Background 50% of antibiotic courses in long-term care facilities (LTCFs) are unnecessary, leading to increased risk of harm such as Clostridiodes difficile infection and antibiotic-resistant organisms. Antimicrobial Stewardship (AS) interventions plays an important role in optimizing antibiotic use. Most studies to improve antibiotic prescribing in LTCFs showed modest and unsustained results. We aimed to identify facilitators, barriers and strategies in implementing a urinary tract infection (UTI)-focused AS intervention at a LTCF with the secondary objective of exploring the pharmacist’s potential role(s) in this intervention. Methods A qualitative approach using conventional content analysis was used. Through purposeful sampling, we recruited different healthcare providers and administrators at Kensington Gardens. Interviewees attended focus groups or one-on-one interviews. Data were collected using a semi-structured interview guide. Data were analyzed inductively using a codebook modified in an iterative analytic process. Barrier and facilitator themes were identified from the transcripts and mapped using the COM-B (capability, opportunity, motivation and behaviour) model (Michie et al). Similarly, themes were identified from the transcripts regarding the pharmacist’s roles in this intervention. Results Sixteen participants were interviewed. Most barriers and facilitators mapped to the opportunities domain of the COM-B model. The main barrier themes were lack of access, lack of knowledge, ineffective communication, lack of resources and external factors while the main facilitator themes were education, effective collaboration, good communication, sufficient resources and access. For the pharmacist’s role, the barrier themes were ineffective collaboration and communication. Furthermore, the pharmacist can play a role in education and antibiotic selection. Conclusions A UTI-focused antimicrobial stewardship intervention in LTCF should consider strategies to improve access, knowledge, communication and collaboration in its design, having sufficient resources and addressing external factors in order to optimize the intervention’s success. Pharmacists can play a role in education and antibiotic selection. / Thesis / Master of Science (MSc) / Half of antibiotics prescribed in long-term care are not needed, leading to increased harm. It is unclear which strategies should be used to improve antibiotic prescribing. This project aims to identify facilitators, barriers and strategies in identifying and managing urinary tract infection in a long-term care facility as well as exploring the role of the pharmacist in this setting. We conducted focus groups and interviews to gather information and analyzed the transcripts to determine barrier and facilitator themes relating to urinary tract infection management and the role of the pharmacist. The main barrier themes were lack of access, lack of knowledge, ineffective communication, lack of resources and external factors while the main facilitator themes were education, effective collaboration, good communication, sufficient resources and access. For the pharmacist’s role, the barrier themes were ineffective collaboration and communication. In addition, the pharmacist can play a role in education and antibiotic selection.

Cities around the United States are looking to urban green infrastructure (UGI) as a critical investment to help address a host of urban challenges, including stormwater management, climate change mitigation, rising heat temperatures and increased risk of flooding. As a result, volunteers are being asked to help construct, maintain, and contribute to UGI projects. Current investigations of UGI highlight the need to consider UGI from an environmental justice perspective, emphasizing a three-pronged approach including distribution, recognition, and procedural justice. This dissertation seeks to investigate UGI equity from a labor perspective, specifically how volunteer labor is acknowledged, valued, and contributed among race, class, and gender. Using UGI initiatives in Philadelphia, PA as a case study, it asks; to what extent are urban sustainability initiatives in Philadelphia relying upon the unpaid labor of citizens in the construction of new, UGI? How might this labor exhibit unrecognized forms of social reproductive labor, when observed from an intersectional feminist perspective? How has the contribution of UGI (such as trees, parks) labor changed over time? Drawing from a range of qualitative methods, including ethnographic fieldwork, online surveys, semi-structured interviews, oral histories and archival analysis, results reveal how volunteers play a significant role in the construction and maintenance of UGI over the past hundred years, including the often-invisible contributions of women and women of color. In applying a feminist labor lens, findings suggest gender and racial inequities in how UGI labor is acknowledged and paid as infrastructure work. Future research must consider intersectional labor dimensions as a key component in achieving a more ‘just’ urban green environment for all. / Geography

Yes / The concept of corporate and social responsibility (CSR) has gained increasing momentum and importance in business operations today and companies have globally responded to this philosophy. To what end though? Product Stewardship (PS) and the corporate, social and environmental responsibilities associated within this term are a key part of a business’s CSR agenda. In the extant literature, it is a challenge to clearly identify the boundaries of responsibility for PS - who sets these boundaries for governance and what are the actions taken under the guise of PS. This paper aims to start the process of demystification in responding to the title of this work, stimulate further musings and outline a future research agenda.

