This research explores the intricate ethical landscape of pain management in Maltese family medicine, emphasizing the delicate balance between opioid prescribing practices and patient well-being, and aiming to balance effective patient care while minimizing the risk of addiction. Rooted in Beauchamp and Childress’ ethical principles, the study aims to provide nuanced insights into local and global considerations, including deontological theories, rights-based ethics, communitarianism, and ethics of care. By employing a mixedmethods approach, the research seeks to inform evidence-based guidelines, enhance practitioner training, and foster community dialogue. Through a comprehensive exploration, the findings aspire to contribute not only to the refinement of local practices but also to the broader international discourse on responsible and patient-centred pain management

Initially supply chain profits and costs were exclusively positioned as financial or economic costs but over the years logistical activities were observed to have direct impacts on the environmental and social profits and costs that affect the environment through pollution and waste of resources, the health and the safety of people and social corporate responsibility. Cocoa Processing Company Limited still relies only on hydro-electricity and fossil fuel for its primary and supporting activities which is a managerial problem that has to be solved due to unreliable prices and supply of these energy sources. Ghana has an installed capacity of renewable energy of about 2% and the government is looking at ways to increase this figure to 10% by 2020 from the use of solar, wind and bioenergy alternative energy sources (Afrelec, 2017). CPC can go green by using efficient renewable sources of energy such as solar energy, biofuel, biomass and even wind to reduce cost of operations by supporting electricity usage since its high energy consumption contributes largely on its cost of operations. The above project is a case study that is aimed at ascertaining the long term necessity of investing into clean and lean logistics. Hence, the main purpose of this project is to incorporate green logistics into the logistical activities of Cocoa Processing Company Limited (CPC). It is for this reason that the research will use the qualitative method to retrieve information from customers, so as to perform a value chain analysis and use the quantitative method by the analysis of data for a trend in electricity consumption of CPC. The aim of logistical activities is to coordinate all activities in the supply chain hence these concepts of green logistics has to be implemented in a way that does not negatively affect meeting customer requirements and shareholder equity but rather further minimize costs economically, environmentally and socially. The overall study objective is to analyze the trend in energy consumption levels of CPC and ascertain if its operations can be powered with other alternative sources of energy to reduce electricity consumption. The study will allow CPC and other manufacturing industries realize the validity of investing into cleaner and efficient activities in moving products and information for long term high expected rates of returns to its shareholders although it may have high initial costs. It will also This study will help CPC leverage on alternative energy which will reduce operations costs in terms of energy consumption and make the value chain leaner if implemented by CPC, thereby improving profitability in cost leadership and in the long run aid in reducing energy wastage, transportation costs and pollution. It will also provide an insight into concepts such value chain analysis and the trend analysis of a manufacturing company for the use by scholars in similar future studies. It is therefore time for CPC to use green logistics in the aspects of energy consumption to save on operational cost while protecting the environment in the long time whiles avoiding the backlash of the unreliable power supply in Ghana. It is for this reason that the case study has the title “The use of green logistics: The way forward for Cocoa Processing Company Limited (CPC)”.

Estimation of beneficial proficiency has yielded conflicting results due to contrasts in meanings of the sources of info and yields of the gainful procedure, bringing about almost the same number of meanings of information sources, yields and firm productivity as there are articles regarding the matter. This proceeded with absence of agreement in characterizing information sources and yields has lead to issues of overlooked factors just as clashing mixes of data sources as well as yields between articles. The beneficial effectiveness writing has inspected the wellsprings of wasteful aspects, concentrating on specialized, allocative and scale wasteful aspects. This article looks at working and financing wasteful aspects as parts of profitable wastefulness. For both working and financing wastefulness, the conventional ideas of specialized and allocative effectiveness still apply. Working wasteful aspects emerge from the choices made when obtaining components of production and the decisions made in the production of merchandise and enterprises, bringing about the age of lower money streams than generally conceivable. Financing wasteful aspects are the aftereffect of the decisions made while raising obligation and equitycapital making the firm cause more prominent expenses than would normally be appropriate consequently producing less resources accessible for usage in the present and resulting periods in this manner diminishing future working effectiveness. This detachment has not been tended to in the writing. The accounting report is made out of absolute resources, which are the wellspring of benefits created by the firm, and liabilities and value, which are the wellsprings of financing for the firm. Total compensation is a record of the BANKS AND FINANCIAL INSTITUTIONS ISBN:978-93-94676-00-8 Page 45 benefits produced by the firm just as the results of its financing decisions. Accordingly, the accounting report fills in as the legitimate hotspot for discovering inputs and the pay articulation fills in as the consistent hotspot for discovering yields.

De acuerdo con la información levantada por la Encuesta Nacional de Demanda Laboral (ENADEL) 2019; se estableció una brecha en algunas ocupaciones laborales ligadas al sector de la construcción, las que aluden principalmente a laboratoristas viales, albañiles y carpinteros de obra, además de especialización en oficios sobre materiales térmicos. En virtud de esto, durante el 2022 el Observatorio Laboral de Aysén realizó un estudio de Profundización de Ocupaciones con un enfoque cualitativo, abarcando los puestos de trabajo de Laboratoristas viales y Carpinteros de obras, se ahondó sobre las competencias técnicas y socioemocionales requeridas, las nuevas tecnologías aplicadas, la inclusión de grupos prioritarios y prospectiva laboral de ambas ocupaciones. En el Estudio de Demanda de Capital Humano para Empresas de la Construcción, realizado por la Cámara Chilena de la Construcción (Programa de Conexión Laboral, SENCE-OTIC CChC, marzo 2021), se indica que, en la macro zona sur, el sector de la construcción se compone principalmente de obras de tamaño Micro o Pequeño (20,5% y 43,6% respectivamente), en menor medida quedan las obras grandes que representan un 4,7%. En esta línea, cabe mencionar que la mayoría de las obras existentes son de carácter habitacional. De acuerdo con el Instituto Nacional de Estadísticas, el número de los permisos de edificación en la Región de Aysén alcanzó 125 en área rural y 269 permisos en área urbana; estos datos incluyen obras nuevas y regularización de ampliaciones, con destino principalmente en viviendas, industrias, comercio y establecimientos financieros. Cabe señalar, que estos permisos de edificación es posible obtenerlos mediante el CENSO que mide la actividad de construcción con la finalidad de contribuir estadísticamente a la información del sector.

