15707 research outputs found
Sort by
The EU Commission touches upon the meaning of undertaking while exercising its power to obtain information (RAI/UNITEL)
No full textCase Comment on the EU Commission's decision in the 1978 competition law case RAI/UNITEL
Perceived barriers to implementing building information modeling in Iranian Small and Medium-Sized Enterprises (SMEs): a Delphi survey of construction experts
No full textBuilding information modeling (BIM) is a disruptive information technology tool in the construction sector. Although this technology had a significant impact on the manufacturing industries, it, like any other technology, encountered several challenges when applied to the construction sector. Conversely, small and medium-sized enterprises (SMEs) in developing economies often face significant impediments when using innovative technologies. Thus, this paper seeks to determine and investigate the perceived barriers to applying BIM in construction SMEs based in Iran. Three rounds of Delphi surveys were carried out with 15 BIM experts engaged in construction SMEs to identify the key barriers to BIM implementation in SMEs. An empirical survey questionnaire comprising these identified barriers was subsequently designed and disseminated to the invited experts. Altogether, 56 valid survey responses were received and analyzed. The study’s findings revealed SMEs management’s hesitancy to adopt BIM, stakeholders’ reluctance to change their established methods, and a lack of technical understanding as the critical impediments to BIM adoption in construction SMEs. Also, the study identified four barrier dimensions – technology, legal, management, and financial. These BIM implementation barrier dimensions can be employed to better allocate resources and financing for BIM deployment and construction innovation in SMEs. The study will assist major project stakeholders and SMEs make better-informed BIM adoption decisions, particularly in developing nations like Iran
The assessment of paraspinal muscle epimuscular fat in participants with and without low back pain: A case-control study
Get PDFIt remains unclear whether paraspinal muscle fatty infiltration in low back pain (LBP) is i) solely intramuscular, ii) is lying outside the epimysium between the muscle and fascial plane (epimuscular) or iii) or combination of both, as imaging studies often use different segmentation protocols that are not thoroughly described. Epimuscular fat possibly disturbs force generation of paraspinal muscles, but is seldomly explored. This project aimed to 1) compare epimuscular fat in participants with and without chronic LBP, and 2) determine whether epimuscular fat is different across lumbar spinal levels and associated with BMI, age, sex and LBP status, duration or intensity. Fat and water lumbosacral MRIs of 50 chronic LBP participants and 41 healthy controls were used. The presence and extent of epimuscular fat for the paraspinal muscle group (erector spinae and multifidus) was assessed using a qualitative score (0–5 scale; 0 = no epimuscular fat and 5 = epimuscular fat present along the entire muscle) and quantitative manual segmentation method. Chi-squared tests evaluated associations between qualitative epimuscular fat ratings and LBP status at each lumbar level. Bivariate and partial spearman’s rho correlation assessed relationships between quantitative and qualitative epimuscular fat with participants’ characteristics. Epimuscular fat was more frequent at the L4-L5 (X2 = 13.781, p = 0.017) and L5-S1 level (X2 = 27.825, p < 0.001) in participants with LBP compared to controls, which was not found for the higher lumbar levels. The total qualitative score (combined from all levels) showed a significant positive correlation with BMI, age, sex (female) and LBP status (r = 0.23–0.55; p < 0.05). Similarly, the total area of epimuscular fat (quantitative measure) was significantly correlated with BMI, age and LBP status (r = 0.26–0.57; p < 0.05). No correlations were found between epimuscular fat and LBP duration or intensity. Paraspinal muscle epimuscular fat is more common in chronic LBP patients. The functional implications of epimuscular fat should be further explored
A multi-actor perspective of humanised midwifery care excellence: An exploratory survey
Get PDFHumanised midwifery care is a fundamental human right and need. This exploratory online survey presents a collective perception of meaningful standards of humanised midwifery care for excellent daily practice obtained from an international multi-actor group of maternity service users and providers. After performing a literature review, 137 key elements of humanised midwifery were extracted, listed, and rephrased into criteria. The criteria were distributed, and participants added 38 criteria. The perceived level of humanised midwifery performance was scored from 1 (low/substandard) to 10 (excellent). The 9–10 scores benchmarked humanised midwifery care excellence. 312 care professionals benchmarked 42 criteria, and 277 pregnant and postpartum women benchmarked 23 criteria showing a 30 % overlap. A total set of 50 criteria emerged, promoting humanised midwifery excellence. The benchmarking criteria suggest a shared conceptual thinking of person-centeredness and meaningfulness and provide a practical paradigm for the provision and receipt of humanised midwifery care
Football viewing centres in an African megacity: viewers’ characteristics and operational dynamics
Get PDFThis study examines viewers’ characteristics and operational dynamics of football viewing centres (FVCs) in Agege, Lagos Megacity, Nigeria. It anchors on the “theory of happiness” and the microeconomic vitality of FVCs using a mixed-methods approach. The results of the descriptive and inferential statistics revealed that most viewers can afford subscriptions for digital TV in their homes, yet patronize the FVCs. Factors attributed to patronage are happiness, excitement, and other social opportunities, with some perspectives of leisure and microeconomic vitality benefits. Finally, the study suggests a new policy direction to mitigate the negative effects of unplanned areas resulting in the proliferation of FVCs
Healers and Midwives Accused of Witchcraft (1563-1736) - What Secondary Analysis of the Scottish Survey of Witchcraft Can Contribute to the Teaching of Nursing and Midwifery History
