Bakgrund: Immobilisering är en vedertagen omvårdnadsåtgärd inom dagens prehospitala traumavård, detta trots att det inte finns några randomiserade kontrollerade studier angående åtgärden. Många studier har dock visat att riskerna med immobilisering är många varför det är viktigt att undersöka omvårdnadshandlingen närmare. Syfte: Syftet med studien var att undersöka förekomsten av radiologiskt fastställda spinala skador hos patienter som immobiliserats prehospitalt efter trauman, samt på vilka indikationer denna immobilisering gjordes. Metod: En kvantitativ retrospektiv studie där 288 journaler granskades i ambulansens journalsystem MobiMed 3.0 och i sjukhusets journalsystem Cosmic. Därefter analyserades resultaten i SPSS deskriptivt och grafiskt, med chi2-test samt med oberoende t-test. Resultat: Resultatet visade att av de 246 patienter som genomgått en radiologisk undersökning fanns en konstaterad spinal skada hos 48 patienter, vilket motsvarade cirka 17 %. Alla inkluderade patienter hade varit utsatta för trubbigt våld och den vanligaste indikationen för immobilisering var smärta/ömhet över kotpelaren. Medelåldern hos patienterna med spinala skador var signifikant högre än medelåldern hos de utan spinala skador och en signifikant skillnad fanns mellan patienterna med spinal skada och utan spinal skada och samtidig smärta/ömhet över kotpelaren. Slutsats: Ett större antal patienter uppvisade skador i denna studie jämfört med tidigare studier, hos den stora majoriteten fanns dock inga spinala skador. Detta innebär att patienterna utsätts för en potentiellt onödig omvårdnadsåtgärd som är svagt vetenskapligt underbyggd och medför ett flertal risker. Fler studier inom området behövs för att kunna minska patienters potentiella lidande i och med att immobiliseras prehospitalt. / Background: Spinal immobilization is an established practice in today’s prehospital trauma care. This even though there is a lack of randomized controlled studies regarding this practice. Many studies points to the risks regarding spinal immobilization why it is of importance to further examine the practice. Aim: The aim of this study was to investigate the incidence of radiologically confirmed spinal injuries in patients immobilized after prehospital trauma and on what indications this immobilization was done Method: A quantitative retrospective study of 288 medical records acquired from the ambulance medical record system Mobimed 3.0 and the hospital's medical record Cosmic were examined. The results were analyzed in SPSS descriptive and graphic, with chi2-test and independent t-test. Result: The results show that of the 246 patients who underwent a radiological examination, 46 had a spinal injury, approximately 17 %. All of the included patients had been exposed to blunt trauma and the most common indication for immobilization was pain/tenderness over the spine. The mean age of the patients with spinal injuries was significantly higher than the mean age of those without spinal injuries. A significant difference was also found between patients with pain/tenderness over the spine and spinal injury and those without spinal injury. Conclusion: A greater number of patients had a spinal injury in this study compared with previous studies, although the majority of the patients had no spinal injury. This means that the majority of the patients were exposed to a potentially unnecessary procedure that lacks scientifically evidence. More studies about immobilization are required to reduce the patients' potential suffering in connection with prehospital immobilization.

An zwei sächsischen Lößstandorten wurden sorten- und fruchtfolgespezifische Anbauvergleiche zur Minderung des Befallsrisikos mit Ährenfusarium und nachfolgender Mykotoxinbildung durchgeführt. Die Ergebnisse dokumentieren den deutlichen Einfluss der Vorfrucht und der Minimierung von Ernterückständen auf das Fusariumrisiko. Die Ertragsdifferenz zur Rapsvorfrucht lag im Vergleich zu Mais und Winterweizen im Versuchsjahr 2007 zwischen 10 bis 18 dt/ha. Ein Anstieg der Risikofaktoren führte zu nachlassenden Wirkungsgraden bei den fungiziden Maßnahmen gegen Ährenfusariosen. Weder wenig anfällige Sorten noch Fungizidbehandlungen in der Blüte garantieren bei optimalen Infektionsbedingungen die Einhaltung der gesetzlich festgelegten Mykotoxinhöchstmenge. Gute Ergebnisse zeigten das im Projekt geprüfte Schnelltestverfahren zur Deoxynivalenolbestimmung sowie die Vorerntebemusterung.

