968 resultados para Bereavement leave


Relevância:

10.00% 10.00%

Publicador:

Resumo:

Agência Financiadora: Fundação para a Ciência e a Tecnologia - Pest-OE/QUI/UI0100/2013; PTDC/CTM-BPC/122447/2010; RECI/QEQ-QIN/0189/2012; SFRH/BPD/78854/2011

Relevância:

10.00% 10.00%

Publicador:

Resumo:

Small mammals from a water well near Morgadinho indicate an age comprised between Middle Villafranchian, MN 17 zone and lowermost Middle Pleistocene, MN 20. This fauna corresponds to an humid region under a possibly temperate (certainly not cool) climate. Nearly all Gastropoda have quaternary affinities. Most are freshwater dwellers. Ostracoda lived in lacustrine or extensive swamp enviromnents rich in plants. They also point out to fresh waters (eventually oligohaline; this may suggest some kind of communication with the sea, which would not be very close by), and to water temperatures over 10.5°C. Charophyta thrive in fresh, carbonate-rich waters. Cyprinid fishes are also freshwater dwellers, and amphibians exclude any significant salinity. Palynological analysis shows climate should be warm and rather humid. Near Morgadinho there was a mixte mesophytic forest (and perhaps a sempervirent, large leave type forest at Algoz). Morgadinho and Algoz (this locality being dated MN 20, lowermost Middle Pleistocene) are probably correlative, and this may also be true for lacustrine limestones at Ponte das Lavadeiras, near Faro.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

In beacon-enabled mode, IEEE 802.15.4 is ruled by the slotted CSMA/CA Medium Access Control (MAC) protocol. The standard slotted CSMA/CA mechanism does not provide any means of differentiated services to improve the quality of service for timecritical events (such as alarms, time slot reservation, PAN management messages etc.). In this paper, we present and discuss practical service differentiation mechanisms to improve the performance of slotted CSMA/CA for time-critical events, with only minor add-ons to the protocol. The contribution of our proposal is more practical than theoretical since our initial requirement is to leave the original algorithm of the slotted CSMA/CA unchanged, but rather tuning its parameters adequately according to the criticality of the messages. We present a simulation study based on an accurate model of the IEEE 802.15.4 MAC protocol, to evaluate the differentiated service strategies. Four scenarios with different settings of the slotted CSMA/CA parameters are defined. Each scenario is evaluated for FIFO and Priority Queuing. The impact of the hiddennode problem is also analyzed, and a solution to mitigate it is proposed.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

OBJECTIVE To analyze lifestyle risk factors related to direct healthcare costs and the indirect costs due to sick leave among workers of an airline company in Brazil. METHODS In this longitudinal 12-month study of 2,201 employees of a Brazilian airline company, the costs of sick leave and healthcare were the primary outcomes of interest. Information on the independent variables, such as gender, age, educational level, type of work, stress, and lifestyle-related factors (body mass index, physical activity, and smoking), was collected using a questionnaire on enrolment in the study. Data on sick leave days were available from the company register, and data on healthcare costs were obtained from insurance records. Multivariate linear regression analysis was used to investigate the association between direct and indirect healthcare costs with sociodemographic, work, and lifestyle-related factors. RESULTS Over the 12-month study period, the average direct healthcare expenditure per worker was US$505.00 and the average indirect cost because of sick leave was US$249.00 per worker. Direct costs were more than twice the indirect costs and both were higher in women. Body mass index was a determinant of direct costs and smoking was a determinant of indirect costs. CONCLUSIONS Obesity and smoking among workers in a Brazilian airline company were associated with increased health costs. Therefore, promoting a healthy diet, physical activity, and anti-tobacco campaigns are important targets for health promotion in this study population.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

