In 2003, Winter, Watson, Gillman-Smith, Gilbert and Acton criticised the DSM-IV’s psychiatric conceptualisation of BPD, proposing a set of alternative descriptions based on Kelly’s (1955) Personal Construct Psychology (PCP) and diagnostic constructs. According to Winter et al. (2003), PCP offers not only a less “pre-emptive” stance towards BPD but is more clinically useful given its intrinsic implications for treatment. This correlational research study aimed to determine whether BPD symptomatology is associated with these proposed characteristics of construing. In addition, it was hypothesised that those with a belief that BPD was a part of their identity and untreatable would display higher levels of hopelessness. Ten participants with an existing diagnosis of BPD completed the following measures: a) Personal Construct Inventory (PCI; Chambers & O’Day, 1984); b) Millon Clinical Multiaxial Inventory, Third Edition, (MCMI-III, Millon, 1994); and c) Beck Hopelessness Scale (BHS; Beck & Steer, 1988). Participants were also asked to complete a repertory grid and a Likert Scale indicating the extent of their belief that: a) BPD is an intrinsic part of them; and b) BPD is a treatable condition. Two of the participants are presented as case examples. The most significant finding related to the hypothesis that greater BPD symptomatology would be associated with a higher degree of change in self-construction over time (‘slot-rattling’). Contrary to our prediction, similarity of construing of the elements ‘Me Now’ and ‘Me in the Past’ was correlated with greater BPD symptomatology. This may indicate a belief among participants that they are unable to change or may represent Kellian hostility. Construing one’s mother and father similarly to one’s therapist was associated with greater BPD symptomatology, as was construing one’s father and partner similarly, suggesting, as hypothesised, that those diagnosed with BPD tend to construe current relationships in the same terms as early relationships. Pre-emptive construing and poorly elaborated self-construction were also found to be associated with increased BPD symptoms as predicted. Content analyses performed on elicited constructs revealed that emotion regulation is the most salient area for participants. While the majority of participants considered that BPD was a part of their identity, most were uncertain as to whether BPD is treatable although these findings were not significantly correlated with levels of hopelessness. Participants’ feedback about their experiences of being diagnosed with BPD raises important ethical questions. Further hypotheses are generated based on the study findings and suggestions are made for a revision of the way in which psychological distress is conceptualized, with a particular emphasis on the utility of the PCP approach towards BPD. Clinical implications, limitations of the study and possibilities for further research are discussed.

The study explores the role of management control systems in a strategy formulation process, this by viewing management control systems as a package and addressing its role in the Value Based Health Care (VBHC) strategy formulation process at Uppsala University Hospital. Previous studies exploring the relationship between management control systems and strategy have found the relationship to be interrelated and that management control systems can take either an interactive or diagnostic role. However, these studies are limited in their approach as they do not address management control systems as a package, thus failing to capture the importance of informal control systems and the impact separate controls have on each other. Applying a case study design using semi-structured interviews, the study partly supports the findings of earlier studies emphasizing how management control systems can be classified and used for both interactive as well as diagnostic purposes. The study however, expands the view of earlier research by emphasizing how diagnostic controls should be further classified as either enforcing or reinforcing control systems, as well as emphasizing the importance of timing for understanding the different roles of management control systems in a strategy formulation process.

