more efficient than allopathic and specialty medicine, the inclusion of complementary and alternative medicine providers in new delivery systems such as accountable care organizations could help slow growth in national health care spending.

  10. Comparison research on stakeholders analysis of disposition of medical dispute between China and abroad

    Directory of Open Access Journals (Sweden)

    Qin Chen

    2015-01-01

    Full Text Available Objective: We learn about the methods, process, effects of each stakeholder and the principles of the disposition of medical dispute home and abroad through stakeholder analysis. Methods: We investigate the methods, process and the principles of the disposition of medical dispute home and abroad by literature retrieval, key informant interview and depth interview. Results: The stakeholders of medical disputes mainly include patients and families, medical staff and hospitals, pharmaceutical companies, governments, laws, non-government organizations and media. They play different roles in medical disputes and have different effects. Over all, patients and families, medical staff and hospitals have the greatest effect and then laws, media, government, non-government organizations and pharmaceutical companies. Conclusion: Different stakeholders affect the disposition of medical disputes differently. It is crucial to establish harmonious relationship between patients and doctors and to build harmonious society by untangling the responsibility between all the stakeholders and dispose medical disputes quickly and effectively.

  11. Workplace violence in emergency medicine

    Directory of Open Access Journals (Sweden)

    A. Chatterjee*

    2013-12-01

    Conclusion: Violence against ED health care workers is a real problem with significant implications to the victims, patients, and departments/institutions. ED WPV needs to be addressed urgently by stakeholders through continued research on effective interventions specific to Emergency Medicine. Coordination, cooperation, and active commitment to the development of such interventions are critical.

  12. PERAN STAKEHOLDER PADA ASPEK KONSERVASI DALAM PENGELOLAAN TAMAN NASIONAL LAUT KEPULAUAN SERIBU (TNKpS

    Directory of Open Access Journals (Sweden)

    Eka Dana Prabowo

    2016-01-01

    Full Text Available The TNKpS area was marine consist of 110 small land with 108 land outside management authority of TNKpS and five of which are settlement land which occupied by 14,061 people. Beside the area condition, management complexities were actualization of protection, preservation, and utilization of natural resources in TNKpS. To overcome the management complexities, collaboration with other stkakeholders were needed so that the goals of management could be achieved. The purpose of this research is to identify the main role of stakeholder in conservation aspects. Research was done on the all of TNKpS’ SPTN at the islands where the stakeholder standby, using a closed-ended questionnaire method to 77 indicator in 11 criteria, and analyzed as descriptive. Stakeholders consist of government institutions, private sectors, NGOs, and the communities organization. Positive roles were the dominant to conservation activities. The stakeholder role focused on certain indicator that appropriate with organization main function and goals along with collaboration agreement. The role that less only the management of abration and intrution, utilization, and carrying capacity has not been done by all of the stakeholders.  Keyword: collaboration, management complexities, role, stakeholders, TNKpS 

  13. Clinical imaging guidelines part 4: challenges in identifying, engaging and collaborating with stakeholders.

    Science.gov (United States)

    Bettmann, Michael A; Oikarinen, Helja; Rehani, Madan; Holmberg, Ola; del Rosario Perez, Maria; Naidoo, Anusha; Do, Kyung-Hyun; Dreyer, Keith; Ebdon-Jackson, Steve

    2015-04-01

    The effective development and use of clinical imaging guidelines requires an understanding of who the stakeholders are, what their interests in the process are, and what roles they should play. If the appropriate stakeholders are not engaged in the right roles, it is unlikely that clinical imaging guidelines will be successfully developed, relied on, and actually used. Some stakeholders are obvious: for the development of clinical imaging guidelines, both imagers and those who request examinations, such as general practitioners, internists, and medical specialists, must be involved. To gain acceptance, other relevant groups are stakeholders, including medical societies, other health care professionals, insurers, health IT experts and vendors, and patients. The role of stakeholders must be dictated by their specific interest. For some, involvement in the creation of guidelines is the right role. For others, such as regulators or insurers, reviews or invitations to comment are required, and for others, such as medical educators, it is probably sufficient to provide information and create awareness. Only through a careful consideration of who the stakeholders are and what are their interests are the successful development, acceptance, and use of clinical imaging guidelines likely to occur. Future efforts must focus on collaboration, particularly among groups that create clinical imaging guidelines and those that can support their use, and on regulatory roles and mandates. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  14. Defining program sustainability: differing views of stakeholders.

    Science.gov (United States)

    Hanson, Heather M; Salmoni, Alan W; Volpe, Richard

    2009-01-01

    Sustainability is a highly desired outcome of health promotion programs, yet it often eludes program planners looking to achieve it. This study aimed to uncover how the goal of program sustainability was interpreted by key stakeholders from three fall prevention program demonstration sites. Collected as part of a larger study on program sustainability that made use of a multiple case study methodology, semi-structured interviews were conducted with key informants involved in a wide range of program initiatives throughout the two-year funding period. Forty participants across the three sites provided definitions of sustainability. Most stakeholders reported that it was some version of the general fall prevention program that should be sustained. Fewer stakeholders reported that it was the successful elements or solutions to the program goals that should be sustained. The most common suggestions reported by stakeholders for how sustainability should be achieved were awareness raising and securing new funding sources. Although a number of key elements emerged, there were significant differences in stakeholders' definitions of sustainability, both within and between demonstration sites. This research provided insight into the unique meanings of sustainability held by different stakeholders during their involvement in a fall prevention program. The array of definitions held by stakeholders demonstrates how easily the efforts of those involved can become fragmented and, therefore, less effective in reaching the end goal of program sustainability when the project team is not working from the same definition of what that goal means.

  15. Stakeholder approach for evaluating organizational change projects.

    Science.gov (United States)

    Peltokorpi, Antti; Alho, Antti; Kujala, Jaakko; Aitamurto, Johanna; Parvinen, Petri

    2008-01-01

    This paper aims to create a model for evaluating organizational change initiatives from a stakeholder resistance viewpoint. The paper presents a model to evaluate change projects and their expected benefits. Factors affecting the challenge to implement change were defined based on stakeholder theory literature. The authors test the model's practical validity for screening change initiatives to improve operating room productivity. Change initiatives can be evaluated using six factors: the effect of the planned intervention on stakeholders' actions and position; stakeholders' capability to influence the project's implementation; motivation to participate; capability to change; change complexity; and management capability. The presented model's generalizability should be explored by filtering presented factors through a larger number of historical cases operating in different healthcare contexts. The link between stakeholders, the change challenge and the outcomes of change projects needs to be empirically tested. The proposed model can be used to prioritize change projects, manage stakeholder resistance and establish a better organizational and professional competence for managing healthcare organization change projects. New insights into existing stakeholder-related understanding of change project successes are provided.

