The evolution and assessment of pharmaceutical care: Structure, processes, and outcomes

The evolution of pharmaceutical care is identified through a complete review of the literature published in the American Journal of Health-System Pharmacy, the sole comprehensive publication of institutional pharmacy practice. The evolution is categorized according to characteristics of structure (organizational structure, the role of the pharmacist), process (drug delivery systems, formulary management, acquiring drug products, methods to impact drug therapy decisions), and outcomes (cost of drug delivery, cost of drug acquisition and use, improved safety, improved health outcomes) recorded from the 1950s through the 1990s. While significant progress has been made in implementing basic drug distribution systems, levels of pharmacy involvement with direct patient care is still limited.^ A new practice framework suggests enhanced direct patient care involvement through increase in the efficiency and effectiveness of traditional pharmacy services. Recommendations advance internal and external organizational structure relationships that position pharmacists to fully use their unique skills and knowledge to impact drug therapy decisions and outcomes. Specific strategies facilitate expansion of the breadth and scope of each process component in order to expand the depth of integration of pharmacy and pharmaceutical care within the broad healthcare environment. Economic evaluation methods formally evaluate the impact of both operational and clinical interventions.^ Outcome measurements include specific recommendations and methods to increase efficiency of drug acquisition, emphasizing pharmacists' roles that impact physician prescribing decisions. Effectiveness measures include those that improve safety of drug distribution systems, decrease the potential of adverse drug therapy events, and demonstrate that pharmaceutical care can significantly contribute to improvement in overall health status.^ The implementation of the new framework is modeled on a case study at the M.D. Anderson Cancer Center. The implementation of several new drug distribution methods facilitated the redeployment of personnel from distributive functions to direct patient care activities with significant personnel and drug cost reduction. A cost-benefit analysis illustrates that framework process enhancements produced a benefit-to-cost ratio of 7.9. In addition, measures of effectiveness demonstrated significant levels of safety and enhanced drug therapy outcomes. ^

A comprehensive framework for evaluating funder's performance

Evaluation methods for assessing the performance of non-profit funders are lacking. The purpose of the research was to create a comprehensive framework that systematically assesses the goals and objectives of a funder, how these relate to the funder's allocation of resources, and the potential impact of programs and services selected by the funder for resource allocation to address organizational goals and objectives. The Houston Affiliate of Susan G. Komen for the Cure, a local chapter of a national breast cancer awareness advocacy organization, was selected as the funding agency whose performance assessment was to assist in the creation of this framework. Evaluation approaches from the government sector were adapted and incorporated into the research to guide the methods used to answer the three research questions corresponding to the three phases of research within the study: (1) what are the funding goals and objectives of the Affiliate?; (2) what allocation scheme does the organization use to address these goals and objectives and select programs for funding?; and, (3) to what extent do the programs funded by the Affiliate have potential long-term impact? ^ Within the first stage of the research, document reviews of the Affiliate's mission-based documents and bylaws and interviews with organizational and community informants revealed a highly latent constellation of broad objectives that were not formalized into one guiding document, thus creating gaps in management and governance. Within the second phase of the research, reviews of grant applications from the 2008-2009 funding cycle and interviews with employees and volunteers familiar with the funding process revealed competing ideas regarding resource allocation in light of vague organizational documents describing funding goals and objectives. Within the final stage of the research, these findings translated to the Affiliate selecting programs with highly varying potential long-term impact with regards to addressing goals and objectives relating to breast cancer education, screening, diagnostics, treatment, and support. The resulting performance assessment framework, consisting of three phases of research utilizing organizational documents and key informant interviews, demonstrated the importance of clearly defined funding goals and objectives, reference documents and committee participation within the funding process, and regular reviews of potential long-term impact for selected programs, all supported by the active participation and governance of a funder's Board of Directors.^