Las organizaciones dependen de sus clientes y, por lo tanto, deben conocer sus necesidades presentes y futuras, satisfacer sus requerimientos y esforzarse por exceder sus expectativas; por otro lado, es también importante que la empresa optimice los recursos disponibles para garantizar la rentabilidad del negocio. En ese sentido, una adecuada alternativa para cubrir los objetivos antes mencionados, es la implementación de un modelo de gestión de calidad, que enfoque los procesos de la organización y oriente los resultados de los mismos hacia el cliente, con un apropiado nivel de eficacia y eficiencia; nos referimos a la Norma ISO 9000, modelo que plantea un conjunto de aspectos clave para una Gestión de la Calidad basada en Procesos, asegurando la calidad del producto o servicio, e incrementando la satisfacción del cliente. La estructura de los sistemas de gestión de calidad debe ser tal que sea factible realizar una coordinación y un control ordenado y permanente sobre la totalidad de las actividades que se realizan en una organización. El presente trabajo de investigación bibliográfica intentará servir como primera lectura al profesional de sistemas que participará en la implantación de un sistema de gestión de calidad basado en procesos.

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Thesis (Ph. D.)--University of Hawaii at Manoa, 1995. / Includes bibliographical references (leaves 376-389). / Microfiche. / 2 v. (xix, 389 leaves, bound) ill. 29 cm

AIMS:The project examines the perceptions of significant stakeholders in the Catholic Education system concerning the nature, outcomes and effectiveness of the implementation of the Quality Assurance Processes developed by the Catholic Education Office (CEO), in the Archdiocese of Sydney. The study identifies factors that were assisting or hindering the effective implementation of these processes as they existed in 1996. It offers suggestions and recommendations for a future and more effective implementation of these processes. SCOPE This research is qualitative in nature, and uses interview as the main source of data collection. The Catholic schools selected for this study are those that have been involved in the implementation of the first Cycle of the Quality Assurance Processes of the CEO, Sydney. Care was taken to select two schools from each of the three Regions under which the Catholic schools in the Archdiocese of Sydney are presently organised. CONCLUSIONS The achievement and maintenance of quality outcomes has always been an integral part of Catholic Education. Through the brief historical background, this study has revealed that leaders in Catholic Education in Sydney have always sought to achieve and maintain quality outcomes since the establishment of the first schools, up until the implementation of the current quality assurance processes. This study found that the current form of Quality Assurance Processes is a most effective means of achieving and maintaining quality outcomes in the present-day Catholic education system. The Processes are professionally articulated in context with current practices, and have the potential to enhance accountability, credibility and development of both the personnel and the schools system. The implementation of the Quality Assurance Processes, to a great degree, has been effective and successful, the present study has shown that, stakeholders are becoming more and more aware of the actual nature and outcomes of these processes. The study also found great optimism among in the key player about the future of the Processes and has concluded that they well received and appreciated across the system. There were a few concerns about the clarity of aims and objectivity, the link between the different processes, and the apparently high and technical terms involved in naming/describing these Processes. The study has, therefore, concluded further that the Processes need streamlining, regular reviews and training programs to strengthen the practice and consolidate the gains and achievement. The implementation of Cycle 2 with appropriate modification is desirable.

This study of four domestic abattoirs in South Australia with Quality Assurance programmes in place established the size of bacterial populations that could be expected on pig carcasses on entry to abattoir dressing floors at pre-evisceration, the extent of contamination occurring during carcass dressing, and the effect of chilling on these populations. Analysis was conducted for salmonellae, Escherichia coli, Total Viable Count, and pseudomonads. Exterior swabbing was compared to swabbing of corresponding interior sites which are sterile initially. The interior swabbing sites were found to be a more reliable measure of contamination during the dressing process than the swabbing of already contaminated exterior sites. During the identification of some of the points of carcass contamination, the effectiveness of end-of-work foam cleaning programmes used at abattoir dressing floors and their relationship to the potential for airborne contamination of carcasses was examined and found to be positive. Operators' work tools and hands were identified as sources of interior carcass contamination combined with failure of operators to adhere to Standard Operating Procedures (SOPs) during carcass dressing, especially those related to hand and forearm washing at appropriate times. Foot-operated full-immersion hot water units for operators' knives and steels were designed and installed at two abattoirs to give operators access to physically and biologically clean work tools throughout carcass dressing. / PhD Doctorate

Thesis (PhD.(Assessment and Quality Assurance))-University of Pretoria, 2007. / Includes bibliographical references (leaves 301-333) Available on the Internet via the World Wide Web.

Thesis (PhD.(Education))-University of Pretoria, 2007. / Includes bibliographical references. Available on the Internet via the World Wide Web.