The behavior of tandem pin heterojunctions based on a-SiC: H alloys is investigated under different optical and electrical bias conditions. The devices are optimized to act as optically selective wavelength filters. Depending on the device configuration (optical gaps, thickness, sequence of cells in the stack structure) and on the applied voltage (positive or negative) and optical bias (wavelength, intensity, frequency) it is possible to combine the wavelength discrimination function with the self amplification of the signal. This wavelength nonlinearity allows the amplification or the rejection of a weak signal-impulse. The device works as an active tunable optical filter for wavelength selection and can be used as an add/drop multiplexer (ADM) which enables data to enter and leave an optical network bit stream without having to demultiplex the stream. Results show that, even under weak transient input signals, the background wavelength controls the output signal. This nonlinearity, due to the transient asymmetrical light penetration of the input channels across the device together with the modification on the electrical field profile due to the optical bias, allows tuning an input channel without demultiplexing the stream. This high optical nonlinearity makes the optimized devices attractive for the amplification of all optical signals. Transfer characteristics effects due to changes in steady state light, control d.c. voltage and applied light pulses are presented. Based on the experimental results and device configuration an optoelectronic model is developed. The transfer characteristics effects due to changes in steady state light, dc control voltage or applied light pulses are simulated and compared with the experimental data. A good agreement was achieved.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

Journal of Human Evolution, V. 55, pp. 148-163

Relevância:

10.00% 10.00%

Publicador:

Resumo:

Mestrado em Auditoria

Relevância:

10.00% 10.00%

Publicador:

Resumo:

RESUMO - Num contexto em que a prestação de cuidados de Fisioterapia e Reabilitação é identificada como apresentando uma desigualdade e desajustamento da oferta regional superior à dos restantes cuidados de saúde, assim como uma falta de adequação dos preços praticados, perante as condições de oferta e procura actualmente existentes, o presente trabalho tem por objectivo investigar, no domínio do Desempenho, a influência do Financiamento na definição da prestação destes cuidados, tendo como pressuposto genérico que as decisões estratégicas e a reestruturação produtiva das organizações de saúde são condicionadas pelo sistema de preços. Considera-se que o actual sistema de Financiamento/Pagamento provoca um constrangimento na qualidade da resposta destes cuidados a dois níveis: um primeiro nível, ao colocar o pagamento no âmbito dos Meios Complementares de Diagnóstico e Terapêutica (MCDTs) a contratar pelo Serviço Nacional de Saúde, com isso determinando a configuração organizativa do sistema; um segundo nível de constrangimento que incide sobre as estruturas das organizações prestadoras, pela modelação que induz, nomeadamente a nível da sua produção. Na impossibilidade de tratar as duas dimensões do problema, pela falta de indicadores de desempenho deste sector, analisou-se, relativamente ao segundo nível de constrangimento, a produção de fisioterapia de três organizações que, potencialmente, teriam o mesmo o mesmo perfil de oferta por se enquadrarem num mesmo perfil de procura. Os resultados reflectem o pressuposto genérico do trabalho e abrem espaço para colocar como futura hipótese de investigação a razão da(s) causa(s) que poderão estar subjacentes à discrepância encontrada na média de tratamentos por sessão (duas vezes e meia) na produção das duas organizações que foi possível comparar.------------------- ABSTRACT - In a context where the provision of Physical Therapy and Rehabilitation care is identified as having a regional mismatch of supply and inequality above all the others health cares, and a lack of adequacy of prices in the current conditions of supply and demand, the present work has, as main purpose, to investigate, in the field of Performance, the Payment’s influence in shaping the provision of such health care. The general assumption tracking this analysis is that the strategic decisions on productive structure of health care organizations are influenced by the price systems. It is considered that the current Finance / Payment system causes two levels of constraints on the quality of such health care: a first constraint, as it putts its payment under the Supplementary Means of Diagnosis and Therapy (MCDTs), witch ends up establishing the organizational setup of the system; a second level of constraint by modelling the internal structure of these organizations. The lack of indicators characterizing the performance of this sector, addressed the present study to the second dimension, in witch was analysed the physical therapy production in three organizations that, potentially, would have the same profile of supply responding to similar characteristics of demand. The results reflect the above mentioned general assumption that supported the work, and leave an open space for future research, about the reason (s) that lay behind the discrepancy found between the average of treatments per session (two and a half times) in

Relevância:

10.00% 10.00%

Publicador:

Resumo:

Thesis submitted to Faculdade de Ciências e Tecnologia of the Universidade Nova de Lisboa, in partial fulfillment of the requirements for the degree of Master in Computer Science

Relevância:

