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.

    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

  3. 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

  4. Stakeholder roles within the IMO

    International Nuclear Information System (INIS)

    Cowbourne, D.; Chuddy, B.; Gregg, L.

    2003-01-01

    This session presents the comments of 3 guest speakers who described the role of stakeholders within Ontario's Independent Electricity Market Operator (IMO). The IMO is committed to achieving a successful electricity market through its governance process. The IMO's 3 main objectives are: (1) give participants and stakeholders an effective say in the evolution of the electricity market, particularly in the area of commercial and reliability impact, (2) enable the market to evolve in a timely manner in step with participant needs, advancements in market technology and the objectives of provincial legislation, and (3) to provide advice on relevant issues and decisions. figs

  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. Development of Family Medicine training in Botswana: Views of key stakeholders in Ngamiland.

    Science.gov (United States)

    Ogundipe, Radiance M; Mash, Robert

    2018-08-31

    Family Medicine training commenced in Botswana in 2011, and Maun was one of the two sites chosen as a training complex. If it is to be successful there has to be investment in the training programme by all stakeholders in healthcare delivery in the district. The aim of the study was to explore the attitudes of stakeholders to initiation of Family Medicine training and their perspectives on the future roles of family physicians in Ngami district, Botswana. Maun and the surrounding Ngami subdistrict of Botswana. Thirteen in-depth interviews were conducted with purposively selected key stakeholders in the district health services. Data were recorded, transcribed and analysed using the framework method. Participants welcomed the development of Family Medicine training in Maun and expect that this will result in improved quality of primary care. Participants expect the registrars and family physicians to provide holistic health care that is of higher quality and expertise than currently experienced, relevant research into the health needs of the community, and reduced need for referrals. Inadequate personal welfare facilities, erratic ancillary support services and an inadequate complement of mentors and supervisors for the programme were some of the gaps and challenges highlighted by participants. Family Medicine training is welcomed by stakeholders in Ngamiland. With proper planning introduction of the family physician in the district is expected to result in improvement of primary care.

  7. 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... site at http://nccam.nih.gov/about/plans/ . Request for Participation: Representatives of stakeholder...

  8. 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

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

    Science.gov (United States)

    2012-11-09

    ... Input From Stakeholders Regarding the Veterinary Medicine Loan Repayment Program (VMLRP) AGENCY... administration of the Veterinary Medicine Loan Repayment Program (VMLRP) authorized under section 1415A of the... agreement, veterinary services in veterinarian shortage situations. As part of the stakeholder input process...

  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. 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

  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. 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

  18. Medicines discovery in the 21st century: the case for a stakeholder corporation.

    Science.gov (United States)

    Dixon, John; England, Paul; Lawton, Geoff; Machin, Peter; Palmer, Alan

    2010-09-01

    It is widely accepted that biopharmaceutical companies have, in recent times, failed to deliver large numbers of new medicines to patients and have simultaneously failed to deliver large financial returns to their investors. We argue that addition of different business constructs with wider stakeholder ownership and/or control offers a way to improve returns from the great advances in medical science and drug discovery processes. Governments and other payers for medicines, the academic institutions engaged in bioscience knowledge creation, patient advocacy groups, venture philanthropists and charitable foundations can come together with commercial profit-centred businesses to develop corporate constructs that mutually benefit all of the stakeholders. A rebalancing of the social and financial motives in medicines research can arrest recent productivity decreases of the sector. Copyright © 2010 Elsevier Ltd. All rights reserved.

  19. 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

  20. role of stakeholders at cape coast ppag youth centre

    African Journals Online (AJOL)

    Elizabeth

    They also knew that film and talk shows, were used to educate the .... stakeholders or through the various mass media to educate the .... be empathic understanding on the part of the stakeholders to resolve the ... Communication Programmes.

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    This paper looks at the universal services policy in Vietnam (interval 2005-2010) via analysing stakeholders in order to clarify how they exerted influence and how they implemented the policy. The stakeholder theory is employed to identify and categorize the stakeholders who participated in perfo......This paper looks at the universal services policy in Vietnam (interval 2005-2010) via analysing stakeholders in order to clarify how they exerted influence and how they implemented the policy. The stakeholder theory is employed to identify and categorize the stakeholders who participated...... 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...... of interviews on some officials was also conducted. The results demonstrate that stakeholders had a huge impact on the success of the universal service policy....

  2. 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.

  3. 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.

  4. 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.

  5. Pharmacy clients' attitudes to expanded pharmacist prescribing and the role of agency theory on involved stakeholders.

    Science.gov (United States)

    Hoti, Kreshnik; Hughes, Jeffery; Sunderland, Bruce

    2011-02-01

    To examine the views of regular pharmacy clients on pharmacist prescribing and employ agency theory in considering the relationship between the stakeholders involved. Computer assisted telephone interviews were conducted with 400 pharmacy clients recruited around Australia. Potential respondents were identified using a random number generation function in Microsoft Excel. Data were analysed with SPSS version 17 using one-way analysis of variance, principal component analysis and linear regression. The relationships between the main stakeholders involved were explored using agency theory. A total of 1153 answered calls recruited 400 consenting pharmacy clients. Most respondents (71%) trusted pharmacists adopting an expanded role in prescribing, however the majority (66%) supported this only after a diagnosis had been made by a doctor. Those who accepted pharmacist diagnosing and prescribing preferred that this was limited to pain management and antibiotics. Most respondents (64%) considered that expanded pharmacist prescribing would improve their access to prescription medicines, although those over 65 years of age were less supportive than younger respondents. Factors which contributed positively to clients' perception of trust in an expanded prescribing role for pharmacists were identified, and improved access to medicines was found to be the strongest predictor (P Agency theory would conceptualize the introduction of pharmacist prescribers, as disrupting the principal (patient) agent (doctor) relationship. Its introduction would best be facilitated by careful change management. © 2011 The Authors. IJPP © 2011 Royal Pharmaceutical Society.

  6. ENHANCING THE ROLE OF STAKEHOLDERS IN THE MANAGEMENT OF UPSTREAM CILIWUNG WATERSHED

    Directory of Open Access Journals (Sweden)

    Iis Alviya

    2016-08-01

    Full Text Available Stakeholders have a ver y important role interm of the management of upstream watershed. Thus, the common understanding on the existence and role of stakeholders is an important factor in order to achieve good governance of watershed management, leading to the attainment of environmental, social and economic benefits. This paper aims to analyse the role, interests, and cooperation among stakeholders and its relationship with the condition of upper Ciliwung watershed. Stakeholder analysis was used in this study to identify stakeholders, to categorize them, and to investigate the relationship between stakeholders. The analysis showed the lack of cooperation among stakeholders both between key stakeholders with primar y stakeholders. This resulted in lack of communities' understanding on the benefits and the importance of conservation activities in the upstream Ciliwung watershed. Meanwhile, the cooperation between key stakeholders and supporting stakeholders, especially the providers of funds, was relatively better/stronger. This can be seen from a better management of inter-agency cooperation in the upstream Ciliwung watershed, although the effort was tend to be project-oriented. Therefore, communication forum need to be established, to taking role for synchronizing , collaborating and coordinating stakeholders' efforts, so that the management programs of upstream Ciliwung watershed can be integrated.

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

    Science.gov (United States)

    2011-01-01

    Background 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. Methods 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. Results 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. Conclusions The current status quo with

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

    Directory of Open Access Journals (Sweden)

    James eLeong

    2015-06-01

    Full Text Available AbstractPurposeThe 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 in a manner that would uphold transparency, consistency and standards. MethodsA 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. ResultsThe 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.ConclusionsThe use of a template may be of value for the communicating benefit-risk assessment of medicines to stakeholders.

  9. 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.

  10. 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

  11. 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

  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. 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

  14. 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.)

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

    OpenAIRE

    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 local contexts shape crop-biotechnology differently; To explore how crop-biotechnology shapes different contexts differently; To make policy recommendations on stakeholder involvement in decision-ma...

  16. The Role of Stakeholders in the Decommissioning of Salaspils Research Reactor

    International Nuclear Information System (INIS)

    Abramenkovs, A.

    2009-01-01

    The paper describes the role of different stakeholders in the decommissioning of the Salaspils Research Reactor. Decommissioning was a large challenge for the Latvia, since the country in this moment had no decommissioning experience and necessary technologies for the implementation of the defined goals by the Government. In this case for facilitation of the decommissioning of Salaspils Research Reactor (SRR), the significant role plays the local and international stakeholders. The paper deals with information on the basic stages of decommissioning of SRR and the role of the wide spectrum of stakeholders in preparation, upgrade and implementation of the decommissioning plan. The role of governmental institutions in the decommissioning of Salaspils research reactor is discussed. It was shown, that local municipalities are very important stakeholders, which significantly influence the decommissioning of SRR. The Salaspils municipalities positive impact on the decommissioning processes are discussed. Basic problems with the Baldone municipality in context of radioactive wastes management are indicated. The role of international stakeholders in decommissioning of Salaspils research reactor is discussed. It was shown, that the support from International Atomic Energy Agency significantly promotes the decommissioning of SRR. The main issues were expert support for solution of different technical problems in radioactive wastes management, area monitoring, and verification of decommissioning plans, training of staff and technical expertise during whole process of decommissioning. It was shown, that technical and economical support from DOE, USA provides the possibility to solve the fuel problem during decommissioning of SRR, as well as, to increase the physical safety of SRR and repository 'Radons'. It was shown, that a proper coordination of all activities and using the services from stakeholders can significantly reduce the total project expenses. The cooperation between

  17. 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…

  18. 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.

  19. 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

  20. 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.

  1. The Changing Role of External Stakeholders: From Imaginary Friends to Effective Actors or Non-Interfering Friends

    Science.gov (United States)

    Magalhães, António; Veiga, Amélia; Amaral, Alberto

    2018-01-01

    Recent shifts in university governance have relied on increased autonomy. Within this context, the enhanced role attributed to governance boards at the expense of academic bodies and the role of external stakeholders has gained momentum. With the aim of understanding the extent of the influence of external stakeholders at the institutional level,…

  2. 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.

  3. 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

  4. 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.

  5. Promoting transparency, accountability, and access through a multi-stakeholder initiative: lessons from the medicines transparency alliance.

    Science.gov (United States)

    Vian, Taryn; Kohler, Jillian C; Forte, Gilles; Dimancesco, Deirdre

    2017-01-01

    Barriers to expanding access to medicines include weak pharmaceutical sector governance, lack of transparency and accountability, inadequate attention to social services on the political agenda, and financing challenges. Multi-stakeholder initiatives such as the Medicines Transparency Alliance (MeTA) may help overcome these barriers. Between 2008 and 2015, MeTA engaged stakeholders in the pharmaceutical sectors of seven countries (Ghana, Jordan, Kyrgyzstan, Peru, Philippines, Uganda, and Zambia) to promote access goals through greater transparency. We reviewed archival data to document MeTA activities and results related to transparency and accountability in the seven countries where it was implemented. We identified common themes and content areas, noting specific activities used to make information transparent and accessible, how data were used to inform discussions, and the purpose and timing of meetings and advocacy activities to help set priorities and influence governance decisions. The cross-case analysis looked for pathways which might link the MeTA strategies to results such as better policies or program improvements. Countries used evidence gathering, open meetings, and proactive information dissemination to increase transparency. MeTA fostered policy dialogue to bring together the many government, civil society and private company stakeholders concerned with access issues, and provided them with information to understand barriers to access at policy, organizational, and community levels. We found strong evidence that transparency was enhanced. Some evidence suggests that MeTA efforts contributed to new policies and civil society capacity strengthening although the impact on government accountability is not clear. MeTA appears to have achieved its goal of creating a multi-stakeholder shared policy space in which government, civil society, and private sector players can come together and have a voice in the national pharmaceutical policy making process

  6. 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…

  7. 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.

  8. 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

  9. 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)

  10. Investigating the role of Clinical Nurse Consultants in one health district from multiple stakeholder perspectives: a cooperative inquiry.

    Science.gov (United States)

    Walsh, Kenneth; Bothe, Janine; Edgar, Denise; Beaven, Geraldine; Burgess, Bernadette; Dickson, Vhari; Dunn, Stephen; Horning, Lynda; Jensen, Janice; Kandl, Bronia; Nonu, Miriam; Owen, Fran; Moss, Cheryle

    2015-01-01

    The impetus for this research came from a group of 11 Clinical Nurse Consultants (CNCs) within a health service in NSW, Australia, who wanted to investigate the CNC role from multiple stakeholder perspectives. With support from academic researchers, the CNCs designed and implemented the study. The aim of this research project was to investigate the role of the CNC from the multiple perspectives of CNCs and other stakeholders who work with CNCs in the Health District. This was a co-operative inquiry that utilised qualitative descriptive research approach. Co-operative inquiry methods enabled 11 CNCs to work as co-researchers and to conduct the investigation. The co-researchers implemented a qualitative descriptive design for the research and used interviews (7) and focus groups (16) with CNC stakeholders (n = 103) to gather sufficient data to investigate the role of the CNC in the organisation. Thematic analysis was undertaken to obtain the results. The CNC role is invaluable to all stakeholders and it was seen as the "glue" which holds teams together. Stakeholder expectations of the CNC role were multiple and generally agreed. Five themes derived from the data are reported as "clinical leadership as core", "making a direct difference to patient care", "service development as an outcome", "role breadth or narrowness and boundaries", and "career development". There was clear appreciation of the work that CNCs do in their roles, and the part that the CNC role plays in achieving quality health outcomes. The role of the CNC is complex and the CNCs themselves often negotiate these complexities to ensure beneficial outcomes for the patient and organisation. For the wider audience this study has given further insights into the role of these nurses and the perspectives of those with whom they work.

  11. The clinical role of lecturers in nursing in Ireland: perceptions from key stakeholder groups in nurse education on the role.

    Science.gov (United States)

    Meskell, Pauline; Murphy, Kathleen; Shaw, David

    2009-10-01

    The clinical role of lecturers in nursing has been a focus of debate since the integration of nurse education into higher education institutions. The purpose of this paper is to report the findings from the preliminary phase of a study, undertaken to investigate the perceptions of key stakeholder groups in nurse education, regarding the current clinical role of nurse lecturers in Ireland. A descriptive exploratory design was used involving focus group and individual interviews, soliciting views of purposefully selected educationalists, clinicians, policy formulators and students. The issue was examined from a policy perspective, aiming to collectively represent views of all participant groups. This approach facilitated a more complete picture of perceptions of the role to emerge, to better inform future decision making. Twenty two focus group interviews and twenty one individual interviews were conducted. Content analysis was used to identify themes. All groups were in agreement that role definition was urgently required to dispel ambiguities surrounding what the clinical role should involve. Conflicting views were evident among groups regarding lecturers' clinical credibility, visibility and teaching effectiveness. Findings highlight the essential nature of nurse lecturers engaging with clinical areas to maintain their skills, demonstrate a value for the practice component of the role and provide a link between education and practice.

  12. Global landscape assessment of screening technologies for medicine quality assurance: stakeholder perceptions and practices from ten countries.

    Science.gov (United States)

    Roth, Lukas; Nalim, Ameena; Turesson, Beth; Krech, Laura

    2018-04-25

    The spread of substandard and falsified (SF) medical products constitutes a growing global public health concern. Some countries use portable, handheld screening technologies (STs) in the field to accelerate detection of SF medicines and reduce the number of medicine samples that undergo costly and time-consuming confirmatory analysis. A multi-country, multi-stakeholder landscape assessment utilizing qualitative methodology was used to examine practices and perceptions related to the use of STs. Qualitative interview guides were designed using the results of a literature review and comprised of open-ended questions with the study participants, who were from national medicine regulatory authorities, pharmaceutical manufacturers, pharmacies, and distributors. Ten geographically and economically diverse countries were selected: Argentina, China, Egypt, India, Jordan, Mexico, Nigeria, Philippines, the United States, and Zimbabwe. Of the completed 53 interviews, 32 were in-person, 16 were phone interviews, and 5 were via written questionnaires. Data analysis shows a wide variation in understanding and usage of STs in different sectors. Virtually all of the study participants indicated a lack of objective, accessible information on STs to advise them on what technologies would be beneficial for their needs. Study participants also described their ideal capabilities of the next generation of STs, including shareable spectral libraries, lower acquisition costs, lesser training requirements, and in-country maintenance and technical support. The results and recommendations presented in this article can be used to help regulators communicate and justify their needs to acquire and invest in new STs. There is a need for additional standardized, trustworthy and scientifically sound evaluations of STs, and to support regulators to effectively deploy the most promising technologies. ST manufacturers can take into account some of the limitations of the technologies the interviewees

  13. 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.

  14. Stakeholder Analysis Worksheet

    Science.gov (United States)

    Stakeholder Analysis WorksheetA worksheet that can be used to document potential stakeholder groups, the information or expertise they hold, the role that they can play, their interests or concerns about the HIA

  15. 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.

  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. 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

  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

    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 Manufactur...

  19. Substitution treatment in the era of "recovery": An analysis of stakeholder roles and policy windows in Britain.

    Science.gov (United States)

    Duke, Karen; Herring, Rachel; Thickett, Anthony; Thom, Betsy

    2013-08-01

    Based on documentary analyses and interviews with twenty key informants in 2012, this paper analyses the shift in British drugs policy towards "recovery" from the perspectives of major stakeholders. The processes involved in reopening the debate surrounding the role of substitution treatment and its re-emergence on to the policy agenda are examined. Drawing on Kingdon's work on agenda-setting, the ways in which methadone maintenance was challenged and defended by key stakeholders in the initial phase of policy development and the negotiation of a "recovery" focus as the organizing concept for British drugs policy are explored. Study limitations are noted.

  20. 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...

  1. Role of Imaging in the Era of Precision Medicine.

    Science.gov (United States)

    Giardino, Angela; Gupta, Supriya; Olson, Emmi; Sepulveda, Karla; Lenchik, Leon; Ivanidze, Jana; Rakow-Penner, Rebecca; Patel, Midhir J; Subramaniam, Rathan M; Ganeshan, Dhakshinamoorthy

    2017-05-01

    Precision medicine is an emerging approach for treating medical disorders, which takes into account individual variability in genetic and environmental factors. Preventive or therapeutic interventions can then be directed to those who will benefit most from targeted interventions, thereby maximizing benefits and minimizing costs and complications. Precision medicine is gaining increasing recognition by clinicians, healthcare systems, pharmaceutical companies, patients, and the government. Imaging plays a critical role in precision medicine including screening, early diagnosis, guiding treatment, evaluating response to therapy, and assessing likelihood of disease recurrence. The Association of University Radiologists Radiology Research Alliance Precision Imaging Task Force convened to explore the current and future role of imaging in the era of precision medicine and summarized its finding in this article. We review the increasingly important role of imaging in various oncological and non-oncological disorders. We also highlight the challenges for radiology in the era of precision medicine. Published by Elsevier Inc.

  2. The status and role of radiobiology in veterinary medicine

    International Nuclear Information System (INIS)

    Benova, K.

    2007-01-01

    In this presentation author deals with history of the University of Veterinary Medicine in Kosice as well as with the status and role of radiobiology in veterinary medicine. Some results of gamma irradiation of Pecilia reticulata are presented. Activity levels of cesium-137 in contaminated mushrooms gathered in Slovakia in 2001 are presented.

  3. The role of general nuclear medicine in breast cancer

    International Nuclear Information System (INIS)

    Greene, Lacey R; Wilkinson, Deborah

    2015-01-01

    The rising incidence of breast cancer worldwide has prompted many improvements to current care. Routine nuclear medicine is a major contributor to a full gamut of clinical studies such as early lesion detection and stratification; guiding, monitoring, and predicting response to therapy; and monitoring progression, recurrence or metastases. Developments in instrumentation such as the high-resolution dedicated breast device coupled with the diagnostic versatility of conventional cameras have reinserted nuclear medicine as a valuable tool in the broader clinical setting. This review outlines the role of general nuclear medicine, concluding that targeted radiopharmaceuticals and versatile instrumentation position nuclear medicine as a powerful modality for patients with breast cancer

  4. Understanding stakeholders' attitudes toward water management interventions: Role of place meanings

    Science.gov (United States)

    Jacobs, Maarten H.; Buijs, Arjen E.

    2011-01-01

    Water resource managers increasingly need to take the opinions of stakeholders into account when planning interventions. We studied stakeholders' concerns in two water management planning contexts, focusing on the meanings assigned to places and on attitudes toward proposed interventions. Semistructured interviews were held, and public meetings were observed in order to collect data. Five categories of place meanings emerged from the analysis: beauty (esthetic judgments), functionality (ways of use), attachment (feelings of belonging), biodiversity (meanings pertaining to nature), and risk (worries about current or future events). These categories reflect the basic dimensions of sense of place. Our results suggest that stakeholders' attitudes toward proposed interventions are, to a great extent, derived from their place meanings. Discussing place meanings during participatory planning processes could contribute substantially to successful water management.

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

    DEFF Research Database (Denmark)

    Thomsen, Elisabeth Houe

    2014-01-01

    by Crane and Ruebottom (2012) may prove more relevant. Stakeholders may construe more than one identity - e.g. be both employees and customers. As Merkur is a sustainable bank and focuses on supporting sustainable businesses, CSR will be the branding issue of interest. Furthermore, studies have indicated...

  6. 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

  7. How stakeholders frame dam removal: The role of current and anticipated future ecosystem service use

    Science.gov (United States)

    Reilly, Kate; Adamowski, Jan

    2016-04-01

    Many river restoration projects, including dam removal, are controversial and can trigger conflicts between stakeholders who are for and against the proposed project. The study of environmental conflicts suggests that differences in how stakeholders 'frame', or make sense of a situation based on their prior knowledge and experiences, can perpetuate conflicts. Understanding different stakeholders' frames, particularly how they converge, can form the basis of successful conflict resolution. In the case of dam removals, it is often assumed that emphasising increased provision of ecosystem services can be a point of convergence between those advocating for ecological restoration and those opposed to removal because of negative human impacts. However, how exactly stakeholders frame a contentious proposed dam removal and how those frames relate to ecosystem services has been little studied. Here we used the case of a potential dam removal in New Brunswick to investigate how people frame the issue and how that relates to their current and anticipated future use of ecosystem services. Based on in-depth interviews with 30 stakeholders in the area, including both people for and against dam removal, we found that both groups currently used ecosystem services and were in favour of ecosystem protection. However, they differed in how they framed the issue of the potential dam removal. The group against dam removal framed the issue as one of loss and risk - they thought that any potential benefits to the ecosystem would be outweighed by the high risk of negative social impacts caused by a loss of access to ecosystem services, such as recreation and aesthetic enjoyment. By contrast, the group in favour of the dam framed the issue as one of opportunity and justice. They thought that following a short transition period, all stakeholders would benefit from the restored river, particularly from a restored salmon fishery, improved aesthetic appeal and the long-term sustainability of an

  8. Stakeholder views on pharmacogenomic testing.

    Science.gov (United States)

    Patel, Haridarshan N; Ursan, Iulia D; Zueger, Patrick M; Cavallari, Larisa H; Pickard, A Simon

    2014-02-01

    Pharmacogenomics has an important role in the evolution of personalized medicine, and its widespread uptake may ultimately depend on the interests and perspectives of key players in health care. Our aim was to summarize studies on stakeholder perspectives and attitudes toward pharmacogenomic testing. Thus, we conducted a review of original research studies that reported stakeholder views on pharmacogenomic testing using a structured approach in PubMed, International Pharmaceutical Abstracts, Cumulative Index to Nursing and Allied Health Literature, and EMBASE. A standardized data abstraction form was developed that included stakeholder group of interest-patients, general public, providers, and payers. Stakeholder views regarding barriers to pharmacogenetic implementation were organized into the following themes: ancillary information-related, clinical, economic, educational, ethical or legal, medical mistrust, and practicality. Of 34 studies that met our inclusion criteria, 37 perspectives were reported (15 on providers, 9 on the general public, 9 on patients, and 4 on payers). The most common topics that arose in studies of providers related to clinical usefulness of genetic data (n=11) and educational needs (n=11). Among the general public, the most common concerns were medical mistrust (n=5), insufficient education (n=5), and practicality (n=5). The most prevalent issues from the patient perspective were ethical or legal (n=6) and economic (n=5) issues. Among payers, leading issues were practicality (n=4) and clinical usefulness (n=3). There was overlap in the topics and concerns across stakeholder perspectives, including lack of knowledge about pharmacogenomic testing. Views on issues related to privacy, cost, and test result dissemination varied by stakeholder perspective. Limited research had been conducted in underrepresented groups. Efforts to address the issues raised by stakeholders may facilitate the implementation of pharmacogenomic testing into

  9. [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.