Thesis (MCur)--Stellenbosch University, 2000. / ENGLISH ABSTRACT: Recent escalation of medical costs, cost containment and decreasing public funds, drew attention to the importance of formulation and evaluation of standards of nursing care. Practice experience and consultations with nurse managers indicated a great need for standards to evaluate the quality of care in the pediatric units of the big hospitals in Swaziland. A non-experimental, explorative and descriptive study was conducted in the four regional hospitals in Swaziland. Checklists were developed by the researcher to evaluate standards of care relating to the structure, process and outcome dimension of care. Structure standards refer to minimum requirements regarding the facilities, equipment, supplies, and availability of generic documents and staff. Process standards are mainly concerned with the specific nursing procedures and practices, while the Outcome standards evaluate the parents' satisfaction with the nursing care of their child, the amount of information received prior to discharge and the level of communication between the parents and the nursing staff. The most important results are: .:. None of the hospitals met the pre-set requirement to be considered as delivering a satisfactory level of care for any of the three dimensions of care . •:. Critical nursing procedures were often performed ineffectively and inefficiently . •:. Most parents viewed their communication with the nursing staff negatively. Recommendations include the development and implementation of a formalized quality improvement programme on all levels of care, auditing of records and patient care and in-service education for all personnel regarding quality care. Keywords: Quality care, formulation and evaluation of standards - pediatric patients / AFRIKAANSE OPSOMMING: Die onlangse verhoging in mediese koste, kostebesparings en verminderde openbare fondse, het die aandag gevestig op die belang van formulering en evaluering van standaarde vir verpleegsorg. Praktykervaring en konsultasies met verpleegbestuurders het aangedui dat daar 'n groot behoefte bestaan vir standaarde om die gehalte van verpleegsorg in pediatriese eenhede in die groot hospitale van Swaziland, te evalueer. 'n Nie-eksperimentele, verkennende en beskrywende studie is onderneem in die vier streekshospitale in Swaziland. Kontrolelyste is deur die navorser ontwikkel om standaarde van sorg te evalueer ten opsigte van die struktuur-, proses-, en uitkomsdimensie van sorg. Struktuurstandaarde verwys na die minimum vereistes ten opsigte van die fasiliteite, toerusting en voorrade, die beskikbaarheid van generiese dokumentasie en die personeel. Prosesstandaarde hou hoofsaaklik verband met spesifieke verpleegprosedures en praktyke terwyl Uitkomsstandaarde die ouers se tevredenheid met die verpleging van hulle kind, die hoeveelheid inligting ontvang voor ontslag en die vlak van kommunikasie tussen die ouers en die verpleegpersoneel evalueer. Die belangrikste resultate is: .:. Geen hospitaal het ten opsigte van enige van die drie dimensies van sorg, aan die voorafbepaalde vereiste voldoen om beskou te word dat hulle 'n bevredigende vlak van sorg lewer nie . •:. Kritiese verpleegprosedures is dikwels oneffektief en ondoeltreffend uitgevoer. .:. Die meeste ouers het fn negatiewe siening gehad ten opsigte van die kommunikasie met die verpleegpersoneel. Aanbevelings sluit in die ontwikkeling en implementering van fn geformaliseerde gehalte verbeteringsprogram op alle vlakke van sorg, oudit van rekords en pasiëntsorg en indiensopleiding vir alle personeel ten opsigte van gehaltesorg. Sleutelwoorde: Gehaltesorg, formulering en evaluering van standaarde - pediatriese pasiënte

Microneedle (MN) enhanced drug delivery is a safe, effective and efficient enhancement method for delivery of drug molecules across the skin. The “poke (press) and patch” approach employs solid stainless steel MN to permeablize the skin prior to application of a regular drug patch over the treated area. It has been previously shown that MN can be used to deliver naltrexone (NTX) at a rate that provides plasma concentrations in the lower end of the therapeutic range in humans. The drug delivery potential of this technique is, however, limited by the re-sealing of the micropores in a 48-72h timeframe. The goal of the current research was to optimize the formulation for a 7 day MN enhanced delivery system for NTX either by adding a second active pharmacological moiety or by optimizing formulation characteristics alone. Three different formulation strategies were explored: formulation pH optimization with NTX; a codrug approach with NTX and a nonspecific cyclooxygenase inhibitor, diclofenac (DIC); and a topical/transdermal approach with NTX and an enzyme inhibitor of the cholesterol synthesis pathway, fluvastatin (FLU). The results indicated that formulation pH cannot be used to extend micropore lifetime, although formulation optimization leads to enhanced transport and thus drug delivery across MN treated skin. The codrug approach was successful in extending the micropore lifetime and further screening of codrug structures and formulation optimization helped in selection of a codrug candidate suitable for evaluation in animal pharmacokinetic studies. Local treatment with FLU helped to keep the micropores open and enabled delivery of NTX for an extended period. The pores re-sealed on removal of treatment within a 30-45 minute timeframe, indicating that infection/irritation should not be a major issue, as in the case of other topical chemical enhancers. Thus, overall it can be concluded that different formulation strategies can be utilized to extend micropore lifetime and enhance delivery of drug molecules across the skin.