Get PDFBackground: Nearly 4000 people were accused of witchcraft in Scotland between 1563-1736. Some of these were healers, midwives, and nurses. Objective: To investigate Scotland’s folk-healers and midwives accused of witchcraft and review their work from a nursing and midwifery perspective.Design: Secondary analysis of the Survey of Scottish Witchcraft.Methods: Those on the Survey with witchcraft accusations relating to folk-healing or midwifery were identified and their biographies were created from Survey data (2021). Individual biographical data were descriptively analysed. Healing/midwifery practice information was tabulated and thematically analysed. Results: 142 individuals were identified (85% women), 51% were found guilty, 90% were executed. Most (98%) were folk-healers with 10 accused for midwifery reasons. Mainly their work was accused of causing harm. Three themes emerged: their use of rituals; unorthodox religious practices and treatments. Rituals included actions carried out a certain number of times. Religious practices frequently referenced Catholicism. Many of their treatments for ingestion, application or bathing used items still recognised for their health properties. Approximately, 10% of the 142, mainly in the 1500s/early 1600s, utilised expensive items and complex treatments which had more in common with ‘elite’ knowledge rather than simple folklore.Conclusions: Across all 142 people, many aspects of their work are identifiable within more contemporary nursing and midwifery practice including their use of rituals, treatments, and holism. Mostly the accused were folk-practitioners, but a few (1500s/early 1600s) appear to have been healers working akin to physicians. Following the Protestant reformation (1560) their work, unlike that of physicians, was marginalised, considered unorthodox and harmful because they were women and/or their work reflected Catholicism. European hospital nursing originates in the monastic houses, but little is known about these early religious nurses. This study is novel in suggesting that whoever taught these accused witch/healers may have been connected to the monastic hospitals pre-Reformation
A single bout of vigorous intensity exercise enhances the efficacy of rituximab against human chronic lymphocytic leukaemia B-cells ex vivo
Get PDFChronic lymphocytic leukaemia (CLL) is characterised by the clonal proliferation and accumulation of mature B-cells and is often treated with rituximab, an anti-CD20 monoclonal antibody immunotherapy. Rituximab often fails to induce stringent disease eradication, due in part to failure of antibody-dependent cellular cytotoxicity (ADCC) which relies on natural killer (NK)-cells binding to rituximab-bound CD20 on B-cells. CLL cells are diffusely spread across lymphoid and other bodily tissues, and ADCC resistance in survival niches may be due to several factors including low NK-cell frequency and a suppressive stromal environment that promotes CLL cell survival. It is well established that exercise bouts induce a transient relocation of NK-cells and B-cells into peripheral blood, which could be harnessed to enhance the efficacy of rituximab in CLL by relocating both target and effector cells together with rituximab in blood. In this pilot study, n = 20 patients with treatment-naïve CLL completed a bout of cycling 15 % above anaerobic threshold for ∼ 30-minutes, with blood samples collected pre-, immediately post-, and 1-hour post-exercise. Flow cytometry revealed that exercise evoked a 254 % increase in effector (CD3−CD56+CD16+) NK-cells in blood, and a 67 % increase in CD5+CD19+CD20+ CLL cells in blood (all p < 0.005). NK-cells were isolated from blood samples pre-, and immediately post-exercise and incubated with primary isolated CLL cells with or without the presence of rituximab to determine specific lysis using a calcein-release assay. Rituximab-mediated cell lysis increased by 129 % following exercise (p < 0.001). Direct NK-cell lysis of CLL cells – independent of rituximab – was unchanged following exercise (p = 0.25). We conclude that exercise improved the efficacy of rituximab-mediated ADCC against autologous CLL cells ex vivo and propose that exercise should be explored as a means of enhancing clinical responses in patients receiving anti-CD20 immunotherapy
Quality and impact of pharmacology digital simulation education on pre-registration healthcare students a systematic literature review
Get PDFObjectiveThis review aimed to assess the quality and nature of the literature related to digital simulation-based pharmacology education. Specifically, we sought to understand the influence of simulations on the knowledge, satisfaction, and confidence of pre-registration nurses and other healthcare students participating in such educational programs.DesignSystematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. This study was registered in the Prospective Register of Systematic Reviews (PROSPERO, reg no: CRD42023437570).Data sourcesPubMed, MEDLINE, APA PsycInfo, ProQuest, Web of Science, ScienceDirect, and CINHAL databases were searched.Review methodsThe review focused on the quantitative findings from the studies published from 2016 to 2023. Only the studies that assessed the impact of digital simulation-based pharmacology education on pre-registration healthcare students' knowledge, satisfaction, and confidence were selected for review. Data were synthesized using a narrative approach. The Mixed Methods Appraisal Tool (MMAT) was used to assess the quality of the included articles. This was followed by a narrative synthesis to consolidate the themes.ResultOut of 1587 articles,16 met the inclusion criteria. A wide variety of digital technologies have been utilised, such as virtual simulation, computer simulation (2D/3D), mixed reality, and augmented reality, with the majority using virtual simulation. All studies implemented single-user simulations. The themes emerging from the narrative synthesis suggest that a digital simulation-based pharmacology course is an effective tool for enhancing students' knowledge, confidence, and satisfaction in learning pharmacological concepts. Furthermore, simulation-based teaching with a blended approach was found to be beneficial. However, the integration of the polypharmacy concept and the intra and interprofessional approach to teaching and learning was not evident in these studies.ConclusionThis systematic literature review provides evidence of the potential of digital simulation-based education in pharmacology teaching among healthcare pre-registration students. In future studies, the integration of polypharmacy content with an intra and interprofessional teaching-learning approach is recommende