  16. Keterlibatan Event Stakeholders pada Keberhasilan Event Pr

    Directory of Open Access Journals (Sweden)

    Lidya Wati Evelina

    2013-04-01

    Full Text Available The objective of this article is to determine how event organizers collaborate with stakeholders including the media, particular community, sponsors, participants, venue providers, accommodation providers, carteres, legal and finance personnel, production, local trade, transportation providers, government and associations for implementation Public Relations event. This paper discusses about the things that must be done for the cooperation and the benefits of cooperation undertaken. The method used in this paper is qualitative research method based on observations, literature and case studies. The results of this research note that the event organizers or companies can together with the stakeholders (the other party make an event as mutually beneficial Public Relations. This means that all parties can achieve through the event. At the conclusion of an event Public Relations, all stakeholders involved for their own purposes. Event organizer must ensure that all stakeholders work together effectively in accordance with the agreed schedule and budget. One important feature of the agreement is to maintain a good flow of communication according to the needs of its stakeholders. All information is documented to avoid misunderstandings. Collaboration between stakeholders continuously until the event is completed. Discussion of issues that arise during the event takes place between the committee with various stakeholders is an important thing for the evaluation and response to the events that occurred. 

  17. Building trust : corporations and their stakeholders

    International Nuclear Information System (INIS)

    Chin, R.I.

    1998-01-01

    The issue of corporate responsibility in terms of societal, economic and environmental matters within the petrochemical sector and the role played in this area by the Council on Economic Priorities (CEP) was discussed. CEP is a non-profit research organization whose mission is to analyse the social and environmental records of corporations in an effort to influence corporate behaviour. CEP campaigns for more communication, more social disclosure and environmentally cleaner corporations. The campaign for cleaner corporations, (C-3), began in 1992 as a public awareness campaign to list the worst environmental performers in the U.S. In the C-3 process, CEP provides recommendations to listed companies and de-lists those which have improved their environmental and social performance. The focus in 1997 was on the petrochemical industry. The overall ranking of 15 major petrochemical companies was provided, along with two case histories illustrating the C-3 process from 'listing' to 'delisting'. Measures used in determining environmental performance for a company include their environmental management policy, environmental impact, environmental reporting and communications, product stewardship and stakeholder relations

  18. Stakeholder Conference on Bee Health

    Science.gov (United States)

    USDA and EPA released a comprehensive scientific report on honey bee health in May 2013. The report points to multiple factors playing a role in honey bee colony declines, including parasites and disease, genetics, poor nutrition, and pesticide exposure.

  19. rural medicine as a sub-specialty

    African Journals Online (AJOL)

    Let me begin by differentiating rural health from rural medicine. If rural health is the big picture, including all the team players and stakeholders concerned with health in rural areas, then rural medicine is the medical slice of that action. It is the medical input to the rural health team. So, depending on the size and the capacity ...

  20. Integrating Stakeholders and Users into the Geography Discipline's Research Process

    Science.gov (United States)

    Hermans, Caroline M.; Taketa, Richard

    2006-01-01

    Future research priorities of Geography emphasize the discipline's leadership role in the U.S. Geological Survey (USGS) in multidisciplinary and integrated research on human and environmental systems and how these systems are interrelated and respond to change Geography's research priorities also emphasize providing science that is usable to society and creating decision support products applicable to given customer problems. To achieve these goals, we must understand the relationship between our research and our customer, and how to integrate the customer into the research process. This report details the elements of the research process that help achieve the degree of stakeholder involvement necessary to ensure a successful end-product. It offers suggestions that can help researchers better understand stakeholders and customers and involve them in the research process more effectively, while preserving the integrity of the science. Its aim is to help researchers understand the problems and challenges faced by our customers and communicate the ways in which Geography can help address their problems. Adopting these guidelines can improve the efficiency of the research process and lead to higher quality output. We will be able to conduct better research because we will have an improved understanding of the research problem and the stakeholders involved. This report covers a broad range of topics, from identifying and communicating with stakeholders and users, to the use of language, to how to effectively present scientific information to the user. It does not offer a 'one size fits all' method. Instead, perhaps only specific sections are suitable for a given project and customers, depending on project scope and needs. This report is based on the objectives of Geography's strategic plan, U. S. Geological Survey's strategic plan, and Department of Interior's strategic plan. Section 2 of these guidelines describes the purpose of the research process in Geography and

  1. Stakeholder participation in comparative effectiveness research: defining a framework for effective engagement.

    Science.gov (United States)

    Deverka, Patricia A; Lavallee, Danielle C; Desai, Priyanka J; Esmail, Laura C; Ramsey, Scott D; Veenstra, David L; Tunis, Sean R

    2012-03-01

    AIMS: Stakeholder engagement is fundamental to comparative effectiveness research (CER), but lacks consistent terminology. This paper aims to define stakeholder engagement and present a conceptual model for involving stakeholders in CER. MATERIALS #ENTITYSTARTX00026; METHODS: The definitions and model were developed from a literature search, expert input and experience with the Center for Comparative Effectiveness Research in Cancer Genomics, a proof-of-concept platform for stakeholder involvement in priority setting and CER study design. RESULTS: Definitions for stakeholder and stakeholder engagement reflect the target constituencies and their role in CER. The 'analytic-deliberative' conceptual model for stakeholder engagement illustrates the inputs, methods and outputs relevant to CER. The model differentiates methods at each stage of the project; depicts the relationship between components; and identifies outcome measures for evaluation of the process. CONCLUSION: While the definitions and model require testing before being broadly adopted, they are an important foundational step and will be useful for investigators, funders and stakeholder groups interested in contributing to CER.

  2. Collaborative learning framework for online stakeholder engagement.

    Science.gov (United States)

    Khodyakov, Dmitry; Savitsky, Terrance D; Dalal, Siddhartha

    2016-08-01

    Public and stakeholder engagement can improve the quality of both research and policy decision making. However, such engagement poses significant methodological challenges in terms of collecting and analysing input from large, diverse groups. To explain how online approaches can facilitate iterative stakeholder engagement, to describe how input from large and diverse stakeholder groups can be analysed and to propose a collaborative learning framework (CLF) to interpret stakeholder engagement results. We use 'A National Conversation on Reducing the Burden of Suicide in the United States' as a case study of online stakeholder engagement and employ a Bayesian data modelling approach to develop a CLF. Our data modelling results identified six distinct stakeholder clusters that varied in the degree of individual articulation and group agreement and exhibited one of the three learning styles: learning towards consensus, learning by contrast and groupthink. Learning by contrast was the most common, or dominant, learning style in this study. Study results were used to develop a CLF, which helps explore multitude of stakeholder perspectives; identifies clusters of participants with similar shifts in beliefs; offers an empirically derived indicator of engagement quality; and helps determine the dominant learning style. The ability to detect learning by contrast helps illustrate differences in stakeholder perspectives, which may help policymakers, including Patient-Centered Outcomes Research Institute, make better decisions by soliciting and incorporating input from patients, caregivers, health-care providers and researchers. Study results have important implications for soliciting and incorporating input from stakeholders with different interests and perspectives. © 2015 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

  3. US Spending On Complementary And Alternative Medicine During 2002–08 Plateaued, Suggesting Role In Reformed Health System

    Science.gov (United States)

    Davis, Matthew A.; Martin, Brook I.; Coulter, Ian D.; Weeks, William B.