10.00% 10.00%

Publicador:

Resumo:

This paper presents an ongoing project that implements a platform for creating personal learning environments controlled by students, integrating Web 2.0 applications and content management systems, enabling the safe use of content created in Web 2.0 applications, allowing its publication in the infrastructure controlled by the HEI. Using this platform, students can develop their personal learning environment (PLE) integrated with the Learning Management System (LMS) of the HEI, enabling the management of their learning and, simultaneously, creating their e-portfolio with digital content developed for Course Units (CU). All this can be maintained after the student completes his academic studies, since the platform will remain accessible to students even after they leave the HEI and lose access to its infrastructure. The platform will enable the safe use of content created in Web 2.0 applications, allowing its protected publication in the infrastructure controlled by HEI, thus contributing to the adaptation of the L&T paradigm to the Bologna process.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

Neste relatório de estágio, procurei redigir tudo aquilo que vivi no decorrer do período do estágio profissional. Assim, inicialmente fiz um enquadramento da entidade que me acolheu, bem como uma breve descrição do contrato no qual estive especificamente inserido. Foi efetuada uma descrição detalhada dos conceitos de manutenção preventiva e correctiva adaptadas ao contrato em questão e de acordo com um plano de manutenção específico dedicado à vertente da construção civil. Neste sentido, foram detalhadas as várias tipologias de infraestruturas fixas a manter, nomeadamente as grandes áreas dos edifícios, obras de arte, túneis ou muros de suporte e contenções, descrevendo os procedimentos de manutenção preventiva e corretiva associados a cada tipologia de infraestrutura. São apresentados vários gráficos demonstrativos das ações de manutenção preventiva e corretiva por infraestrutura tipo, bem como alguns exemplos de intervenções de caracter corretivo efetuadas no decorrer do período do estágio profissional. Por fim, é apresentada uma conclusão daquilo que foi um período de aprendizagem importantíssimo no início da minha vida profissional ligada à área da construção civil.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