The assessment of standardized training programs in public health preparedness

The Texas Bioterrorism Continuing Education Consortium (BCE) provided National Disaster Life Support (NDLS) training courses throughout the state of Texas in 2005, to help improve knowledge and skills pertaining to bioterrorism and other public health emergencies. The NDLS training courses include curriculum in Basic Disaster Life Support (BDLS) and Core Disaster Life Support (CDLS). A course evaluation which included items assessing ability and willingness of training participants, role of responders, and other variables was mailed to all NDLS participants who provided contact information. An analysis was conducted to determine whether the survey respondents participated in the Hurricanes Katrina and/or Rita relief efforts, as well as to evaluate the impact of the NDLS training courses on the participant's ability and willingness to respond during a disaster. The study population (n = 2150) consisted mostly of nurses (50%) (n=1074). A chi-square test of analysis indicated the following results. Among the survey respondents who took the CDLS course, there was no statically significant difference by occupation pertaining to ability or willingness to respond (x2 [df = 5] = 4.02, p= 0.546); (x2 [df = 5] = 2.45, p = .783). However, there was a statistically significant difference among those respondents who took the BDLS course with respect to ability, and a slightly significant difference with respect to willingness (x2 [df = 5] = 13.35, p = .020 and (x2 = [df = 5] = 10.299, p = .067). These findings are similar to previous studies assessing willingness to respond to a disaster.^ A second analysis was conducted with these survey data to evaluate the implications for disaster response training for the NDLS courses. Results indicated that the majority of disaster responders served in the role for which they were professionally trained (Physicians=68%; Nurses = 50.4%). Nurses, EMT, and Fire professionals served in multiple roles. These results suggest the importance of developing training programs that will prepare professionals to serve in multiple roles. The development of standardized evaluation methods would fill an important gap in assessing impact of national training programs. ^

Can Public Child Welfare Help to Prevent Child Maltreatment? Promising Findings from Los Angeles

This article describes promising findings from the Los Angeles County Prevention Initiative Demonstration Project, a systems change approach to developing relationships between public child welfare, allied public agencies, and community-based networks that offer family-centered services, economic assistance and capacity building to support all kinds of families. It describes the conceptual underpinnings and unique structure of the initiative, the evaluation methods used to assess results, and a pattern of promising results.

Adherence to HIV /AIDS therapies among low -literacy populations: The ALP project

Adherence to HIV/AIDS therapies has been an important health problem since the early 1980s when AZT was first prescribed as a therapy for HIV/AIDS. It became particularly important between 1995 and 1997 with the advent of protease inhibitors (Chesney, Ickovics, Hecht, Sikipa, & Rabkin J., 1999) and became even more significant as persons with HIV/AIDS began to develop resistance to medications. Low-literacy populations have poorer health (Brez & Taylor, 1997) and higher AIDS rates (Simon, Hu, Diaz, & Kerndt, 1995), than their higher literacy counterparts due to delayed treatment (Baker, Parker, Williams, Clark, & Nurss, 1997), shame of literacy skills (Parikh, 1996), and poor access to care (Williams, et al., 1995). Poorer health and higher AIDS rates can also be attributed to poor patient-provider relationships (Crespo-Fierro, 1997; Eldred, Wu, Chaisson, & Moore, 1998) to a poorer understanding of medical protocols (Murphy, 1997), and inadequate patient education (Ungvarski, 1997; Davis, Michielutte, Askov, Williams, & Weiss, 1998, Doak, Doak, & Root, 1996). ^ The ALP intervention was developed for HIV positive low-literacy populations of African American women in Houston, Texas. The intervention was based on a needs assessment, using the PRECEDE model, an innovative process referred to as Intervention Mapping, and validated using formative evaluation methods with 54 individuals. The needs assessment resulted in a list of behavioral, environmental, predisposing, enabling, and reinforcing determinants of adherence. The Intervention Mapping framework was used to refine these determinants and develop a list of objectives describing what must be learned or changed to for the target population to adhere to HIV/AIDS therapies. Methods and strategies, were developed using theoretical constructs from the Health Belief Model (Rosenstock, 1974) and Social Cognitive Theory (Bandura, 1986). These theories, empirical evidence, and information from the target population indicated that perceived susceptibility, perceived severity, outcome expectations, and self-efficacy were important and changeable determinants of adherence to HIV/AIDS therapies for this population. ^ These components were brought together in the form of a theory-based color cartoon book and 10-minute cassette tape. The book was developed for people with 2.9 years of U.S. education as measured with the Flesch-Kincaid Grade Level method and the script was recorded onto a cassette tape to make it suitable for populations with even lower-literacy skills. A formative evaluation was conducted to ensure that the content and structure were accurate, clear, realistic, readable, appropriate, and likely to be used as intended. ^