    2013-01-01

    Complementary and alternative medicine services in the United States are an approximately $9 billion market each year, equal to 3 percent of national ambulatory health care expenditures. Unlike conventional allopathic health care, complementary and alternative medicine is primarily paid for out of pocket, although some services are covered by most health insurance. Examining trends in demand for complementary and alternative medicine services in the United States reported in the Medical Expenditure Panel Survey during 2002–08, we found that use of and spending on these services, previously on the rise, have largely plateaued. The higher proportion of out-of-pocket responsibility for payment for services may explain the lack of growth. Our findings suggest that any attempt to reduce national health care spending by eliminating coverage for complementary and alternative medicine would have little impact at best. Should some forms of complementary and alternative medicine—for example, chiropractic care for back pain—be proven more efficient than allopathic and specialty medicine, the inclusion of complementary and alternative medicine providers in new delivery systems such as accountable care organizations could help slow growth in national health care spending. PMID:23297270

  4. Interactions of selected policy-stakeholder groups implementing middle school science standards-based systemic reform

    Science.gov (United States)

    Boydston, Theodore Lewis, III

    1999-12-01

    how divided stakeholders are about what role attitudes and beliefs should play in professional development. The system operates within a context of administrative flux creating instability that, when combined with a chaotic work environment, undermines collegial interactions and the decision-making process. Resolving these differences will require new skills and understandings about the role that assumptions, attitudes, values, and beliefs play in our interactions to allow both decisions and actions to support the reform initiative.

  5. Does stereotype threat affect women in academic medicine?

    Science.gov (United States)

    Burgess, Diana Jill; Joseph, Anne; van Ryn, Michelle; Carnes, Molly

    2012-04-01

    Multiple complex factors contribute to the slow pace of women's advancement into leadership positions in academic medicine. In this article, the authors propose that stereotype threat--under which individuals who are members of a group characterized by negative stereotypes in a particular domain perform below their actual abilities in that domain when group membership is emphasized--may play an important role in the underrepresentation of women in leadership positions in academic medicine. Research to objectively assess the impact of stereotype threat for women in academic medicine is feasible and necessary to confirm this hypothesis. Still, a number of conditions present in the academic medicine community today have been shown to trigger stereotype threat in other settings, and stereotype threat fits with existing research on gender in academic medicine. In the meantime, academic health centers should implement relatively simple measures supported by experimental evidence from other settings to reduce the risk of stereotype threat, including (1) introducing the concept of stereotype threat to the academic medicine community, (2) engaging all stakeholders, male and female, to promote identity safety by enacting and making faculty aware of policies to monitor potential instances of discrimination, and training faculty to provide performance feedback that is free of gender bias, (3) counteracting the effects of sex segregation at academic health centers by increasing exposure to successful female leaders, (4) reducing gender stereotype priming by avoiding stereotypically male criteria for promotion, grants, and awards, and (5) building leadership efficacy among female physicians and scientists.

  6. Nuclear medicine and AIDS

    International Nuclear Information System (INIS)

    Miller, R.F.; Middlesex Hospital, London

    1990-01-01

    Nuclear medicine has a central role to play in the diagnosis of the malignant and infectious conditions. This article reviews the role of radionuclide studies in the diagnosis of HIV-related disease. (orig./MG)

  7. Stakeholder involvement in Swedish nuclear waste management

    Energy Technology Data Exchange (ETDEWEB)

    Elam, Mark; Sundqvist, Goeran [Goeteborg Univ. (Sweden). Section for Science and Technology Studies

    2006-09-15

    This report concerning Swedish nuclear waste management has been produced as part of a cross national research project: CARL - A Social Science Research Project into the Effects of Stakeholder involvement on Decision-Making in Radioactive Waste Management. Besides Sweden, the participating countries are Belgium, Canada, Finland, Slovenia and United Kingdom. A social science research team, working for three years, is in the first phase conducting research in their own countries in order to produce 6 country reports. During the next years the focus will shift to comparisons of stakeholder involvement practices in the participating countries. The report addresses current practices of Swedish nuclear waste management and their historical development. The main focus is on past, current and emerging patterns of stakeholder involvement in the siting of a deep repository for the final disposal of Sweden's spent nuclear fuel. The general questions attended to in the report are: Who are the main stakeholders, and how have they emerged and gained recognition as such? What are the issues currently subject to stakeholder involvement and how have these been decided upon? How is stakeholder involvement organized locally and nationally and how has this changed over time? How has stakeholder involvement gained acceptance as an activity of value in the siting of major waste facilities? The report have attempted to show the development of stakeholder involvement in the siting of a final repository for Sweden's spent nuclear fuel as resembling something other than a straightforward linear process of improvement and refinement. Stakeholder involvement has developed, over the past 15 years or so, into something more like a patchwork of different shapes and forms. Some of the forces that may well contribute to the further elaboration of the patchwork of stakeholder involvement have been pointed out, contingently modifying once more its overall colour and orientation. Questions

  8. Stakeholder involvement in Swedish nuclear waste management

    International Nuclear Information System (INIS)

    Elam, Mark; Sundqvist, Goeran

    2006-09-01

    This report concerning Swedish nuclear waste management has been produced as part of a cross national research project: CARL - A Social Science Research Project into the Effects of Stakeholder involvement on Decision-Making in Radioactive Waste Management. Besides Sweden, the participating countries are Belgium, Canada, Finland, Slovenia and United Kingdom. A social science research team, working for three years, is in the first phase conducting research in their own countries in order to produce 6 country reports. During the next years the focus will shift to comparisons of stakeholder involvement practices in the participating countries. The report addresses current practices of Swedish nuclear waste management and their historical development. The main focus is on past, current and emerging patterns of stakeholder involvement in the siting of a deep repository for the final disposal of Sweden's spent nuclear fuel. The general questions attended to in the report are: Who are the main stakeholders, and how have they emerged and gained recognition as such? What are the issues currently subject to stakeholder involvement and how have these been decided upon? How is stakeholder involvement organized locally and nationally and how has this changed over time? How has stakeholder involvement gained acceptance as an activity of value in the siting of major waste facilities? The report have attempted to show the development of stakeholder involvement in the siting of a final repository for Sweden's spent nuclear fuel as resembling something other than a straightforward linear process of improvement and refinement. Stakeholder involvement has developed, over the past 15 years or so, into something more like a patchwork of different shapes and forms. Some of the forces that may well contribute to the further elaboration of the patchwork of stakeholder involvement have been pointed out, contingently modifying once more its overall colour and orientation. Questions have been

  9. Partnering with stakeholders in radioactive waste management

    International Nuclear Information System (INIS)

    Pescatore, C.; Vari, A.

    2009-01-01

    Site selection for radioactive waste management (RWM) facilities draws considerable attention from implementers, government bodies, local communities and the public at large. Facility siting processes have generally tended to be marred by conflicts, disagreements and delays. In response, efforts have been made to shift from a more traditional 'decide, announce and defend' model to one of 'engage, interact and co-operate'. The essence of the new approach is co-operation or partnership between the implementer and the affected communities, involving dialogue between experts and citizens, mutual learning and public participation in the decision-making process. National ministries and authorities have also been called to and do play a more visible role. The intensity and degree of partnering can vary from country to country and in different phases of project development. Important changes have taken place in citizen participation in radioactive waste management over the past decade. These changes can be summarised as follows: - shift from information and consultation towards partnership, i.e. from token involvement to citizen influence and power; - shift from a passive to an active role of local communities: from resigned acceptance to collaboration, volunteering and veto; - development of a great variety of administrative formats for collaboration; - recognition of the need for, and legitimacy of, community empowerment measures and socio-economic benefits; - emergence of new ideals and bases for collaboration including mutual learning, adding values to the host community/region and sustainable development. Involving local actors in the design of the facility and community benefits are likely to result in solutions that will add value to the host region. In all cases, social capital is augmented as local stakeholders develop new skills and increase their knowledge about the interests and ideals of their community. Implementers and other institutional players also

  10. Engaging stakeholders in rehabilitation research: a scoping review of strategies used in partnerships and evaluation of impacts.