  10. 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 .

  11. The model of Western integrative medicine: the role of Chinese medicine.

    Science.gov (United States)

    Dobos, Gustav; Tao, Iven

    2011-01-01

    The basic concept of integrative medicine (IM) is that by combining mainstream (biomedicine) with complementary and alternative medicine (CAM), synergistic therapeutic effects can be attained. When the methods of mind/body medicine (MBM) are added to this combination, as in Western countries, a new concept emerges that drastically changes the approach toward illness.It is interesting to note that the joining of traditional Chinese medicine and Western medicine in the early days of the Peoples' Republic of China preceded the Western model of IM by almost 50 years. Several elements that make up the key components of IM as practiced today in the West were already present in the Chinese version of IM, and Chinese medicine has played and continues to play an important role in advancing IM. However, one of the major differences between the Chinese and the Western models of IM today, besides MBM and some other treatment options, is that Western integrative medicine (WIM) strictly requires its CAM methods to be supported by scientific evidence.The therapeutic methods of IM and their applications are many and varied. However, they are most frequently employed to treat chronic medical conditions, e.g., bronchial asthma, rheumatic disease, chronic inflammatory bowel disorder and chronic pain. Other fields in which IM may be applied are internal medicine (inflammatory bowel diseases and cardiovascular diseases), musculoskeletal disorders, oncology (chemotherapy-induced side effects), obstetrics and gynecology (dysmenorrhea, endometriosis, infertility and menopausal complaints), pediatrics, geriatrics, neurology (migraine and chronic headache), and psychiatry (anxiety and depression).The concept of WIM is discussed here in detail by reviewing its scope and implications for the practice of medicine and focusing on the role of Chinese medicine in WIM.

  12. 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

  13. 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.

  14. 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

  15. 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.

  16. 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...

  17. 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.

  18. 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

  19. Status and role of radiobiology in veterinary medicine

    International Nuclear Information System (INIS)

    Benova, K.

    2013-01-01

    In this presentation history of radiobiology in University of Veterinary Medicine and Pharmacy in Kosice from 1949 is presented. Scientific and pedagogic programs, role of veterinary physician as well as concept of radiobiology and cooperation are reviewed. Changes in Poecilia reticulata and Artemia franciscana after gamma radiation are presented.

  20. Aerosols: generation and role in medicine, industry and environment

    International Nuclear Information System (INIS)

    Nambi, K.S.V.; Sapra, B.K.

    1998-01-01

    This book covers a wide range of topics in aerosol sciences. Areas covered for detailed evaluation with respect to the role of aerosols are industry, medicine, health care and environment, besides basic studies. Knowledge in the areas, specially on generation of aerosols and their role in those fields are briefly summarised and problems for future work are highlighted. Articles relevant to INIS are indexed separately

  1. 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.

  2. 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

  3. 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

    2018-05-01

    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.

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

    Science.gov (United States)

    Isaac, Sami; Saini, Bandana; Chaar, Betty B

    2016-01-01

    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. 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. 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. 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 will help shape future policies for the

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

    Directory of Open Access Journals (Sweden)

    Sami Isaac

    Full Text Available 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.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.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.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 will help shape future

  6. 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…

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. Stakeholder Governance

    DEFF Research Database (Denmark)

    Flak, Leif Skiftenes; Rose, Jeremy

    2005-01-01

    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...... of governance. Finally, the paper makes recommendations for future work in adapting ST to the e-government context....

  12. 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.

  13. Stakeholder Definition for Indonesian Integrated Agriculture Information System (IAIS)

    Science.gov (United States)

    Budi Santoso, Halim; Delima, Rosa

    2017-03-01

    Stakeholders plays an important roles to determine the system requirements. Stakeholders are people or organizations that has an interest to the enterprise. Timely and effective consultation of relevant stakeholders is a paramount importance in the requirements engineering process. From the research and analysis of system stakeholder finds that there are four stakeholder groups in IAIS. Stakeholder analysis is being implemented by identifying stakeholder, stakeholder category, and analysis interaction between stakeholders.

  14. 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

    2018-07-15

    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.

  15. 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

    2018-05-01

    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 (odds ratio = 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.

  16. 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...... 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...... to the simultaneous interaction with and of a variety of stakeholders and the fact that customers and other stakeholders of a company can take the initiative to that interaction. Stakeholders can launch a discussion, spread news, participate in value creation, can heavily influence each other and a company''s market...

  17. 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.

  18. 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.

  19. 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.

  20. Postgraduate internal medicine residents' roles at patient discharge - do their perceived roles and perceptions by other health care providers correlate?

    Science.gov (United States)

    Card, Sharon Elizabeth; Ward, Heather A; Chipperfield, Dylan; Sheppard, M Suzanne

    2014-01-01

    Knowing one's own role is a key collaboration competency for postgraduate trainees in the Canadian competency framework (CanMEDS®). To explore methods to teach collaborative competency to internal medicine postgraduate trainees, baseline role knowledge of the trainees was explored. The perceptions of roles (self and others) at patient discharge from an acute care internal medicine teaching unit amongst 69 participants, 34 physicians (25 internal medicine postgraduate trainees and 9 faculty physicians) and 35 health care professionals from different professions were assessed using an adapted previously validated survey (Jenkins et al., 2001). Internal medicine postgraduate trainees agreed on 8/13 (62%) discharge roles, but for 5/13 (38%), there was a substantial disagreement. Other professions had similar lack of clarity about the postgraduate internal medicine residents' roles at discharge. The lack of interprofessional and intraprofessional clarity about roles needs to be explored to develop methods to enhance collaborative competence in internal medicine postgraduate trainees.

  1. Pharmaceutical Care and the Role of a Pharmacist in Space Medicine

    Science.gov (United States)

    Bayuse, Tina

    2007-01-01

    Space medicine is primarily preventative medicine Outcomes of space medicine pharmaceutical care are: a) Elimination or reduction of a patient's symptomatology; b) Arresting or slowing of long term effects from microgravity; and c) Preventing long term effects or symptomatology as a result of microgravity. Space medicine pharmaceutical care is about both the patient and the mission. Pharmaceutical care in the area of space medicine is evolving. A pharmacist serves a critical role in this care. Commercial space travel will require pharmacist involvement.

  2. 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.

  3. Multiple forms of stakeholder interaction in environmental management: business arguments regarding differences in stakeholder relationships

    OpenAIRE

    Onkila, Tiina

    2011-01-01

    This study describes and interprets differences in stakeholder interaction as rhetorically constructed in environmental reports and in interviews with environmental managers. It also interprets the role of the natural environment among stakeholders, and discusses how that role is justified or not justified. The study focuses in a business perspective on stakeholder interaction in environmental management. Characteristically, stakeholder studies of environmental management have concentrated on...

  4. Defining the Role of the Pharmacy Technician and Identifying Their Future Role in Medicines Optimisation

    Science.gov (United States)

    Boughen, Melanie; Sutton, Jane; Fenn, Tess

    2017-01-01

    Background: Traditionally, pharmacy technicians have worked alongside pharmacists in community and hospital pharmacy. Changes within pharmacy provide opportunity for role expansion and with no apparent career pathway, there is a need to define the current pharmacy technician role and role in medicines optimisation. Aim: To capture the current roles of pharmacy technicians and identify how their future role will contribute to medicines optimisation. Methods: Following ethical approval and piloting, an online survey to ascertain pharmacy technicians’ views about their roles was undertaken. Recruitment took place in collaboration with the Association of Pharmacy Technicians UK. Data were exported to SPSS, data screened and descriptive statistics produced. Free text responses were analysed and tasks collated into categories reflecting the type of work involved in each task. Results: Responses received were 393 (28%, n = 1380). Results were organised into five groups: i.e., hospital, community, primary care, General Practitioner (GP) practice and other (which included HM Prison Service). Thirty tasks were reported as commonly undertaken in three or more settings and 206 (84.7%, n = 243) pharmacy technicians reported they would like to expand their role. Conclusions: Tasks core to hospital and community pharmacy should be considered for inclusion to initial education standards to reflect current practice. Post qualification, pharmacy technicians indicate a significant desire to expand clinically and managerially allowing pharmacists more time in patient-facing/clinical roles. PMID:28970452

  5. Defining the Role of the Pharmacy Technician and Identifying Their Future Role in Medicines Optimisation.

    Science.gov (United States)

    Boughen, Melanie; Sutton, Jane; Fenn, Tess; Wright, David

    2017-07-15

    Traditionally, pharmacy technicians have worked alongside pharmacists in community and hospital pharmacy. Changes within pharmacy provide opportunity for role expansion and with no apparent career pathway, there is a need to define the current pharmacy technician role and role in medicines optimisation. To capture the current roles of pharmacy technicians and identify how their future role will contribute to medicines optimisation. Following ethical approval and piloting, an online survey to ascertain pharmacy technicians' views about their roles was undertaken. Recruitment took place in collaboration with the Association of Pharmacy Technicians UK. Data were exported to SPSS, data screened and descriptive statistics produced. Free text responses were analysed and tasks collated into categories reflecting the type of work involved in each task. Responses received were 393 (28%, n = 1380). Results were organised into five groups: i.e., hospital, community, primary care, General Practitioner (GP) practice and other (which included HM Prison Service). Thirty tasks were reported as commonly undertaken in three or more settings and 206 (84.7%, n = 243) pharmacy technicians reported they would like to expand their role. Tasks core to hospital and community pharmacy should be considered for inclusion to initial education standards to reflect current practice. Post qualification, pharmacy technicians indicate a significant desire to expand clinically and managerially allowing pharmacists more time in patient-facing/clinical roles.

  6. Sleep apps: what role do they play in clinical medicine?

    Science.gov (United States)

    Lorenz, Christopher P; Williams, Adrian J

    2017-11-01

    Today's smartphones boast more computing power than the Apollo Guidance Computer. Given the ubiquity and popularity of smartphones, are we already carrying around miniaturized sleep labs in our pockets? There is still a lack of validation studies for consumer sleep technologies in general and apps for monitoring sleep in particular. To overcome this gap, multidisciplinary teams are needed that focus on feasibility work at the intersection of software engineering, data science and clinical sleep medicine. To date, no smartphone app for monitoring sleep through movement sensors has been successfully validated against polysomnography, despite the role and validity of actigraphy in sleep medicine having been well established. Missing separation of concerns, not methodology, poses the key limiting factor: The two essential steps in the monitoring process, data collection and scoring, are chained together inside a black box due to the closed nature of consumer devices. This leaves researchers with little room for influence nor can they access raw data. Multidisciplinary teams that wield complete power over the sleep monitoring process are sorely needed.

  7. 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)

  8. 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)

  9. 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

  10. 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.

  11. 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.

  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. [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.

  15. 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

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

    Energy Technology Data Exchange (ETDEWEB)

    Caniato, M., E-mail: marcocaniato@gmail.com [Research Centre on Appropriate Technologies for Environmental Management in Developing Countries (CeTAmb), University of Brescia, Brescia (Italy); Tudor, T. [Centre for Sustainable Waste Management, School of Science and Technology, University of Northampton, Northampton (United Kingdom); Vaccari, M. [Research Centre on Appropriate Technologies for Environmental Management in Developing Countries (CeTAmb), University of Brescia, Brescia (Italy)

    2015-01-15

    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

  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. 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…

  19. 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

  20. 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…

  1. Medicines

    Science.gov (United States)

    Medicines can treat diseases and improve your health. If you are like most people, you need to take medicine at some point in your life. You may need to take medicine every day, or you may only need to ...

  2. Balancing the Roles of a Family Medicine Residency Faculty: A Grounded Theory Study.

    Science.gov (United States)

    Reitz, Randall; Sudano, Laura; Siler, Anne; Trimble, Kristopher

    2016-05-01

    Great variety exists in the roles that family medicine residency faculty fill in the lives of their residents. A family medicine-specific model has never been created to describe and promote effective training relationships. This research aims to create a consensus model for faculty development, ethics education, and policy creation. Using a modified grounded theory methods, researchers conducted phone interviews with 22 key informants from US family medicine residencies. Data were analyzed to delineate faculty roles, common role conflicts, and ethical principles for avoiding and managing role conflicts. Key informants were asked to apply their experience and preferences to adapt an existing model to fit with family medicine residency settings. The primary result of this research is the creation of a family medicine-specific model that describes faculty roles and provides insight into how to manage role conflicts with residents. Primary faculty roles include Role Model, Advisor, Teacher, Supervisor, and Evaluator. Secondary faculty roles include Friendly Colleague, Wellness Supporter, and Helping Hand. The secondary roles exist on a continuum from disengaged to enmeshed. When not balanced, the secondary roles can detract from the primary roles. Differences were found between role expectations of physician versus behavioral science faculty and larger/university/urban residencies versus smaller/community/rural residencies. Diversity of opinion exists related to the types of roles that are appropriate for family medicine faculty to maintain with residents. This new model is a first attempt to build consensus in the field and has application to faculty development, ethics education, and policy creation.

  3. The role of chemical engineering in medicinal research including Alzheimer's.

    Science.gov (United States)

    Kontogeorgis, Georgios M

    2015-01-01

    Various disciplines of chemical engineering, especially thermodynamics and kinetics, play an important role in medicinal research and this has been particularly recognized during the last 10-15 years (von Stockar and van der Wielen, J Biotechnol 59:25, 1997; Prausnitz, Fluid Phase Equilib 53:439, 1989; Prausnitz, Pure Appl Chem 79:1435, 2007; Dey and Prausnitz, Ind Eng Chem Res 50:3, 2011; Prausnitz, J Chem Thermodynamics 35:21, 2003; Tsivintzelis et al. AIChE J 55:756, 2009). It is expected that during the twenty-first century chemical engineering and especially thermodynamics can contribute as significantly to the life sciences development as it has been done with the oil and gas and chemical sectors in the twentieth century. Moreover, it has during the recent years recognized that thermodynamics can help in understanding diseases like human cataract, sickle-cell anemia, Creuzfeldt-Jacob ("mad cow" disease), and Alzheimer's which are connected to "protein aggregation." Several articles in the Perspectives section of prominent chemical engineering journals have addressed this issue (Hall, AIChE J 54:1956, 2008; Vekilov, AIChE J 54:2508, 2008). This work reviews recent applications of thermodynamics (and other areas of chemical engineering) first in drug development and then in the understanding of the mechanism of Alzheimer's and similar diseases.

  4. The role of palliative medicine in the organizational frame of oncological care in Slovakia

    International Nuclear Information System (INIS)

    Krizanova, K.

    2012-01-01

    In this work we would like to describe the role of palliative medicine in the organizational frame of oncological care in Slovakia. Basic statistic data are revealing that number of beds in palliative medicine and hospices is shaped rather coincidently according to the reimbursement rates and the effort to reduce a number of chronic beds. Further on we would like to point out a distinction between palliative treatments of cancer and palliative medicine, a distinction between social care and hospice care, the role and relevance of palliative medicine and we bring about some suggestions how to improve the present situation. (author)

  5. 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

  6. 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

  7. 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.

  8. Stakeholder perspectives on new ways of delivering unscheduled health care: the role of ownership and organizational identity.

    Science.gov (United States)

    Haddow, Gill; O'Donnell, Catherine A; Heaney, David

    2007-04-01

    To explore stakeholder perspectives of the implementation of a new, national integrated nurse-led telephone advice and consultation service [National Health Service 24 (NHS 24)], comparing the views of stakeholders from different health care organizations. Semi-structured interviews with 26 stakeholders including partner organizations located in primary and secondary unscheduled care settings [general practitioner (GP) out-of-hours cooperative; accident and emergency department; national ambulance service, members of NHS 24 and national policy makers. Attendance at key meetings, documentary review and email implementation diaries provided a contextual history of events with which interview data could be compared. The contextual history of events highlighted a fast-paced implementation process, with little time for reflection. Key areas of partner concern were increasing workload, the clinical safety of nurse triage and the lack of communication across the organizations. Concerns were most apparent within the GP out-of-hours cooperative, leading to calls for the dissolution of the partnership. Accident and emergency and ambulance service responses were more conciliatory, suggesting that such problems were to be expected within the developmental phase of a new organization. Further exploration of these responses highlighted the sense of ownership within the GP cooperative, with GPs having both financial and philosophical ownership of the cooperative. This was not apparent within the other two partner organizations, in particular the ambulance service, which operated on a regional model very similar to that of NHS 24. As the delivery of unscheduled primary health care crosses professional boundaries and locations, different organizations and professional groups must develop new ways of partnership working, developing trust and confidence in each other. The results of this study highlight, for the first time, the key importance of understanding the professional

  9. 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.

  10. 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

  11. 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.

  12. 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.

  13. 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.

  14. 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)

  15. The Role of social media discourses on stakeholder crises awareness and perception – A meta-theoretical framework

    DEFF Research Database (Denmark)

    Valentini, Chiara; Romenti, Stefania; Kruckeberg, Dean

    , such perspective is best suited to explain the relationships between publics and organizations in the online environment. According to this perspective, organizations are not the hub of stakeholder communications and interactions, but rather they are simply spikes in a more complex network. Public......This paper provides a meta-theoretical framework to examine social media communications and crisis communication in these social media through the lens of communicative constitution of reality. Our claim is that discourse and online conversations are significant in shaping publics’ opinions...... in social media, both in general and specifically in discussions about crisis situations. Therefore, studying language and discourse becomes paramount to understand how conversations structure relationships and public opinions. We approach this task through a network-based perspective because, we argue...

  16. 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.

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

    African Journals Online (AJOL)

    A review of the role of African traditional medicine in the management of oral diseases. ... traditional healers include herbalism, psychotherapy, simple surgical procedures, ... Some practices of traditional healers included tooth extractions with ...

  18. 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.

  19. Introduction to the role of model of value-based medicine in the development of private hospitals

    Directory of Open Access Journals (Sweden)

    Shou-ping CHEN

    2014-01-01

    Full Text Available Value-based medicine is the tendency of modern medicine.This paper elaborated the properties of value-based medicine,analyzed the role of model of value-based medicine in modern medicine,and put forward ideas and related measures with the model of value-based medicine to promote the development of private hospitals, which provided some reference for development of private hospitals. 

  20. Introduction to the role of model of value-based medicine in the development of private hospitals

    OpenAIRE

    Shou-ping CHEN

    2014-01-01

    Value-based medicine is the tendency of modern medicine.This paper elaborated the properties of value-based medicine,analyzed the role of model of value-based medicine in modern medicine,and put forward ideas and related measures with the model of value-based medicine to promote the development of private hospitals, which provided some reference for development of private hospitals. 

  1. Stakeholder collaboration and heritage management

    OpenAIRE

    Aas, C.; Ladkin, Adele; Fletcher, John

    2005-01-01

    This article examines a collaborative approach to the relationship between heritage management and tourism development in Luang Prabang, Laos. The purpose is to examine stakeholder collaboration and management roles, heritage tourism development, as well as the interdependence of the heritage conservation and tourism relationship. The research examines a UNESCO/Norwegian government project, which aiming to promote collaboration between heritage conservation and tourism through stakeholder inv...

  2. 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

  3. 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...... and languages. An alignment of vocabularies of motives between regulation and voluntary CSR is found to be useful for building trust between conflicting parties. Furthermore the findings shows that the more stakeholders’ languages, motives and logics can coexist, the more trust can be recovered. The research...

  4. Stakeholder Dissonance

    DEFF Research Database (Denmark)

    Lauesen, Linne Marie

    2013-01-01

    of motives between regulation and voluntary corporate social responsibility is found viable for building trust between the conflicting parties. The findings have prospects reaching out of its local context and can be used in processing trust1recovery in other sectors that suffers from severe trust......After the recent financial crisis issues of trust-breakdown in various business sectors and the public sector have occurred. The question of whether corporate social responsibility can be used as a link of trust between business and society is the issue that this paper wants to explore. This paper...... 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...

  5. 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.

  6. Nuclear radiation and its role in general nuclear medicine

    International Nuclear Information System (INIS)

    Kempaiah, A.; Ravi, C.

    2012-01-01

    Radiation is really nothing more than the emission of energy through space, as well as through physical objects. Nuclear radiations are emitted due to decay of nuclei of radioactive materials and damage cells and the DNA inside them through its ionizing effect. That causes melanoma and other cancers. Nuclear radiation has a number of beneficial uses especially in medical field with low levels of radioactive compounds, better than X-rays. There are some 440 nuclear reactors worldwide, people around will be under the effect of radiation. In nuclear medicine (medical imaging) small amount of radioactive materials were used to diagnose and determine the severity of or treat a variety of disease, including many types of cancers, heart disease, gastrointestinal, endocrine, neurological disorders and other abnormalities within the body it is painless and cost-effective techniques and provides information about both structure and function. Nuclear medicine diagnostic procedures called Gamma camera, single photon emission computed tomography (SPECT) and positron emission tomography (PET) were discussed in this paper. (author)

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

    Science.gov (United States)

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

    2013-06-01

    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 implementation in daily clinical practice. Literature review. A mechanism based approach may be helpful to personalize medicine for the individual patient to which pharmacogenetics may contribute significantly. The lack of consistency in what we accept in bioequivalence and in pharmacogenetics of drug metabolising enzymes is discussed and illustrated with the example of nortriptyline. The impact of pharmacogenetics on examples like tramadol, clopidogrel, coumarins and abacavir is described. Also the present status of the polymorphisms of 5-HT2A and C receptors in antipsychotic-induced weight gain is presented as a pharmacodynamic example with until now a greater distance to clinical implementation. The contribution of pharmacogenetics to tailor-made pharmacotherapy, which especially might be of value for patients deviating from the average, has not yet reached the position it seems to deserve.

  8. The growing role of biologics and biosimilars in the United States: Perspectives from the APhA Biologics and Biosimilars Stakeholder Conference.

    Science.gov (United States)

    Crespi-Lofton, Judy; Skelton, Jann B

    The American Pharmacists Association (APhA) convened the Biologics and Biosimilars Stakeholder Conference on November 30, 2016, in Washington DC. The objectives of the Conference were to determine the key issues and challenges within the marketplace for biologics, follow-on biologics (FOBs), and biosimilars, identify potential roles and responsibilities of pharmacists regarding biologic and biosimilar medications, and identify actions or activities that pharmacists may take to optimize the safe and cost-effective use of biologics and biosimilars. National thought leaders and stakeholder representatives, including individuals from the Food and Drug Administration, Centers for Medicare and Medicaid Services, a private third-party payer, manufacturers, and several national organizations of health care professionals, participated in the conference. Information shared by this group was supplemented with relevant legal and regulatory information and published literature. Biologics play a valuable role in the treatment of numerous health conditions, but their associated costs, which tend to be greater than those of small-molecule drugs, place a burden on the health care system. Biosimilars (both noninterchangeable and interchangeable) are highly similar copies of the originator biologic and offer the potential to reduce costs and improve patient access to biological products by increasing treatment options and creating a more competitive market. Despite the potential benefits of biosimilars, certain factors may limit their uptake. The conference participants explored issues that different stakeholders think influence the use of biologics, including biosimilars, in the United States. Barriers included technology, prescriber-pharmacist communication, legislation and regulations, limited patient and health care practitioner knowledge of biological products, patient and health care practitioner perceptions of biosimilars, and evolving science or lack of long-term data. After

  9. 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

  10. 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

  11. The role of medical education in the development of the scientific practice of medicine.

    Science.gov (United States)

    Cardinal, Lucien; Kaell, Alan

    2017-01-01

    The authors describe the important role of medical schools and graduate medical education programs (residencies) in relationship to the advances in Medicine witnessed during the twentieth century; diagnosis, prognosis and treatment were revolutionized. This historical essay details the evolution of the education system and the successful struggle to introduce a uniform, science-based curriculum and bedside education. The result was successive generations of soundly educated physicians prepared with a broad knowledge in science, an understanding of laboratory methods and the ability to practice medicine at the bedside. These changes in medical education created a foundation for the advancement of medicine.

