Abstract This study aims at continuously exploring government procurement policy itself via the views of both constructors and the government officials, based on the Likert-scale questionnaire designed by the author. With cluster sampling, the subjects are 99 officials from the government officials of Kaohsiung city and 44 constructors in the south of Taiwan . The key point is to evaluate the policy impact, in other word is to assess the achievement of policy effectiveness & policy goal. Is there any significantly difference for and against practicing the government procurement law between constructors and the government? This study construct policy impact evaluation with in the way of management, politics & law; based on policy effectiveness, system maintenance, responsiveness, To evaluate whether or not can the illegal thing be reduced because of practicing government procurement law which based on policy effectiveness, system maintenance, responsiveness & appropriateness. Results from questionnaire are statistically processed with SPSS. There are several conclusions. Both constructors & the government officials have the same views toward practicing the government procurement law. Both of them agree that the procurement environment itself has been significantly changed. Though the efficiency & quality of government procurement have been improved since the government procurement law had been practiced. But the efficiency & quality of government procurement still has not improved equally, even the government procurement procedure were fair & information openly. The persons who proceeded procurement have no confidence toward their own departments is rather alarming. Anyway, NT$500 thousand have been thought to be the appropriate standard of internet procurement. The findings can serve as reference of improvement of government procurement policy. Key words¡GPublic Policy, Policy Impact, Policy Effectiveness, System Maintenance, Responsiveness, Appropriateness

The following study used politeness theory to explore the impact of simultaneously engaging in a face to face conversation and a text message conversation. Specifically the study used Brown and Levinson’s (1978, 1987) five original politeness strategies to see whether strategy choice (in the face to face conversation) impacts the face threat present in engaging in multiple conversations. Multivariate analysis of covariance was used to understand the impact different politeness strategies had on the following variables: conversational appropriateness, relational/social appropriateness, immediacy, attentiveness, and politeness. Findings show that when a face to face partner ignores (no verbal/nonverbal politeness) a text message interruption the partner is seen as more relational/socially appropriate, immediate, attentive, and polite. Findings also indicate that aside from ignoring the text message, politeness messages that acknowledge the text message interruption and offer a relevant verbal message are viewed as more relationally/socially appropriate, immediate, attentive, and polite than those that indirectly deal with the text interruption. This study partially supports the popular belief that texting in the presence of others violates face to face conversational expectations and is perceived as “rude.” However, future studies need to look at the role and influence mediated conversational expectations play in overall conversational expectations.

The proposed thesis project consists of an art presentation precinct where art works will be exhibited, presented and performed before being presented to under-exposed communities in outlying areas of Tshwane and beyond. The dissertation responds to certain identified requirements. Its approach will be preservation based, while being sensitive to the distinctiveness of the site. The aim is that the aesthetics will add to the character of the site and that, at completion, visual appropriateness will be prominent. Please note that the text on pages 28-39, 44, 46-64, 71-77, Images and Bibliography is illegible / Dissertation (MArch(Prof))--University of Pretoria, 2008. / Architecture / unrestricted

This mixed methods study aimed to provide some validity evidence for the use of the ESL sociopragmatics test developed by Roever, Elder and Fraser (2014) for formative purposes. The test developers recommend further validation of the tool, originally developed for the Australian context. In this study, the test items were used to reveal areas of weakness in sociopragmatic knowledge in a group of learners of an academically oriented English Intensive Program in Canada. Analysis of the test scores revealed a lack of knowledge of norms of appropriateness and politeness in English, which was further targeted with an instructional unit informed by the items of the test. Two weeks after the instructional unit was delivered, the participants were asked to complete a follow-up questionnaire. The questionnaire results provided insight into the participants’ perceptions of usefulness of the instructional unit. The learners found explicit instruction on ESL sociopragmatics useful for their language learning experience as well as day-to-day interactions in English. Particularly, they claimed to feel more confident communicating in English after receiving explicit instruction on ESL sociopragmatics. They were able to use information from the lesson in situations such as talking to their language instructors, communicating with university personnel, and participating in service encounter interactions. Therefore, the test proved to have potential for developing instructional materials in an academic context. Based on the findings of the study, suggestions on incorporating sociopragmatic competence into the institution’s EAP curriculum were made.