    Science.gov (United States)

    Camden, Chantal; Shikako-Thomas, Keiko; Nguyen, Tram; Graham, Emma; Thomas, Aliki; Sprung, Jennifer; Morris, Christopher; Russell, Dianne J

    2015-01-01

    To describe how stakeholder engagement has been undertaken and evaluated in rehabilitation research. A scoping review of the scientific literature using five search strategies. Quantitative and qualitative analyses using extracted data. Interpretation of results was iteratively discussed within the team, which included a parent stakeholder. Searches identified 101 candidate papers; 28 were read in full to assess eligibility and 19 were included in the review. People with disabilities and their families were more frequently involved compared to other stakeholders. Stakeholders were often involved in planning and evaluating service delivery. A key issue was identifying stakeholders; strategies used to support their involvement included creating committees, organizing meetings, clarifying roles and offering training. Communication, power sharing and resources influenced how stakeholders could be engaged in the research. Perceived outcomes of stakeholder engagement included the creation of partnerships, facilitating the research process and the application of the results, and empowering stakeholders. Stakeholder engagement outcomes were rarely formally evaluated. There is a great interest in rehabilitation to engage stakeholders in the research process. However, further evidence is needed to identify effective strategies for meaningful stakeholder engagement that leads to more useful research that positively impacts practice. Implications for Rehabilitation Using several strategies to engage various stakeholders throughout the research process is thought to increase the quality of the research and the rehabilitation process by developing proposals and programs responding better to their needs. Engagement strategies need to be better reported and evaluated in the literature. Engagement facilitate uptake of research findings by increasing stakeholders' awareness of the evidence, the resources available and their own ability to act upon a situation. Factors influencing

  11. A survey of the role of the UK physicist in nuclear medicine: a report of a joint working group of the British Institute of Radiology, British Nuclear Medicine Society, and the Institute of Physics and Engineering in Medicine.

    Science.gov (United States)

    Tindale, W B; Thorley, P J; Nunan, T O; Lewington, V; Shields, R A; Williams, N R

    2003-01-01

    Guidelines for the provision of physics support to nuclear medicine were published in 1999 by a joint working group of the British Institute of Radiology, the British Nuclear Medicine Society, and the Institute of Physics and Engineering in Medicine. Following publication of the guidelines, a survey was conducted by the working group to gather data on the actual level of physicist support in UK hospitals of different types and on the activities undertaken by physicists. The data were collected in the 12 months following the publication of guidelines and cover different hospital models and seven UK regions. The results provide evidence that many of the smaller units - small teaching hospitals and, particularly, small district general hospitals - have insufficient physics support. Although, on average, there is good agreement between the guidelines and the survey data for medium and large district general hospitals, there is wide variation in the level of physics provision between hospitals delivering apparently similar services. This emphasizes the need for national guidelines, against which institutions may be bench-marked and which may be used as a recommendation for the staffing levels necessary to ensure services are delivered safely and standards are not compromised. The complexity and variety of workload is an important factor in determining the level of physics support. As services develop, it is vital that this aspect is recognized to ensure that appropriate resources are available for the required physics input, even if any new service represents only a modest clinical throughput in terms of patient numbers.

  12. Key informants' perspectives on development of family medicine training programs in Ethiopia

    Directory of Open Access Journals (Sweden)

    Gossa W

    2016-04-01

    Full Text Available Weyinshet Gossa,1,2 Dawit Wondimagegn,3 Demeke Mekonnen,4 Wondwossen Eshetu,5 Zerihun Abebe,6 Michael D Fetters2 1Department of Family and Community Medicine, University of Maryland School of Medicine, Baltimore, MD, USA; 2Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA; 3Department of Psychiatry, Addis Ababa University, Addis Ababa, 4Department of Pediatrics, Jimma University, Jimma, 5Federal Ministry of Health, 6St Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia Abstract: As a very low-income country, Ethiopia faces significant development challenges, though there is great aspiration to dramatically improve health care in the country. Family medicine has recently been recognized through national policy as one potential contributor in addressing Ethiopia's health care challenges. Family medicine is a new specialty in Ethiopia emerging in the context of family medicine development in Sub-Saharan Africa. The Addis Ababa University family medicine residency program started in 2013 and is the first and the only family medicine program in the country as of March 2016. Stakeholders on the ground feel that family medicine is off to a good start and have great enthusiasm and optimism for its success. While the Ministry of Health has a vision for the development of family medicine and a plan for rapid upscaling of family medicine across the country, significant challenges remain. Continuing discussion about the potential roles of family medicine specialists in Ethiopia and policy-level strategic planning to place family medicine at the core of primary health care delivery in the country is needed. In addition, the health care-tier system needs to be restructured to include the family medicine specialists along with appropriately equipped health care facilities for training and practice. Key stakeholders are optimistic that family medicine expansion can be successful in Ethiopia through a coordinated effort by

  13. Water Governance, Stakeholder Engagement, and Sustainable Water Resources Management

    Directory of Open Access Journals (Sweden)

    Sharon B. Megdal

    2017-03-01

    Full Text Available Water governance and stakeholder engagement are receiving research attention for their role in formulating and implementing solutions to the world’s critical water challenges. The inspiration for this Special Issue came from our desire to provide a platform for sharing results and informing the global water governance community about the wealth of excellent interdisciplinary and transdisciplinary research and projects being carried out around the world. The 20 peer-reviewed papers collected in this Special Issue have been grouped into three categories: stakeholder engagement, tools for building water management and governance capacity, and perspectives on water management and governance. Following a brief summary of the papers, concluding remarks that reflect on what the papers, taken as a whole, contribute to our understanding are provided.

  14. Value issues and stakeholders' views in radioactive waste management

    International Nuclear Information System (INIS)

    Colglazier, E.W.; Dungan, D.L.; Reaven, S.J.

    1987-01-01

    The authors review a study in progress that is examining the role played by ethical and value issues in high-level and low-level radioactive waste management. For each policy issue, they attempt to separate its ''value concerns'' into three categories, called procedural, distributional, and evidential aspects. These categories refer to concerns about fairness and appropriateness of process, outcomes, and scientific evidence, respectively. For each value concern, attempt to state the rationale used by key stakeholder groups in justifying their policy positions and to extract the ''underlying general principles'' (UGP's) that appear to be the basis for the arguments. By examining patterns of UGP's across groups for an issue, and across issues for a group, the authors hope to explain the patterns of UGP's in terms of more fundamental attributes of stakeholders' ''world views'' and notions about science and society

  15. Personalized medicine and the role of health economics and outcomes research: issues, applications, emerging trends, and future research.