  12. 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...

  13. The role of nuclear medicine in acute gastrointestinal bleeding

    International Nuclear Information System (INIS)

    Robinson, P.

    1993-01-01

    In most patients with upper gastrointestinal (GI) bleeding, endoscopy will locate the site and cause of bleeding, and also provide an opportunity for local therapy. The cause of lower GI bleeding is often difficult to attribute, even when pathology is found by colonoscopy or barium enema. Nuclear medicine techniques can be used to identify the site of bleeding in those patients in whom the initial diagnostic procedures are negative or inconclusive. Methods using transient labelling of blood (e.g. 99 Tc m -sulphur colloid) produce a high target-to-background ratio in positive cases, give quick results and localize bleeding sites accurately, but depend upon bleeding being active at the time of injection. Techniques using stable blood labelling (e.g. 99 Tc m -labelled red blood cells) may be positive even with intermittent bleeding but may take several hours to produce a result and are less precise in localization. The most useful application is in patients with recurrent or prolonged bleeding, those with inconclusive endoscopy or barium studies, and those who are high-risk surgical candidates. (author)

  14. [Pressure sores in geriatric medicine: the role of nutrition].

    Science.gov (United States)

    Fontaine, Juliette; Raynaud-Simon, Agathe

    2008-01-01

    Malnutrition is frequent in geriatric patients: it affects 30 to 60% of elderly residents of institutions and 30 to 70% of patients admitted for short-term hospitalization. Malnutrition is a risk factor for developing pressure sores, and patients with them are more often and more severely malnourished than patients without them. In elderly subjects, multiple and interlinked factors may trigger or aggravate malnutrition; they may be physical, psychological or social and may be worsened by drugs and some diets. Malnutrition has been recognized as a risk factor for the onset and perpetuation of pressure sores. Of the dietary factors, protein intake seems most important. A low body mass index (BMI), low serum albumin, and weight loss are associated with an increased risk of pressure sores. A physician observing pressure sores must conduct a nutritional assessment, using clinical and laboratory screening tools. The criteria for malnutrition in elderly subjects are weight loss > or =5% in 3 months or > or =10% in 6 months, BMIpressure sores in geriatric medicine. It must be adapted for each patient. The recommended calorie intake in malnourished patients at risk of or with pressure sores is 30-40 kcal/kg/d, with 1.2-1.5 g of proteins/kg/d.

  15. The role of nuclear medicine in acute gastrointestinal bleeding

    Energy Technology Data Exchange (ETDEWEB)

    Robinson, P. (Saint James' s Hospital, Leeds (United Kingdom). Dept. of Radiology)

    1993-10-01

    In most patients with upper gastrointestinal (GI) bleeding, endoscopy will locate the site and cause of bleeding, and also provide an opportunity for local therapy. The cause of lower GI bleeding is often difficult to attribute, even when pathology is found by colonoscopy or barium enema. Nuclear medicine techniques can be used to identify the site of bleeding in those patients in whom the initial diagnostic procedures are negative or inconclusive. Methods using transient labelling of blood (e.g. [sup 99]Tc[sup m]-sulphur colloid) produce a high target-to-background ratio in positive cases, give quick results and localize bleeding sites accurately, but depend upon bleeding being active at the time of injection. Techniques using stable blood labelling (e.g. [sup 99]Tc[sup m]-labelled red blood cells) may be positive even with intermittent bleeding but may take several hours to produce a result and are less precise in localization. The most useful application is in patients with recurrent or prolonged bleeding, those with inconclusive endoscopy or barium studies, and those who are high-risk surgical candidates. (author).

  16. [Occupational medicine and communication: which role for print media?].

    Science.gov (United States)

    Cecaro, M; Bernardini, M; Isolani, L; Passamonti, C

    2010-01-01

    The diffusion of recent regulations on work safety has captured mass-media's interest on work accidents. The present work aims to highlight the role of print media in building a social representation of work safety, by performing a qualitative analysis of articles published between 2009 and 2010 in three of the main national newspapers. Results showed that print media are accurate in reporting news, but they do not serve as source of education in work safety's issues. Information is mainly focused around catastrophic events, with headlines inducing negative emotions. Very few articles contain a critical discussion of methods and operational proposals tested around the Country. A possible transformation of media's role in promoting work safety is discussed.

  17. Role of nuclear medicine in pulmonary neoplastic processes

    International Nuclear Information System (INIS)

    Waxman, A.D.

    1986-01-01

    It has been demonstrated that the single most important factor in determining survival in patients with bronchogenic carcinoma is the extent of spread of metastasis from the primary lesion. This explains the extensive efforts in developing accurate staging tests for pulmonary tumors, both primary and metastatic, with special emphasis on the determination of pulmonary hilar and mediastinal spread of disease. Continued improvements in nuclear medicine instrumentation along with the development of tumor specific radiopharmaceuticals, as well as agents that have the capability of tracking tumor viability, have changed the orientation of scintigraphic techniques in the evaluation of pulmonary neoplastic processes. Gallium scintigraphy is no longer considered as a primary imaging modality in the staging of pulmonary tumors, and in most institutions has been replaced by computed tomography (CT) for this purpose. It has been demonstrated that gallium, relative to other imaging modalities, is a sensitive indicator of hilar spread of tumor. However, because of the normally high background activity within the sternum and spine, mediastinal abnormalities are poorly detected. Since most pulmonary tumors metastasize via regional nodes to the pulmonary hilum and then to the mediastinum, the high sensitivity for the detection of pulmonary hilar abnormalities and the high specificity for mediastinal lesion detection suggest that gallium scintigraphy is a valuable adjunctive test when used appropriately. Thallium 201 as a tumor agent is being studied by several institutions. Preliminary results indicate a high degree of sensitivity for the detection of pulmonary hilar and mediastinal lesions and there are early indications that thallium is a promising agent to evaluate tumor viability. 52 references

  18. Functional genomics and proteomics - the role of nuclear medicine

    Energy Technology Data Exchange (ETDEWEB)

    Haberkorn, U. [Heidelberg Univ. (Germany). Abt. fuer Klinische Nuklearmedizin; German Cancer Research Center, Heidelberg (Germany); Altmann, A. [German Cancer Research Center, Heidelberg (Germany); Eisenhut, M. [German Cancer Research Center, Heidelberg (Germany). Dept. of Radiopharmacy

    2002-01-01

    Now that the sequencing of the human genome has been completed, the basic challenges are finding the genes, locating their coding regions and predicting their functions. This will result in a new understanding of human biology as well as in the design of new molecular structures as potential novel diagnostic or drug discovery targets. The assessment of gene function may be performed using the tools of the genome program. These tools represent high-throughput methods used to evaluate changes in the expression of many or all genes of an organism at the same time in order to investigate genetic pathways for normal development and disease. This will lead to a shift in the scientific paradigm: In the pre-proteomics era, functional assignments were derived from hypothesis-driven experiments designed to understand specific cellular processes. The new tools describe proteins on a proteome-wide scale, thereby creating a new way of doing cell research which results in the determination of three-dimensional protein structures and the description of protein networks. These descriptions may then be used for the design of new hypotheses and experiments in the traditional physiological, biochemical and pharmacological sense. The evaluation of genetically manipulated animals or newly designed biomolecules will require a thorough understanding of physiology, biochemistry and pharmacology and the experimental approaches will involve many new technologies, including in vivo imaging with single-photon emission tomography and positron emission tomography. Nuclear medicine procedures may be applied for the determination of gene function and regulation using established and new tracers or using in vivo reporter genes such as enzymes, receptors, antigens or transporters. Pharmacogenomics will identify new surrogate markers for therapy monitoring which may represent potential new tracers for imaging. Also, drug distribution studies for new therapeutic biomolecules are needed, at least

  19. Functional genomics and proteomics - the role of nuclear medicine

    International Nuclear Information System (INIS)

    Haberkorn, U.; Altmann, A.; Eisenhut, M.

    2002-01-01

    Now that the sequencing of the human genome has been completed, the basic challenges are finding the genes, locating their coding regions and predicting their functions. This will result in a new understanding of human biology as well as in the design of new molecular structures as potential novel diagnostic or drug discovery targets. The assessment of gene function may be performed using the tools of the genome program. These tools represent high-throughput methods used to evaluate changes in the expression of many or all genes of an organism at the same time in order to investigate genetic pathways for normal development and disease. This will lead to a shift in the scientific paradigm: In the pre-proteomics era, functional assignments were derived from hypothesis-driven experiments designed to understand specific cellular processes. The new tools describe proteins on a proteome-wide scale, thereby creating a new way of doing cell research which results in the determination of three-dimensional protein structures and the description of protein networks. These descriptions may then be used for the design of new hypotheses and experiments in the traditional physiological, biochemical and pharmacological sense. The evaluation of genetically manipulated animals or newly designed biomolecules will require a thorough understanding of physiology, biochemistry and pharmacology and the experimental approaches will involve many new technologies, including in vivo imaging with single-photon emission tomography and positron emission tomography. Nuclear medicine procedures may be applied for the determination of gene function and regulation using established and new tracers or using in vivo reporter genes such as enzymes, receptors, antigens or transporters. Pharmacogenomics will identify new surrogate markers for therapy monitoring which may represent potential new tracers for imaging. Also, drug distribution studies for new therapeutic biomolecules are needed, at least

  20. 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

  1. 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.

  2. 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 comp...... 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.......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...

  3. 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.

  4. Hospital board oversight of quality and safety: a stakeholder analysis exploring the role of trust and intelligence.

    Science.gov (United States)

    Millar, Ross; Freeman, Tim; Mannion, Russell

    2015-06-16

    Hospital boards, those executive members charged with developing appropriate organisational strategies and cultures, have an important role to play in safeguarding the care provided by their organisation. However, recent concerns have been raised over boards' ability to enact their duty to ensure the quality and safety of care. This paper offers critical reflection on the relationship between hospital board oversight and patient safety. In doing so it highlights new perspectives and suggestions for developing this area of study. The article draws on 10 interviews with key informants and policy actors who form part of the 'issue network' interested in the promotion of patient safety in the English National Health Service. The interviews surfaced a series of narratives regarding hospital board oversight of patient safety. These elaborated on the role of trust and intelligence in highlighting the potential dangers and limitations of approaches to hospital board oversight which have been narrowly focused on a risk-based view of organisational performance. In response, a need to engage with the development of trust based organisational relationships is identified, in which effective board oversight is built on 'trust' characterised by styles of leadership and behaviours that are attentive to the needs and concerns of both staff and patients. Effective board oversight also requires the gathering and triangulating of 'intelligence' generated from both national and local information sources. We call for a re-imagination of hospital board oversight in the light of these different perspectives and articulate an emerging research agenda in this area.

  5. [The fight against counterfeit medicines in Africa: experience and role of pharmacists].

    Science.gov (United States)

    Chauvé, Martine

    2008-12-01

    The counterfeiting of medicines is a global scourge, which is particularly serious in the African continent. According to WHO estimations, whereas counterfeit medicines represent 1% of the market in developed countries, up to 30% of the medicines sold in African countries are counterfeit. Several factors may explain this high rate in Africa, from the weaknesses of legislation and controls, to the lack of affordability of medicines and the attitude of governments. A counterfeit medicine represents different levels of risk, depending if the active substance is present or not, if the dosage is the right one, if the product contains toxic substances, etc. In Africa, several examples sadly showed the terrible impact the use of counterfeit medicines may have (i.e. Nigeria, 1990, Niger, 1995). Pharmacists have a crucial role to play in fighting against the penetration of counterfeit medicines, both in securing the distribution chain, and in leading some actions towards patients. The FIP has produced some guidelines on this issue by adopting a statement (which was last updated in 2003) and by providing pharmacists with useful tools on its website. Several international organizations such as the CIOPF (International conference of French-speaking Orders) produced recommendations on this issue. However, the experience and expertise gained by national organizations from countries such as Côte d'Ivoire are also worth sharing and are presented here.

  6. 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

  7. The role of nutraceuticals in anti-aging medicine.

    Science.gov (United States)

    Vranesić-Bender, Darija

    2010-12-01

    'Nutraceuticals' is a wide term including all kinds of food with health or medical effect. Regulations in the world on functional food and nutraceuticals are developed along with the development of new products. This nomenclature is not aligned across legal regulations in different countries. There are several theories trying to interpret the phenomenon of aging and the most interesting theory in terms of nutrition is free radical theory and the possible role of antioxidants in aging process. A large group of substances including vitamins, carotenoids, flavonoids and minerals have in vitro or in vivo clinically significant antioxidant characteristics. There is great interest in anti-aging substances derived from food, and the most popular ingredients are antioxidants, especially coenzyme Q10, phytoestrogens, probiotics and omega-3 fatty acids. These substances have beneficial effect on digestive and immune systems, and modulate inflammatory and degenerative processes in the body. The challenge in the future will be strategic combining of cosmeceuticals and nutraceuticals in order to intervene in biological aging processes and degenerative skin changes.

  8. 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.

  9. 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.

  10. Stakeholder initiatives in flood risk management: exploring the role and impact of bottom-up initiatives in three ‘Room for the River’ projects in the Netherlands

    NARCIS (Netherlands)

    J. Edelenbos (Jurian); M.W. van Buuren (Arwin); D. Roth (Dik); M.H. Winnubst (Madelinde)

    2017-01-01

    textabstractIn recent years stakeholder participation has become a popular topic in flood management. Little is known about how and under which circumstances local stakeholders initiate and develop successful flood management strategies and how governmental actors respond to them. Drawing on

  11. 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 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.

  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. 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

  14. 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.  

  15. Towards a theoretical model on medicines as a health need.

    Science.gov (United States)

    Vargas-Peláez, Claudia Marcela; Soares, Luciano; Rover, Marina Raijche Mattozo; Blatt, Carine Raquel; Mantel-Teeuwisse, Aukje; Rossi Buenaventura, Francisco Augusto; Restrepo, Luis Guillermo; Latorre, María Cristina; López, José Julián; Bürgin, María Teresa; Silva, Consuelo; Leite, Silvana Nair; Mareni Rocha, Farias

    2017-04-01

    Medicines are considered one of the main tools of western medicine to resolve health problems. Currently, medicines represent an important share of the countries' healthcare budget. In the Latin America region, access to essential medicines is still a challenge, although countries have established some measures in the last years in order to guarantee equitable access to medicines. A theoretical model is proposed for analysing the social, political, and economic factors that modulate the role of medicines as a health need and their influence on the accessibility and access to medicines. The model was built based on a narrative review about health needs, and followed the conceptual modelling methodology for theory-building. The theoretical model considers elements (stakeholders, policies) that modulate the perception towards medicines as a health need from two perspectives - health and market - at three levels: international, national and local levels. The perception towards medicines as a health need is described according to Bradshaw's categories: felt need, normative need, comparative need and expressed need. When those different categories applied to medicines coincide, the patients get access to the medicines they perceive as a need, but when the categories do not coincide, barriers to access to medicines are created. Our theoretical model, which holds a broader view about the access to medicines, emphasises how power structures, interests, interdependencies, values and principles of the stakeholders could influence the perception towards medicines as a health need and the access to medicines in Latin American countries. Copyright © 2017 Elsevier Ltd. All rights reserved.

  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. 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.

  18. 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…

  19. [Drugs in veterinary medicine. The role of the veterinary drug industry].

    Science.gov (United States)

    Baars, J C

    1984-02-01

    Veterinary medicines constitute an unescapable element in the scheme of animal health and welfare. Nowadays, they are used more and more to improve health and productivity in farm animals. When a veterinary medicine is prescribed it must not only be effective but must also be safe for both animals and humans. Due to ever changing regulations and constant improvements in residue detection techniques it is necessary to conduct new investigations with existing products. It therefore costs a great deal of time and money to introduce, and maintain, a product in the market. In future, therefore, fewer medicines with more limited indications will be introduced and these will be to combat important production disorders in the more significant species only. In view of the above, research and production will be restricted to large, international, concerns. Due to our well structured agricultural industry and the existence of well organized and equipped veterinary research institutions, and practitioners, Holland is able to play an important role in the development of veterinary medicines. Close co-operation between all involved parties coupled with an efficient registration procedure is not ony of benefit to the veterinary pharmaceutical industry but also for international recognition of our national animal husbandry industry, ancillary industries and veterinary and other consultants. In this scheme of things the accent is not upon qualifications but upon the skills of veterinarians - wherever placed - who are involved in the administration of veterinary medicines.

  20. 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.

  1. 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

  2. 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

  3. Teaching psychosomatic medicine using problem-based learning and role-playing.

    Science.gov (United States)

    Heru, Alison M

    2011-01-01

    Problem-based learning (PBL) has been implemented in medical education world-wide. Despite its popularity, it has not been generally considered useful for residency programs. The author presents a model for the implementation of PBL in residency programs. The author presents a description of a PBL curriculum for teaching psychosomatic medicine to PGY 2 members in a psychiatry training program. The goals of PBL are to encourage self-directed learning; enhance curiosity, using case-based, contextualized learning; promote collaborative practice; and support patient-centered care. The addition of role-playing exercises helps PGY 2 residents to develop their skills from simply developing a differential diagnosis to being able to construct biopsychosocial formulations, and it provides these residents an opportunity to practice presenting case formulations to the patient and family. Residents and faculty enjoyed the PBL role-playing sessions. Residents wanted the learning objectives given to them rather than generating their own learning objectives, to move through the cases faster, and to receive more information and more cases. Teaching psychosomatic medicine, using PBL and role-playing, allows many of the proposed Academy of Psychosomatic Medicine residency core competencies to be met. However, further refinement of the PBL method needs to take place in order to adapt its use to residency programs.

  4. Probable role of trace elements of some medicinal plants in cardio-vascular diseases

    International Nuclear Information System (INIS)

    Siddiqui, H.A.; Kan, H.A.; Khan, S.U.; Hamdard, M.E.

    1990-01-01

    A number of herbal drugs are used in the Unani (Greco-Arab) System of Medicine for cardiovascular diseases. The herbs were analyzed by flame AAS and ICP-AES to determine if their therapeutic actions can be associated with the elements present in them. Cadmium, cobalt, chromium, copper, iron, potassium, magnesium, manganese, sodium, nickel, phosphorus, lead and zinc were some of the elements which play various roles in cardiovascular affections. An effort was made to correlate the role of these elements in cardiac diseases. (Auth.). 2 tabs., 32 refs

  5. Probable role of trace elements of some medicinal plants in cardio-vascular diseases

    Energy Technology Data Exchange (ETDEWEB)

    Siddiqui, H A; Kan, H A; Khan, S U; Hamdard, M E

    1990-01-01

    A number of herbal drugs are used in the Unani (Greco-Arab) System of Medicine for cardiovascular diseases. The herbs were analyzed by flame AAS and ICP-AES to determine if their therapeutic actions can be associated with the elements present in them. Cadmium, cobalt, chromium, copper, iron, potassium, magnesium, manganese, sodium, nickel, phosphorus, lead and zinc were some of the elements which play various roles in cardiovascular affections. An effort was made to correlate the role of these elements in cardiac diseases. (Auth.). 2 tabs., 32 refs.

  6. 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.

  7. The role of emergency medicine physicians in trauma care in North America: evolution of a specialty

    Directory of Open Access Journals (Sweden)

    Grossman Michael D

    2009-08-01

    Full Text Available Abstract The role of Emergency Medicine Physicians (EMP in the care of trauma patients in North America has evolved since the advent of the specialty in the late 1980's. The evolution of this role in the context of the overall demands of the specialty and accreditation requirements of North American trauma centers will be discussed. Limited available data published in the literature examining the role of EMP's in trauma care will be reviewed with respect to its implications for an expanded role for EMPs in trauma care. Two training models currently in the early stages of development have been proposed to address needs for increased manpower in trauma and the critical care of trauma patients. The available information regarding these models will be reviewed along with the implications for improving the care of trauma patients in both Europe and North America.

  8. 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.

  9. Co-creating Stakeholder and Brand Identities

    DEFF Research Database (Denmark)

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

    2017-01-01

    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...... 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...

  10. 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

  11. 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

  12. [Practice of Internal Medicine in Latin America. Role of the internist].

    Science.gov (United States)

    Varela, Nacor

    2002-01-01

    This article explores the causes of the crisis in the role of internists. As in the United States, the progressive specialization of internists lead to a dehumanized, expensive and technical practice of medicine. Aiming to better incomes and prestige, more than 60% of internists practice as specialists. Primary care physicians, with a very low rate of problem solving, cover 75% of consultations. Specialists, with increasing costs, cover the rest of consultations. Patients, medical schools and health organizations are claiming the return of the general internal medicine specialist. To increase the interest for general internal medicine, several strategies are applicable. Medical students interested in general internal medicine could receive a focused training, provided by these specialists. A greater emphasis should be put on primary care. More independent, secondary care diagnostic and treatment centers, should be created. Continuous medical education should be done with periodical re certification of physicians. The public health system should increase its wages and the generalist view should be maintained by physicians when practicing at their private offices.

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

    Energy Technology Data Exchange (ETDEWEB)

    Nofal, M

    1993-12-31

    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

  14. 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.

  15. 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...

  16. 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.

  17. The role of traditional healers in the provision of health care and family planning services: Malay traditional and indigenous medicine.

    Science.gov (United States)

    Raden Sanusi, H R; Werner, R

    1985-01-01

    The practitioners of traditional and indigenous medicine rely mainly upon medicinal plants and herbs for the preparation of therapeutic substances. The therapeutic properties of several medicinal plants and popular traditional medicine remedies are being investigated and validated. Present health care systems place people from developing countries in a dilemma. Countries can either continue providing a type of health care which cannot be extended to all in need or rethink and offer more inclusive types of medical care and delivery systems. Traditional medicine has a clear role to play in society, and even the World Health Organization supports the practice of traditional medicine to complement modern medicine. Traditional Malay medicine is the distillation of vast historical experience dating back more than 1000 years. It is often based upon observation, clinical trials, and experiments. The promotion and development of Malay traditional medicine can both foster dignity and self-confidence in communities through self-reliance, while considerably reducing the country's drug costs. The integrity and dignity of a people stems from self-respect and self-reliance. The practice of traditional medicine practitioners can help promote such conditions in many ways. It serves as an important focus for international technical cooperation and offers the potential for major breakthroughs in therapeutics and health care delivery. Effort should be taken to keep the practice of traditional medicine alive in Malaysia.

  18. 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.

  19. 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

  20. Why Stakeholder Engagement will not be Tweeted

    DEFF Research Database (Denmark)

    Castello, Itziar; Etter, Michael

    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......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...

  1. Stakeholder analysis of Agroparks

    NARCIS (Netherlands)

    Wubben, E.F.M.; Isakhanyan, G.

    2011-01-01

    An agropark is a cluster in which several primary producers and processors cooperate to enhance sustainable agrofood production. Because agroparks represent complex system innovations, this article studies their realisation trajectories from the stakeholder management perspective. By using the case

  2. 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...

  3. 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...

  4. 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.

  5. Stakeholder Values and Ecosystems

    OpenAIRE

    Sveinsdottir, Thordis; Wessels, Bridgette; Smallwood, Rod; Linde, Peter; Kalla, Vasso; Tsoukala, Victoria; Sondervan, Jeroen

    2013-01-01

    This report is the deliverable for Work Package 1 (WP1), Stakeholder Values and Ecosystems, of the EU FP7 funded project RECODE (Grant Agreement No: 321463), which focuses on developing Policy Recommendations for Open Access to Research Data in Europe. WP1 focuses on understanding stakeholder values and ecosystems in Open Access, dissemination and preservation in the area of scientific and scholarly data (thus not government data). The objectives of this WP are as follows: • Identify and map ...