RESUMO: Os carcinomas localizados no nariz são muito frequentes em todas as séries conhecidas. São de diagnóstico clínico fácil e a sua confirmação por biópsia é muito segura. As terapêuticas mais indicadas são a cirurgia e a radioterapia, genericamente eficazes. Verifica-se, no entanto, que os pacientes continuam a solicitar tratamento em estádios muito avançados, mesmo conhecendo o diagnóstico e tendo acesso aos serviços sem custos. Esta situação poderá explicar-se face ao curso relativamente lento de muitos destes tumores e à idade geralmente avançada dos doentes que, de acordo com alguns inquéritos, receiam mais a terapeûtica do que a doença. Para obtenção de informação útil para condução deste problema, foram ainda analisados outros parâmetros. A maioria dos pacientes continua a solicitar tratamento quando as lesões envolvem duas subunidades nasais. Esta circunstância permite planear o tratamento cirúrgico com relativa facilidade, isto é, com exérese e reconstrução cujo resultado estético final é bastante aceitável. Os tumores de grandes dimensões, envolvendo várias subunidades, sendo frequentes, raramente implicam rinectomia total. Pelo contrário, são mais frequentes os tumores que envolvem metade do nariz e as estruturas vizinhas tais como o maxilar, a órbita e o lábio superior, atingindo mesmo a base do crânio. O controlo da doença nestes estádios é muito difícil. Não raramente, quando se crê que a doença está controlada, a cirurgia reconstrutiva bem como outras formas de reabilitação conjugadas, deixam ainda muita insatisfação. A nossa actividade tem-se desenvolvido seguindo os critérios adoptados nos melhores centros, isto é, as técnicas clássicas, complementadas com refinamentos recentes. Porém reflectindo sobre os resultados obtidos no tratamento de tumores do nariz, surge-nos um conjunto de questões para as quais ainda não encontrámos respostas cabais. Actuando de acordo com os princípios que definem o estado da arte, não obtivemos ainda resultados que satisfaçam tanto os doentes quanto os cirurgiões. Incessantemente procuramos novos dados técnicos e científicos que nos permitam sair deste ciclo vicioso em que o doente retarda a procura de assistência, receoso de que a terapêutica o deixe desfigurado. Tendo sempre em vista a obtenção dos melhores resultados com o mínimo de tempos cirúrgicos, valorizamos alguns detalhes praticados nos retalhos com padrão vascular bem definido. Dado que as sequelas na zona dadora de tecidos são uma incontornável preocupação, procuramos refinar a sua aplicação no sentido de as atenuarmos. A fronte, excelente zona dadora para reconstrucção nasal major, era sede de sequelas actualmente inaceitáveis. Estudado o comportamento dos tecidos na fronte, depois de levantado o retalho e efectuado o seu encerramento com uso da técnica de expansão intra-operatória, determinámos a presença do Factor de Crescimento Vascular Endotelial no próprio retalho e na zona dadora, tendo em vista que a sua presença poderá explicar o comportamento dos tecidos que foram submetidos a esta técnica. Procurou-se estudar a qualidade da reconstrução em 45 pacientes submetidos a cirurgia de exérese e reconstrução nasal major, assim como a qualidade de vida, relacionada com a doença e a terapêutica. Embora se possa admitir a existência de dados sugestivos de estratégias mais adequadas, não foi possível relacionar a qualidade da reconstrução com qualidade de vida dos pacientes. Poderá eventualmente concluir-se que a observação permanente da reconstrução, com qualidade estética e funcional, será o melhor método de alterar a ideia clássica, ainda muito divulgada, mas já ultrapassada, de que a cirurgia reconstrutiva do nariz não é mais que transformar um defeito horroroso num defeito ridículo.---------------ABSTRACT: Malignant tumours found in the nose are very frequent in all known series. Clinical diagnosis is simple and confirmation of biopsy diagnosis is accessible and safe. The most advisable therapies are surgery and radiotherapy. Despite everything patients continue to wait until the tumour is in an advanced stage before asking for therapy, although they know the diagnosis and have free access to specialised services. This situation could probably be explained by the slow development rate of the tumours which is associated with the age of the patient. Upon inquiry, it was found that a significant number of patients are more afraid of therapy than of the disease itself. Other parameters have been analysed in order to obtain useful information about the management of this problem. The majority of patients seek adequate treatment when the lesions involve two nasal subunits. This allows the programming of surgical therapy with relative ease as they may be removed and reconstructed with interesting final aesthetical results. Large tumours involving several subunits are frequent, but they rarely call for total rhinectomy. On the contrary, tumours more frequently involve half of the nose and their neighbouring structures: for example, maxillary, orbital and upper lip, even reaching as far as the base of the skull. The control of the disease is very difficult in these stages.In cases in which it is believed that the disease is under control, reconstructive surgery in conjunction with other forms of rehabilitation still result in a lot of dissatisfaction. In our activity we try to follow the criteria adopted by the best centres following classic techniques, complemented with recent refinements. Reflecting on the treatment of tumours of the nose has led us to a series of questions to which we haven’t yet found the answers. In accordance with the defined principles of ‘the state of the art’ it still doesn’t satisfy either the patients or the surgeons. We are looking for new technical and