Caracterización de poblaciones nativas de maíz mediante Análisis de Procrustes Generalizado y Análisis Factorial Múltiple

El establecimiento de relaciones entre taxones es un paso esencial en el proceso de catalogación y evaluación del material conservado en un Banco de Germoplasma. Existen distintos métodos de evaluación en función del tipo de caracteres estudiados. Cuando el registro de caracteres se repite en el tiempo y en distintos ambientes, se debe separar la variabilidad intrínsecamente genética entre los taxones de aquella que se debe al ambiente, y más aún, de la posible variabilidad debida a la interacción genotipo*ambiente para el posterior establecimiento de relaciones puramente filogenéticas. En el presente trabajo se estudia comparativamente la factibilidad de aplicación de dos estrategias de análisis estadístico para dar solución a este problema. La primera corresponde al análisis tradicional donde se realiza un Análisis de Componentes Principales sobre los caracteres promedios a lo largo de los diferentes ambientes; y la segunda son métodos más complejos en los cuales cada dato es originado por tres modos: individuos, variables y condiciones ambientales, tales como el Análisis Factorial Múltiple y el Análisis de Procrustes Generalizado. Si bien las configuraciones resultantes fueron todas equivalentes, los métodos de tres vías permiten la interpretación de la interacción genotipo*ambiente.

Evaluating the achievements and impacts of EC framework programme transport projects

Purpose The purpose of this paper is to present what kind of elements and evaluation methods should be included into a framework for evaluating the achievements and impacts of transport projects supported in EC Framework Programmes (FP). Further, the paper discusses the possibilities of such an evaluation framework in producing recommendations regarding future transport research and policy objectives as well as mutual learning for the basis of strategic long term planning. Methods The paper describes the two-dimensional evaluation methodology developed in the course of the FP7 METRONOME project. The dimensions are: (1) achievement of project objectives and targets in different levels and (2) research project impacts according to four impact groups. The methodology uses four complementary approaches in evaluation, namely evaluation matrices, coordinator questionnaires, lead user interviews and workshops. Results Based on the methodology testing, with a sample of FP5 and FP6 projects, the main results relating to the rationale, implementation and achievements of FP projects is presented. In general, achievement of objectives in both FPs was good. Strongest impacts were identified within the impact group of management and co-ordination. Also scientific and end-user impacts of the projects were adequate, but wider societal impacts quite modest. The paper concludes with a discussion both on the theoretical and practical implications of the proposed methodology and by presenting some relevant future research needs.

Considerations on the success rate in aeronautical engineering studies in Spain

The relationship between different learning evaluation methods and the academic success in an aeronautical engineering degree in Spain is analysed. The study is based on data about the evolution of academic achievement obtained along the last ten year, along which the evaluation and learning’s methods have suffered huge changes.