    Science.gov (United States)

    O'Donnell, John C

    2013-01-01

    The decade since the completion of the sequencing of the human genome has witnessed significant advances in the incorporation of genomic information in diagnostic, treatment, and reimbursement practices. Indeed, as case in point, there are now several dozen commercially available genomic tests routinely applied across a wide range of disease states in predictive or prognostic applications. Moreover, many involved in the advancement of personalized medicine would view emerging approaches to stratify patients in meaningful ways beyond genomic information as a signal of the progress made. Yet despite these advances, there remains a general sense of dissatisfaction about the progress of personalized medicine in terms of its contribution to the drug development process, to the efficiency and effectiveness of health care delivery, and ultimately to the provision of the right treatment to the right patient at the right time. Academicians, payers, and manufacturers alike are struggling not only with how to embed the new insights that personalized medicine promises but also with the fundamental issues of application in early drug development, implications for health technology assessment, new demands on traditional health economic and outcomes research methods, and implications for reimbursement and access. In fact, seemingly prosaic issues such as the definition and composition of the term "personalized medicine" are still unresolved. Regardless of these issues, practitioners are increasingly compelled to find practical solutions to the challenges and opportunities presented by the evolving face of personalized medicine today. Accordingly, the articles comprising this Special Issue offer applied perspectives geared toward professionals and policymakers in the field grappling with developing, assessing, implementing, and reimbursing personalized medicine approaches. Starting with a framework with which to characterize personalized medicine, this Special Issue proceeds to

  16. Understanding and Modeling Freight Stakeholder Behavior

    Science.gov (United States)

    2012-04-01

    This project developed a conceptual model of private-sector freight stakeholder decisions and interactions for : forecasting freight demands in response to key policy variables. Using East Central Wisconsin as a study area, empirical : models were de...

  17. Stakeholder Risk Management in Ethical Decision Making

    DEFF Research Database (Denmark)

    Lauesen, Linne Marie

    Stakeholder management has for the last three decades been concerned either with strategic business management or business ethics, values and quality. Many models have been developed, but recently the literature asks for more dynamic models instead of the staticism that characterizes some models....... management models does – for the sake of the wider social responsibilities of the businesses and its stakeholders.......Stakeholder management has for the last three decades been concerned either with strategic business management or business ethics, values and quality. Many models have been developed, but recently the literature asks for more dynamic models instead of the staticism that characterizes some models...... evidence from hybrid organizations as Publicly Owned Enterprises (POEs) mixed of private corporations and political administration. The model offers a new way of combining risk management with ethical decisionmaking processes by the inclusion of multiple stakeholders. Not only does the model apply...

  18. Young adult and parent stakeholder perspectives on participation in patient-centered comparative effectiveness research.

    Science.gov (United States)

    Saunders, Tully; Mackie, Thomas I; Shah, Supriya; Gooding, Holly; de Ferranti, Sarah D; Leslie, Laurel K

    2016-08-01

    Explore perspectives of adolescent and young adult (AYA) and parent stakeholders regarding their engagement in comparative effectiveness research (CER) evaluating cholesterol screening and treatment strategies for 17-21 year olds. All nine AYAs and parent stakeholders participating in a 20-member panel of AYAs, parents and professionals (i.e., clinicians, researchers, policy makers, payers), completed a quantitative survey and a semistructured interview at the completion of the core CER study. AYAs and parents stakeholders emphasized the role of power differentials regarding shared knowledge, relationships and trust, and logistics. To mitigate power differentials, stakeholders recommended more materials, clearer definition of roles and in-person meetings. Perceived positive outcomes included diversity of perspectives provided, better understanding their own health and decision-making and improving CER.

  19. Stakeholders' perspective on ecological modeling in environmental risk assessment of pesticides

    DEFF Research Database (Denmark)

    Hunka, Agnieszka; Meli, Mattia; Thit, Amalie

    2013-01-01

    The paper closely examines the role of mechanistic effect models (e.g., population models) in the European environmental risk assessment (ERA) of pesticides. We studied perspectives of three stakeholder groups on population modeling in ERA of pesticides. Forty-three in-depth, semi-structured inte......The paper closely examines the role of mechanistic effect models (e.g., population models) in the European environmental risk assessment (ERA) of pesticides. We studied perspectives of three stakeholder groups on population modeling in ERA of pesticides. Forty-three in-depth, semi......-structured interviews were conducted with stakeholders from regulatory authorities, industry and academia all over Europe. The key informant approach was employed in recruiting our participants. They were first identified as key stakeholders in the field and then sampled by means of a purposive sampling, where each...

  20. Developing an Integrative Treatment Program for Cancer-Related Fatigue Using Stakeholder Engagement - A Qualitative Study.

    Science.gov (United States)

    Canella, Claudia; Mikolasek, Michael; Rostock, Matthias; Beyer, Jörg; Guckenberger, Matthias; Jenewein, Josef; Linka, Esther; Six, Claudia; Stoll, Sarah; Stupp, Roger; Witt, Claudia M

    2017-11-01

    Although cancer-related fatigue (CRF) has gained increased attention in the past decade, it remains difficult to treat. An integrative approach combining conventional and complementary medicine interventions seems highly promising. Treatment programs are more likely to be effective if the needs and interests of the people involved are well represented. This can be achieved through stakeholder engagement. The aim of the study was to develop an integrative CRF treatment program using stakeholder engagement and to compare it to an expert version. In a qualitative study, a total of 22 stakeholders (4 oncologists, 1 radiation-oncologist, 1 psycho-oncologist, 5 nurses/nurse experts, 9 patients, 1 patient family member, 1 representative of a local Swiss Cancer League) were interviewed either face-to-face or in a focus group setting. For data analysis, qualitative content analysis was used. With stakeholder engagement, the integrative CRF treatment program was adapted to usual care using a prioritizing approach and allowing more patient choice. Unlike the expert version, in which all intervention options were on the same level, the stakeholder engagement process resulted in a program with 3 different levels. The first level includes mandatory nonpharmacological interventions, the second includes nonpharmacological choice-based interventions, and the third includes pharmacological interventions for severe CRF. The resulting stakeholder based integrative CRF treatment program was implemented as clinical practice guideline at our clinic (Institute for Complementary and Integrative Medicine, University Hospital Zurich). Through the stakeholder engagement approach, we integrated the needs and preferences of people who are directly affected by CRF. This resulted in an integrative CRF treatment program with graded recommendations for interventions and therefore potentially greater sustainability in a usual care setting.

  1. Stakeholder management from the business perspective

    Directory of Open Access Journals (Sweden)

    Krstić Nataša

    2014-01-01

    Full Text Available In an increasingly global and highly competitive business world of today, the business sector pays meticulous attention to stakeholders - groups or individuals, which affect or are affected by business decisions. The paper examines the methodology of identifying key stakeholders, demonstrates the process of their various mapping models, as well as the manner in which stakeholders, in cooperation with a corporation, create the opportunity to be engaged at an early stage of a project, activity or business decision, thus establishing a precedent according to which both sides benefit. By doing so, the business sector can ensure that its actions will receive 'a social licence to operate', whereas various groups of stakeholders will be offered a possibility to be included in business dealings for the sake of protecting their interests. The authors of the paper have analysed a two-way process of stakeholder management in establishing corporate reputation which is reflected in business performance and results. It was concluded that stakeholder engagement should foster innovation and lead to broader social prosperity, achieving the main goal of sustainability: business excellence according to the principles of the triple final result, by realizing synergy between the social community, environment and profit.