  6. THE STAKEHOLDER MODEL REFINED

    OpenAIRE

    Y. FASSIN

    2008-01-01

    The popularity of the stakeholder model has been achieved thanks to its powerful visual scheme and its very simplicity. Stakeholder management has become an important tool to transfer ethics to management practice and strategy. Nevertheless, legitimate criticism continues to insist on clarification and emphasises on the perfectible nature of the model. Here, rather than building on the discussion from a philosophical or theoretical point of view, a different and innovative approach has been c...

  7. 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

  8. 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.

  9. 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.

  10. 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.

  11. The use of medicinal plants and the role of faith in family care.

    Science.gov (United States)

    Lima, Crislaine Alves Barcellos de; Lima, Ângela Roberta Alves; Mendonça, Cledenir Vergara; Lopes, Caroline Vasconcellos; Heck, Rita Maria

    2017-05-04

    To understand the use of medicinal plants and the role of faith in the family care system. The adopted methodology is qualitative research, conducted in April and July 2015, in a municipality of Rio Grande do Sul, Brazil, Brazil, with three informants who have knowledge of the healthcare practices. The data were interpreted using interpretive anthropology. Data interpretation led to two categories: Medicinal plants in health care and Care with the use of plants in the blessing ritual. It was identified that the use of plants and faith healing is a particular form of self-care in that given community. The purpose of this practice is to cure people from a biological and comprehensive perspective, involving the body, soul, spirit, and environment. The research revealed that medicinal plants go beyond the merely biological relationship in the family care system. Use of these plants is not based on the principle of buying and selling, but rather on the act of exchanging, giving, receiving, and reciprocating.

  12. [AT THE CROSSROADS: THE ROLE OF LABORATORY MEDICINE IN THE PATIENT CARE PROCESS].

    Science.gov (United States)

    Geffen, Yuval; Zaidise, Itzhak

    2017-06-01

    In recent decades, the laboratory medicine profession has undergone significant changes due to both technological developments and economic constraints. Technological innovations support automation, provide faster and more accurate equipment, and allow increased efficiency through the use of commercial test kits. These changes, combined with budgetary constraints, have led to mergers and centralization of medical laboratories to optimize work and cut costs. While this centralization may be a business necessity, it leads to a disconnection between the laboratory and the clinical context. In addition, laboratory tests are treated as a commodity, which places emphasis on price only, rather than quality. In this article, we review the developments and changes that medical laboratories and the laboratory medicine profession have undergone in recent decades. We focus on technological and structural challenges affecting the functioning of medical laboratories and the relations between laboratory workers and medical teams. We then introduce vocational education changes required for the laboratory medicine profession. We propose defining the role of medical laboratory directors in terms of their basic training as medical doctors or doctors of science. We suggest that laboratory employees should become a reliable source of information regarding selection of appropriate test methods, processing data and presenting the results to the medical staff. Laboratory workers must deepen their clinical knowledge and become an integral part of the patient care process, along with medical and nursing staff. Special training programs for medical laboratory workers and directors must be developed in order to match the complex activities currently being conducted in laboratories.

  13. 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

  14. The role of informatics in patient-centered care and personalized medicine.

    Science.gov (United States)

    Hanna, Matthew G; Pantanowitz, Liron

    2017-06-01

    The practice of cytopathology has dramatically changed due to advances in genomics and information technology. Cytology laboratories have accordingly become increasingly dependent on pathology informatics support to meet the emerging demands of precision medicine. Pathology informatics deals with information technology in the laboratory, and the impact of this technology on workflow processes and staff who interact with these tools. This article covers the critical role that laboratory information systems, electronic medical records, and digital imaging plays in patient-centered personalized medicine. The value of integrated diagnostic reports, clinical decision support, and the use of whole-slide imaging to better evaluate cytology samples destined for molecular testing is discussed. Image analysis that offers more precise and quantitative measurements in cytology is addressed, as well as the role of bioinformatics tools to cope with Big Data from next-generation sequencing. This article also highlights the barriers to the widespread adoption of these disruptive technologies due to regulatory obstacles, limited commercial solutions, poor interoperability, and lack of standardization. Cancer Cytopathol 2017;125(6 suppl):494-501. © 2017 American Cancer Society. © 2017 American Cancer Society.

  15. Role of nuclear medicine and AIDS: Overview and perspective for future

    International Nuclear Information System (INIS)

    Ganz, W.I.; Serafini, A.N.

    1995-01-01

    The human immunodeficiency virus (HIV) is the causative agent for the expanding epidemic of the acquired immunodeficiency syndrome (AIDS). Sixteen million individuals were estimated to be infected worldwide with HIV by the World Health Organization in 1995, with over 10 million in Africa and one million in the USA. As the HIV cost in dollars and lives continues to rise it will become more important to understand AIDS and to foresee the potential role of nuclear medicine in HIV diseases. Nuclear medicine may have a role in the assessment of immune function, including the ability to predict if individuals can avoid progression to HIV+ status, if pre-AIDS to AIDS conversion can be prevented, and if an individual's immune status requires addition of prophylaxis. Also it can be used for disease detection at an early stage and determination of the extent of disease. It is especially useful to assist clinicians in optimizing therapy and assessing its efficacy. In the future new radiopharmaceuticals for detecting a specific infections and tumors will be needed. This will require collaborative efforts with basic scientists and clinicians working hand in hand to address specific issues related to AIDS

  16. 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.

  17. Shareholder, stakeholder-owner or broad stakeholder maximization

    OpenAIRE

    Mygind, Niels

    2004-01-01

    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 stakeholder-owner. Maximization of shareholder value is a special case of owner-maximization, and only under quite re-strictive assumptions shareholder maximization is larger or equal to stakeholder-owner...

  18. 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...

  19. 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.

  20. The role of emergency physicians in the institutionalization of emergency medicine.

    Science.gov (United States)

    van Schothorst, Jannine; van den Brand, Crispijn L; Gaakeer, Menno I; Wallenburg, Iris

    2017-08-01

    Emergency medicine is a fast-growing medical profession. Nevertheless, the clinical activities emergency physicians (EPs) carry out and the responsibilities they have differ considerably between hospitals. This article addresses the question how the role of EPs is shaped and institutionalized in the everyday context of acute care in hospitals. A cross-case ethnographic study was conducted, comprising observations, document analysis, and in-depth interviews in three emergency departments in the Netherlands. Drawing on the theoretical concept of institutional work, we show that managers, already established medical specialties, and EPs all conduct institutional work to enhance private interests, which both restricts and enlarges EPs' work domain. These actions are strategic and intentional, as well as unintentional and part of EPs' everyday work in acute care delivery. It is in this very process that tasks and responsibilities are redistributed and the role of the EP is shaped. In contemporary literature it is often argued that the role and status of EPs should be enhanced by strengthening regulation and improving training programs. This article shows that attention should also be paid to the more subtle everyday processes of role development.

  1. 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....... Even the smallest company, the single consumer and the tiniest decision made by anyone may in the future – perhaps even tomorrow – affect stakeholders, we didn’t know existed. The future generation is also to be considered as stakeholders, which decisions made today may affect. Companies, consumers......, everyday people including children already know this even from the first day at school if not before. What we need is not knowledge about these phenomena – it is how to think globally when we decide locally: in companies, in daily households, in education of our future generations. This chapter discusses...

  2. EDUCATIONAL PROJECTS STAKEHOLDER MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Юлія Юріївна ГУСЄВА

    2016-02-01

    Full Text Available An approach based on an integration of requirements breakdown structure and work breakdown structure of the project is proposed. It can complement existing methods of project stakeholders classification with the indicator of resource input, which can be defined in monetary terms. A method of requirements monitoring is proposed, which allows you to track the requirements of project stakeholders over time according to the actual amount of resources spent by analogy with the earned value method. Proposed indexes are the basis not only for monitoring but for the forecast of the project. The need of creating of a mechanism for getting baseline data taking into account the existence of different types of requirements of project stakeholders is grounded.

  3. 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 motivation was observed among 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

  4. 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.

  5. Physiological changes due to hepatotoxicity and the protective role of some medicinal plants

    Directory of Open Access Journals (Sweden)

    Howida S. Abou Seif

    2016-06-01

    Full Text Available The liver is the largest, important organ and the site for essential biochemical reactions in the human body. It has the function to detoxify toxic substances and synthesize useful biomolecules. Therefore, damage to the liver leads to grave consequences. This damage resulted from chronic alcoholic abuse, viral hepatitis or inherited metabolic disease. Liver damage is associated with cellular necrosis, fibrosis, and increase in tissue lipid peroxidation and depletion in tissue glutathione level. Most of the hepatotoxic chemicals damage liver cells mainly by inducing lipid peroxidation and other oxidative damages in the liver. Natural antioxidants are found in many compounds classified as secondary plant metabolites, e.g. polyphenols (phenolic acids and flavonoids and terpenoids (carotenoids, and the consumption of foods that contain these compounds in large quantities seems to play an important role in prophylaxis against many diseases. Herbal medicines derived from plant extracts are being increasingly utilized to treat a wide variety of clinical disease. More attention has been paid to the protective effects of natural antioxidants against drug induced toxicities especially whenever free radical generation is involved. Popularity of herbal remedies is increasing and at least one quarter of patients with liver disease use botanicals. The World Health Organization (WHO estimates that 80 percent of the population of some Asian and African countries presently use herbal medicine for some aspect of primary health care. Some medicinal herbs have proven hepatoprotective potential. Silybum marianum (milk thistle has been used to treat liver diseases since the 16th century. Its major constituents are the flavonoids silibinin, silydianin, silychristin, and isosilibinin, of which silibinin is the biologically most active compound and used for standardization of pharmaceutical products.

  6. 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.

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

    Science.gov (United States)

    Egharevba, Efe; Atkinson, Jacqueline

    2016-08-15

    Clinical trials still represent the gold standard in testing the safety and efficacy of new and existing treatments. However, developing regions including sub-Saharan Africa remain underrepresented in pharmaceutical industry sponsored trials for a number of reasons including fear of corruption and unethical behaviour. This fear exists both on the part of pharmaceutical companies, and investigators carrying out research in the region. The objective of this research was to understand the ethical considerations associated with the conduct of pharmaceutical industry sponsored clinical trials in sub-Saharan Africa. Corruption was identified as a significant issue by a number of stakeholders who participated in semi-structured interviews and completed questionnaires. Additionally, fear of being perceived as corrupt or unethical even when conducting ethically sound research was raised as a concern. Thus corruption, whether actual or perceived, is one of a number of issues which have precluded the placement of a greater number of pharmaceutical sponsored clinical trials in this region. 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.

  8. 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

    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......Many cellular functions rely on the coordinated expression and repression of a large number of messenger RNAs; these are tightly controlled in part by microRNAs (miRNAs) at the posttranscriptional level. The number of characterised miRNAs that are involved in tissue development and repair...... 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...

  9. Chemical constituents of the genus Polygonatum and their role in medicinal treatment.

    Science.gov (United States)

    Zhao, Xueying; Li, Ji

    2015-04-01

    Polygonatum is a famous traditional Chinese medicine that is widely used in China, Korea and Japan. In the last decade, constituents of the genus have been reported including steroidal saponins, flavones, alkaloids, lignins, amino acids and carbohydrates, some of which show biological properties such as antiviral and antitumor activity, variable effects on the immune system and anticoagulant activity. In addition, some findings provide novel evidence that Polygonatum species may contain potential anti-tumor and anti-viral proteins for possible medical application and large-scale pharmaceutical production. In this review, we focus on the updated research of the chemical constituents of Polygonatum including polysaccharides, steroidal saponins, flavonoids and lectins, and their potential therapeutic roles.

  10. The role of chemical engineering in medicinal research including Alzheimer’s

    DEFF Research Database (Denmark)

    Kontogeorgis, Georgios M.

    2015-01-01

    Various disciplines of chemical engineering, especially thermodynamics and kinetics, play an important role in medicinal research and this has been particularly recognized during the last 10–15 years (von Stockar and van der Wielen, J Biotechnol 59:25, 1997; Prausnitz, Fluid Phase Equilib 53......:439, 1989; Prausnitz, Pure Appl Chem 79:1435, 2007; Dey and Prausnitz, Ind Eng Chem Res 50:3, 2011; Prausnitz, J Chem Thermodynamics 35:21, 2003; Tsivintzelis et al. AIChE J 55:756, 2009). It is expected that during the twenty-first century chemical engineering and especially thermodynamics can contribute......” disease), and Alzheimer’s which are connected to “protein aggregation.” Several articles in the Perspectives section of prominent chemical engineering journals have addressed this issue (Hall, AIChE J 54:1956, 2008; Vekilov, AIChE J 54:2508, 2008). This work reviews recent applications of thermodynamics...

  11. 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.

  12. Access to essential medicines for sexual and reproductive health care: the role of the pharmaceutical industry and international regulation.

    Science.gov (United States)

    Cottingham, Jane; Berer, Marge

    2011-11-01

    The range of medicines and technologies that are essential for sexual and reproductive health care is well established, but access to them is far from universally assured, particularly in less developed countries. This paper shows how the pharmaceutical industry plays a major role in the lack of access to essential medicines for sexual and reproductive health care, by a) investing in products for profit-making reasons despite their negative health impact (e.g. hormone replacement therapy), b) marketing new essential medicines at prices beyond the reach of countries that most need them (e.g. HPV vaccines), and c) failing to invest in the development of new products (e.g. microbicides and medical abortion pills). Small companies, some of them non-profit-making, struggle to fill some of that demand (e.g. for female condoms). International patent protection contributes to high prices of medicines, and while international agreements such as compulsory licensing under TRIPS and the Medicines Patent Pool allow for mechanisms to enable poorer countries to get access to essential medicines, the obstacles created by "big pharma" are daunting. All these barriers have fostered a market in sub-standard medicines (e.g. fake medical abortion pills sold over the internet). An agenda driven by sexual and reproductive health needs, based on the right to health, must focus on universal access to essential medicines at prices developing countries can afford. We call for greater public investment in essential medicines, expanded production of affordable generic drugs, and the development of broad strategic plans, that include affordable medicines and technologies, for addressing identified public health problems, such as cervical cancer. Copyright © 2011 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  13. 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.

  14. Role of PET/CT for precision medicine in lung cancer: perspective of the Society of Nuclear Medicine and Molecular Imaging.

    Science.gov (United States)

    Greenspan, Bennett S

    2017-12-01

    This article discusses the role of PET/CT in contributing to precision medicine in lung cancer, and provides the perspective of the Society of Nuclear Medicine and Molecular Imaging (SNMMI) on this process. The mission and vision of SNMMI are listed, along with the guidance provided by SNMMI to promote best practice in precision medicine. Basic principles of PET/CT are presented. An overview of the use of PET/CT imaging in lung cancer is discussed. In lung cancer patients, PET/CT is vitally important for optimal patient management. PET/CT is essential in determining staging and re-staging of disease, detecting recurrent or residual disease, evaluating response to therapy, and providing prognostic information. PET/CT is also critically important in radiation therapy planning by determining the extent of active disease, including an assessment of functional tumor volume. The current approach in tumor imaging is a significant advance over conventional imaging. However, recent advances suggest that therapeutic response criteria in the near future will be based on metabolic characteristics and will include the evaluation of biologic characteristics of tumors to further enhance the effectiveness of precision medicine in lung cancer, producing improved patient outcomes with less morbidity.

  15. 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.

  16. Shareholder, stakeholder-owner or broad stakeholder maximization

    DEFF Research Database (Denmark)

    Mygind, Niels

    2004-01-01

    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...... 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...... not traded on the mar-ket, and therefore there is no possibility for practical application. Broad stakeholder maximization instead in practical applications becomes satisfying certain stakeholder demands, so that the practical application will be stakeholder-owner maximization un-der constraints defined...

  17. Workplace health promotion and stakeholder positions: a Finnish case study.

    Science.gov (United States)

    Auvinen, Ari-Matti; Kohtamäki, Kari; Ilvesmäki Msc, Antti

    2012-01-01

    Modern workplace health promotion (WHP) requires collaboration, partnerships, and alliances with both internal and external stakeholders. However, the identification of the key stakeholders as well as the systematic mapping of their views has barely been covered in the existing research literature. This article describes the stakeholders and stakeholder positions in WHP in Finland. In this study, the stakeholders were classified as internal, interface, and external stakeholders. Furthermore, based on the authors' research, stakeholders and their positions were represented on a stakeholder map as well as by the power-interest matrix of the stakeholders. The governmental authorities play a key role in driving the strategic change toward WHP by preparing the required legislation and regulatory measures. However, both active employers and active employees can through their own work accelerate the development of new WHP services. Close collaboration between employers and employees is required at the individual workplaces. Some stakeholders, such as pension funds and occupational health services (OHS) providers, can act as important driving forces and support the strategic implementation of WHP in the workplaces. However, alone they have only limited opportunities to organize the WHP activities. Understanding the various stakeholders and the systematic mapping of their positions is essential for the successful planning and implementation of WHP activities.

  18. 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.

  19. 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.

  20. 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

  1. 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 ...

  2. Culture Matters: The Pivotal Role of Culture for Women’s Careers in Academic Medicine

    Science.gov (United States)

    Speck, Rebecca M.; Dupuis Sammel, Mary; Scott, Patricia; Conant, Emily F.; Tuton, Lucy Wolf; Abbuhl, Stephanie B.; Grisso, Jeane Ann

    2014-01-01

    Purpose Women in academic medicine are not achieving the same career advancement as men, and face unique challenges in managing work and family alongside intense work demands. The purpose of this study was to investigate how a supportive department/division culture buffered women from the impact of work demands on work-to-family conflict. Method As part of a larger intervention trial, the authors collected baseline survey data from 133 women assistant professors at the University of Pennsylvania Perelman School of Medicine in 2010. Validated measures of work demands, work-to-family conflict, and a department/division culture were employed. Pearson correlations and general linear mixed modeling were used to analyze the data. Authors investigated whether work culture moderated the association between work demands and work-to-family conflict. Results Heavy work demands were associated with increased levels of work-to-family conflict. There were significant interactions between work demands, work-to-family conflict, and department/division culture. A culture conducive to women’s academic success significantly moderated the effect of work hours on time-based work-to-family conflict and significantly moderated the effect of work overload on strain-based work-to-family conflict. At equivalent levels of work demands, women in more supportive cultures experienced lower levels of work-to-family conflict. Conclusions The culture of the department/division plays a crucial role in women’s work-to-family conflict and can exacerbate or alleviate the impact of extremely high work demands. This finding leads to important insights about strategies for more effectively supporting the careers of women assistant professors. PMID:24556773

  3. 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.

  4. 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,

  5. 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…

  6. Managing stakeholders in transformational government

    DEFF Research Database (Denmark)

    Reinwald, Anja Kaldahl; Kræmmergaard, Pernille

    2012-01-01

    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...

  7. 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.

  8. 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

  9. 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.

  10. 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.

  11. Resisting market-inspired reform in healthcare: the role of professional subcultures in medicine.

    Science.gov (United States)

    Martinussen, Pål Erling; Magnussen, Jon

    2011-07-01

    The reorganisation efforts of the hospital sector in many Western countries in recent decades have challenged the role, identity and autonomy of medical professionals. This has led to increased focus on the role and impact of physicians who are also managers and on the unique discourse being formed through the integration of medical and managerial knowledge. Following the line of studies addressing the professional subcultures in medicine, we investigated whether assessments of health reform differ between medical doctors with managerial responsibilities and their colleagues at the clinical level as well as between those involved in direct patient care and those who are not. The analysis was performed within the context of the Norwegian hospital sector, where a major reform was implemented in 2002, and it was based on a survey of a representative sample of hospital physicians in 2006. The analysis focused on how the respondents viewed the overall effect of the reform and on the reform's effect on three central health policy goals: equity, quality and productivity. Combining data from the survey with organisational and financial data from the hospitals, we employed multilevel techniques to control for a number of individual and hospital-specific factors that could explain the physicians' views. As expected, respondents with managerial responsibilities were more positive in their evaluations of the reform, whereas respondents who spent time on direct patient-related work showed the opposite pattern. Of the hospital-specific factors of interest, the share of department managers with medical backgrounds and the economic situation positively affected the evaluations. Our findings support the view that, rather than managerialist values colonising the medical profession through a process of hybridisation, there is heterogeneity within the profession: some physician managers are adopting management values and tools, whereas others remain alienated from them. Copyright

  12. Earning empowerment from stakeholders

    International Nuclear Information System (INIS)

    Johnson, P.T.

    1994-01-01

    If you want to be stopped in your tracks today through political action, litigation or both, then ignore the concerns of stakeholders who believe that they have been or will be adversely impacted by what you want to do. The frustrated attempts by the United States to permanently dispose of its high level radioactive waste confirm this reality. Unless and until fundamental changes are made in the decision making process, the gridlock of litigation and political maneuvering precipitated by efforts to perfect a permanent repository will remain and likely intensify

  13. Nuclear Energy Stakeholders in Argentina

    International Nuclear Information System (INIS)

    Gadano, Julian

    2017-01-01

    Mr Gadano, Undersecretary for Nuclear Energy, Argentina spoke from the perspective of a country looking forward to becoming a member of the NEA. He reviewed the place of nuclear energy in his country's energy mix and called attention to its role in positively addressing the global challenges of climate change and energy security. Mr Gadano also described the federal system which governs Argentina. Drawing on his expertise as a lawmaker and nuclear regulator but also as an academic sociologist, he stressed that reaching agreement on siting initiatives for example requires a sustainable relation with stakeholders, including regional governments. This is important because in the end, 'the best project is the one you can finish'

  14. The role of irrational thought in medicine adherence: people with diabetic kidney disease.

    Science.gov (United States)

    Williams, Allison F; Manias, Elizabeth; Walker, Rowan

    2009-10-01

    This paper is a report of a study conducted to examine how irrational thinking affects people's adherence to multiple medicines prescribed to manage their diabetic kidney disease. Approximately 50% of people are non-adherent to their prescribed medicines and the risk of non-adherence escalates as the number of prescribed medicines increases. Adherence to prescribed medicines can slow disease progression in diabetic kidney disease. A descriptive exploratory design was used. In-depth interviews were conducted with 23 participants recruited from a nephrology outpatient clinic in Australia in 2007. Data were analysed using a 'framework' method. Participants' mean age was 59 years, they had approximately six chronic conditions in addition to their diabetic kidney disease and were prescribed a median of ten medicines daily. Two major themes of irrational thinking--heuristics and denial--and subthemes were identified. Heuristics contributed to inaccurate risk assessment and biases affecting rational judgement concerning medicines, whereas denial was used to enhance coping necessary to manage this complex health condition. Participants underestimated their health risks because they had been taking medicines for many years and preferred not to dwell on their ill health. A large amount of irrational thinking was related to maintaining the emotional strength necessary to manage their comorbid conditions as best they could. Regular assessment and support of medicine adherence throughout the disease course is necessary to avert the development of counterproductive heuristics and denial affecting medicine adherence.

  15. 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

  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. The views of key leaders in South Africa on implementation of family medicine: critical role in the district health system.