Background. Around 25-45% of elective total joint arthroplasty (TJA) for primary hip and knee osteoarthritis (OA) are of questionable appropriateness. -- Objective. To examine how appropriateness of elective TJA for hip and knee OA is determined. -- Methods and results. Multi-methods studies guided by the Knowledge-To-Action (KTA) framework and the six Hawker appropriateness criteria for TJA. Study 1 was an interpretive descriptive study exploring barriers and facilitators to using the Hawker appropriateness criteria for adults with knee OA. Nine semi-structured interviews with healthcare professionals and 14 with adults with a TKA revealed: a) 15 barriers (including difficulties in using criteria, lack of accessible conservative treatments, unreceptivity to practice change, clinical judgement limited to OA severity and age, patients receiving information after the decision is made); and b) one facilitator (providing research evidence to obtaining healthcare team buy-in). Study 2 was a systematic review identifying and appraising instruments to assess elective TJA appropriateness for adults with hip and knee OA. None of the 55 instruments met all the Hawker appropriateness criteria; the most included criteria were OA impact on quality of life and evidence of OA while the least included were trial of conservative treatments and elements of shared decision-making. There was limited evidence on psychometric properties. Study 3 was an environmental scan of online Canadian resources for adults with hip or knee OA considering TJA and healthcare professionals participating in the decision. The 73 patient resources were understandable for diverse health literacy levels, but only four were patient decisions aids. Thirteen healthcare professional resources typically recognized OA impact on quality of life, evidence of OA, trial of conservative treatments, and did not discuss elements of shared decision-making. -- Conclusion. When determining appropriateness of elective TJA for primary hip and knee OA, clinical practice and instruments typically focus on OA symptoms negatively impacting quality of life and radiographic evidence of OA, while trial of conservative treatments is less reported. The appropriateness decision-making process poorly acknowledges or supports patient preferences (e.g., shared decision-making). Appropriateness of elective TJA needs to be reconsidered and conceptualized in a way that supports early conservative treatments and patient-centred care.

59 Abstract Applicatin of MiFID directive on activities in universal bank MiFID or Markets on financial instruments Directive, is extensive and key European financial market regulation. Introduced into the laws of all the Member States many new applications and employed a large number of companies. The content of this work is to first clarify the concept of a universal bank, the bank and the reason why the Directive applies to them. Furthermore, analysis of specific activities and procedures, which are due to the introduction of the Directive into law occurred mainly by retail investors, the current clients of universal bank. Most attention is devoted to investor protection, mainly test the approprietness and suitability, performance instructions for the customer. The following chapter is devoted to issues of organizational changes, the new rules required. Part of the text is devoted to the transposition process in individual countries and especially in the Czech Republic. Another chapter is concerned with problems that frequently appear in the application and in the last chapter outlines recent developments, particularly in the new draft directive, revising MiFID after almost five years of operation, which is just being born on the soil of the European Union. The conclusion is the finding that changes in...

53 Abstract Application of MiFID directive on activities in universal bank MiFID or Markets on financial instruments Directive, is extensive and key European financial market regulation. Introduced into the laws of all the Member States many new applications and employed a large number of companies. The content of this work is to first clarify the concept of a universal bank, the bank and the reason why the Directive applies to them. Furthermore, analysis of specific activities and procedures, which are due to the introduction of the Directive into law occurred mainly by retail investors, the current clients of universal bank. Most attention is devoted to investor protection, mainly test the appropriateness and suitability, performance instructions for the customer. The following chapter is devoted to issues of organizational changes, the new rules required. Part of the text is devoted to the transposition process in individual countries and especially in the Czech Republic. Another chapter is concerned with problems that frequently appear in the application and in the last chapter outlines recent developments, particularly in the new draft directive, revising MiFID after almost five years of operation, which is just being born on the soil of the European Union. The conclusion is the finding that changes in...

L'évolution des soins médicaux en milieu hospitalier se caractérise par une intensité accrue des soins et de l'utilisation des médicaments, ces derniers étant de plus en plus nombreux et souvent onéreux. De plus, les personnes âgées, en nombre croissant dans notre société, souffrent fréquemment de pathologies concomitantes et nécessitent donc une polythérapie. Il devient dès lors de plus en plus complexe d'assurer un usage optimal (efficace, non toxique, et économique) des médicaments, et également d'assurer un suivi adéquat du traitement lorsque ces patients sont transférés entre milieux de soins aigus et chroniques. De nombreuses publications ont mis en évidence, à l'étranger, une prévalence élevée d'utilisation inappropriée des médicaments en gériatrie (sous forme d'overuse, de misuse, et d'underuse). Les facteurs explicatifs d'une utilisation inappropriée n'ont cependant jamais été étudiés dans cette population. Or, cette étape d'identification est indispensable pour le développement d'interventions appropriées. Elle a donc constitué la première partie du travail de recherche (1). Ensuite, certaines études ont tenté d'évaluer l'impact de diverses approches permettant d'améliorer la prescription (y compris la pharmacie clinique), mais peu ont utilisé une méthodologie robuste. De plus, l'intérêt de cette approche de pharmacie clinique n'a jamais été évaluée en Belgique, alors qu'il existe un potentiel certain pour la développer. C'est dans ce cadre que s'est effectuée la deuxième partie du travail (2). (1) Pour répondre au premier objectif, une étude qualitative combinant des données issues d'entretiens et d'observations avec des professionnels et patients au sein de services de gériatrie a été réalisée. Trois grandes catégories de facteurs sous-jacents à une utilisation inappropriée des médicaments ont été identifiés : référence au modèle de soins de santé aigus pour des adultes en général ; attitude d'apprentissage passive; prise de décisions paternaliste. A l'inverse la prise en charge par un gériatre et la communication multidisciplinaire permettent une meilleure utilisation des médicaments. Les mesures d'optimisation potentielles devraient donc entre autres concerner les compétences individuelles, les relations médecin-patient et médecin-médecin, et les systèmes de transfert d'informations entre milieux de soins. (2) Afin de quantifier la qualité de prescription, et l'impact d'une collaboration avec un pharmacien clinicien, une étude randomisée contrôlée a été réalisé, et a inclus 200 patients hospitalisés au sein d'un service de gériatrie. Les résultats montrent que l'intervention d'un pharmacien clinicien permet de réduire de façon significative l'overuse, l'underuse et le misuse des médicaments. L'acceptation des interventions est excellente, et leur pertinence clinique élevée.Enfin, l'intervention s'accompagne d'une tendance à une diminution de la mortalité et de la morbidité des patients, un an après leur sortie de l'hôpital. Ce travail démontre donc l'intérêt de la pharmacie clinique dans le contexte belge, et ouvre plusieurs perspectives, dont une évaluation de la généralisation à d'autres services cliniques, et une évaluation de son rapport coût-efficacité.