  2. Stakeholder Perceptions of Risk in Construction.

    Science.gov (United States)

    Zhao, Dong; McCoy, Andrew P; Kleiner, Brian M; Mills, Thomas H; Lingard, Helen

    2016-02-01

    Safety management in construction is an integral effort and its success requires inputs from all stakeholders across design and construction phases. Effective risk mitigation relies on the concordance of all stakeholders' risk perceptions. Many researchers have noticed the discordance of risk perceptions among critical stakeholders in safe construction work, however few have provided quantifiable evidence describing them. In an effort to fill this perception gap, this research performs an experiment that investigates stakeholder perceptions of risk in construction. Data analysis confirms the existence of such discordance, and indicates a trend in risk likelihood estimation. With risk perceptions from low to high, the stakeholders are architects, contractors/safety professionals, and engineers. Including prior studies, results also suggest that designers have improved their knowledge in building construction safety, but compared to builders they present more difficultly in reaching a consensus of perception. Findings of this research are intended to be used by risk management and decision makers to reassess stakeholders' varying judgments when considering injury prevention and hazard assessment.

  3. Community engagement in the CTSA program: stakeholder responses from a national Delphi process.

    Science.gov (United States)

    Freeman, Elmer; Seifer, Sarena D; Stupak, Matthew; Martinez, Linda Sprague

    2014-06-01

    In response to the Institute of Medicine (IOM) Committee's December 2012 public request for stakeholder input on the Clinical and Translational Science Award (CTSA) program, two nonprofit organizations, the Center for Community Health Education Research and Service, Inc. (CCHERS) and Community-Campus Partnerships for Health (CCPH), solicited feedback from CTSA stakeholders using the Delphi method. Academic and community stakeholders were invited to participate in the Delphi, which is an exploratory method used for group consensus building. Six questions posed by the IOM Committee to an invited panel on community engagement were electronically sent to stakeholders. In Round 1 stakeholder responses were coded thematically and then tallied. Round 2 asked stakeholders to state their level of agreement with each of the themes using a Likert scale. Finally, in Round 3 the group was asked to rank the Round 2 based on potential impact for the CTSA program and implementation feasibility. The benefits of community engagement in clinical and translational research as well as the need to integrate community engagement across all components of the CTSA program were common themes. Respondents expressed skepticism as to the feasibility of strengthening CTSA community engagement. © 2014 Wiley Periodicals, Inc.

  4. An Innovative Approach to Stakeholder Theory: application in spanish transnational corporations

    Directory of Open Access Journals (Sweden)

    Jose Luis Retolaza

    2015-09-01

    Full Text Available Objective – This paper describes a different perspective on the application of stakeholder theory, concentrating only on the interests of stakeholders rather than on their roles. The purpose of this article is to provide an option for solving Jensen’s “problem of governance”; this approach will allow the agent to manage the stakeholders having ascertained that the needs of stakeholders overlap and, accordingly, the agent should be able to monitor multiple stakes as they are aligned. Design/methodology/approach – A Delphi method was used with the aim to achieve consensus about the interests of stakeholders for companies in Spain. The confirmatory phase was based on interviews to test whether the interests identified in the preliminary study match the interests that the IBEX-35 firms recognized in relation with their stakeholders. Findings – The main contributions are: the addition of a new interestbased perspective to the different classifications made by stakeholder theory; a solution to the diversity of indicators between stakeholders and shareholders; and, finally, a proposal for an integrated accounting system, incorporating economic as well as social issues employing a common metric (monetary. Practical implications – A new perspective focusing on stakeholder interests and the confirmation that interests may converge permits the control and management of multiple principals in transnational corporations operating in different countries. Originality/value – There is a gap in the applicability of stakeholder management that the interest-based perspective can help resolve; moreover the monetization of social value is an option to efficiently manage transnational corporations.

  5. Stakeholder approach, Stakeholders mental model: A visualization test with cognitive mapping technique

    Directory of Open Access Journals (Sweden)

    Garoui Nassreddine

    2012-04-01

    Full Text Available The idea of this paper is to determine the mental models of actors in the firm with respect to the stakeholder approach of corporate governance. The use of the cognitive map to view these diagrams to show the ways of thinking and conceptualization of the stakeholder approach. The paper takes a corporate governance perspective, discusses stakeholder model. It takes also a cognitive mapping technique.

  6. Precision medical communication to optimize stakeholder information exchange: a '4M-Quadrant' approach.

    Science.gov (United States)

    Ashkenazy, Rebecca

    2016-07-01

    Personalized and precision medicine concepts have transformed the healthcare delivery environment from research and development to commercialization. Precision medical communication (PMC) represents a strategy to maximize personalized healthcare elements in medical-related exchanges to optimize value from the activity for the associated stakeholders. It is a discipline of developing the right message through the right mechanism at the right moment to the right healthcare member. PMC enhances the value of information exchange among stakeholders because it integrates data, analytics, and environmental and medical insights to efficiently disseminate more precise content to specified audiences in a balanced and compliant manner. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Evaluation Use and Involvement of Internal Stakeholders: The Case of a New Non-Degree Online Program in Brazil

    Science.gov (United States)

    Cornachione, Edgard B., Jr.; Trombetta, Maria R.; Casa Nova, Silvia P. C.

    2010-01-01

    To what extent does the intense and direct involvement of internal stakeholders, such as program managers and staff members, play a significant role toward evaluation use? Stakeholder involvement is a key element in evaluation and evaluation use is considered within a broader sense that includes organizational knowledge, individual skills, and…

  8. Agricultural Innovation Systems (AIS): A Study of Stakeholders and Their Relations in System of Rice Intensification (SRI)

    Science.gov (United States)

    Suchiradipta, Bhattacharjee; Raj, Saravanan

    2015-01-01

    Purpose: This paper identifies the stakeholders of System of Rice Intensification (SRI), their roles and actions and the supporting and enabling environment of innovation in the state as the elements of the Agricultural Innovation Systems (AIS) in SRI in Tripura state of India and studies the relationship matrix among the stakeholders.…

  9. [Training session on healthy environments: evaluation of an intervention for local stakeholders].

    Science.gov (United States)

    Roy, Virginie; Rivard, Marie-Claude; Trudeau, François

    2016-01-01

    Around the world, various interventions have been developed to encourage the adoption of healthy lifestyles, particularly nutrition and physical activity. Physical, political, economic and socio-cultural environments have a major influence on individual attitudes in relation to healthy lifestyle. However, stakeholders with the greatest impact on improving these environments are not always well informed about the theory and their roles on the creation of environments favourable to healthy lifestyles. Various stakeholders from the province of Quebec were therefore invited to attend training sessions in order to prepare them to act on these four environments. 1) To describe the perceptions of the stakeholders who attended these sessions concerning the content and teaching methods and 2) to identify stakeholders’ changes of perceptions and practices following the training session. Twelve (12) focus groups and 52 individual interviews were conducted across Quebec with stakeholders who attended a training session. Our results indicate increased awareness of stakeholders on the importance of their role but also the need to more precisely target those aspects requiring increased awareness. A content better suited to the level of expertise is therefore proposed to maximize the benefits of these training sessions. Training sessions must be addressed to influential stakeholders with a limited knowledge on the subject, which is often the case for municipal decision-makers known to play a major role in promoting environments favourable to healthy eating and physical activity.