    Science.gov (United States)

    Moosa, Shabir; Mash, Bob; Derese, Anselme; Peersman, Wim

    2014-06-25

    Integrated team-based primary care is an international imperative. This is required more so in Africa, where fragmented verticalised care dominates. South Africa is trying to address this with health reforms, including Primary Health Care Re-engineering. Family physicians are already contributing to primary care despite family medicine being only fully registered as a full specialty in South Africa in 2008. However the views of leaders on family medicine and the role of family physicians is not clear, especially with recent health reforms. The aim of this study was to understand the views of key government and academic leaders in South Africa on family medicine, roles of family physicians and human resource issues. This was a qualitative study with academic and government leaders across South Africa. In-depth interviews were conducted with sixteen purposively selected leaders using an interview guide. Thematic content analysis was based on the framework method. Whilst family physicians were seen as critical to the district health system there was ambivalence on their leadership role and 'specialist' status. National health reforms were creating both threats and opportunities for family medicine. Three key roles for family physicians emerged: supporting referrals; clinical governance/quality improvement; and providing support to community-oriented care. Respondents' urged family physicians to consolidate the development and training of family physicians, and shape human resource policy to include family physicians. Family physicians were seen as critical to the district health system in South Africa despite difficulties around their precise role. Whilst their role was dominated by filling gaps at district hospitals to reduce referrals it extended to clinical governance and developing community-oriented primary care - a tall order, requiring strong teamwork. Innovative team-based service delivery is possible despite human resource challenges, but requires family

  18. Prehospital Medicine and the Future Will ECMO Ever Play a Role?

    Science.gov (United States)

    Macku, David; Hedvicak, Pavel; Quinn, John; Bencko, Vladimir

    Due to the hybrid warfare currently experienced by multiple NATO coalition and NATO partner nations, the tactical combat casualty care (TCCC) paradigm is greatly challenged. One of the major challenges to TCCC is the ad hoc extension phase in resource-poor environments, referred to as prolonged field care (PFC) and forward resuscitative care (FRC). The nuanced clinical skills with limited resources required by warfighters and auxiliary health care professionals to mitigate death on the battlefield and prevent morbidity and mortality in the PFC phase represent a balance that is still under review. The aim of our article is to describe the connection between extracorporeal membrane oxygenation (ECMO) or the extracorporeal life support (ECLS) treatment and its possible improvement in prehospital trauma care, at a Role 1 or 2 facility and, more provocatively, in the PFC phase of care in the future through innovative technology and how it connects with FRC. We report and describe here the primary components of ECMO/ECLS and present the main concept of a human extracorporeal circulation cocoon as a transitional living form for the cardiopulmonary stabilization of wounded combatants on the battlefield and their transportation to higher echelons of care and treatment facilities (to include damage control resuscitation [DCR] and damage control surgery [DCS]). As clinical governance, these matters would fall within the remit of the Committee on Surgical Combat Casualty Care (CoSCCC) and the Committee on Enroute Combat Casualty Care (CoERCCC), and it is within this framework that we propose this concept piece of ECMO in the prehospital space. We caution that this report is a proposed innovation to TCCC but also serves to push the envelope of the PFC and FRC paradigm. What we propose will not change the practice this year, but as ECMO technology progresses, it may change our practice within the next decade. We conclude with proposed novel future research to save life on the

  19. 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...

  20. What is the role of exotic medicinal plants in local medical systems? A study from the perspective of utilitarian redundancy

    Directory of Open Access Journals (Sweden)

    Nélson Leal Alencar

    Full Text Available Medicinal plants are an important aspect of local medical systems. The composition of a medicinal plant collection is influenced by cultural and environmental factors. Additionally, the functionality of a local medical system can be threatened by the replacement of native species with exotic ones, as well as by cultural factors such as the erosion of knowledge. The objectives of this study are: 1 examine the composition of the medicinal plant collection of two rural communities settled in the caatinga (savanna-like vegetation of the state of Pernambuco (Brazil; 2 observe the role of exotic plants in the local medical systems; and 3 identify the profile of the species utilized according to the Utilitarian Redundancy Model. Similarities were observed between the medicinal floras of the communities studied, emphasizing the importance of the surrounding biome within the possibilities of species selection, although exotic species appear to contribute by increasing the diversity of species considered in the communities to be medicinal. The native species act broadly among the body systems recognized in the two communities, whereas exotic species act in specific body systems, for which there are few associated native species.

  1. Does nurses' role, health or symptoms influence their personal use of ingestible complementary and alternative medicines?

    Science.gov (United States)

    Dimitrelis, Sofia; Perry, Lin; Gallagher, Robyn; Duffield, Christine; Sibbritt, David; Nicholls, Rachel; Xu, Xiaoyue

    2017-12-01

    To investigate the influence of work-related characteristics, health, health behaviours and symptoms on ingestible biologically-based Complementary and Alternative Medicine (CAM) use within the Australian nursing and midwifery workforce. CAM use is widespread worldwide, but there is little research into nurses' and midwives' personal use of ingestible CAM in Australia. An online survey in 2014-15 used validated instruments and items to examine use of ingestible biologically-based CAM (herbs, foods and vitamins, minerals, amino acids, enzymes and other supplements), and the health and work-related characteristics of 5041 nurses and midwives recruited through the New South Wales Nurses and Midwives Association and professional networks. A small proportion of nurses (6.8%) identified as personal CAM users. Most were female, older, worked in foundational roles (frontline Registered and Enrolled Nurses/Midwives) and used one CAM, most commonly a multivitamin, although Vitamin D, Fish Oil, Calcium and Glucosamine±Chondroitin were also common. In comparison to non-users, CAM users were less likely to take sick days or indulge in risky drinking, but more likely to be symptomatic (with stiff joints, bodily/joint pain, severe tiredness, allergies, indigestion/heartburn), diagnosed with osteoarthritis and to adhere to healthy diet recommendations. Findings showed a credible pattern of front line workers with physically demanding workloads that impact their physical health and are linked to frequent symptoms, using CAM treatments and achieving some success in being able to continue working and avoid sickness absence. Further investigation is warranted to protect and maintain the health of the nursing and midwifery workforce. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. 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.

  3. 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...

  4. Integrating Environmental and Stakeholder Management

    DEFF Research Database (Denmark)

    Madsen, Henning; Ulhøi, John Parm

    2001-01-01

    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...... 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...

  5. Sincerity in corporate philanthropy, stakeholder perceptions and firm value

    NARCIS (Netherlands)

    Cuypers, Ilya R. P.; Koh, Ping-Sheng; Wang, Heli

    2016-01-01

    This study extends the literature on symbolic management by incorporating the role of stakeholder perceptions into the context of corporate philanthropy. In particular, we differentiate between the quantitative (generous giving) and qualitative (innovative giving) aspects of giving. We argue that

  6. 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.

  7. 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...

  8. Lab Plays Central Role in Groundbreaking National Clinical Trial in Precision Medicine | FNLCR Staging

    Science.gov (United States)

    The Molecular Characterization Laboratory at the Frederick National Laboratory for Cancer Research lies at the heart of an ambitious new approach for testing cancer drugs that will use the newest tools of precision medicine to select the best treatme

  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. Role of forensic medicine in evaluating non-fatal physical violence against women by their husbands in Jordan.

    Science.gov (United States)

    Abedr-Rahman, Hasan; Salameh, Hafsah Omar; Salameh, Rakiz J; Alabdallat, Laith I; Al-Abdallat, Imad M

    2017-07-01

    Intimate partner violence against women is a major health problem in most nations, but to date, there has been little awareness of the extent or seriousness of this issue in Jordan. Forensic medical practitioners play a significant role in diagnosing, evaluating and reporting these cases. The Jordanian judicial system is dependent on forensic reports. This study aims to assess the role of forensic medicine in evaluating the physical injuries sustained by women who are abused by their husbands. A retrospective review of 158 forensic reports of Jordanian women alleging assault by their husbands and who were seen at Jordan University Hospital over the period 2010-2015. Of the 158 women who presented, 87 had multiple injuries. The majority of injuries were soft tissue injuries, but others included fractures, tympanic membrane perforation, burns and neck contusions. Twelve women were pregnant at the time of the assessment. The period of incapacity caused by these injuries (an important factor for the Jordanian judicial system) was between 1 and 14 days. Intimate partner violence can present with a range of injuries from relatively minor to potentially disabling or life threatening. Forensic medicine has a role in documenting and evaluating these injuries and advising the judicial system in these cases. These are all key elements in increasing the awareness of the nature and extent of this behavior and its impact on women (and men) and the wider society. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  11. Stakeholder analysis in the management of irrigation in Kampili area

    Science.gov (United States)

    Jumiati; Ali, M. S. S.; Fahmid, I. M.; Mahyuddin

    2018-05-01

    Irrigation has appreciable contribution in building food security, particularly rice crops. This study aims to analyze the role of stakeholders involved in distributing of irrigation water. The study was conducted in the Kampili Irrigation Area in South Sulawesi Province Indonesia, the data were obtained through observation and interviews with stakeholders involved, and analysed by stakeholder analysis, based on the interests and power held by the actors. This analysis is intended to provide an optimal picture of the expected role of each stakeholder in the management of irrigation resources. The results show that there were many stakeholders involved in irrigation management. In the arrangement of irrigation distribution there was overlapping authority of the stakeholders to its management, every stakeholder had different interests and power between each other. The existence have given positive and negative values in distributing irrigation water management, then in the stakeholder collaboration there was contestation between them. This contestation took place between the agriculture department, PSDA province, the Jeneberang River Region Hall, the Farmers Group and the P3A.

  12. Role and influence of the patient′s companion in family medicine consultations: "The patient′s perspective"

    Directory of Open Access Journals (Sweden)

    Marie Andrades

    2013-01-01

    Full Text Available Background: Companions often accompany the patient in family medicine clinics and may influence the consultation. This study aims to determine the patients′ perspective regarding the role and influence of the companion in the consultation process. Materials and Methods: A cross-sectional study was conducted at the family medicine clinics of a university hospital. Adult patients accompanied by companions during the consultation were interviewed through a structured questionnaire. Attributes with respect to role and influence of companion on the consultation were assessed. Data was entered and analyzed through IBM Statistical Product and Service Solutions (SPSS software version 18 using the Chi-square test. Results: A total of 100 patients accompanied by companions participated in the study. Majority of companions were present to either provide company (90% and/or emotional support (90%. Immediate relatives had a role in mobility (P = 0.016 and decision making (P = 0.006. Most companions remained passive and did not contribute to the doctor patient relationship (P = 0.058. Male companions were relatively helpful (54% vs. 25%, P = 0.008 in achieving the expectations from the visit. The companion played a supportive role in 62% of the consultations. Conclusion: This study signifies a supportive role of companion in a consultation which emphasizes the need of consultation models to include the "companion."

  13. The role of endemic plants in Mauritian traditional medicine - Potential therapeutic benefits or placebo effect?

    Science.gov (United States)

    Rummun, Nawraj; Neergheen-Bhujun, Vidushi S; Pynee, Kersley B; Baider, Cláudia; Bahorun, Theeshan

    2018-03-01

    The Mauritian endemic flora has been recorded to be used as medicines for nearly 300 years. Despite acceptance of these endemic plants among the local population, proper documentation of their therapeutic uses is scarce. This review aims at summarising documented traditional uses of Mauritian endemic species with existing scientific data of their alleged bioactivities, in a view to appeal for more stringent validations for their ethnomedicinal uses. A comprehensive bibliographic investigation was carried out by analysing published books on ethnopharmacology and international peer-reviewed papers via scientific databases namely ScienceDirect and PubMed. The keywords "Mauritius endemic plants" and "Mauritius endemic medicinal plants" were used and articles published from 1980 to 2016 were considered. 675 works of which 12 articles were filtered which documented the ethnomedicinal uses and 22 articles reported the biological activities of Mauritian endemic plants. Only materials published in English or French language were included in the review. Available data on the usage of Mauritian endemic plants in traditional medicine and scientific investigation were related. We documented 87 taxa of Mauritian endemic plants for their medicinal value. Endemic plants are either used as part of complex herbal formulations or singly, and are prescribed by herbalists to mitigate a myriad of diseases from metabolic disorders, dermatological pathologies, arthritis to sexually transmissible diseases. However, these species have undergone a limited consistent evaluation to validate their purported ethnomedicinal claims. As the World Health Organization Traditional Medicine Strategy 2014-2023 emphasises on moving traditional medicine into mainstream medicine on an equally trusted footage, the re-evaluation and modernization of Mauritius cultural heritage become necessary. With a consumer-driven 'return to nature', scientific validation and valorization of the herbal remedies, including

  14. The Emerging Role of Proteomics in Precision Medicine: Applications in Neurodegenerative Diseases and Neurotrauma.

    Science.gov (United States)

    Alaaeddine, Rana; Fayad, Mira; Nehme, Eliana; Bahmad, Hisham F; Kobeissy, Firas

    2017-01-01

    Inter-individual variability in response to pharmacotherapy has provoked a higher demand to personalize medical decisions. As the field of pharmacogenomics has served to translate personalized medicine from concept to practice, the contribution of the "omics" disciplines to the era of precision medicine seems to be vital in improving therapeutic outcomes. Although we have observed significant advances in the field of genomics towards personalized medicine , the field of proteomics-with all its capabilities- is still in its infancy towards the area of personalized precision medicine. Neurodegenerative diseases and neurotrauma are among the areas where the implementation of neuroproteomics approaches has enabled neuroscientists to broaden their understanding of neural disease mechanisms and characteristics. It has been shown that the influence of epigenetics, genetics and environmental factors were among the recognized factors contributing to the diverse presentation of a single disease as well as its treatment establishing the factor-disease interaction. Thus, management of these variable single disease presentation/outcome necessitated the need for factoring the influence of epigenetics, genetics, epigenetics, and other factors on disease progression to create a custom treatment plan unique to each individual. In fact, neuroproteomics with its high ability to decipher protein alterations along with their post translational modifications (PTMs) can be an ideal tool for personalized medicine goals including: discovery of molecular mechanisms underlying disease pathobiology, development of novel diagnostics, enhancement of pharmacological neurotherapeutic approaches and finally, providing a "proteome identity" for patients with certain disorders and diseases. So far, neuroproteomics approaches have excelled in the areas of biomarker discovery arena where several diagnostic, prognostic and injury markers have been identified with a direct impact on the

  15. 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…

  16. 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

  17. Stakeholder orientation vs. shareholder value

    DEFF Research Database (Denmark)

    Rose, Caspar

    2003-01-01

    management in listed firms and other traditional remedies. The theoretical insightsare applied on a case from the Danish Supreme Court (Louis Poulsen A/S) where theinterests of the stakeholders were decisive. However, it is shown that the verdict mayinstead harm the relevant stakeholders illustrating how...

  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. Open Innovation and Stakeholder Engagement

    Directory of Open Access Journals (Sweden)

    Robert Wayne Gould

    2012-09-01

    Full Text Available The paradox of open innovation lies in the conflict between the practical desire to reap the benefits of open innovation and concern over the risk that others will misappropriate those benefits. Stakeholder theory and recent developments in value creation through stakeholder engagement can assist with reconciliation of this inherent structural risk. The limitations of existing open innovation typologies are identified, and a process-based model of open innovation is proposed. The model is then expanded to include stakeholder engagement. When integrated with stakeholder engagement, open innovation processes can be understood to generate benefits beyond the acquisition of specific information sought from external experts. The addition of stakeholder engagement to the open innovation model allows for greater understanding and easier acceptance of the risks inherent in the open innovation process.

  20. 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' sta...... 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.......' stakeholder-oriented sustainability activities. Findings – The paper illustrates how a company is striving to transform the general stakeholder principles into concrete, manageable actions. Moreover, the paper describes some of the needs, challenges, and paradoxes experienced by an organisation that is trying...

  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...... lacked between the company and stakeholders. Vattenfall was accused of green-washing, resulting in a communications crisis. Negative stakeholder reactions consisted of prejudiced and non-negotiable argumentation indicating that social media imposes new managerial challenges since communication processes...... technologies and we question to what extent social media serve the enhancement of improved understandings across corporate and civil society on CSR issues. This paper suggests that managers face a risk of the “double-edge of stakeholder communication” when incorporating social media into their CSR strategies...

  2. Ensuring the Safety and Accuracy of Radiation Medicine: The Role of Medical Physicists

    International Nuclear Information System (INIS)

    Dixit, Aabha

    2014-01-01

    In nuclear medicine and radiology, what are the risks of carrying out a procedure without the presence of a qualified medical physicist and without adequate guidelines? • The patient may receive an incorrect dose which can jeopardize the success of the medical treatment or the quality of diagnosis; • The medical staff and the public might be in danger of radiation exposure; • In extreme cases, the procedure could lead to a serious accident. Globally, over 10 000 hospitals use radioisotopes in medicine, with almost 90 per cent for diagnostic procedures. Nuclear medicine technologies, both for treatment and diagnostic imaging for diseases such as cancer or cardiovascular diseases, are being constantly developed and deployed globally in health care systems

  3. 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

  4. Health is primary: Family medicine for America's health.

    Science.gov (United States)

    Phillips, Robert L; Pugno, Perry A; Saultz, John W; Tuggy, Michael L; Borkan, Jeffrey M; Hoekzema, Grant S; DeVoe, Jennifer E; Weida, Jane A; Peterson, Lars E; Hughes, Lauren S; Kruse, Jerry E; Puffer, James C

    2014-10-01

    More than a decade ago the American Academy of Family Physicians, American Academy of Family Physicians Foundation, American Board of Family Medicine, Association of Departments of Family Medicine, Association of Family Practice Residency Directors, North American Primary Care Research Group, and Society of Teachers of Family Medicine came together in the Future of Family Medicine (FFM) to launch a series of strategic efforts to "renew the specialty to meet the needs of people and society," some of which bore important fruit. Family Medicine for America's Health was launched in 2013 to revisit the role of family medicine in view of these changes and to position family medicine with new strategic and communication plans to create better health, better health care, and lower cost for patients and communities (the Triple Aim). Family Medicine for America's Health was preceded and guided by the development of a family physician role definition. A consulting group facilitated systematic strategic plan development over 9 months that included key informant interviews, formal stakeholder surveys, future scenario testing, a retreat for family medicine organizations and stakeholder representatives to review strategy options, further strategy refinement, and finally a formal strategic plan with draft tactics and design for an implementation plan. A second communications consulting group surveyed diverse stakeholders in coordination with strategic planning to develop a communication plan. The American College of Osteopathic Family Physicians joined the effort, and students, residents, and young physicians were included. The core strategies identified include working to ensure broad access to sustained, primary care relationships; accountability for increasing primary care value in terms of cost and quality; a commitment to helping reduce health care disparities; moving to comprehensive payment and away from fee-for-service; transformation of training; technology to support

  5. 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.

  6. 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.

  7. Healthy lifestyle interventions to combat noncommunicable disease-a novel nonhierarchical connectivity model for key stakeholders: a policy statement from the American Heart Association, European Society of Cardiology, European Association for Cardiovascular Prevention and Rehabilitation, and American College of Preventive Medicine.

    Science.gov (United States)

    Arena, Ross; Guazzi, Marco; Lianov, Liana; Whitsel, Laurie; Berra, Kathy; Lavie, Carl J; Kaminsky, Leonard; Williams, Mark; Hivert, Marie-France; Cherie Franklin, Nina; Myers, Jonathan; Dengel, Donald; Lloyd-Jones, Donald M; Pinto, Fausto J; Cosentino, Francesco; Halle, Martin; Gielen, Stephan; Dendale, Paul; Niebauer, Josef; Pelliccia, Antonio; Giannuzzi, Pantaleo; Corra, Ugo; Piepoli, Massimo F; Guthrie, George; Shurney, Dexter; Arena, Ross; Berra, Kathy; Dengel, Donald; Franklin, Nina Cherie; Hivert, Marie-France; Kaminsky, Leonard; Lavie, Carl J; Lloyd-Jones, Donald M; Myers, Jonathan; Whitsel, Laurie; Williams, Mark; Corra, Ugo; Cosentino, Francesco; Dendale, Paul; Giannuzzi, Pantaleo; Gielen, Stephan; Guazzi, Marco; Halle, Martin; Niebauer, Josef; Pelliccia, Antonio; Piepoli, Massimo F; Pinto, Fausto J; Guthrie, George; Lianov, Liana; Shurney, Dexter

    2015-08-14

    Noncommunicable diseases (NCDs) have become the primary health concern for most countries around the world. Currently, more than 36 million people worldwide die from NCDs each year, accounting for 63% of annual global deaths; most are preventable. The global financial burden of NCDs is staggering, with an estimated 2010 global cost of $6.3 trillion (US dollars) that is projected to increase to $13 trillion by 2030. A number of NCDs share one or more common predisposing risk factors, all related to lifestyle to some degree: (1) cigarette smoking, (2) hypertension, (3) hyperglycemia, (4) dyslipidemia, (5) obesity, (6) physical inactivity, and (7) poor nutrition. In large part, prevention, control, or even reversal of the aforementioned modifiable risk factors are realized through leading a healthy lifestyle (HL). The challenge is how to initiate the global change, not toward increasing documentation of the scope of the problem but toward true action-creating, implementing, and sustaining HL initiatives that will result in positive, measurable changes in the previously defined poor health metrics. To achieve this task, a paradigm shift in how we approach NCD prevention and treatment is required. The goal of this American Heart Association/European Society of Cardiology/European Association for Cardiovascular Prevention and Rehabilitation/American College of Preventive Medicine policy statement is to define key stakeholders and highlight their connectivity with respect to HL initiatives. This policy encourages integrated action by all stakeholders to create the needed paradigm shift and achieve broad adoption of HL behaviors on a global scale. © 2015 Mayo Foundation for Medical Education and Research, and the European Society of Cardiology. This article is being published concurrently in Mayo Clinic Proceedings [1]. The articles are identical except for minor stylistic and spelling differences in keeping with each journal's style. Either citation can be used when

  8. 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.

  9. From Metabonomics to Pharmacometabonomics: The Role of Metabolic Profiling in Personalized Medicine

    Science.gov (United States)

    Everett, Jeremy R.

    2016-01-01

    Variable patient responses to drugs are a key issue for medicine and for drug discovery and development. Personalized medicine, that is the selection of medicines for subgroups of patients so as to maximize drug efficacy and minimize toxicity, is a key goal of twenty-first century healthcare. Currently, most personalized medicine paradigms rely on clinical judgment 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. PMID:27660611

  10. Lab Plays Central Role in Groundbreaking National Clinical Trial in Precision Medicine | Poster

    Science.gov (United States)

    The Molecular Characterization Laboratory lies at the heart of an ambitious new approach for testing cancer drugs that will use the newest tools of precision medicine to select the best treatment for individual patients based on the genetic makeup of their tumors. The protocol, called NCI-Molecular Analysis for Therapy Choice (NCI-MATCH), will start with tumor biopsies from as

  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. 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.

  13. [Role and management of cancer clinical database in the application of gastric cancer precision medicine].

    Science.gov (United States)

    Li, Yuanfang; Zhou, Zhiwei

    2016-02-01

    Precision medicine is a new medical concept and medical model, which is based on personalized medicine, rapid progress of genome sequencing technology and cross application of biological information and big data science. Precision medicine improves the diagnosis and treatment of gastric cancer to provide more convenience through more profound analyses of characteristics, pathogenesis and other core issues in gastric cancer. Cancer clinical database is important to promote the development of precision medicine. Therefore, it is necessary to pay close attention to the construction and management of the database. The clinical database of Sun Yat-sen University Cancer Center is composed of medical record database, blood specimen bank, tissue bank and medical imaging database. In order to ensure the good quality of the database, the design and management of the database should follow the strict standard operation procedure(SOP) model. Data sharing is an important way to improve medical research in the era of medical big data. The construction and management of clinical database must also be strengthened and innovated.

  14. 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.

  15. The Role of Space Medicine in Management of Risk in Spaceflight

    Science.gov (United States)

    Clark, Jonathan B.

    2001-01-01

    The purpose of Space Medicine is to ensure mission success by providing quality and comprehensive health care throughout all mission phases to optimize crew health and performance and to prevent negative long-term health consequences. Space flight presents additional hazards and associated risks to crew health, performance, and safety. With an extended human presence in space it is expected that illness and injury will occur on orbit, which may present a significant threat to crew health and performance and to mission success. Maintaining crew health, safety and performance and preventing illness and injury are high priorities necessary for mission success and agency goals. Space flight health care should meet the standards of practice of evidence based clinical medicine. The function of Space Medicine is expected to meet the agency goals as stated in the 1998 NASA Strategic Plan and the priorities established by the Critical Path Roadmap Project. The Critical Path Roadmap Project is an integrated NASA cross-disciplinary strategy to assess, understand, mitigate, and manage the risks associated with long-term exposure to the space flight environment. The evidence based approach to space medicine should be standardized, objective process yielding expected results and establishing clinical practice standards while balancing individual risk with mission (programmatic) risk. The ability to methodically apply available knowledge and expertise to individual and mission health issues will ensure appropriate priorities are assigned and resources are allocated. NASA Space Medicine risk management process is a combined clinical and engineering approach. Competition for weight, power, volume, cost, and crew time must be balanced in making decisions about the care of individual crew with competing agency resources.