全球人口正在老龄化，患有慢性病的人数不断增加。为了应对这些趋势，社区加强的社会医疗保健实践是一种新的社会处方范式，旨在通过结合社区参与、组织变革和个人层面的实践来提高社区和个人的健康水平。评估中国社区护理干预对心理健康的有效性，重点关注疾病预防策略的护理干预。评估将探讨这些干预措施对心理健康结果、社区参与以及中国医疗保健系统中基于社区的方法的整体有效性的影响。本次调查采用了主题分析方法。使用社会处方镜头对中国以社区为基础的健康老龄化社会保健实践进行了开放式主题研究。

This paper explores the use of autobiographical and autoethnographic approaches in understanding and analysing individuals’ lived experiences within psychoanalytic or psychotherapeutic frameworks. Autobiographical and auto ethnographic methods involve the researcher or therapist engaging in self-reflection and self-analysis to gain insights into their own experiences, which can then inform their understanding of clients’ narratives and therapeutic processes. By drawing on personal stories, these approaches aim to bridge the gap between subjective experiences and theoretical frameworks, offering a unique lens through which to explore the complexities of human psychology and therapeutic relationship. The theoretical foundations and practical applications of autobiographical and autoethnographic approaches in psychoanalysis and psychotherapy is highlighted alongside the significance of personal narratives as a source of knowledge and insight, emphasising the importance of reflexivity and self-analysis in therapeutic process. Drawing on existing literature, the potential benefits and challenges associated with using autobiographical and autoethnographic methods including ethical considerations, countertransference and the balance between personal and professional boundaries is elucidated. Furthermore, case studies illustrating the ways in which autobiographical and autoethnographic approaches have been employed in psychoanalytic and psychotherapeutic settings are highlighted. These examples demonstrate how personal narratives can enhance clinicians’ understanding of experiences, facilitate empathy and rapport, and contribute to the overall therapeutic process. Potential limitations and areas for further exploration in utilising these approaches, such as potential biases and the need for ongoing self-reflection and supervision is explored. This paper seeks to contribute to the growing body of literature on narrative approaches within psychoanalysis and psychotherapy.

El presente trabajo de investigación bibliográfica examinó el incumplimiento de las normas de bioseguridad por parte del personal de enfermería en el Hospital Básico El Triunfo durante el primer semestre de 2021. Después de la revisión de 6 documentos, se determinó que el 83,33% de los estudios identificó insuficiencias en el seguimiento de estas regulaciones. En específico, un 33,33% de los casos estudiados destacaron la existencia de desafíos en la salud mental de los enfermeros, lo cual está relacionado con el estrés continuo y la presión agravada por la pandemia de COVID-19. Este efecto en la salud mental tiene el potencial de ejercer un impacto negativo en la calidad de la atención. En un 50% de los casos, se señaló un incumplimiento de las normas de bioseguridad en relación con los medicamentos, ya sea debido al uso inapropiado de los fármacos o a problemas en el proceso de dispensación. Estas deficiencias pueden influir en la eficacia de los tratamientos y aumentar la mortalidad, incluyendo el riesgo de enfermedades como la tuberculosis. Sin embargo, el 16,67% de los estudios mostraron una retroalimentación positiva por parte de los pacientes en el sector de atención obstétrica, lo que sugiere que al menos en esta área, se están cumpliendo las normas de bioseguridad y proporcionando atención de calidad. Estos hallazgos resaltan la urgencia de fortalecer la formación y supervisión del personal de enfermería en cuestiones de bioseguridad, así como de abordar la salud mental de los profesionales para mantener una atención de alta calidad. También es esencial asegurar el estricto cumplimiento de las normas de bioseguridad con relación a medicamentos para mejorar la efectividad del tratamiento y reducir el riesgo de propagación de enfermedades.

This paper seeks to analyze the impact of Science, Technology and Innovation (STI) clubs, on performance of secondary school students. The study focuses on Mwanza Secondary School. The study will look at the experiences, challenges and success stories of the school. The year 2018 saw the introduction of STI Clubs in most secondary schools of Malawi including Mwanza Secondary School. These clubs were spear headed by Dr. Chomora Mikeka who is currently the Director of the Department of Science, Technology and Innovation. The Department now works with the Department of Innovation and creativity in the office of the president and cabinet, which was established in November 2020 by His Excellency, Dr. Lazarous MCathy Chakwera, The President of the Republic of Malawi. Through these initiatives, Mwanza secondary school’s performance, especially in science subjects improved and more students are currently being selected to public universities. The club helps equip all science students with the necessary skills and knowledge to solve various problems in their community through innovation and creativity. These innovations are fostering the achievement of the pillars of Malawi 2063 and the Malawi Recovery Plan. Since 2018, the club has participated in four National School Sciences Fair hosted by Kamuzu Academy. Currently, on October 2023, Mwanza secondary school registered one of its innovations, “Antifungal lotion”, with the Innovation and Engineering Hub of the Malawi University of Science and Technology (MUST-MIIRI).

uso de la tecnología y su aplicación para informar del valor nutricional de las frutas

Usar programas para informar y catalogar frutas, informando sus valores nutricionales