9 pp. / Arizona Watershed Stewardship Guide (10 related modules to be published in combined form) / Arizona Watershed Stewardship Guide was created to help individuals and groups build a mutual foundation of basic knowledge about watersheds in Arizona. It is intended to help Arizonans understand and be good stewards of their watersheds. The guide was designed to compliment the mission of Arizona Master Watershed Steward program to educate and train citizens across the state of Arizona to serve as volunteers in the restoration, conservation, monitoring, and protection of their water and watersheds. The guide consists of 10 self-contained modules which teach about important aspects of watershed science and management.

Archaeological sites in the boreal forest are facing threats due to urban development, resource exploitation, vandalism, and infrastructure development, among others. In the context of archaeological site preservation as a public issue, I examine the perspectives of various publics towards the preservation and stewardship of archaeological sites in the boreal forest. Through a series of interviews, I examine the opinions of three publics involved in the archaeological process in Ontario: developers, First Nations, and archaeologists. I outline the participants??? opinions on the meaning and goals of preservation, the preservation of non-physical aspects of sites, such as oral history and site spirituality, preservation methods, site ownership and access, land use and development, involvement in the archaeological process, and funding. I also identify common themes which presented themselves throughout the interview process, such as the importance of education; the necessity for communication, collaboration, and cooperation; the problem of artifact curation; the perceived lack of genuine government involvement; and the publication of cultural resource management (CRM) archaeology???s ???grey literature???. Finally, I present suggestions on the preservation of archaeological sites which take into account the participants??? perspectives uncovered during the interview process. I conclude that preserving archaeological sites can be done using three techniques: education; communication, collaboration, and compromise; and using one of three general methods to preserve sites and artifacts. Education can be used to create public issues, teach people about the importance of archaeology and archaeological sites, and teach the involved publics about the goals and methods of CRM archaeology in Ontario. Encouraging communication, collaboration, and compromise between the interested publics includes the perspectives of formerly neglected parties, builds relationships between publics, and creates newly vested interests in site preservation. Three methods to preserve archaeological sites include site stabilization and monitoring, allowing sites to decay naturally, and excavating sites and curating the artifacts and oral histories for the long-term.

Environmental stewardship schemes are an important driver of biodiversity and habitat improvement throughout England, with the provision of funding to land managers to deliver effective land management that will benefit wildlife, habitats, natural resources and the population. Participation in agri-environment schemes is voluntary and much is done to encourage scheme participation. Dartmoor is a designated landscape, a National Park, and a Special Area of Conservation and encompasses areas of Sites of Special Scientific Interest (SSSI). Dartmoor is a farmed landscape, with the area divided into 92 common land units, over which a diversity of common rights are exercised. At present, the majority of Dartmoor Commons are managed by Environmental agreements, protecting the habitat and the SSSI’s. There is a demand for Dartmoor to be a recreational area, an environmental jewel, and a farmed landscape. Protection of this landscape requires the amalgamation of various organisations and individuals. Research indicates the benefits of group agri-environment schemes, of a landscape-scale approach to the improvement of habitats and the provision of wildlife corridors, crossing the boundaries of land ownership. vi The research considers the factors associated with group agri-environment schemes, where it is not necessarily like-minded individuals who come together because of a common cause and a shared vision. The issue surrounding common rights results in persons coming together because they have common rights and not necessarily a common view. A combination of interview responses and questionnaire data has been pulled together to ascertain the factors affecting agri-environment scheme participation on Dartmoor. The data reflects on the impacts of group agri-environment schemes on the commons of Dartmoor. The question remains as to the voluntary nature of group agri-environment schemes on Dartmoor. Hardin (1968) recognised the impact of one commoner’s decision had on another. Dartmoor agri-environment schemes require participation from the majority of commoners; therefore an individual’s action has a consequence. This research aims to investigate the impacts of agri-environment schemes on the commons of Dartmoor.

During the last few years, companies have had an increasing interest on playing a more significant role in society, besides their merely economic function. Corporate Social Responsibility (CSR) has become a relevant concept leading them to do so. However, after the recent economic decline, the business model of most corporations had to be reviewed, including the CSR policy. This dissertation work discusses the impact of recession on CSR. The topic is highly relevant, since the consequences of the economic crisis have still a strong influence on business environment, in the form of a degrading level of trust and a decline of moral commitment to society. In order to evaluate this phenomenon, a research was conducted in three companies that are engaged in long-term CSR. With case study as research method, the impact of recession on CSR has been identified and a trend for future development has been outlined. As one of the main conclusions of this research it was proved, that after the economic decline, rather than dismissed, CSR was re-aimed in a more efficient way. CSR has helped companies to survive better the economic crisis and has taught them, how it can be beneficial not only for business but also for the society.