With the advance of combinational chemistry and high throughput screening, an increasing number of pharmacologically active compounds have been discovered and developed. A significant proportion of those drug candidates are poorly water-soluble, thereby exhibiting limited absorption profiles after oral administration. Therefore, advanced formulation and processing technologies are demanded in order to overcome the biopharmaceutical limits of poorly water-soluble drugs. A number of pharmaceutical technologies have been investigated to address the solubility issue, such as particle size reduction, salt formation, lipid-based formulation, and solubilization. Within the scope of this dissertation, two of the pharmaceutical technologies were investigated names thin film freezing and hot-melt extrusion. The overall goal of the research was to improve the oral bioavailability of poorly water-soluble drugs by producing amorphous solid dispersion systems with enhanced wetting, dissolution, and supersaturation properties. In Chapter 1, the pharmaceutical applications of hot-melt extrusion technology was reviewed. The formulation and process development of hot-melt extrusion was discussed. In Chapter 2, we investigated the use of thin film freezing technology combined with template emulsion system to improve the dissolution and wetting properties of itraconazole (ITZ). The effects of formulation variables (i.e., the selection of polymeric excipients and surfactants) and process variables (i.e., template emulsion system versus cosolvent system) were studied. The physic-chemical properties and dissolution properties of thin film freezing compositions were characterized extensively. In Chapter 3 and Chapter 4, we investigated hot-melt extrusion technology for producing amorphous solid dispersion systems and improving the dissolution and absorption of ITZ. Formulation variables (i.e., the selection of hydrophilic additives, the selection of polymeric carriers) and process variables (i.e., the screw configuration of hot-melt extrusion systems) were investigated in order to optimize the performance of ITZ amorphous solid dispersions. The effects of formulation and process variables on the properties of hot-melt extrusion compositions were investigated. In vivo studies revealed that the oral administration of advanced ITZ amorphous solid dispersion formulations rendered enhanced oral bioavailability of the drug in the rat model. Results indicated that novel formulation and processing technologies are viable approaches for enhancing the oral absorption of poorly water-soluble drugs. / text

No description available.

Thesis (M.M. (Public and Development Management))--University of the Witwatersrand, Faculty of Commerce, Law and Management, Graduate School of Public and Development Management, 2015. / Development aid plays a significant role on the African continent in a number of ways which include, but is not limited to, financing budget deficits, conflict resolution and humanitarian assistance. South Africa, China, India and Brazil are among the “four main South powers” emerging on the global scene with aid policies designed at providing development aid to African Countries [Tjønneland, 2013: 1]. This study has examined the establishment and implementation of the African Renaissance and International Co-operation Fund (ARF) by analysing the policy processes that led to its creation and operation, from 2000 to 2009. The principle behind the development of such an act was South Africa’s desire to show its commitment in assisting in resolving Africa’s socio-economic challenges that impede development in Africa. ARF has suffered inconsistency in policy making and implementation. The study has found that the challenges in ARF policy processes were attributed to governance issues, issues of accountability, temptation to be used as a state fund for political interest, weakness in the institutional framework, absence of autonomy in management, absence of monitoring and evaluation, political power and poor administration systems.

No description available.