  16. 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)

  17. 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

  18. 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

  19. 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

  20. 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.

  1. Athletes and the arts--the role of sports medicine in the performing arts.

    Science.gov (United States)

    Dick, Randall W; Berning, Jacqueline R; Dawson, William; Ginsburg, Richard D; Miller, Clay; Shybut, George T

    2013-01-01

    Performing artists are athletes. Like athletes, performing artists practice and/or perform most days with little off season, play through pain, "compete" in challenging environments, and risk career-threatening injury. Athletes and the Arts is a multiorganizational initiative linking the sport athlete and musician/performing artist communities. Performing artists of all ages and genre are an underserved population related to medical coverage, care, injury prevention, performance enhancement, and wellness. Sports medicine professionals are a valuable resource for filling this gap by applying existing knowledge of treating sport athletes (nutrition, injury prevention) while gaining a better understanding of performers' unique needs (hearing loss, focal dystonia) and environment. These applications can occur in the clinical setting and through developing organizational policies. By better understanding the needs of the performing arts population and applying existing concepts and knowledge, sports medicine professionals can expand their impact to a new patient base that desperately needs support.

  2. 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.

  3. 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.

  4. 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.

  5. Translating stem cell therapies: the role of companion animals in regenerative medicine

    OpenAIRE

    Volk, Susan W.; Theoret, Christine

    2013-01-01

    Veterinarians and veterinary medicine have been integral to the development of stem cell therapies. The contributions of large animal experimental models to the development and refinement of modern hematopoietic stem cell transplantation were noted nearly five decades ago. More recent advances in adult stem cell/regenerative cell therapies continue to expand knowledge of the basic biology and clinical applications of stem cells. A relatively liberal legal and ethical regulation of stem cell r...

  6. Use of Strychnos Nux-Vomica (Azraqi) Seeds in Unani System of Medicine: Role of Detoxification

    OpenAIRE

    Akbar, Seema; Khan, Shamshad A; Masood, Akbar; Iqbal, M

    2010-01-01

    Some plants used in Unani system of medicine are toxic, even deadly poisonous. The drugs having such plants as their components are detoxified before they are dispensed to the patients. One such drug, capsule Hudar, has Strychnos nux-vomica L. (Azraqi) seeds as one of its components and is very effectively used to elevate blood pressure. Ancient manuscripts describe many methods of its detoxification. It has been found that the detoxification processes studied reduce the strychnine content, a...

  7. 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.

  8. 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

  9. 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

  10. 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

  11. Linking environmental and stakeholder management

    DEFF Research Database (Denmark)

    Madsen, Henning; Ulhøi, John Parm

    1999-01-01

    is to discuss how the influence from an increasing number of stakeholders may influence the companies to adopt a more proactive attitude towards environmentally related initiatives. The first part of the paper will discuss the relevant theory and introduce a model to analyse and identify the most relevant......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...... stakeholder groups and their influence. Based on a recent survey among Danish companies the second part of the paper will report on the actual perceived influence from a variety of stakeholders to force companies to introduce environmentally-related initiatives. The results will then be discussed in light...

  12. Port Stakeholder Summit - April 2014

    Science.gov (United States)

    EPA's National Port Stakeholders Summit, Advancing More Sustainable Ports, focused on actions to protect air quality while reducing climate risk and supporting economic growth, making ports more environmentally sustainable.

  13. 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

  14. 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

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

    Energy Technology Data Exchange (ETDEWEB)

    Moody, D.C.; Peterson, E.J. (comps.)

    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.

  16. Stakeholder conflicts and dividend policy

    OpenAIRE

    Bøhren, Øyvind; Josefsen, Morten G.; Steen, Pål E.

    2012-01-01

    This is the authors’ final, accepted and refereed manuscript to the article This paper compares the dividend policy of owner-controlled firms with that of firms where the owners are a minority relative to non-owner employees, customers, and community citizens. We find that regardless of whether owners or non-owners control the firm, the strong stakeholder uses the dividend payout decision to mitigate rather than to intensify the conflict of interest with the weak stakeholder. H...

  17. 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.

  18. 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

  19. The future of discovery chemistry: quo vadis? Academic to industrial--the maturation of medicinal chemistry to chemical biology.

    Science.gov (United States)

    Hoffmann, Torsten; Bishop, Cheryl

    2010-04-01

    At Roche, we set out to think about the future role of medicinal chemistry in drug discovery in a project involving both Roche internal stakeholders and external experts in drug discovery chemistry. To derive a coherent strategy, selected scientists were asked to take extreme positions and to derive two orthogonal strategic options: chemistry as the traditional mainstream science and chemistry as the central entrepreneurial science. We believe today's role of medicinal chemistry in industry has remained too narrow. To provide the innovation that industry requires, medicinal chemistry must play its part and diversify at pace with our increasing understanding of chemical biology and network pharmacology. 2010 Elsevier Ltd. All rights reserved.

  20. 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.

  1. 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.

  2. Role of nuclear medicine bone scans in evaluating pain in athletic injuries

    International Nuclear Information System (INIS)

    Martire, J.R.

    1987-01-01

    The utilization of nuclear medicine bone scanning examinations early in the diagnostic process allows physicians to render prompt and correct treatment in urgent or difficult athletic cases. Bone scanning should be performed for athletic injuries whenever (1) x-rays are normal but bone or joint pain persists; (2) x-rays are positive but it cannot be determined if the findings are acute or chronic; (3) soft-tissue injuries present and x-rays are not useful; and (4) bone pain or joint impairment present without a history of trauma.89 references

  3. Healthy Lifestyle Interventions to Combat Noncommunicable Disease—A Novel Nonhierarchical Connectivity Model for Key Stakeholders: A Policy Statement From the American Heart Association, European Society of Cardiology, European Association for Cardiovascular Prevention and Rehabilitation, and American College of Preventive Medicine.

    Science.gov (United States)

    Arena, Ross; Guazzi, Marco; Lianov, Liana; Whitsel, Laurie; Berra, Kathy; Lavie, Carl J; Kaminsky, Leonard; Williams, Mark; Hivert, Marie-France; Franklin, Nina Cherie; Myers, Jonathan; Dengel, Donald; Lloyd-Jones, Donald M; Pinto, Fausto J; Cosentino, Francesco; Halle, Martin; Gielen, Stephan; Dendale, Paul; Niebauer, Josef; Pelliccia, Antonio; Giannuzzi, Pantaleo; Corra, Ugo; Piepoli, Massimo F; Guthrie, George; Shurney, Dexter

    2015-08-01

    Noncommunicable diseases (NCDs) have become the primary health concern for most countries around the world. Currently, more than 36 million people worldwide die from NCDs each year, accounting for 63% of annual global deaths; most are preventable. The global financial burden of NCDs is staggering, with an estimated 2010 global cost of $6.3 trillion (US dollars) that is projected to increase to $13 trillion by 2030. A number of NCDs share one or more common predisposing risk factors, all related to lifestyle to some degree: (1) cigarette smoking, (2) hypertension, (3) hyperglycemia, (4) dyslipidemia, (5) obesity, (6) physical inactivity, and (7) poor nutrition. In large part, prevention, control, or even reversal of the aforementioned modifiable risk factors are realized through leading a healthy lifestyle (HL). The challenge is how to initiate the global change, not toward increasing documentation of the scope of the problem but toward true action-creating, implementing, and sustaining HL initiatives that will result in positive, measurable changes in the previously defined poor health metrics. To achieve this task, a paradigm shift in how we approach NCD prevention and treatment is required. The goal of this American Heart Association/European Society of Cardiology/European Association for Cardiovascular Prevention and Rehabilitation/American College of Preventive Medicine policy statement is to define key stakeholders and highlight their connectivity with respect to HL initiatives. This policy encourages integrated action by all stakeholders to create the needed paradigm shift and achieve broad adoption of HL behaviors on a global scale. Copyright © 2015 Mayo Foundation for Medical Education and Research and the European Society of Cardiology. Published by Elsevier Inc. All rights reserved.

  4. 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

  5. Environmental Assessments and Stakeholder Involvement

    Energy Technology Data Exchange (ETDEWEB)

    Wesolowski, Cassandra [Univ. of Manchester, School of Environment and Development (United Kingdom). Planning and Landscape

    2006-09-15

    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.

  6. 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

  7. 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

  8. Role of Anthropometric Dimensions of Human Body in Identifying Temperament in Traditional Persian Medicine

    Directory of Open Access Journals (Sweden)

    A Vahedi

    2016-07-01

    Full Text Available BACKGROUND AND OBJECTIVE: From the viewpoint of Traditional Persian Medicine (TPM, temperament of each person influences his physical and physiological properties such as body dimensions. The aim of this study is to review the reasons behind the diversity of human anthropometric measurements and their status in identifying temperament of people. METHODS: In this descriptive study, we searched online databases such as Sid.ir, PubMed, Scopus, Magiran.com and Google Scholar for Persian key words such as "Anthropometry", "ergonomics" and "temperament" and their English equivalent. Authentic TPM books such as "The Canon of Medicine" by Avicenna, "Complete Book of the Medical Art" by al-Majusi, "al-Mansouri fi al-Tibb" (The book on medicine dedicated to al-Mansur by Zakariya al-Razi, " Kholasa't ol Hikma" (summary of wisdom by Aghili Khorasani, “Zakhireh kharazmshahi”(The treasure of Kharazm Shah by Ismail Jurjani and "Bahr al-jawahir" (sea jewels were also studied. FINDINGS: Results of the study demonstrated that there is a direct relationship between weight gain, BMI and dimensions of soft tissue which are primarily signs of obesity and fat gain and cardiovascular diseases and diabetes. Since increase in the aforementioned indices can be a sign of coldness and wetness of temperament, one can argue that people with cold and wet temperament are more susceptible to such diseases. In references of TPM, temperament is mentioned as an agent that changes body dimensions and among the indices that identify temperament, "shape of organs" and "physique" is related to anatomic dimensions of body and obesity and thinness condition, receptively. Magnitude of chest and other organs is a sign of hotness; thinness is a sign of dryness; dominance of muscle tissue is a sign of hotness and wetness and dominance of adipose tissue is a sign of coldness and wetness of temperament. CONCLUSION: According to the results of the present study, variety of anthropometric

  9. 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)

  10. 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.

  11. [Role of complementary medicine in type 1 diabetes mellitus in two Swiss centres].

    Science.gov (United States)

    Scheidegger, U A; Flück, C E; Scheidegger, K; Diem, P; Mullis, P E

    2009-09-09

    Insulin replacement is the only effective treatment of type 1 Diabetes mellitus (T1DM). Nevertheless, many complementary treatments are in use for T1DM. In this study we assessed by questionnaire that out of 342 patients with T1DM, 48 (14%; 13.4% adult, 18.5% paediatric; 20 male, 28 female) used complementary medicine (CM) in addition to their insulin therapy. The purpose of the use of CM was to improve general well-being, ameliorate glucose homeostasis, reduce blood glucose levels as well as insulin doses, improve physical fitness, reduce the frequency of hypoglycaemia, and control appetite. The modalities most frequently used are cinnamon, homeopathy, magnesium and special beverages (mainly teas). Thus, good collaboration between health care professionals will allow optimal patient care.

  12. 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

  13. Use of Strychnos nux-vomica (Azraqi) seeds in Unani system of medicine: role of detoxification.

    Science.gov (United States)

    Akbar, Seema; Khan, Shamshad A; Masood, Akbar; Iqbal, M

    2010-01-01

    Some plants used in Unani system of medicine are toxic, even deadly poisonous. The drugs having such plants as their components are detoxified before they are dispensed to the patients. One such drug, capsule Hudar, has Strychnos nux-vomica L. (Azraqi) seeds as one of its components and is very effectively used to elevate blood pressure. Ancient manuscripts describe many methods of its detoxification. It has been found that the detoxification processes studied reduce the strychnine content, as determined either by using uv-vis spectrophotometer or HPLC, present in Strychnos nux vomica seeds which is responsible for Strychnos nux vomica toxicity. The decrease in strychnine amount was best when the seeds were immersed for detoxification in excess of water for 5 days, in milk for 2 days followed by their boiling in milk. Strychnine in small amounts has been reported to give subjective feeling of stimulation.

  14. 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.

  15. [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.

  16. [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.

  17. 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

  18. 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

  19. 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.

  20. 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.

  1. 78 FR 20119 - Broad Stakeholder Survey

    Science.gov (United States)

    2013-04-03

    ... DEPARTMENT OF HOMELAND SECURITY [Docket No. DHS-2012-0042] Broad Stakeholder Survey AGENCY... concerning the Broad Stakeholder Survey. DHS previously published this ICR in the Federal Register on August... across the Nation. The Broad Stakeholder Survey is designed to gather stakeholder feedback on the...

  2. 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.

  3. 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...

  4. Business resiliency and stakeholder management.

    Science.gov (United States)

    Carey, Noel; Perry, Tony

    2014-01-01

    The authors facilitated separate round table discussions at the City and Financial Conference in London on 29th January, 2014. The theme of these discussions was business resiliency and stakeholder management. This topic attracted the largest group of all the breakout sessions, as the issue continues to generate much interest across the business resilience community. In this paper, the authors summarise the discussions held at the event and add their own insights into the subject of who are stakeholders, and the different means and messages to communicate to them.

  5. Stakeholder Engagement Through Social Media

    DEFF Research Database (Denmark)

    Etter, Michael; Castello, Itziar

    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......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...... introduced by social media....

  6. 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

  7. 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.

  8. Ebola outbreak response: the role of information resources and the National Library of Medicine.

    Science.gov (United States)

    Love, Cynthia B; Arnesen, Stacey J; Phillips, Steven J

    2015-02-01

    The US National Library of Medicine (NLM) offers Internet-based, no-cost resources useful for responding to the 2014 West Africa Ebola outbreak. Resources for health professionals, planners, responders, and researchers include PubMed, Disaster Lit, the Web page "Ebola Outbreak 2014: Information Resources," and the Virus Variation database of sequences for Ebolavirus. In cooperation with participating publishers, NLM offers free access to full-text articles from over 650 biomedical journals and 4000 online reference books through the Emergency Access Initiative. At the start of a prolonged disaster event or disease outbreak, the documents and information of most immediate use may not be in the peer-reviewed biomedical journal literature. To maintain current awareness may require using any of the following: news outlets; social media; preliminary online data, maps, and situation reports; and documents published by nongovernmental organizations, international associations, and government agencies. Similar to the pattern of interest shown in the news and social media, use of NLM Ebola-related resources is also increasing since the start of the outbreak was first reported in March 2014.

  9. Addressing overuse in emergency medicine: evidence of a role for greater patient engagement.

    Science.gov (United States)

    Newton, Erika H

    2017-12-01

    Overuse of health care refers to tests, treatments, and even health care settings when used in circumstances where they are unlikely to help. Overuse is not only wasteful, it threatens patient safety by exposing patients to a greater chance of harm than benefit. It is a widespread problem and has proved resistant to change. Overuse of diagnostic testing is a particular problem in emergency medicine. Emergency physicians cite fear of missing a diagnosis, fear of law suits, and perceived patient expectations as key contributors. However, physicians' assumptions about what patients expect are often wrong, and overlook two of patients' most consistently voiced priorities: communication and empathy. Evidence indicates that patients who are more fully informed and engaged in their care often opt for less aggressive approaches. Shared decision making refers to (1) providing balanced information so that patients understand their options and the trade-offs involved, (2) encouraging them to voice their preferences and values, and (3) engaging them-to the extent appropriate or desired-in decision making. By adopting this approach to discretionary decision making, physicians are better positioned to address patients' concerns without the use of tests and treatments patients neither need nor value.

  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. [Application of evidence based medicine to the individual patient: the role of decision analysis].

    Science.gov (United States)

    Housset, B; Junod, A F

    2003-11-01

    The objective of evidence based medicine (EBM) is to contribute to medical decision making by providing the best possible information in terms of validity and relevance. This allows evaluation in a specific manner of the benefits and risks of a decision. The limitations and hazards of this approach are discussed in relation to a clinical case where the diagnosis of pulmonary embolism was under consideration. The individual details and the limited availability of some technical procedures illustrate the need to adapt the data of EBM to the circumstances. The choice between two diagnostic tests (d-dimers and ultrasound of the legs) and their optimal timing is analysed with integration of the consequences for the patient of the treatments proposed. This allows discussion of the concept of utility and the use of sensitivity analysis. If EBM is the cornerstone of rational and explicit practise it should also allow for the constraints of real life. Decision analysis, which depends on the same critical demands as EBM but can also take account of the individual features of each patient and test the robustness of a decision, gives a unique opportunity reconcile rigorous reasoning with individualisation of management.

  12. 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

  13. 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

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

    Science.gov (United States)

    Pachankis, John E.

    2016-01-01

    Abstract Purpose: 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. Methods: 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. Results: 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 work–life balance as strong influences on specialty choice. Exposure as a medical student to SGM faculty did not predict specialty prestige among SGM. Conclusion: 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

  15. STAKEHOLDER LINKAGES FOR SUSTAINABLE LAND ...

    African Journals Online (AJOL)

    Osondu

    Key words: Stakeholders; farmer-expert linkages; resource management; Ethiopia. Introduction ... decentralized democratic decision making processes and thus ..... district offices within the given time limits. They were often .... -less willing and less ready to hearing weaker performance reports (expect more success with ...

  16. Managing resources through stakeholder networks

    NARCIS (Netherlands)

    Ogada, Job Ochieng; Krhoda, George Okoye; Veen, Van Der Anne; Marani, Martin; Oel, van Pieter Richards

    2017-01-01

    Stakeholder analysis and social network analysis were used to analyze stakeholders’ social and structural characteristics based on their interests, influence and interactions in Lake Naivasha basin, Kenya. Even though the Kenyan government and its agencies seem to command higher influence and

  17. 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...

  18. Engaging Stakeholders in Curriculum Development

    Science.gov (United States)

    Wood, Jo Nell

    2010-01-01

    This article investigates the importance of parent and community engagement in curriculum development, along with curriculum leadership, engaging stakeholders, and the importance of curriculum. Parent and community member engagement is examined in light of curriculum committee participation as reported by Missouri superintendents. Survey responses…

  19. 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

  20. Role of Statistical Random-Effects Linear Models in Personalized Medicine.

    Science.gov (United States)

    Diaz, Francisco J; Yeh, Hung-Wen; de Leon, Jose

    2012-03-01

    Some empirical studies and recent developments in pharmacokinetic theory suggest that statistical random-effects linear models are valuable tools that allow describing simultaneously patient populations as a whole and patients as individuals. This remarkable characteristic indicates that these models may be useful in the development of personalized medicine, which aims at finding treatment regimes that are appropriate for particular patients, not just appropriate for the average patient. In fact, published developments show that random-effects linear models may provide a solid theoretical framework for drug dosage individualization in chronic diseases. In particular, individualized dosages computed with these models by means of an empirical Bayesian approach may produce better results than dosages computed with some methods routinely used in therapeutic drug monitoring. This is further supported by published empirical and theoretical findings that show that random effects linear models may provide accurate representations of phase III and IV steady-state pharmacokinetic data, and may be useful for dosage computations. These models have applications in the design of clinical algorithms for drug dosage individualization in chronic diseases; in the computation of dose correction factors; computation of the minimum number of blood samples from a patient that are necessary for calculating an optimal individualized drug dosage in therapeutic drug monitoring; measure of the clinical importance of clinical, demographic, environmental or genetic covariates; study of drug-drug interactions in clinical settings; the implementation of computational tools for web-site-based evidence farming; design of pharmacogenomic studies; and in the development of a pharmacological theory of dosage individualization.

  1. 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

  2. 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.

  3. A lifeline to treatment: the role of Indian generic manufacturers in supplying antiretroviral medicines to developing countries.

    Science.gov (United States)

    Waning, Brenda; Diedrichsen, Ellen; Moon, Suerie

    2010-09-14

    Indian manufacturers of generic antiretroviral (ARV) medicines facilitated the rapid scale up of HIV/AIDS treatment in developing countries though provision of low-priced, quality-assured medicines. The legal framework in India that facilitated such production, however, is changing with implementation of the World Trade Organization Agreement on Trade-Related Aspects of Intellectual Property Rights, and intellectual property measures being discussed in regional and bilateral free trade agreement negotiations. Reliable quantitative estimates of the Indian role in generic global ARV supply are needed to understand potential impacts of such measures on HIV/AIDS treatment in developing countries. We utilized transactional data containing 17,646 donor-funded purchases of ARV tablets made by 115 low- and middle-income countries from 2003 to 2008 to measure market share, purchase trends and prices of Indian-produced generic ARVs compared with those of non-Indian generic and brand ARVs. Indian generic manufacturers dominate the ARV market, accounting for more than 80% of annual purchase volumes. Among paediatric ARV and adult nucleoside and non-nucleoside reverse transcriptase inhibitor markets, Indian-produced generics accounted for 91% and 89% of 2008 global purchase volumes, respectively. From 2003 to 2008, the number of Indian generic manufactures supplying ARVs increased from four to 10 while the number of Indian-manufactured generic products increased from 14 to 53. Ninety-six of 100 countries purchased Indian generic ARVs in 2008, including high HIV-burden sub-Saharan African countries. Indian-produced generic ARVs used in first-line regimens were consistently and considerably less expensive than non-Indian generic and innovator ARVs. Key ARVs newly recommended by the World Health Organization are three to four times more expensive than older regimens. Indian generic producers supply the majority of ARVs in developing countries. Future scale up using newly

  4. 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.

  5. 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

  6. 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.

  7. 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.

  8. Advanced Renal Cell Carcinoma: Role of the Radiologist in the Era of Precision Medicine.

    Science.gov (United States)

    Shinagare, Atul B; Krajewski, Katherine M; Braschi-Amirfarzan, Marta; Ramaiya, Nikhil H

    2017-08-01

    For the past decade, advanced renal cell carcinoma (RCC) has been at the forefront of oncologic innovation. Our rapidly evolving understanding of the molecular and genetic basis of RCC has revolutionized the management of advanced RCC; 10 novel molecular targeted agents and immune checkpoint inhibitor have received U.S. Food and Drug Administration approval for treatment of advanced RCC in a little over a decade. Amid this progress, imaging has assumed a central role in metastatic surveillance and follow-up of advanced RCC. State-of-the-art knowledge of the molecular basis of RCC and its treatment and imaging will help ensure that the radiology community remains relevant and central in the care of patients with advanced RCC. This article will review developments in management of advanced RCC from a radiologist's perspective to highlight our clinical role. It will describe how the underlying molecular mechanisms of RCC provide specific targets for novel anticancer agents. The relationship between the mechanisms of action of these novel anticancer agents and the imaging appearance of tumor response will be discussed, along with the available tumor response criteria and their strengths and weaknesses, thus assisting radiologists in response assessment in the setting of clinical trials or routine practice. The class- and drug-specific toxicities and complications associated with the novel anticancer agents will be summarized, since these are frequently missed or misinterpreted and require the radiologist's input in prompt detection and management. The potential role of radiogenomics and texture analysis in the management of advanced RCC will also be discussed. © RSNA, 2017.

  9. 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.

  10. The future role of personalized medicine in the treatment of glioblastoma multiforme

    Directory of Open Access Journals (Sweden)

    Jing Li

    2010-08-01

    proliferation, and recent research has found key molecules that regulate GBM cell migration that can be targeted by therapy. Current standard of care for GBM remains nonspecific; however, pharmacogenomic studies are underway to pave the way for patient-specific therapies that are based on the unique aberrant pathways in individual patients. In conclusion, recent studies in GBM have found many diverse molecular targets possible for therapy. The next obstacle in treating this fatal tumor is ascertaining which molecules in each patient should be targeted and how best to target them, so that we can move our current nonspecific therapies toward the realm of personalized medicine.Keywords: GBM, oncogenomics, genetics, signaling cascades, pharmacogenomics

  11. 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

  12. 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.