Detta är en kvalitativ studie där syftet var att bidra med kunskap kring hur icke-vinstdrivande organisationer konstruerar hållbarhetskommunikation, detta genom att undersöka hur Marine Stewardship Council [MSC] konstruerar sin hållbarhetskommunikation utifrån hållbarhetsdimensionerna: ekonomisk-, social- och ekologisk hållbarhet. Detta genom en riktad kvalitativ innehållsanalys av MSC:s externa kommunikation från deras hemsida och instagramkonto. Det teoretiska ramverk som applicerats på analysen är de tre hållbarhetsdimensionerna, vilka även utgör temana i analysen. Analysen har utförts utifrån ett kodschema där kategorier, underkategorier och koder har identifierats i materialet. Resultatet av analysen visade att MSC framställt sin kommunikation genom de tre hållbarhetsdimensionerna på flera olika sätt. Deras arbete kan också relateras till det teoretiska ramverket för denna studie. Dock konstateras det att det finns utrymme för vidare diskussion kring huruvida en mer allvarsam ton är en användbar strategi för MSC eller inte. Vidare visar resultatet att MSC beskriver flera av fiskeindustrins problem i relation till samtliga hållbarhetsdimensioner, dock hade kommunikationen upplevts mer trovärdig om en mer nyanserad bild av lösningar framställts.  Slutligen diskuteras resultatet i relation till tidigare forskning och därefter presenteras slutsats, reflektion samt förslag på vidare forskning. / This is a qualitative study with the purpose of contributing knowledge about how non-profit organizations construct sustainability communication. This has been done through analyzing how MSC construct their sustainability communication in relation to the following dimensions of sustainability: economic-, social-, and environmental sustainability. By doing a directed qualitative content analysis of MSC's external communication from their website and Instagram profile. The theoretical framework that has been applied to the analysis is the three sustainability dimensions, which also forms the themes of the analysis. The analysis was done using a coding scheme where categories, subcategories, and codes were identified in the material. The result of the analysis showed that the MSC portrays their communication through the three dimensions of sustainability in several ways. Additionally, their work is related to the theoretical framework of the study. However, there is room for further discussion on whether the MSC would benefit to use a more serious tone or not. Furthermore, the result shows that the MSC describes several problems that relates to the fishing industry. Although, their communication would be perceived as more believable if a more nuanced image of solutions were presented. Lastly, the result is discussed in relation to previous research followed by the conclusion, a reflection, and suggestions for future research.

Background: In preterm infants with premature rupture of membranes, antibiotic treatment is frequently started but rates of early onset sepsis are lower. In line with national guidelines, a stratified approach in the decision to start antibiotic treatment using maternal history, clinical impression and biomarkers has been implemented in our level III neonatal center and its results are evaluated. - Methods: Retrospective cohort study of all preterm newborns with rupture of membranes at least 1 h prior to delivery admitted to our tertiary neonatal intensive care unit. Data on antibiotic exposure, mortality and major neonatal complications were extracted from the electronic patient charts to evaluate the effects and safety of our stratified approach. - Results: Four hundred fifty-six infants met the inclusion criteria. 120 (26%) received primary antibiotics whereas 336 (74%) did not. Of those receiving primary antibiotics, 13 (11%) had a blood culture positive sepsis, 46 (38%) met the criteria of clinical sepsis and in 61 (51%) sepsis was ruled out and antibiotics were stopped after 48-96 h. All infants with blood culture positive sepsis were identified and treated within the first 24 h of life using this approach. None of the 336 infants who were not started on antibiotics primarily needed antibiotic therapy within the first 5 days of life. There were no deaths or major neonatal complications in the group that did not receive empiric antibiotics. - Conclusions: Our stratified approach for preterm infants with premature rupture of membranes allows a safe reduction of antibiotic exposure even in this high risk population. As a result, only 25% of high risk preterm newborns are treated with antibiotics of which more than half receive less than 5 days of treatment. To treat one infant with blood culture positive sepsis, only 9 infants receive empiric antibiotics.