De nos jours, le bloc est le produit le plus vendu en préfabrication, avec un chiffre d’affaires de 418 millions d’euros en 2015 (chiffres issus de la Fédération de l’Industrie du Béton). Toutefois, ce résultat atteste d’une baisse de production constatée depuis 2012.Dans ce contexte économique difficile, les industriels cherchent à optimiser la formulation de leurs produits. Les particularités de ceux-ci (consistance sèche et teneur en air moyenne comprise entre 7 et 15 %) rendent impossible l’utilisation des outils existants.L’objectif de la thèse est alors de mettre au point une méthode de formulation adaptée aux blocs, permettant d’optimiser le rapport coûts/performances. Cela implique de diminuer le dosage en ciment, matériau le plus couteux du béton et également le plus négatif en termes d’émissions de CO2. Pour cela un squelette granulaire optimal doit être utilisé.La méthodologie de formulation mise au point se déroule ainsi en deux étapes. La première consiste à sélectionner le mélange granulaire présentant l’arrangement maximal. La deuxième détermine les volumes des autres constituants (ciment, eau efficace, air et addition) en fonction des exigences de consistance et de performances mécaniques. Les travaux ont permis d’obtenir un modèle d’empilement compressible adapté à la mise en place des mélanges granulaires secs à l’aide d’une presse vibrante et d’un moule de bloc. Celui-ci calcule la compacité des mélanges granulaires dans de telles conditions et permet de sélectionner le mélange optimal. Les travaux ont également permis de relier les propriétés aux états frais et durcis à la formulation des bétons secs. La résolution du système d’équations obtenu permet de déterminer la formulation qui optimise le rapport coûts/performances.Un outil numérique regroupant ces résultats est développé. Il nécessite de renseigner un ensemble de données (squelettes granulaires, masses volumiques réelles, coûts, etc.), ainsi que les exigences de consistance et de performances mécaniques. Il propose alors la formulation optimisant le rapport coûts/performances. Celle-ci peut ensuite être testée à échelle réduite sur des cubes car les résultats ont permis de relier les performances mécaniques des cubes et des blocs. / Construction’s sector is knowing an important mutation and is confronted with unpresented stakes with major importance for next decades: population growth and needs in accommodation and infrastructures, climate change, uses of durable and natural resources, societal expectations from consumers as well as territorial’s stakeholders. Concrete precast industry is strongly enlisted to answer at these news needs, for the constructive systems proposed as well as for the production processes of concrete’s products. The stake is especially important for concrete masonry units with a production in France in 2017 of 6.7 million tons. These products are realized using press which compact concrete with vibration and pression. Blocs are made of dry cast concrete with average air content between 7 and 15%. Today, formulation methodologies are adapted to delayed demoulding products and so not made for bloc concrete.This thesis aims to develop a formulation methodology adapted to blocs and to their process, in order to optimize their performances in economic conditions. This implies disposing of robust tools able to determine optimal proportions for each constituent, considering process specifications. Especially, it is necessary to use an optimized aggregates mix.The formulation methodology developed runs through two steps. The first one consists in choosing the aggregates mix with maximal packing density. The second one determines other constituents volumes (cement, efficient water, air and addition) according to consistency and mechanical performances requirements. The compressive packing model (F.de Larrard) is adapted to dry aggregates mix casting with vibrating press in a bloc mold. Results also make it possible to connect fresh and hardened properties to the formulation of dry cast concretes. Solving the system of equations gives the formulation optimizing the ratio costs/performances.

Monoclonal antibodies (mAbs) represent one of the fastest growing classes of therapeutic proteins. This success is due to a number of attractive properties such as high binding affinity, specificity, low immunogenicity and high aqueous solubility. Despite this, mAbs can suffer from undesirable physical instabilities, especially reversible self-association (RSA), which can lead to aggregation and phase separation. One aspect of formulation is therefore to find solution conditions which minimise mAb aggregation propensity during storage at high concentrations. Hence, the buffer, excipient and pH must be carefully considered to obtain the optimal formulation. Currently, if a platform formulation process is non-ideal for a particular candidate mAb, then an alternative strategy is to utilise high-throughput screening to measure various physical parameters indicative of physical stability. Arginine (in the form of hydrochloride salt Arg·HCl) is often used in formulations exhibiting high RSA and a propensity for aggregation. The interaction of Arg with the protein surface is complex and dependent on both the salt form and concentration. Here the focus was on the glutamate salt of arginine (Arg·Glu), to quantify its effect on mAb conformational and colloidal stability under different pH conditions. Arg·Glu was able to decrease the propensity of the mAbs to aggregate, particularly at pH values closer to their pI.The work also included the use of in vitro cell culture models to examine cell viability in the presence of the various arginine salts over a range of osmolalities. Whilst Arg·Glu is composed of two naturally occurring amino acids and both of which are considered non-toxic individually, the effect of the increased concentrations of their combination, on cells has not been explored previously. In vitro cell lines were chosen to represent the subcutaneous tissue, the effect of Arg·Glu on cell viability was compared against NaCl, Arg·HCl and sodium glutamate (NaGlu). The work concluded there was no additional toxicity associated with the presence of Arg·Glu in the cell culture models studied, therefore Arg·Glu has the potential as an excipient as it reduces aggregation and is nontoxic. Another aspect of the work was to assess the use of solution NMR spectroscopy as an orthogonal technique in mAb formulation characterisation. 1H NMR spectroscopy was used to measure a number of experimental parameters for high concentration mAb solution. The work proposed that 1H NMR spectroscopy can serve as a valuable orthogonal method for mAb characterization and formulation.