Efficient local unfolding with ancestor stacks for full prolog

The integration of powerful partial evaluation methods into practical compilers for logic programs is still far from reality. This is related both to 1) efficiency issues and to 2) the complications of dealing with practical programs. Regarding efnciency, the most successful unfolding rules used nowadays are based on structural orders applied over (covering) ancestors, i.e., a subsequence of the atoms selected during a derivation. Unfortunately, maintaining the structure of the ancestor relation during unfolding introduces significant overhead. We propose an efficient, practical local unfolding rule based on the notion of covering ancestors which can be used in combination with any structural order and allows a stack-based implementation without losing any opportunities for specialization. Regarding the second issue, we propose assertion-based techniques which allow our approach to deal with real programs that include (Prolog) built-ins and external predicates in a very extensible manner. Finally, we report on our implementation of these techniques in a practical partial evaluator, embedded in a state of the art compiler which uses global analysis extensively (the Ciao compiler and, specifically, its preprocessor CiaoPP). The performance analysis of the resulting system shows that our techniques, in addition to dealing with practical programs, are also significantly more efficient in time and somewhat more efficient in memory than traditional tree-based implementations.

Nutrition and physical activity programs for obesity treatment (PRONAF study). methodological approach of the project

Este trabajo aborda la metodología seguida para llevar a cabo el proyecto de investigación PRONAF (Clinical Trials Gov.: number NCT01116856.) Background: At present, scientific consensus exists on the multifactorial etiopatogenia of obesity. Both professionals and researchers agree that treatment must also have a multifactorial approach, including diet, physical activity, pharmacology and/or surgical treatment. These two last ones should be reserved for those cases of morbid obesities or in case of failure of the previous ones. The aim of the PRONAF study is to determine what type of exercise combined with caloric restriction is the most appropriate to be included in overweigth and obesity intervention programs, and the aim of this paper is to describe the design and the evaluation methods used to carry out the PRONAF study. Methods/design: One-hundred nineteen overweight (46 males) and 120 obese (61 males) subjects aged 18–50 years were randomly assigned to a strength training group, an endurance training group, a combined strength + endurance training group or a diet and physical activity recommendations group. The intervention period was 22 weeks (in all cases 3 times/wk of training for 22 weeks and 2 weeks for pre and post evaluation). All subjects followed a hypocaloric diet (25-30% less energy intake than the daily energy expenditure estimated by accelerometry). 29–34% of the total energy intake came from fat, 14–20% from protein, and 50–55% from carbohydrates. The mayor outcome variables assesed were, biochemical and inflamatory markers, body composition, energy balance, physical fitness, nutritional habits, genetic profile and quality of life. 180 (75.3%) subjects finished the study, with a dropout rate of 24.7%. Dropout reasons included: personal reasons 17 (28.8%), low adherence to exercise 3 (5.1%), low adherence to diet 6 (10.2%), job change 6 (10.2%), and lost interest 27 (45.8%). Discussion: Feasibility of the study has been proven, with a low dropout rate which corresponds to the estimated sample size. Transfer of knowledge is foreseen as a spin-off, in order that overweight and obese subjects can benefit from the results. The aim is to transfer it to sports centres. Effectiveness on individual health-related parameter in order to determine the most effective training programme will be analysed in forthcoming publications.

Seismic Activity Rates in the Iberian Peninsula

Evaluating the seismic hazard requires establishing a distribution of the seismic activity rate, irrespective of the methodology used in the evaluation. In practice, how that activity rate is established tends to be the main difference between the various evaluation methods. The traditional procedure relies on a seismogenic zonation and the Gutenberg-Richter (GR) hypothesis. Competing zonations are often compared looking only at the geometry of the zones, but the resulting activity rate is affected by both geometry and the values assigned to the GR parameters. Contour plots can be used for conducting more meaningful comparisons, providing the GR parameters are suitably normalised. More recent approaches for establishing the seismic activity rate forego the use of zones and GR statistics and special attention is paid here to such procedures. The paper presents comparisons between the local activity rates that result for the complete Iberian Peninsula using kernel estimators as well as two seismogenic zonations. It is concluded that the smooth variation of the seismic activity rate produced by zoneless methods is more realistic than the stepwise changes associated with zoned approaches; moreover, the choice of zonation often has a stronger influence on the results than its fairly subjective origin would warrant. It is also observed that the activity rate derived from the kernel approach, related with the GR parameter “a”, is qualitatively consistent with the epicentres in the catalogue. Finally, when comparing alternative zonations it is not just their geometry but the distribution of activity rate that should be compared.