Bakgrund: Personer över 80 år har ökat med nästan 22 % under åren 1992 – 2005. Under samma tid har vårdplatserna inom hela akutsjukvården nästan halverats. Detta har lett till ökat vårdbehov och större belastning på framför allt akutmottagningar, medicinkliniker, primärvården och kommunen. Tidigare studier har visat att inadekvata akutmedicinska inläggningar sker ofta runtom i Europa. Syfte: Syftet med studien var att studera inskrivning och utskrivning av patienter vid akutmedicinska avdelningar på ett sjukhus i Sverige. Metod: Studien genomfördes under 2007 på en akutmedicinsk klinik i Sydöstra Sverige. 411 akutmedicinska patientinläggningar bedömdes med Appropriateness Evaluation Protocol (AEP). Lika många hade möjlighet att besvara en enkätfråga, riktad till patienter, sjuksköterskor och läkare, om bedömning av utskrivningen. Resultat: Studien visar att 28,7% av patientinläggningarna inte uppfyllde AEP’s kriterier. De flesta patienter hade bröstsmärta som inskrivningsorsak oavsett adekvat eller inadekvat inläggning. Nära 30 % av patienterna, sjuksköterskorna och läkarna bedömde möjlig utskrivning ett dygn tidigare. Slutsats: Studien visar att inadekvata akutmedicinska inläggningar, enligt instrumentet AEP utgör en betydande del av beläggningen på en medicinklinik som är potentiellt påverkbar. Studien visar också att beläggningen kan påverkas genom tidigarelagd utskrivning enligt bedömningar av såväl patienter som sjuksköterskor och läkare. Resultatet talar för att en bättre kommunikation mellan patienter, sjuksköterskor och läkare skulle kunna optimera längden för akuta medicinska vårdtillfällen. / Background: Persons aged over 80 has increased by almost 22% during 1992-2005. In that time, bed occupancy throughout the emergency medical services has almost decreased to the half. This has led to increased care needs and greater burden, especially on emergency wards, medical clinics, primary care and community. Previous studies have shown that inadequate emergency medical admissions are frequently around Europe. Aim: The aim was to study admission and discharge of patients in acute medical wards at a hospital in Sweden. Method: The study was conducted in 2007 at an acute medical clinic in Southeast Sweden. 411 acute medical patient admissions were assessed with the Appropriateness Evaluation Protocol (AEP). Just as many were able to answer a survey question, directed to patients, nurses and doctors, on the assessment of discharge. Results: The study shows that 28.7% of patients' admissions did not meet AEP's criteria. Most patients had chest pain that enrollment cause any adequate or inadequate curing. Almost 30% of patients, nurses and doctors thought that discharge of the patient was possible one day earlier. Conclusion: The study shows that inadequate emergency medical admissions, with the instrument AEP, are an important part of the hospital bed occupancy of a medical clinic that is potentially impressionable. The study also shows that the hospital bed occupancy can be influenced by earlier discharge according to assessments by both patients, nurses and doctors.

Abstract: The purpose of this study is to examine how the Swedish policy of neutrality has changed between the years 1990-2008. The research method used for this essay has been comparative case study, which strives to answer four research questions. Two of these questions are: Which specific occurrences have been fundamental in changing the Swedish policy of neutrality? How have the Swedish policy of neutrality and the policy of non-alignment changed between the years 1990-2008? The theoretical frame work of this study consists of Europeanization as a comprehensive theoretical perspective. In order to explain the Swedish act regarding the policy of neutrality, Logic of Consequences and Logic of appropriateness are used. The conclusion of the study points out that Sweden has become much more flexible in terms of policy of neutrality and policy of security. The years between 1990-2008 are distinguished due to the fact that the international cooperation has become much more important in the Swedish act of security. Sweden still has the policy of non-alignment, but cooperation between the states is more and more prioritized to secure peace around the world.