scientific data which allows us to leave this vicious cycle, in that the deferred patient avoids looking for assistance, based on the fear that therapy could leave them disfigured. We attach importance to some practiced details on the well-defined vascular pattern of the flaps, with the principle aim of obtaining a good result, from the minimum number of operations. It is known that sequels in donor sites are a concern, so applied refinements are used in order to reduce the defect. The forehead has been considered an excellent donor site for major nasal reconstruction but the area of sequel is nowadays unacceptable. We tried to study the behaviour of the tissues of the forehead after taking the flap and closing the wound, using the intraoperative expansion technique. We determined the presence of Vascular Endothelial Growth Factor in the flaps and in the donor site, in which its presence could explain the behaviour of the tissues of the forehead that are submitted to this technique. The quality of the reconstruction was studied in 45 patients who were submitted to surgical exeresisand major nasal reconstruction, as was the relationship between the disease and the therapy regarding quality of life. It was not possible to directely relate the quality of the reconstruction to the quality of patients life, although some suggestive data of more adequate manegement may be interesting. One might eventually conclude that, permanent exposure of the reconstruction with aesthetic and funcional quality would be the best method in order to modify the classic idea which is still known although overridden today, that nasal reconstruction could transform a horrible defect into a ridiculous one.-------RÉSUMÉ: Les carcinomes situés sur le nez sont très fréquents dans toutes les séries connues. Ils sont de diagnostic facile et la confirmation de ce dernier par une biopsie, est accessible et très fiable. La chirurgie et la radiothérapie sont les thérapeutiques les mieux indiquées. Toutefois les patients continuent de solliciter un traitement, seulement dans des états très avancés bien qu’ils aient eu connaissance du diagnostic et ayant accès aux services. Cette situation pourra probablement s’expliquer par l’évolution relativement indolente de beaucoup de tumeurs, associée à l’âge des malades; bien que selon quelques enquêtes réalisées un nombre élevé de malades craint davantage la thérapeutique que la maladie. D’autres paramètres sont analysés en vue d’obtenir des informations utiles pour l’accompagnement de ce problème. La majorité de nos patients sollicite le traitement adéquat quand les lésions entourent deux sous-unités nasales, ce qui permet de planifier le traitement chirurgique avec une certaine facilité, c’est à dire l’exérèse et la reconstruction ayant un résultat final esthétique généralement très acceptable. Les tumeurs de grandes dimensions entourant différentes sous-unités sont fréquentes mais elles impliquent rarement une amputation nasal total. Au contraire, les tumeurs les plus fréquentes sont celles qui entourent la moitié du nez et les structures voisines comme le maxillaire, l’orbite et la lèvre supérieure, parfois, elles peuvent même atteindre la base du crâne. Le contrôle de la maladie dans ces états est très difficile et quand nous pensons que la maladie est contrôlée, la chirurgie reconstructrice associée à d’autres formes de réhabilitation provoquent encore une grande insatisfaction. Nous exerçons notre activité en essayant de suivre les critères adoptés dans les meilleurs centres. Nous appliquons les techniques classiques complétées de retouches pour obtenir un meilleur resultat. Le fait de traiter les tumeurs nasales nous fait réfléchir et poser un ensemble de questions auxquelles nous n’avons pas pu trouver de réponses. En actuant en accord avec les principes qui définissent l’état de l’art, nous n’avons pas obtenu de résultats qui satisfassent les malades et les chirurgiens. Nous recherchons de nouvelles données techniques et scientifiques qui nous permettent de sortir de ce cercle vicieux dans lequel le patient retarde la recherche d’aide craignant que la thérapeutique le défigure. Nous valorisons certains détails pratiqués sur les lambeaux de patron vasculaire bien défini et ayant comme principaux objectifs l’obtention d’un bon résultat en moins de temps de chirurgie. Nous savons que les séquelles de la zone donneuse de tissus sont préoccupantes, ainsi, que les retouches qui ont été appliqués dans l’objectif de les atténuer. Le front, excellente zone donneuse pour la reconstruction nasale majeure, était une source de séquelle actuellement inacceptable. Nous avons étudié le comportement des tissus du front après avoir relevé le lambeau et effectué la fermeture avec la technique de l’expansion intraoperative. Nous avons déterminé la présence du Facteur de Croissance Vasculaire Endothéliale dans le propre lambeau et dans la zone donneuse, celle-ci pourra expliquer le comportement des tissus du front qui ont été soumis à cette technique. On a essayé d´etudier la qualité de la reconstruction sur 45 patients soumis à la chirurgie d´exérèse et la reconstruction nasal majeure, ainsi comme la qualité de vie en relation avec la maladie et la thérapie. Quoique l´on puisse conclure par l´existence des données subjectives des stratégies plus justes, il est impossible de faire un rapport sur la qualité de la reconstruction avec la qualité de vie des patients. Eventuellement l´on purrait conclure que l´observation permanente de la reconstruction avec qualité esthétique et fonctionnelle, se serait la meilleure méthod de changer l´idée classique, mais depassée, de que la rhinopoièse n´est pas que transformer un affreux défaut par un défaut ridicule.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