Systematic Approach for the selection of monitoring technologies in CO2 geological storage projects. Application of multicriteria decision making

Geologic storage of carbon dioxide (CO2) has been proposed as a viable means for reducing anthropogenic CO2 emissions. Once injection begins, a program for measurement, monitoring, and verification (MMV) of CO2 distribution is required in order to: a) research key features, effects and processes needed for risk assessment; b) manage the injection process; c) delineate and identify leakage risk and surface escape; d) provide early warnings of failure near the reservoir; and f) verify storage for accounting and crediting. The selection of the methodology of monitoring (characterization of site and control and verification in the post-injection phase) is influenced by economic and technological variables. Multiple Criteria Decision Making (MCDM) refers to a methodology developed for making decisions in the presence of multiple criteria. MCDM as a discipline has only a relatively short history of 40 years, and it has been closely related to advancements on computer technology. Evaluation methods and multicriteria decisions include the selection of a set of feasible alternatives, the simultaneous optimization of several objective functions, and a decision-making process and evaluation procedures that must be rational and consistent. The application of a mathematical model of decision-making will help to find the best solution, establishing the mechanisms to facilitate the management of information generated by number of disciplines of knowledge. Those problems in which decision alternatives are finite are called Discrete Multicriteria Decision problems. Such problems are most common in reality and this case scenario will be applied in solving the problem of site selection for storing CO2. Discrete MCDM is used to assess and decide on issues that by nature or design support a finite number of alternative solutions. Recently, Multicriteria Decision Analysis has been applied to hierarchy policy incentives for CCS, to assess the role of CCS, and to select potential areas which could be suitable to store. For those reasons, MCDM have been considered in the monitoring phase of CO2 storage, in order to select suitable technologies which could be techno-economical viable. In this paper, we identify techniques of gas measurements in subsurface which are currently applying in the phase of characterization (pre-injection); MCDM will help decision-makers to hierarchy the most suitable technique which fit the purpose to monitor the specific physic-chemical parameter.

Validación de sistemas constructivos de los cerramientos de la edificación mediante la aplicación de los métodos de decisión multicriterio : aplicación al catálogo de elementos constructivos del Código Técnico de la Edificación