  10. Predictors of Work-Family Role Conflict and Its Impact on Professional Women in Medicine, Engineering, and Information Technology in Nigeria.

    Science.gov (United States)

    Uzoigwe, Anthonia Ginika; Low, Wah Yun; Noor, Siti Nurani Mohd

    2016-10-01

    This study examines work-family role conflict and the factors predicting it, with a sample of 173 professional women in engineering and information technology (IT) firms, including 2 hospitals-1 public and 1 private. Our findings show no significant difference in the level of work-family role conflict encountered by women across medicine, engineering, and IT, whereas hours of work, family responsibilities, job demand, and work role overload were significantly correlated with work-family role conflict. Multiple linear regression analysis indicates that only work role overload, family responsibilities, and hours of work significantly predicted 45.9% of work-family role conflict. This implies that working women are burdened by work demands, which invariably affects the work-family role conflict they experience and leads to deterioration of their occupational health. It is suggested that employers should create a flexible work schedule and establish family-friendly policies in the workplace to promote a healthy work-life balance for women in science careers.

  11. Board Effectiveness and Employee Engagement: Nigeria Stakeholder Perceptions

    Directory of Open Access Journals (Sweden)

    Bashir Mande

    2013-03-01

    Full Text Available The objective of this study is to determine whether employee participation yields effective board performance. To stimulatedebates inthe stakeholder theoretical perspective in an attempt to offer more inclusive approach to strengthen the existing governance structure in Nigeria.This research intends to investigate the suitability of employees participating in board’s decision-making hierarchy because of their contractual importance as wealth creators of the firm. A conceptual model is proposed and tested on public listed companies in Nigeria based on survey perception of sampled 154 respondents. The study employs in-depth confirmatory factory analysis in a structural equation modeling approach. Building upon constructs such as union relations, productivity, and skilled-labor turnover, the study found the indicator variables measure employee participation, which focused more on the board’s control, operational decisions, and strategy in monitoring, service, and networking roles. Hence, we conclude that employees as important contractual company stakeholders affect board performance. Builds on the limited research agenda for boards and corporate governance that focus on coordinating, exploring and distribution of stakes using adventurous research designs and statistical tools, especially in Nigerian emerging economy. This paper exposes the firm’s potentials as provider of sustainable and longer-term benefits not only limited to equityholders, but also to employees as wealth creators, which will improve mutual trust, harmony and confidence for more stable and productive outputs that could give visibility to income inequality. The paper provides valid measures that link corporate governance debates to broader stakeholder perspective.

  12. Identity-driven differences in stakeholder concerns about hunting wolves.

    Science.gov (United States)

    Lute, Michelle L; Bump, Adam; Gore, Meredith L

    2014-01-01

    Whereas past wolf management in the United States was restricted to recovery, managers must now contend with publicly contentious post-recovery issues including regulated hunting seasons. Understanding stakeholder concerns associated with hunting can inform stakeholder engagement, communication, and policy development and evaluation. Social identity theory (SIT) has been used to understand how groups interact, why they conflict, and how collaboration may be achieved. Applying SIT to stakeholder conflicts about wolf hunting may help delineate groups according to their concern about, support for or opposition to the policy choice of hunting wolves. Our objective was to assess concerns about hunting as a tool to resolve conflict in Michigan, using SIT as a framework. We used a mixed-modal sampling approach (e.g., paper, Internet) with wolf hunting-related public meeting participants in March 2013. Survey questions focused on 12 concerns previously identified as associated with hunting as a management tool to resolve conflict. Respondents (n  =  666) cared greatly about wolves but were divided over hunting wolves. Wolf conflicts, use of science in policy decisions, and maintaining a wolf population were the highest ranked concerns. Principle components analysis reduced concerns into three factors that explained 50.7% of total variance; concerns crystallized over justifications for hunting. General linear models revealed a lack of geographic influence on care, fear and support for hunting related to wolves. These findings challenge assumptions about regional differences and suggest a strong role for social identity in driving dichotomized public perceptions in wildlife management.

  13. United Kingdom [Stakeholder involvement in decommissioning]. Annex I.G

    International Nuclear Information System (INIS)

    2009-01-01

    This annex describes the policy and practice for Stakeholder engagement being developed by the Nuclear Decommissioning Authority (NDA) in the UK. It is too early to report upon the success or otherwise of the approach so this is provided as 'work in progress' which can be further tracked via the NDA's website at www.nda.gov.uk. The Nuclear Decommissioning Authority is a non-departmental public body, set up in April 2005 under the Energy Act 2004 to take strategic responsibility for the UK's nuclear legacy. Its core objective is to ensure that the 20 civil public sector nuclear sites under our ownership are decommissioned and cleaned up safely, securely, cost effectively and in ways that protect the environment for this and future generations. It will lead the development of a unified and coherent decommissioning strategy, working in partnership with regulators and site licensees to achieve best value, optimum impact on local communities, and the highest environmental standards. The text in Annex I.Ga provides a brief background to the role of the NDA, then it considers NDA's policy towards stakeholder engagement. It then goes onto report upon how this policy is being implemented with active engagement of stakeholders

  14. Is laboratory medicine ready for the era of personalized medicine?

    DEFF Research Database (Denmark)

    Malentacchi, Francesca; Mancini, Irene; Brandslund, Ivan

    2015-01-01

    in the integration of personalized medicine in routine health care and set the state-of-the-art knowledge about personalized medicine and laboratory medicine in Europe, a questionnaire was constructed under the auspices of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) and the European......Developments in "-omics" are creating a paradigm shift in laboratory medicine leading to personalized medicine. This allows the increase in diagnostics and therapeutics focused on individuals rather than populations. In order to investigate whether laboratory medicine is ready to play a key role...... Society of Pharmacogenomics and Personalised Therapy (ESPT). The answers of the participating laboratory medicine professionals indicate that they are aware that personalized medicine can represent a new and promising health model, and that laboratory medicine should play a key role in supporting...

  15. How Stakeholder Co-management Reproduces Conservation Conflicts: Revealing Rationality Problems in Swedish Wolf Conservation

    Directory of Open Access Journals (Sweden)

    Erica von Essen

    2015-01-01

    Full Text Available 'Stakeholder' has become the primary category of political actor in decision-making, not least within nature conservation. Drawing from Habermas' theory on communicative action, this article argues that there are democratic deficits to the stakeholder model that promote citizens to remain locked in predetermined, polarized positions. It contends that the stakeholder model must, hence, be scrutinized with respect to its potential role in perpetuating conservation conflicts in modernity. Using the case study of stakeholder-based game management delegations (GMDs in Sweden, our research identifies four barriers, which tie to the instrumental basis and liberal democratic legacy of the stakeholder approach: 1 strong sense of accountability; 2 overly purposive atmosphere; 3 overemphasis on decision as final outcome; and 4 perceived inability on the part of the delegates to influence science-led decision-making. The article suggests that these democratic deficits preclude the deliberation and contestation necessary to legitimate conservation policy. Indeed, stakeholder rationality causes citizens to become inert, instrumental agents who approach discussion with strategic rather than communicative rationality. We conclude that the deficits of the stakeholder model currently: 1 restrict democratic freedom for citizens; 2 engender a crisis of legitimacy of management; and 3 reproduce the conflict, which in Sweden relates to the conservation of wolves.