  13. Role of substrate biomechanics in controlling (stem) cell fate: Implications in regenerative medicine.

    Science.gov (United States)

    Macri-Pellizzeri, Laura; De-Juan-Pardo, Elena M; Prosper, Felipe; Pelacho, Beatriz

    2018-04-01

    Tissue-specific stem cells reside in a specialized environment known as niche. The niche plays a central role in the regulation of cell behaviour and, through the concerted action of soluble molecules, supportive somatic cells, and extracellular matrix components, directs stem cells to proliferate, differentiate, or remain quiescent. Great efforts have been done to decompose and separately analyse the contribution of these cues in the in vivo environment. Specifically, the mechanical properties of the extracellular matrix influence many aspects of cell behaviour, including self-renewal and differentiation. Deciphering the role of biomechanics could thereby provide important insights to control the stem cells responses in a more effective way with the aim to promote their therapeutic potential. In this review, we provide a wide overview of the effect that the microenvironment stiffness exerts on the control of cell behaviour with a particular focus on the induction of stem cells differentiation. We also describe the process of mechanotransduction and the molecular effectors involved. Finally, we critically discuss the potential involvement of tissue biomechanics in the design of novel tissue engineering strategies. Copyright © 2017 John Wiley & Sons, Ltd.

  14. 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.

  15. 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

  16. Strategies for Primary Care Stakeholders to Improve Electronic Health Records (EHRs).

    Science.gov (United States)

    Olayiwola, J Nwando; Rubin, Ashley; Slomoff, Theo; Woldeyesus, Tem; Willard-Grace, Rachel

    2016-01-01

    The use of electronic health records (EHRs) and the vendors that develop them have increased exponentially in recent years. While there continues to emerge literature on the challenges EHRs have created related to primary care provider satisfaction and workflow, there is sparse literature on the perspective of the EHR vendors themselves. We examined the role of EHR vendors in optimizing primary care practice through a qualitative study of vendor leadership and developers representing 8 companies. We found that EHR vendors apply a range of strategies to elicit feedback from their clinical users and to engage selected users in their development and design process, but priorities are heavily influenced by the macroenvironment and government regulations. To improve the "marriage" between primary care and the EHR vendor community, we propose 6 strategies that may be most impactful for primary care stakeholders seeking to influence EHR development processes. © Copyright 2016 by the American Board of Family Medicine.

  17. Nuclear medicine and lymphoma: the role of the FDG PET in non Hodgkin's lymphoma in children

    International Nuclear Information System (INIS)

    Montravers, F.; Kerrou, K.; Gutman, F.; Grahek, D.; Talbot, J.N.

    2006-01-01

    As for adult population, FDG PET is recognized as an efficient tool for staging, adaptation of therapy and follow-up of Hodgkin's disease in children. The interpretation of PET needs however to take into account some specificities of imaging as the frequent brown fat activation and the physiologic thymic uptake. The role of FDG PET in non Hodgkin's lymphoma (NHL) in children is less established. Although LNH are more frequent than Hodgkin 's lymphoma in children, FDG PET is rarely performed at diagnosis, probably due to the therapeutic emergency of these aggressive pediatric forms. During follow-up, FDG PET has been however shown to be useful, especially for the characterization of residual masses. (authors)

  18. The role of nuclear medicine in the management of Graves' disease

    International Nuclear Information System (INIS)

    Freitas, J.E.

    1999-01-01

    1 31 I therapy is safe and effective for most Graves' disease patients. It is being used more frequently in previously restricted populations such as children, adolescents, and women of childbearing age. It affords prompt, consistent relief of hyperthyroidism, but permanent hypothyroidism ensues in almost all patients. This complication is readily diagnosed with modern in vitro assays and inexpensive, life-long replacement therapy renders the patient asymptomatic and able to resume a normal lifestyle. Recent changes in NRC requirements have further liberalized the use of 1 31 I for Graves' disease in the USA, permitting more patients to be treated with effective outpatient therapy. The controversial role of 1 31 I in exacerbation of GO has been further clarified and preventive measures are available

  19. 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.

  20. Complementary Medicine and the Role of Oncology Nurses in an Acute Care Hospital: The Gap Between Attitudes and Practice.

    Science.gov (United States)

    Admi, Hanna; Eilon-Moshe, Yael; Ben-Arye, Eran

    2017-09-01

    To describe hospital nurses' knowledge, attitudes, and practices regarding complementary medicine (CM); to compare the knowledge and attitudes of nurse managers to staff nurses with diverse oncology experience; and to assess attitudes toward integrating CM into the role of the hospital oncology nurse. 
. Descriptive, cross-sectional study.
. Rambam Health Care Campus in northern Israel.
. A convenience sample of 434 hospital nurses with varied oncology experience.
. Nurses completed a knowledge and attitude questionnaire developed for the current study. Data were analyzed using parametric and nonparametric statistical tests. 
. Hospital nurses' knowledge of and attitudes toward CM, and attitudes toward integrating CM into the role of the hospital oncology nurse.
. Nurses lack knowledge and are unaware of the risks associated with CM. However, they believe this approach can improve the quality of life of patients with cancer; 51% expressed an interest in receiving training. Oncology nurses were ambivalent about the feasibility of applying an integrative approach, whereas nurse managers expressed significantly more positive attitudes toward integrating CM within the scope of nursing practices.
. A large discrepancy remains between nurses' strong interest in CM and awareness of associated benefits, and their ambivalence toward its integration in their nursing practice. 
. Although improving nurses' knowledge should be mandatory, it remains insufficient; a shift in the approach to integrating CM into conventional health care is needed, from practitioners' responsibility to healthcare policymakers' responsibility. Legislations and policies are necessary, along with providing respectable infrastructures.

  1. 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.

  2. 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.

  3. 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

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. Stakeholder involvement in developing brochures

    International Nuclear Information System (INIS)

    Vargas, M.; Garing, K.; Waldrop, D.

    1994-01-01

    The Department of Energy's (DOE's) Office of Environmental Management involved stakeholders (i.e., people who perceive themselves to be affected by the DOE's activities) in a pre-decisional draft of a DOE public document-a practice that the public has called for if the DOE is to begin real public participation. Early and ongoing public input is key to realizing Environmental Management's goal of increasing public participation. The stakeholder review process employed in the development of this document, a brochure outlining public participation information, demonstrates that Environmental Management is open-quotes practicing what it preachesclose quotes about institutionalizing public participation in its program. environmental Management's objective for the brochure is to create a document that uses plain, direct language that encourages citizens to become involved in its decision making process. The information in the brochure provides the public with the information they need to become involved stakeholders. The breadth and volume of comments received assisted in the development of a brochure that includes many viewpoints

  9. The Role of Phlebotomy (Fasd) and Wet Cupping (Hijamat) to Manage Dizziness and Vertigo From the Viewpoint of Persian Medicine

    Science.gov (United States)

    Kordafshari, Gholamreza; Ardakani, Mohammad Reza Shams; Keshavarz, Mansoor; Esfahani, Mohammad Mehdi; Nazem, Esmaeil; Moghimi, Maryam; Zargaran, Arman; Kenari, Hoorieh Mohammadi

    2016-01-01

    Dizziness and vertigo are the most common complaints of patients that has a high economic burden on the health system. In modern medicine, treatment for dizziness and vertigo consists of chemical pharmacological therapy. Although these drugs are useful in controlling the disease, their side effects and inefficiency in full control of the disease require the use of complementary medicine in this field. Persian medicine consists of valuable experiences of Persian medicine scholars based on the theory of humors and temperaments. In Persian medicine, 2 types of disease are presented: dizziness (sadar) and vertigo (dovar). Persian medicine physicians expressed a different mechanism of action than modern medicine for these diseases. They believed that accumulation of abnormal humors, reeh (normal bloating) or causative pathologic substances, is the basic cause of sadar and dovar and that the most important treatment is cleansing the body, particularly the head from accumulated substances by bloodletting methods.

  10. "Take your pill": the role and fantasy of pills in modern medicine.

    Science.gov (United States)

    Leder, Drew; Krucoff, Mitchell W

    2014-06-01

    The pharmaceutical industry has undergone a vast expansion in the 20th and 21st centuries. This article explores the central role now played by pills in clinical practice, but also in the public imagination. First, this article analyzes four properties that, together, account for many of the promises and perils associated with pills: They are ingestible, potent, reproducible, and miniaturized. This allows them to serve as ideal consumer items for widespread distribution and sale and also as model technological "devices" capable of downloading into the body healing chemicals. As such, they seem to promise a disburdening solution to many of life's ills. In our cultural fantasy, often shared by physician and patient alike, pills can be used not only to treat and prevent disease but also raise energy, lose weight, lessen pain, lift mood, cope with stress, and enhance sexual and athletic performance. This article also explores many adverse effects not only of pills themselves but of this exaggerated cultural fantasy of the pill. It tends to distract us from other, more holistic understandings of the locus of disease and healing. It even fosters misunderstandings of the ways in which pills themselves work, which is to assist bodily processes, and the mind's "meaning response." The intent here is not to demonize all pills-many have great therapeutic potential-but to learn how to better choose and use them wisely. We propose that this process be assisted through recontextualizing the pill as a multidimensional gift. Taken in such a way, with appropriate gratitude and discernment, we may ingest fewer pills, but with greater efficacy.

  11. 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.

  12. Stakeholder Governance, Competition and Firm Value

    OpenAIRE

    Allen, Franklin; Carletti, Elena; Marquez, Robert

    2014-01-01

    In many countries, the legal system or social norms ensure that firms are stakeholder oriented. We analyze the advantages and disadvantages of stakeholder-oriented firms that are concerned with employees and suppliers compared to shareholder-oriented firms in a model of imperfect competition. Stakeholder firms are more (less) valuable than shareholder firms when marginal cost uncertainty is greater (less) than demand uncertainty. With globalization shareholder firms and stakeholder firms ofte...

  13. 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

  14. Understanding Processes of Multi-Stakeholder Brand-Interessement

    DEFF Research Database (Denmark)

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

    2013-01-01

    -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...

  15. 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.

  16. 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.

  17. 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…

  18. 18 CFR 50.4 - Stakeholder participation.

    Science.gov (United States)

    2010-04-01

    ... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Stakeholder... ELECTRIC TRANSMISSION FACILITIES § 50.4 Stakeholder participation. A Project Participation Plan is required to ensure stakeholders have access to accurate and timely information on the proposed project and...

  19. 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...

  20. 7 CFR 3430.607 - Stakeholder input.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 15 2010-01-01 2010-01-01 false Stakeholder input. 3430.607 Section 3430.607 Agriculture Regulations of the Department of Agriculture (Continued) COOPERATIVE STATE RESEARCH, EDUCATION... § 3430.607 Stakeholder input. CSREES shall seek and obtain stakeholder input through a variety of forums...

  1. 7 CFR 3430.15 - Stakeholder input.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 15 2010-01-01 2010-01-01 false Stakeholder input. 3430.15 Section 3430.15... Stakeholder input. Section 103(c)(2) of the Agricultural Research, Extension, and Education Reform Act of 1998... RFAs for competitive programs. CSREES will provide instructions for submission of stakeholder input in...

  2. 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.

  3. 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.

  4. 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.

  5. 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)

  6. 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…

  7. Stakeholders' Perceptions of IELTS as an Entry Requirement for Higher Education in the UK

    Science.gov (United States)

    Hyatt, David

    2013-01-01

    This project explores stakeholders' perceptions of the role of the International English Language Testing System (IELTS) in the admissions processes of UK higher education (HE) institutions. The term "stakeholders" here refers to HE academic and administrative staff responsible for the acceptance of students whose first language is not…

  8. 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…

  9. 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…

  10. Object of intervention or stakeholder?

    DEFF Research Database (Denmark)

    Iversen, Ann-Merete

    (Sanders & Stappers, 2008) or radical organizational innovation (Scharmer & Kaüfer, 2014). Taking co-creation processes into the world of social work however, envokes a number of questions. Basically; what is the problem and to whom? Who are the stakeholders and what is their motivation? How is power...... are equal partners (Fenwick 2012), which in some cases is not entirely true. Preliminary findings indicate that the mindset required for co-creation to take place is not necessarily in tune with professional habits in social work nor with public governance. A gap between political vision and paedagogical...

  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. Stakeholder Alignment and Changing Geospatial Information Capabilities

    Science.gov (United States)

    Winter, S.; Cutcher-Gershenfeld, J.; King, J. L.

    2015-12-01

    Changing geospatial information capabilities can have major economic and social effects on activities such as drought monitoring, weather forecasts, agricultural productivity projections, water and air quality assessments, the effects of forestry practices and so on. Whose interests are served by such changes? Two common mistakes are assuming stability in the community of stakeholders and consistency in stakeholder behavior. Stakeholder communities can reconfigure dramatically as some leave the discussion, others enter, and circumstances shift — all resulting in dynamic points of alignment and misalignment . New stakeholders can bring new interests, and existing stakeholders can change their positions. Stakeholders and their interests need to be be considered as geospatial information capabilities change, but this is easier said than done. New ways of thinking about stakeholder alignment in light of changes in capability are presented.

  14. 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.

  15. 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

  16. Developing a stakeholder engagement strategy

    Energy Technology Data Exchange (ETDEWEB)

    Nixon, J.A. [Shell Canada Ltd., Calgary, AB (Canada)

    2004-07-01

    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.

  17. 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 ...

  18. 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.

  19. 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.

  20. Sex-Divergent Clinical Outcomes and Precision Medicine: An Important New Role for Institutional Review Boards and Research Ethics Committees

    Directory of Open Access Journals (Sweden)

    Ignacio Segarra

    2017-07-01

    Full Text Available 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.

  1. 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.

  2. 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.

  3. Exploring the role of multiple chronic conditions in traditional Chinese medicine use and three types of traditional Chinese medicine therapy among adults in Taiwan.

    Science.gov (United States)

    Cheng, Ting-Yi; Chou, Yiing-Jenq; Huang, Nicole; Pu, Christy; Chou, Yu-Ju; Chou, Pesus

    2015-06-01

    Numerous people with chronic conditions like to use traditional Chinese medicine (TCM) treatment, or integrated treatment of TCM and Western medicine (WM). Our study explored the associations between multiple chronic conditions (MCC) and TCM use and the use of specific types of TCM therapy among adults in Taiwan. In addition, we explored the TCM use of adults with seven common types of chronic conditions. In our study, a national representative sample in 2005 was used. The Chronic Condition Indicator and the Clinical Classifications System created by the U.S. Agency for Healthcare Research and Quality were used to define the number of chronic conditions of adults. Logistic regressions adjusted for demographic characteristics were used to analyze the associations. The frequency of TCM use among adults with different numbers of chronic conditions was quantified. TCM use for adults with ≥5 chronic conditions (odds ratio [OR] 1.86) was higher than TCM use for adults with 2-4 chronic conditions (OR 1.51) and TCM use for adults with one chronic condition (OR 1.48). The increase in the OR of the use of Chinese herbs and traumatology manipulative therapy according to the number of chronic conditions was not as substantial as that of acupuncture-moxibustion. The frequency of TCM use exhibited an increasing trend with the increase in the number of chronic conditions (pherbs use, traumatology manipulative therapy use, and, particularly, acupuncture-moxibustion use increased as the number of chronic conditions increased. We suggest that government policy makers emphasize administering integrated TCM and WM care to people with chronic conditions or MCC.

  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. 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....

  7. Stakeholders in the Political Marketing Context

    DEFF Research Database (Denmark)

    Ormrod, Robert

    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’......./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...

  8. 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.

  9. Lab Plays Central Role in Groundbreaking National Clinical Trial in Precision Medicine | Frederick National Laboratory for Cancer Research

    Science.gov (United States)

    The Molecular Characterization Laboratory at the Frederick National Laboratory for Cancer Research lies at the heart of an ambitious new approach for testing cancer drugs that will use the newest tools of precision medicine to select the best treatme

  10. Current collective engagement stakeholder strategies for South African labour relations

    Directory of Open Access Journals (Sweden)

    Popi C. Madlala

    2018-05-01

    Full Text Available Orientation: Collective engagement stakeholder strategies are significant for the creation of harmony in the workplace. It is a known fact that the South African (SA labour environment has been dominated by industrial action before and after the 1994 democratic transition. To be precise, the statistics reveals that industrial action has increased and become more destructive post-1994. Purpose: The purpose of this article was to present the current collective engagement stakeholder strategies for South African labour relations. Motivation for the study: The SA mining sector has seen more violent strikes, with a higher number of deaths, injuries, criminal activities, arrests, dismissals and job losses in recent years. This article captures the current mining stakeholder strategies shaping the existing labour relations environment. Research approach, design and method: This is a theoretical article highlighting the recent literature on collective engagement in the mining sector in South Africa. Main findings: This article presents the current labour relations incidents, reflecting the need for more effective collective engagement and stakeholder management strategies. Practical and managerial implications: The current labour relations context has prompted key stakeholders at the National Economic Development and Labour Council (NEDLAC to look specifically at promoting employment, labour market stability, the right to strike, minimising violence through collective bargaining and highlighting the role of the state, reducing vulnerability through social protection and increasing the minimum wage. Contribution or value add: This article adds theoretically to the existing body of knowledge regarding collective engagement and stakeholder strategies in the SA mining sector.

  11. Stakeholder mapping of CSR in Switzerland

    OpenAIRE

    Looser, S; Wehrmeyer, WCH

    2015-01-01

    Purpose – This paper aims to investigate, using stakeholder map methodology, showing power, urgency, legitimacy and concerns of different actors, the current state of corporate social responsibility (CSR) in Switzerland. Previous research on CSR in Europe has made few attempts to identify stakeholders and their contribution to this topic. Design/methodology/approach – To derive this map, publicly available documents were explored, augmented by 27 interviews with key stakeholders (consumers, m...

  12. Stakeholder capitalism, corporate governance and firm value

    OpenAIRE

    Allen, Franklin; Carletti, Elena; Marquez, Robert

    2007-01-01

    In countries such as Germany, the legal system is such that firms are necessarily stakeholder oriented. In others like Japan social convention achieves a similar effect. We analyze the advantages and disadvantages of stakeholder-oriented firms that are concerned with employees and suppliers compared to pure shareholder-oriented firms. We show that in a context of imperfect competition stakeholder firms have higher prices and lower output than shareholder-oriented firms. Surprisingly, we also ...

  13. 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

  14. 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.

  15. Organising stakeholder workshops in research and innovation

    DEFF Research Database (Denmark)

    Nielsen, Morten Velsing; Bryndum, Nina; Bedsted, Bjørn

    2017-01-01

    This article addresses the theory and practice of creating responsiveness among actors through deliberative dialogue processes with stakeholders from diverse institutional settings. The EU’s decision to mainstream stakeholder deliberation in research and innovation, as part of its focus......, 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....

  16. Medical Imaging Informatics in Nuclear Medicine

    NARCIS (Netherlands)

    van Ooijen, Peter; Glaudemans, Andor W.J.M.; Medema, Jitze; van Zanten, Annie K.; Dierckx, Rudi A.J.O.; Ahaus, C.T.B. (Kees)

    2016-01-01

    Medical imaging informatics is gaining importance in medicine both in clinical practice and in scientific research. Besides radiology, nuclear medicine is also a major stakeholder in medical imaging informatics because of the variety of available imaging modalities and the imaging-oriented operation

  17. Does Stereotype Threat Affect Women in Academic Medicine?

    Science.gov (United States)

    Burgess, Diana Jill; Joseph, Anne; van Ryn, Michelle; Carnes, Molly

    2012-01-01

    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. PMID:22361794

  18. 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.

  19. 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)

  20. 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

  1. 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.

  2. 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

  3. 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.

  4. Stakeholder Value Matrix - Die VErbindung zwischen Shareholder Value und Stakeholder Value

    OpenAIRE

    Frank Figge

    2004-01-01

    Die Studie zeigt, was unter Stakeholder Value verstanden werden kann, wie Shareholder Value und Stakeholder Value gemessen werden können und welche Verbindung zwischen beiden Konzepten besteht. In dieser Studie wird erstmals die Wertbeitragsanalyse von Stakeholderbeziehungen vorgestellt. Anhand der Stakeholder Value Matrix lässt sich zeigen, welche Stakeholdergruppen zusammen positiv zum Unternehmenswert beitragen.

  5. Stakeholder initiatives in flood risk management

    NARCIS (Netherlands)

    Edelenbos, Jurian; Buuren, Van Arwin; Roth, Dik; Winnubst, Madelinde

    2017-01-01

    In recent years stakeholder participation has become a popular topic in flood management. Little is known about how and under which circumstances local stakeholders initiate and develop successful flood management strategies and how governmental actors respond to them. Drawing on theories of

  6. 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

  7. 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.…

  8. Stakeholder integration : Building Mutually Enforcing Relationships

    NARCIS (Netherlands)

    P.P.M.A.R. Heugens (Pursey); F.A.J. van den Bosch (Frans); C.B.M. van Riel (Cees)

    2002-01-01

    textabstractThis study examines the central contention ofinstrumental stakeholder theory— namely, that firms that breed trust-based, cooperative ties with their stakeholders will have a competitive advantage over firms that do not.Acase study of the introduction ofgenetically modified food products

  9. Stakeholder mismanagement and corporate social responsibility crises

    NARCIS (Netherlands)

    Kolk, A.; Pinkse, J.

    2006-01-01

    In the past decade, the stakeholder approach has gained much acceptance among academics and practitioners. Noticeably, there has been little consideration of the motivations and processes used by businesses to avoid or neglect stakeholder power and pressures. This is all the more remarkable in the

  10. 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

  11. 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.…

  12. 77 FR 50144 - Broad Stakeholder Survey

    Science.gov (United States)

    2012-08-20

    ... DEPARTMENT OF HOMELAND SECURITY [Docket No. DHS-2012-0042] Broad Stakeholder Survey AGENCY... Information Collection Request: 1670-NEW. SUMMARY: The Department of Homeland Security (DHS), National... (Pub. L. 104-13, 44 U.S.C. Chapter 35). NPPD is soliciting comments concerning the Broad Stakeholder...

  13. 76 FR 34087 - Broad Stakeholder Survey

    Science.gov (United States)

    2011-06-10

    ... DEPARTMENT OF HOMELAND SECURITY [Docket No. DHS-2011-0027] Broad Stakeholder Survey AGENCY... Information Collection Request: 1670-NEW. SUMMARY: The Department of Homeland Security (DHS), National... (Pub. L. 104-13, 44 U.S.C. Chapter 35). NPPD is soliciting comments concerning the Broad Stakeholder...

  14. 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 ...

  15. Enforcing a security pattern in stakeholder goal models

    OpenAIRE

    Yu, Yijun; Kaiya, Haruhiko; Washizaki, Hironori; Xiong, Yingfei; Hu, Zhenjiang; Yoshioka, Nobukazu

    2008-01-01

    Patterns are useful knowledge about recurring problems and solutions. Detecting a security problem using patterns in requirements models may lead to its early solution. In order to facilitate early detection and resolution of security problems, in this paper, we formally describe a role-based access control (RBAC) as a pattern that may occur in stakeholder requirements models. We also implemented in our goal-oriented modeling tool the formally described pattern using model-driven queries and ...

  16. Forum on stakeholder confidence: Spain

    International Nuclear Information System (INIS)

    Vari, A.; Pescatore, C.