The study seeks to identify the determinant factors of the repatriate’s decision to remain or leave the company after repatriation, in a convenience sample of 40 Portuguese returnees working in companies based in Portugal. The main results were as follows: (1) there are seven factor categories: (a) salaries and benefits; (b) possibility of promotion, development, professional development; (c) organizational support (during and after the international mission) recognition of work; (d) economic and social atmosphere of the company, (e) good relationship with leadership; (f) convenience and/or personal / family well-being and; (g) external alternatives; (2) the main factors leading to permanence are (a) possibility of promotion, development and professional development and; (b) the existence of personal and family well-being / convenience; (3) the main factors leading to abandonment are (a) lack of organizational support and recognition of work performed; (b) lack of possibility of promotion, development and professional development and; (c) lack of personal / family well-being / convenience. Globally, the study suggests that the factors leading to permanence are very similar to those that lead to abandonment, although in reverse.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

RESUMO - Nas últimas décadas, a especialização dos cuidados médicos tem conduzido a uma fragmentação do sistema de prestação, que, associada a uma deficiente coordenação entre serviços, cuidados e prestadores, torna a navegabilidade dos utentes nos sistemas de saúde uma tarefa complexa. Um novo modelo de organização, assente na procura de valor para os cidadãos, deve adoptar uma abordagem sistémica, que tenha subjacente uma coordenação integrada de serviços, numa perspectiva de ciclo de cuidados. Reorientar a prestação de cuidados para a obtenção de resultados e valor em saúde, exige uma reengenharia em torno da estrutura, organização e avaliação1 dos cuidados, requerendo, nomeadamente: i) instrumentos e ferramentas que auxiliem e estruturem este novo modelo; ii) assumpção dos papéis definidos para cada um dos actores do sistema, nomeadamente ao nível da coordenação; iii) encorajamento à adopção de modelos de contratualização, pagamento e competição, que responsabilizem os actores envolvidos não só pela prática que desenvolvem, mas pelos resultados em saúde. Estes mecanismos constituem uma oportunidade para expandir e sustentar abordagens, programas e intervenções integradas. Investir num sistema de pagamento por valor em saúde — P4V — payment for value, traduz uma aposta na relação entre diagnóstico, tratamento, resultados clínicos e custos, enquanto estratégia para assegurar ganhos em qualidade dos cuidados, eficiência dos processos e valor em saúde para o cidadão. Neste contexto, a gestão da doença enquanto modelo direccionado para o reforço da perspectiva e participação activa do cidadão, e avaliação compreensiva de novas formas de organização e gestão do sistema de prestação, constitui um instrumento para informar e sustentar esse processo de reengenharia do sistema. Um modelo que procura assegurar o encontro entre o estado da arte na prestação de cuidados e um nível óptimo, garantindo a qualidade de vida expectável para a pessoa com doença crónica. ----------------- ---------ABSTRACT – In the last decades advanced medical sciences trend to specialized care and fragmented health systems, leaving patients with a challenge on navigating services and care, requiring them to see a sequence of specialists each delivering discrete interventions. To overcome these challenges, every health system must redefine health care delivery to use its resources more efficiently and improve quality of care through an organization of the system as a whole. A system currently organized around value for patients, entails a framework that comprises the entire set of activities needed to address a patient´s medical condition, over the full cycle of care. Value- based care delivery therefore requires an integrated practice, both across services and time, and implies a movement through new structures, organization models, evaluation efforts and payment systems that enables, catalyze and reinforces the extension and sustainability of the steps needed to the change required. A shift from a payment for performance to a payment for value focuses attention on maximizing the overall value of care, and encourages coordination and integration between components of care that extends from screening, diagnoses, all the way through treatment, outcomes and costs, and ensuring an incentive for potentially high value types of care as well as innovation. These leave the actors of the system with the task of best allocating and valuing components of care. Disease management as a model designed to structure patient engagement and involvement in their care, and assure a comprehensive evaluation and monitoring of new organization and care delivery strategies align an opportunity as a source of information and sustainability for the progress of a growing number of likeminded efforts now underway across care delivery for chronic diseases. This framework will allow the fulfillment of the gap between sta

Relevância:

10.00% 10.00%

Publicador:

Resumo:

Dissertation presented to obtain a Doctoral degree in Biology by Instituto de Tecnologia Química e Biológica