  16. Comparing Approaches for the Integration of Stakeholder Perspectives in Environmental Decision Making

    Directory of Open Access Journals (Sweden)

    Anna Scolobig

    2016-11-01

    Full Text Available Including stakeholder perspectives in environmental decision making is in many countries a legal requirement and is widely seen as beneficial as it can help increase decision legitimacy, likelihood of implementation, and quality of the outcome. Whereas the theoretical literature on stakeholder engagement is large, less attention has been devoted to comparing and discussing different methodological approaches. Here, we compare three approaches—multi-criteria analysis, plural rationality theory, and scenario construction—that include stakeholders’ perspectives in environmental decision making. We find differences between the approaches concerning the assumptions about stakeholder rationality and whether experts and/or stakeholders are in charge of framing the problem. Further differences concern the type of data input from stakeholders and how it is used by the experts, as well as the role of stakeholders and whether they are involved early—already for identifying options—or later in the process, for evaluating or ranking alternatives analyzed by the experts. The choice of approach thus predetermines the type and depth of stakeholder engagement. No approach is “better” than another, but they are suited for different problems and research aims: the choice of the approach, however, has a large impact on the results.

  17. Stakeholder engagement for promoting the Comprehensive Nuclear-Test-Ban Treaty (CTBT): Malaysia’s experience

    Science.gov (United States)

    Rashid, F. I. A.; Zolkaffly, M. Z.; Jamal, N.

    2018-01-01

    In order to keep abreast on issues related to CTBT in Malaysia, Malaysian Nuclear Agency (Nuklear Malaysia), as the CTBT National Authority in Malaysia, has collaborated with local partners to implement various stakeholder engagement programme. This paper aims at highlighting Malaysia’s approach in promoting CTBT through stakeholder engagement programme targeted at multilevel stakeholders, both national and international. Such programmes includes participation in the international forums, inter-agency meetings, awareness seminars, training courses, technical visits to IMS station, promoting civil and scientific application of International Monitoring System (IMS) data and International Data Centre (IDC) products using Virtual Data Exploitation Center (vDEC), inviting youth groups to participate in the CTBTO Youth Group, and publications of CTBT-related topics. This approach has successfully fortify Malaysia’s commitments at the international level, enhanced national awareness of global multilateral framework, increased stakeholders awareness and their roles related to CTBT, as well as building domestic capacity on CTBT matters. In conclusion, stakeholder engagement is crucial in promoting and enhancing stakeholders understanding on CTBT. Continuous engagement with relevant stakeholders will enable effective dissemination and smooth implementation of CTBT related matters that will eventually support global universalization of CTBT.

  18. Stakeholders of Voluntary Forest Carbon Offset Projects in China: An Empirical Analysis

    Directory of Open Access Journals (Sweden)

    Derong Lin

    2015-01-01

    Full Text Available Climate change is one of the defining challenges facing the planet. Voluntary forest carbon offset project which has the potential to boost forest carbon storage and mitigate global warming has aroused the global concern. The objective of this paper is to model the game situation and analyze the game behaviors of stakeholders of voluntary forest carbon offset projects in China. A stakeholder model and a Power-Benefit Matrix are constructed to analyze the roles, behaviors, and conflicts of stakeholders including farmers, planting entities, communities, government, and China Green Carbon Foundation. The empirical analysis results show that although the stakeholders have diverse interests and different goals, a win-win solution is still possible through their joint participation and compromise in the voluntary forest carbon offset project. A wide governance structure laying emphasis on benefit balance, equality, and information exchanges and being regulated by all stakeholders has been constructed. It facilitates the agreement among the stakeholders with conflicting or different interests. The joint participation of stakeholders in voluntary forest carbon offset projects might change the government-dominated afforestation/reforestation into a market, where all participators including government are encouraged to cooperate with each other to improve the condition of fund shortage and low efficiency.

  19. The role and importance of economic evaluation of traditional herbal medicine use for chronic non-communicable diseases

    Directory of Open Access Journals (Sweden)

    Hughes GD

    2015-07-01

    Full Text Available Gail D Hughes,1 Oluwaseyi M Aboyade,1 John D Hill,2 Rafia S Rasu3 1South African Herbal Science and Medicine Institute, University of the Western Cape, Western Cape, South Africa; 2Department of Pharmacy, Cleveland Clinic, Cleveland, OH, 3School of Pharmacy, University of Kansas, Lawrence, KS, USA Background: Non-communicable diseases (NCD constitute major public health problems globally, with an impact on morbidity and mortality ranking high and second to HIV/AIDS. Existing studies conducted in South Africa have demonstrated that people living with NCD rely on traditional herbal medicine (THM primarily or in combination with conventional drugs. The primary research focus has been on the clinical and experimental aspects of THM use for NCD, with limited data on the economic impact of health care delivery. Therefore, the purpose of this study will be to determine the cost and utilization of resources on THM in South Africa for NCD. Materials and methods: Study describes the methods toward incorporating cost estimations and economic evaluation illustrated with the Prospective Urban and rural Epidemiological (PURE study in South Africa. The South African PURE cohort is investigating the geographic and socioeconomic influence of THM spending and utilization, variations in spending based on perceived health status, marital status, and whether spending patterns have any impact on hospitalizations and disability. Data collection and evaluation plan: Since the individual costs of THM are not regulated nor do they have a standardized price value, information obtained through this study can be utilized to assess differences and determine underlying factors contributing to spending. This insight into THM spending patterns can aid in the development and implementation of guidelines or standardized legislation governing THM use and distribution. An economic evaluation and cost estimation model has been proposed, while the data collection is still ongoing

  20. Stakeholder Participation in REDD+ Readiness Activities for Three Collaborative Projects in Lao PDR

    Directory of Open Access Journals (Sweden)

    Saykham Boutthavong

    2017-04-01

    Full Text Available A key challenge for reducing emission from deforestation and forest degradation (REDD in developing countries is to balance the power of various stakeholders in decision making. This study explores the forms of stakeholder participation in the implementation of three pilot projects in Laos, with a focus on who actually makes decisions on project activities. We found that stakeholder roles in making decisions were imbalanced. The central government and development partner organizations were the ones who actually fulfill the roles of decision-makers in most project activities. Although local communities were not the key stakeholders in decision making in most activities, their roles seem to have increased in the activities where participatory approaches were applied. Participation of the private sector, non-governmental organizations, academic and research institutes and mass organizations was limited. Opportunities to reach decision-makers regarding project activities came through service contract agreements. Our findings suggest that an understanding of who fulfills the key roles will support a decentralization of decision making by balancing power and redistributing the roles from dominant to weaker stakeholders. In addition, the private sector’s participation may enhance opportunities to harmonize their investments for supporting REDD+ development and reduce the negative impacts on the forests and the environment.