    2006-01-01

    The FSC workshop in Spain provided an important opportunity to carry out an in-depth examination of decision-making processes undertaken in an NEA member country, and to reflect on the evolution that has taken place over time. It offered a well-rounded perspective on the inclusion of stakeholders in decision making, and the atmosphere of the meetings was conducive to an honest and open exchange of ideas. The workshop started with the introduction of two case studies: the earlier attempt in Spain to locate a potential site for a high-level waste (HLW) disposal facility, and the dismantling of the Vandellos-I nuclear power plant. This was followed by two days of presentations and round-table discussions based on the recent COWAM Spain initiative (stemming from the EU-wide project on Community Waste Management), which aims at developing recommendations for institutional arrangements and decision-making processes concerning the siting of waste management facilities in Spain. This article provides a brief summary of the case studies and the COWAM Spain initiative, followed by some of the lessons learnt from an international perspective. (authors)

  17. 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)

  18. Improving patient safety in transfusion medicine: contemporary challenges and the roles for bedside and laboratory biovigilance in addressing them

    Directory of Open Access Journals (Sweden)

    Andrzejewski Jr C

    2014-07-01

    Full Text Available Chester Andrzejewski Jr,1 Darlene Cloutier,1 David Unold,2 Richard C Friedberg1 1Transfusion Medicine Services, Department of Pathology, Baystate Medical Center, Baystate Health, Springfield, MA, 2Department of Laboratory Medicine, Yale University School of Medicine, New Haven, CT, USA Abstract: Throughout the history of hemotherapy (HT, various challenges and concerns have been encountered in its practical application. When viewed using a prismatic lens of history, recurrent themes regarding adverse HT sequelae separate and become apparent. These can be broadly classified into three categories: infectious, noninfectious, and administrative/logistical. Using the HT care map as a frame of reference along with its associated rites, we examine the contemporary spectrum of HT adverse events and concerns, and some approaches as to how these may be addressed from bedside and laboratory medicine biovigilance perspectives enhancing patient care and blood transfusion safety. Although our vantage point is from an academic community hospital venue, the issues and concerns identified are germane to many if not all transfusion-medicine practice environments. Included among the subjects we explore are patient/specimen identification issues, blood-management initiatives, unrecognized and/or unreported suspected transfusion reactions, transfusion-associated adverse pulmonary sequelae (including transfusion-related acute lung injury and transfusion-associated circulatory overload, expanded applications of electronic health records and issues regarding their “meaningful use” and interinstitutional “digital compatibilities”, biovigilance integration of electronic data networks within and between health care entities, and anticipated workforce contractions secondary to projected declines in the availability of qualified laboratory professionals. Cooperative initiatives between accreditation and regulatory entities, blood collectors and suppliers, hospital

  19. Environmental management initiatives and stakeholder influences

    DEFF Research Database (Denmark)

    Madsen, Henning; Ulhøi, John Parm

    1999-01-01

    in Danish industrial companies. These findings are discussed in the light of similar reported results and case studies of companies which are reportedly pioneers in the introduction of environmental initiatives from a number of EU countries. Implications for theory, practice and training are addressed...... of change, from the point of view of stakeholder theory, from a merely reactive attitude in industry, where companies only tend to respond to stakeholder pressure which cannot be ignored (e.g. ex post responses to one or two stakeholders, such as regulators and customers), towards an increasingly proactive...... attitude characterised by ex ante responses to several strategic groups of stakeholders (including NGOs, employees, neighbours, etc.). The present situation is illustrated by the findings in two recent surveys concerning perceived stakeholder influence in relation to environmental management initiatives...

  20. How can stakeholder involvement be improved?

    International Nuclear Information System (INIS)

    2015-12-01

    Radioactive waste management is embedded in broader societal issues such as environment, risk management, sustainability, energy and health policy. In all these fields, there is an increasing demand for public involvement, participation or engagement. Guidance for public authorities also generally encourages greater involvement of the public. Involvement may take different forms at different phases and can include sharing information, consulting, dialoguing or deliberating on decisions with relevant stakeholders. Stakeholder involvement should be seen as a meaningful part of formulating and implementing public policy. There is no single technique for organising engagement. Initiatives should respond to their context and to stakeholders' particular needs. As the number of stakeholder involvement approaches and publications describing them continues to grow, new opportunities are opening up through social media, which has become an important tool for stakeholder involvement in recent years

  1. 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.

  2. Universal Health Insurance Coverage in Vietnam: A Stakeholder Analysis From Policy Proposal (1989) to Implementation (2014).

    Science.gov (United States)

    Hoang, Chi K; Hill, Peter; Nguyen, Huong T

    In 1989, health insurance (HI) was introduced in Vietnam and began to be implemented in 1992. There was limited progress until the 2014 Law on HI that was revised with the aim of universal health insurance coverage (UHIC) by 2020. This article explores stakeholder roles and positions from the initial introduction of HI to the implementation of the Master Plan accelerating UHIC. To better understand the influence of stakeholders in accelerating UHIC to achieve equity in health care. Using a qualitative study design, we conducted content analysis of HI-related documents and interviewed social security and health system key informants, government representatives, and community stakeholders to determine their positions and influence on UHIC. Our findings demonstrate different levels of support of stakeholders that influence in the HI formulation and implementation, from opposition when HI was first introduced in 1989 to collaboration of stakeholders from 2013 when the Master Plan for UHIC was implemented. Despite an initial failure to secure the support of the Parliament for a Law on HI, a subsequent series of alternative legislative strategies brought limited increases in HI coverage. With government financial subsidization, the involvement of multiple stakeholders, political commitment, and flexible working mechanisms among stakeholders have remained important, with an increasing recognition that HI is not only a technical aspect of the health system but also a broader socioeconomic and governance issue. The different levels of power and influence among stakeholders, together with their commercial and political interests and their different perceptions of HI, have influenced stakeholders' support or opposition to HI policies. Despite high-level policy support, stakeholders' positions may vary, depending on their perceptions of the policy implications. A shift in government stakeholder positions, especially at the provincial level, has been necessary to accelerate

  3. 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.

  4. Involving stakeholders and developing a policy for stakeholder involvement in the European network for Health Technology Assessment, EUnetHTA

    DEFF Research Database (Denmark)

    Palmhøj Nielsen, Camilla; Wadmann, Sarah; Børlum Kristensen, Finn

    2009-01-01

    in national/regional policy making. A stakeholder Web site, analyses of stakeholder opinions on HTA and EUnetHTA in a discussion topic catalog, and a draft stakeholder policy resulted from the work. Conclusions: Stakeholder involvement in EUnetHTA is necessary to ensure the legitimacy and prospects...... be continued. Our experience shows the challenge of obtaining balanced stakeholder representation across the identified stakeholder groups. Continued attention should be given to achieving balanced stakeholder representation....

  5. 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.

  6. Communication and collaboration among return-to-work stakeholders.

    Science.gov (United States)

    Russell, Elizabeth; Kosny, Agnieszka

    2018-05-17

    Workers who are injured or become ill on the job are best able to return-to-work when stakeholders involved in their case collaborate and communicate. This study examined health care providers' and case managers' engagement in rehabilitation and return-to-work following workplace injury or illness. In-depth interviews were conducted with 97 health care providers and 34 case managers in four Canadian provinces about their experiences facilitating rehabilitation and return-to-work, and interacting with system stakeholders. A qualitative thematic content analysis demonstrated two key findings. Firstly, stakeholders were challenged to collaborate as a result of: barriers to interdisciplinary and cross-professional communication; philosophical differences about the timing and appropriateness of return-to-work; and confusion among health care providers about the workers' compensation system. Secondly, these challenges adversely affected the co-ordination of patient care, and consequentially, injured workers often became information conduits, and effective and timely treatment and return-to-work was sometimes negatively impacted. Communication challenges between health care providers and case managers may negatively impact patient care and alienate treating health care providers. Discussion about role clarification, the appropriateness of early return-to-work, how paperwork shapes health care providers' role expectations, and strengthened inter-professional communication are considered. Implications for Rehabilitation Administrative and conceptual barriers in workers' compensation systems challenge collaboration and communication between health care providers and case managers. Injured workers may become conduits of incorrect information, resulting in adversarial relationships, overturned health care providers' recommendations, and their disengagement from rehabilitation and return-to-work. Stakeholders should clarify the role of health care providers during

  7. 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.

  8. The Research of Stakeholder Power Impact on Project Implementation

    Directory of Open Access Journals (Sweden)

    Artur Biskupek

    2016-12-01

    Full Text Available Purpose of the article: The article show summarized information about stakeholders and their role in project implementation based on literature review. The second part of the article is dedicated for the research about stakeholder influence on project implementation. The only condition to participate in the survey was managing projects. Although the respondents are employed in the area of south Poland, they implement projects all over Poland. The research tool was a questionnaire which was sent by e-mail to the respondents. 90 project managers from the area of south Poland were invited to join the project, and 62 people sent back a completed questionnaire. Methodology/methods: The research was done by a questionnaire with twenty two question, which was divided into three parts. The first part was the imprint, which consisted of three questions. The second part consisted of two questions, which concerned the way of defining the word “stakeholder”. The third part concerned the topic of the research and consisted of seventeen questions. Scientific aim: The aim of the article is presenting the results of the research which was done, to show the research results of project stakeholder influence on the project implementation. Findings: The results received from the survey in the process of analysis and interpretation allow to put forward a thesis that stakeholders as a whole group are significant for the implementation of the whole project. Their impact is so important that it is possible to tell that they decide also about the project success or failure. Conclusions: The respondents show that stakeholders affect every area in large extent or very big extent. The fact has been proved in table 1 which shows the most frequently chosen answers by responders. However, by conducted analysis by the standard deviation it is possible to see a large dispersion of the results.

  9. 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.

  10. Stakeholder Involvement in Brazil. Appendix IX.4

    International Nuclear Information System (INIS)

    2016-01-01

    In response to public concerns about mining projects, mechanisms for stakeholder involvement in decisions concerning the licensing process of mining operations have been established. The most popular ones are the public hearings. The environmental regulatory body, Brazilian Institute of the Environment and Renewable Natural Resources (Instituto Brasileiro do Meio Ambiente e dos Recursos Naturais Renováveis, IBAMA), makes use of these events to inform the local community about impacts on the economic, physical and social issues caused by the operation of a mining project. However, by legislation, a uranium mining and processing plant is not regulated solely by the environmental regulator at the state and federal level. The Brazilian National Nuclear Energy Commission (Comissão Nacional de Energia Nuclear, CNEN) plays the key role as the nuclear regulatory body, and in many situations, it is perceived by local communities, where uranium mining projects are developed, as the main responsible party responding to regulatory issues regarding this type of operation. The situation gets even more complicated when it is seen that uranium mining and processing operations are state owned activities and the independency of the regulatory body (mainly the nuclear regulatory authority) is questioned, or at least put under scrutiny. It is not common for an ‘independent’ organization to be requested to provide regulatory oversight and this undermines the trust the communities may have on the regulatory process carried on regarding that specific operation

  11. 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

  12. 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.

  13. aligning the interests of stakeholders

    African Journals Online (AJOL)

    and management (executive directors) are separate role-players. Performance- ... financial year) as part of a performance bonus scheme. This was despite ... managers by mitigating the risk of chief executive officers (CEOs) approving risky.

  14. 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.

  15. 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

  16. 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.

  17. Stakeholder analysis for the development of a community pharmacy service aimed at preventing cardiovascular disease.

    Science.gov (United States)

    Franco-Trigo, L; Hossain, L N; Durks, D; Fam, D; Inglis, S C; Benrimoj, S I; Sabater-Hernández, D

    Participatory approaches involving stakeholders across the health care system can help enhance the development, implementation and evaluation of health services. These approaches may be particularly useful in planning community pharmacy services and so overcome challenges in their implementation into practice. Conducting a stakeholder analysis is a key first step since it allows relevant stakeholders to be identified, as well as providing planners a better understanding of the complexity of the health care system. The main aim of this study was to conduct a stakeholder analysis to identify those individuals and organizations that could be part of a leading planning group for the development of a community pharmacy service (CPS) to prevent cardiovascular disease (CVD) in Australia. An experienced facilitator conducted a workshop with 8 key informants of the Australian health care system. Two structured activities were undertaken. The first explored current needs and gaps in cardiovascular care and the role of community pharmacists. The second was a stakeholder analysis, using both ex-ante and ad-hoc approaches. Identified stakeholders were then classified into three groups according to their relative influence on the development of the pharmacy service. The information gathered was analyzed using qualitative content analysis. The key informants identified 46 stakeholders, including (1) patient/consumers and their representative organizations, (2) health care providers and their professional organizations and (3) institutions and organizations that do not directly interact with patients but organize and manage the health care system, develop and implement health policies, pay for health care, influence funding for health service research or promote new health initiatives. From the 46 stakeholders, a core group of 12 stakeholders was defined. These were considered crucial to the service's development because they held positions that could drive or inhibit progress

  18. Stakeholder involvement in CSR strategy-making?

    DEFF Research Database (Denmark)

    Trapp, Leila

    2014-01-01

    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...... 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...

  19. 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

  20. 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

  1. [Anorexia nervosa in German medical literature 1900 to 1945. The role of anorexia nervosa in the origin of psychosomatic medicine].

    Science.gov (United States)

    Habermas, T

    1992-01-01

    German-language publications on anorexia nervosa and Simmonds' disease from between 1900 and 1945 are reviewed in order to trace factors inherent in medical thinking which have mostly hindered German-language medicine in understanding anorexia nervosa. It is demonstrated that a) the few German-language physicians who did describe central and possible characteristics of a.n. (weight-phobia, overactivity, bulimia, self-induced vomiting) were enabled to do so by valuing detailed clinical description, also of psychic characteristics, and an interest in the neuroses; b) the concept of anorexia nervosa was better known than previously assumed, though largely misunderstood; c) typical diagnostic misinterpretations led to typical biases in the description of the syndrome; d) in Germany more than in other countries a.n. was confounded with Simmonds' disease; and e) in addition to other factors, one reason for this lay in the 'holistic' ideal of psychosomatic medicine in the 1930s.

  2. Some doctors of medicine who published optometry books and played significant roles in early twentieth century optometric education.

    Science.gov (United States)

    Goss, David A

    2011-01-01

    This paper provides brief profiles of four doctors of medicine who wrote books for optometrists and who were faculty members in, and/or directors of, optometry schools in the early twentieth century. Those studied were Thomas G. Atkinson (1870-1946), Marshall B. Ketchum (1856-1937), Joseph I. Pascal (1890-1955), and Clarence W. Talbot (1883-1958). The content of the books they wrote is also discussed.

  3. Drug-related problems identification in general internal medicine: The impact and role of the clinical pharmacist and pharmacologist.

    Science.gov (United States)

    Guignard, Bertrand; Bonnabry, Pascal; Perrier, Arnaud; Dayer, Pierre; Desmeules, Jules; Samer, Caroline Flora

    2015-07-01

    Patients admitted to general internal medicine wards might receive a large number of drugs and be at risk for drug-related problems (DRPs) associated with increased morbidity and mortality. This study aimed to detect suboptimal drug use in internal medicine by a pharmacotherapy evaluation, to suggest treatment optimizations and to assess the acceptance and satisfaction of the prescribers. This was a 6-month prospective study conducted in two internal medicine wards. Physician rounds were attended by a pharmacist and a pharmacologist. An assessment grid was used to detect the DRPs in electronic prescriptions 24h in advance. One of the following interventions was selected, depending on the relevance and complexity of the DRPs: no intervention, verbal advice of treatment optimization, or written consultation. The acceptance rate and satisfaction of prescribers were measured. In total, 145 patients were included, and 383 DRPs were identified (mean: 2.6 DRPs per patient). The most frequent DRPs were drug interactions (21%), untreated indications (18%), overdosages (16%) and drugs used without a valid indication (10%). The drugs or drug classes most frequently involved were tramadol, antidepressants, acenocoumarol, calcium-vitamin D, statins, aspirin, proton pump inhibitors and paracetamol. The following interventions were selected: no intervention (51%), verbal advice of treatment optimization (42%), and written consultation (7%). The acceptance rate of prescribers was 84% and their satisfaction was high. Pharmacotherapy expertise during medical rounds was useful and well accepted by prescribers. Because of the modest allocation of pharmacists and pharmacologists in Swiss hospitals, complementary strategies would be required. Copyright © 2015 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  4. Syringe shape and positioning relative to efficiency volume inside dose calibrators and its role in nuclear medicine quality assurance programs

    International Nuclear Information System (INIS)

    Santos, J.A.M.; Carrasco, M.F.; Lencart, J.; Bastos, A.L.

    2009-01-01

    A careful analysis of geometry and source positioning influence in the activity measurement outcome of a nuclear medicine dose calibrator is presented for 99m Tc. The implementation of a quasi-point source apparent activity curve measurement is proposed for an accurate correction of the activity inside several syringes, and compared with a theoretical geometric efficiency model. Additionally, new geometrical parameters are proposed to test and verify the correct positioning of the syringes as part of acceptance testing and quality control procedures.

  5. The role and importance of economic evaluation of traditional herbal medicine use for chronic non-communicable diseases

    OpenAIRE

    Hughes GD; Aboyade OM; Hill JD; Rasu RS

    2015-01-01

    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 conduct...

  6. 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

  7. Precision Medicine in Cancer Treatment

    Science.gov (United States)

    Precision medicine helps doctors select cancer treatments that are most likely to help patients based on a genetic understanding of their disease. Learn about the promise of precision medicine and the role it plays in cancer treatment.

  8. An acute hemolytic transfusion reaction due to the "anti-c" rhesus antibody: A case report emphasizing the role of transfusion medicine

    Directory of Open Access Journals (Sweden)

    Deepti Sachan

    2015-01-01

    Full Text Available Rhesus (Rh mediated hemolytic transfusion reactions (HTR are usually immunoglobulin G mediated and delayed onset. Rh antibodies being the cause of acute HTR (AHTR and intravascular hemolysis are still under debate. We report here a case of a 53-year-old male who developed AHTR due to "anti-c" antibodies within 3 h of blood transfusion, precipitating fatal acute liver failure in a patient with hepatitis C related chronic liver disease. This case emphasizes the need of inclusion of antibody screening in routine pretransfusion testing as well as a critical role of transfusion medicine specialists for early diagnosis and minimizing transfusion-related morbidity and mortality.

  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. Alternative treatment strategies for neuropathic pain: Role of Indian medicinal plants and compounds of plant origin-A review.

    Science.gov (United States)

    Singh, Hasandeep; Bhushan, Sakshi; Arora, Rohit; Singh Buttar, Harpal; Arora, Saroj; Singh, Balbir

    2017-08-01

    Neuropathic pain is a complex, chronic pain state accompanied by tissue injury and nerve damage. This important health issue constitutes a challenge for the modern medicine worldwide. The management of neuropathic pain remains a major clinical challenge, pertaining to an inadequate understanding of pathophysiological mechanisms of neuropathic pain. Various classes of drugs have been reported effective for the management of neuropathic pain viz. opiates, tricyclic antidepressants, and antiepileptic agents. However, association of adverse effects with these drugs hinders their confident prescription in people with neuropathic pain. Recently, various medicinal plants have been reported effective for the management of neuropathic pain. So, it may be prudent to look beyond synthetic drugs pertaining to their unprecedented pharmacotherapeutic effects with lesser adverse effects. The extensive literature review has been carried out from databases such as Science direct, Scifinder, Wiley online library, PubMed, Research gate, Google scholar and Chemical Abstracts. The list of Traditional Indian Medicinal plants (TIMPs) and isolated compounds have been compiled which have been reported effective as an alternative therapy for the management of neuropathic pain. This helps the researchers to discover some novel therapeutic agents against neuropathic pain. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  11. Imaging and development of medicines

    International Nuclear Information System (INIS)

    Syrota, A.

    2000-01-01

    The last developments in medical imaging allow visualization of medicines in organism. Today, these techniques: positron emission tomography (PET) and single photon emission computed tomography (SPECT) play an essential role in the production and the development of new medicines. The medicinal substances labelled with radioisotopes permit to improve the understanding of medicines' action mode. The spectacular advances were observed in the field of medicines acting on the brain (F.M.)

  12. 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

  13. 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.

  14. The role of culinary-medicinal mushrooms on human welfare with a pyramid model for human health.

    Science.gov (United States)

    Chang, Shu Ting; Wasser, Solomon P

    2012-01-01

    Mushrooms are part of fungal biota characterized by wonder. They rise up from lignocellulosic wastes: yet they become so bountiful and nourishing. Mushrooms are environmentally friendly. They biosynthesize their own food from agricultural crop residues, which would otherwise cause health hazards. The extant records show the continued use of some mushrooms, e.g., Lentinus edodes, Ganoderma lucidum, and Cordyceps sinensis are now centuries old. This review presents a pyramid model for mushroom uses (industries), as food, dietary supplements (tonic), and medicine. A regular intake of mushrooms can make us healthier, fitter, and happier, and help us live longer. The sense of purpose and vision for the mushroom industries is also briefly discussed. A variety of mushrooms have been used traditionally in many different cultures for the maintenance of health and in the prevention and treatment of various diseases. A total of 126 medicinal functions are thought to be produced by medicinal mushrooms (MM) and fungi, including antitumor, immunomodulating, antioxidant, radical scavenging, cardiovascular, anti-hypercholesterolemia, antiviral, antibacterial, anti-parasitic, antifungal, detoxification, hepatoprotective, and anti-diabetic effects. Special attention is paid to mushroom polysaccharides. Many, if not all, higher Basidiomycetes mushrooms contain biologically active polysaccharides in fruit bodies, cultured mycelium, and cultured broth. The data on mushroom polysaccharides are summarized for approximately 700 species of higher Hetero- and Homobasidiomycetes. In particular, the most important for modern medicine are polysaccharides with antitumor and immunostimulating properties. Several of the mushroom polysaccharide compounds have proceeded through phase I, II, and III clinical trials and are used extensively and successfully as drugs in Asia to treat various cancers and other diseases. Mushrooms are superior sources of different types of dietary supplements (DSs

  15. 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.

  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. Supporting multi-stakeholder environmental decisions.

    Science.gov (United States)

    Hajkowicz, Stefan A

    2008-09-01

    This paper examines how multiple criteria analysis (MCA) can be used to support multi-stakeholder environmental management decisions. It presents a study through which 48 stakeholders from environmental, primary production and community interest groups used MCA to prioritise 30 environmental management problems in the Mackay-Whitsunday region of Queensland, Australia. The MCA model, with procedures for aggregating multi-stakeholder output, was used to inform a final decision on the priority of the region's environmental management problems. The result was used in the region's environmental management plan as required under Australia's Natural Heritage Trust programme. The study shows how relatively simple MCA methods can help stakeholders make group decisions, even when they hold strongly conflicting preferences.

  18. Stakeholder interaction within the ERICA Integrated Approach.

    Science.gov (United States)

    Zinger, I; Oughton, D H; Jones, S R

    2008-09-01

    Within the ERICA project, stakeholder involvement has been addressed within three main areas: generic interactions throughout the project, specific consultation by means of attendance to events and considerations as part of the ERICA Integrated Approach and Assessment Tool. The word stakeholders meant namely any individual or group who may be affected by or have an interest in an issue, and to include experts, lay-people and the public. An End-Users-Group (EUG) was set up to facilitate the two-way dialogue between the ERICA Consortium and stakeholders. The ERICA EUG consisted of representatives of 60 organisations ranging from regulatory bodies, national advisory bodies, academia, non-governmental organisations, industry, consultants and inter-governmental organisations. Stakeholder interaction was included from the very start of the project. Inputs from the EUG were recorded and in most instances incorporated within the development of the project and thus influenced and helped to shape some of the ERICA deliverables.

  19. Tribal and stakeholder involvement in systems analysis

    International Nuclear Information System (INIS)

    McClure, L.; Swartz, G.; Cooley, C.

    1997-01-01

    Beginning in early 1995, U.S. Department of Energy began an experiment to link tribal and stakeholder representatives into technology assessment activities related to an Integrated Nonthermal Treatment System (INTS) study. The INTS study moved outside the framework of after-the-fact public involvement by providing the opportunity for technical and non-technical stakeholders alike to work together in the early predecision stages of the criteria development and assessment of options for innovative mixed waste treatment. The stakeholders gained an appreciation of the intense level of effort required to complete such an analysis. The engineers and scientists conducting the systems analyses had the opportunity (some for the first time) to learn more about tribal and stakeholder issues and how they might apply to the technical tasks related to technology assessment and selection

  20. 77 FR 38306 - GFIRST Conference Stakeholder Evaluation

    Science.gov (United States)

    2012-06-27

    ...), National Cyber Security Division (NCSD), United States Computer Emergency Readiness Team (US-CERT) will... of Homeland Security, National Protection and Programs Directorate, Office of Cybersecurity and... DEPARTMENT OF HOMELAND SECURITY [Docket No. DHS-2011-0116] GFIRST Conference Stakeholder...