Como punto de partida para el desarrollo de la Tesis, se mantiene la hipótesis de que es posible establecer métodos de evaluación global sobre el grado de utilidad de los sistemas constructivos correspondientes a los cerramientos de la edificación. Tales métodos habrían de posibilitar, de entre una serie finita de sistemas alternativos, cuáles de ellos son los objetivamente más adecuados para su selección en un entorno de decisión concreto, y habrían de permitir fundamentar la justificación objetiva de tal decisión. Paralelamente a esta hipótesis de carácter general, se planteó desde el inicio la necesidad de comprobación de una hipótesis de partida particular según la cual los sistemas constructivos basados en la utilización de componentes prefabricados, o procesos de puesta en obra con un alto grado de industrialización arrojarían valores de utilidad mayores que los sistemas tradicionales basados en la albañilería. Para la verificación de estas dos hipótesis de partida se ha procedido inicialmente a la selección de un conjunto coherente de doce sistemas de cerramientos de la edificación que pudiese servir como testigo de su diversidad potencial, para proceder a su valoración comparativa. El método de valoración propuesto ha entrado a considerar una serie de factores de diversa índole que no son reducibles a un único parámetro o magnitud que permitiese una valoración de tipo lineal sobre su idoneidad relativa, ni que permitiese establecer un grado de prelación entre los distintos sistemas constructivos alternativos de manera absoluta. Para resolver este tour de force o desafío metodológico se ha acudido a la aplicación de metodologías de valoración que nos permitiesen establecer de forma racional dicha comparativa. Nos referimos a una serie de metodologías provenientes en primera instancia de las ciencias exactas, que reciben la denominación de métodos de ayuda a la decisión multicriterio, y en concreto el denominado método ELECTRE. Inicialmente, se ha planteado la aplicación del método de análisis sobre doce sistemas constructivos seleccionados de tal forma que representasen de forma adecuada las tres categorías establecidas para caracterizar la totalidad de sistemas constructivos posibles; por peso, grado de prefabricación y grado de ventilación. Si bien la combinación de las tres categorías básicas anteriormente señaladas produce un total de 18 subcategorías conceptuales, tomamos finalmente doce subcategorías dado que consideramos que es un número operativo suficiente por extenso para el análisis propuesto y elimina tipos no relevantes. Aplicado el método propuesto, a estos doce sistemas constructivos “testigo”, se constata el mayor grado de utilidad de los sistemas prefabricados, pesados y no ventilados. Al hilo del análisis realizado en la Parte II de la Tesis sobre los doce sistemas constructivos “testigo”, se ha realizado un volcado de los sistemas constructivos incluidos en el Catalogo de Elementos Constructivos del CTE (versión 2010) sobre las dieciocho subcategorías definidas en dicha Parte II para caracterizar los sistemas constructivos “testigo”. Posteriormente, se ha procedido a una parametrización de la totalidad de sistemas constructivos para cerramientos de fachadas incluidos en este Catálogo. La parametrización sistemática realizada ha permitido establecer, mediante el cálculo del valor medio que adoptan los parámetros de los sistemas pertenecientes a una misma familia de las establecidas por el Catálogo, una caracterización comparativa del grado de utilidad de dichas familias, tanto en lo relativo a cada uno de los parámetros como en una valoración global de sus valores, de carácter indicativo. Una vez realizada una parametrización completa de la totalidad de sistemas constructivos incluidos en el Catálogo, se ha realizado una simulación de aplicación de la metodología de validación desarrollada en la Parte II de la presente Tesis, con el objeto de comprobar su adecuación al caso. En conclusión, el desarrollo de una herramienta de apoyo a la decisión multicriterio aplicada al Catálogo de Elementos constructivos del CTE se ha demostrado técnicamente viable y arroja resultados significativos. Se han diseñado dos sistemas constructivos mediante la aplicación de la herramienta desarrollada, uno de fachada no ventilada y otro de fachada ventilada. Comparados estos dos sistemas constructivos mejorados con otros sistemas constructivos analizados Se comprueba el alto grado de utilidad objetiva de los dos sistemas diseñados en relación con el resto. La realización de este ejercicio de diseño de un sistema constructivo específico, que responde a los requerimientos de un decisor concreto viene a demostrar, así pues, la utilidad del algoritmo propuesto en su aplicación a los procesos de diseño de los sistemas constructivos. La tesis incorpora dos innovaciones metodológicas y tres innovaciones instrumentales. ABSTRACT The starting point for the thesis is the hypothesis that it is possible to devise suitability degree evaluation methods of building enclosure systems. Such methods should allow optimizing appraisal, given a specific domain of decision, among a finite number of alternative systems, and provide objective justification of such decision. Along with the above mentioned general assumption, a second hypothesis whereby constructive systems based on the use of prefabricated components, or high industrialization degree work processes, would throw efficiency values higher than traditional masonry systems needed to be tested. In order to validate these two hypothesis a coherent set of twelve enclosure systems that could serve as a reference sample of their potential diversity was selected and a comparative evaluation was carried out. The valuation method proposed has considered several different factors that are neither reducible to a single parameter or magnitude that would allow a linear evaluation of their relative suitability nor allow to establishing an absolute priority ranking between different alternative constructive systems. In order to resolve this tour de force or methodological challenge, valuation methodologies that enable use establishing rational assessments were used. We are referring to a number of methodologies taken from the exact sciences field, usually known as aid methods for multi-criteria decision, in particular the so-called ELECTRE method. Even though the combination of the mentioned three basic categories result in eighteen conceptual sub categories, we are finally considering just twelve since we deem it adequately extended for the our intended purpose and eliminates non relevant instances. The method of analysis was initially applied to the set of twelve selected constructive systems is a way that they could represent adequately the three previously established categories set out to characterize all possible enclosure systems, namely weight, prefabrication degree and ventilation degree. Once the proposed method is applied to the sample systems, the higher efficiency of the prefabricated, heavy and not ventilated systems was confirmed. In line with the analysis in Part II of the thesis on the twelve chosen enclosure systems, it has done an uploading data of construction systems listed in the Catalogue of constructive elements of the CTE (version 2010) according the eighteen subcategories used in this part II to characterize the construction systems taken as sample. Subsequently, a parameterization of all enclosure facade systems included in this catalog has been undertaken. The systematic parameterization has allowed to set, by means of calculating the average values of the parameters of the systems belonging to the same family of those established by the Catalog, a comparative characterization of the efficiency degree of these families, both in relation to each parameter as to an overall evaluation of its values, in a indicative way. After the parameterization of all enclosure systems included in the Catalog, a simulation of validation methodology application developed in Part II of this Thesis has been made, in order to assess its consistency to the referred case. In conclusion, the development of a multi-criteria decision aid tool, applied to the CTE Catalog of constructive elements, has proved to be technically feasible and yields significant results. Two building systems through the application of the developed tool, a non-ventilated façade and a ventilated façade have been designed. Comparing these two improved construction systems with other building systems analyzed, we were able to assess the high degree of objective efficiency of the two systems designed in relation to the rest. The exercise of designing a specific enclosure system that meets the requirements of a particular decision-maker hence shows the suitability of the proposed algorithm applied to the process of enclosure systems design. This Thesis includes two methodological innovations and three instrumental innovations.