A aprovação da norma contábil IAS 41- Agriculture em 2001 trouxe uma série de desafios nas práticas contábeis das empresas, sendo a principal delas o reconhecimento de ganhos/perdas durante o crescimento biológico de um ativo e a mensuração destes ganhos/perdas pelo valor justo. Toda forma de reconhecimento e mensuração apresenta relação com o modelo de negócios da empresa e irá afetar o relacionamento entre os envolvidos neste contexto e a forma como os usuários da informação contábil avaliam a gestão dos recursos investidos na entidade, que é o stewardship. Desta forma o objetivo deste trabalho foi discutir quais e como os fatores internos e externos presentes no contexto social das organizações, contribuíram para que a informação contábil a valor justo atingisse o objetivo de stewardship. Para isto foi realizado um estudo etnográfico por meio de entrevistas direcionadas aos responsáveis pela informação contábil em onze empresas de diferentes segmentos do agronegócio. O modelo de analise primeiramente se ateve ao entendimento do Modelo de Mensuração dos ativos biológicos dentro destas empresas, e como esta informação é utilizada para fins de stewardship. Em três empresas, a informação contábil referente ao ativo biológico é utilizada para fins de avaliação de performance global e do gestor e para o relacionamento com o credor, que constituem elementos para a proxy do stewardship. O processo de mudança nestas empresas, analisado conforme modelo desenvolvido por Miller (1991) se deu primeiramente pela Problematização ocorrida no contexto social destas empresas, em que seu modelo de negócios tem a madeira como produto final, bem como no modelo de gestão que visa em primeiro lugar o retorno do capital investido, mensurado pela valorização da floresta ao longo dos anos. Os atores que agem para que isto se torne numa mudança efetiva, denominados de Comunidades Epistêmicas, são os acionistas e os credores destas empresas. Os acionistas que são fundos de investimentos têm que apresentar aos seus cotistas a valorização destes investimentos, e o credor (em uma das empresas) vincula a garantia dos empréstimos ao valor da floresta. Também atua neste processo de uma forma mais distante (Ação à Distância) a cultura dos fundos de investimentos, em que a gestora florestal é responsável pela formação e venda de novas áreas florestais, bem como a legislação específica da constituição destes fundos. Nas outras empresas, além de o ativo biológico ser um insumo de produção no modelo de negócios na maioria dos casos analisados, o modelo de gestão é baseado na eficiência operacional. Desta forma, a mensuração a ser utilizada deve ser relacionada tanto ao modelo de negócios como ao modelo de gestão da empresa, que são fatores que revelam como os ativos estão sendo geridos, e isto influencia na perspectiva de geração de caixa do negócio. Apesar da obrigatoriedade que uma norma contábil impõe, a prática contábil segue suas próprias leis no âmbito social que operam as empresas, e qualquer alteração imposta passa por um extenso processo de problematização antes de esta norma ser socialmente aceita. / The adoption of IAS 41- Agriculture in 2001 brought a lot of challenges to companies´ the accounting practices, and the most important is the recognition of gains / losses during the biological growth of an asset and the measurement of these gains / losses at fair value. All forms of recognition and measurement are correlated with the company\'s business model and will affect the relationship between those involved in this context, and how the users of accounting information assess the management of resources invested in the entity, i.e. the stewardship. Therefore, the aim of this study was to discuss what and how internal and external factors in the social context of organizations, contributed to the accounting fair value to reach stewardship´s purpose. The ethnographic study has been conducted through interviews directed to the responsible of accounting information in eleven companies from agribusiness´ different segments. The analysis model first adhered to the understanding of \"Measurement Model\" of biological assets within these companies, and how this information is used for stewardship purposes. In three companies the information of biological assets is used for evaluate both, the companies\' performance and management´s performance, and for relationship with lender, which are elements for proxy of stewardship. The change in these companies, analyzed according to Miller (1991) starts by Problematization occurred in the social context of these companies, in which the forest is an output in its business model, as well as the purpose of management´s model is firstly the return on capital invested, measured by the appreciation of the forest over the years. The actors who work in order to transform this in an effective change, called Epistemic Communities, are the shareholders and the debtholder of these companies. Shareholders, which are Investment Funds, have to present to its investors with the appreciation of these investments, as well as the debtholder (in one of the companies) that ensure the debt with the forest value. Also in this process, working in action at distance: the culture of investment funds, in which forest management is responsible to develop and sale new forest areas as well as the specific legislation of the constitution of these funds. In other companies, besides the fact that biological assets are an input in the business model in most cases, the management model is based on the operational efficiency. Thus, the accounting measurement should be related to both the business model and the company\'s management model, which are factors that reveal how the assets are being managed, and influences in the perspective of business cash flow. Despite the obligation that an accounting standard imposes, the accounting practice follows its own laws in the social context of each company, and any changes imposed undergoes an extensive problematization process before this standard is socially accepted.