Toward the ultimate synthesis/recognition system.

This paper predicts speech synthesis, speech recognition, and speaker recognition technology for the year 2001, and it describes the most important research problems to be solved in order to arrive at these ultimate synthesis and recognition systems. The problems for speech synthesis include natural and intelligible voice production, prosody control based on meaning, capability of controlling synthesized voice quality and choosing individual speaking style, multilingual and multidialectal synthesis, choice of application-oriented speaking styles, capability of adding emotion, and synthesis from concepts. The problems for speech recognition include robust recognition against speech variations, adaptation/normalization to variations due to environmental conditions and speakers, automatic knowledge acquisition for acoustic and linguistic modeling, spontaneous speech recognition, naturalness and ease of human-machine interaction, and recognition of emotion. The problems for speaker recognition are similar to those for speech recognition. The research topics related to all these techniques include the use of articulatory and perceptual constraints and evaluation methods for measuring the quality of technology and systems.

Análise de métodos de avaliação de eco eficiência.

Para que a sustentabilidade seja gerenciada e praticada de maneira efetiva, ela deve ser mensurada, utilizando-se de métodos de avaliação da sustentabilidade. Estão disponíveis diferentes métodos de avaliação, que geralmente reduzem o resultado desse levantamento à indicadores de desempenho ambiental, econômico e social (POPEA; ANNANDALE; MORISON-SAUNDERSB, 2004). Uma das denominações mais bem aceitas e difundidas para a conjunção da dimensão ambiental e econômica é conhecida por avaliação de eco eficiência (AEE). Eco eficiência é o \"aspecto da sustentabilidade que relaciona o desempenho ambiental de um sistema de produto ao valor do sistema de produto\" (ISO, 2012). Estão disponíveis diferentes métodos de AEE, porém sem evidência das suas semelhanças e particularidades e como essas características influenciam na escolha do método mais adequado de AEE em relação às potenciais aplicações O objetivo desta pesquisa é, portanto, analisar e indicar os tipos de métodos de avaliação de eco eficiência (AEE) mais adequados para ações gerenciais nas quais caibam tais abordagens. Foram selecionados onze métodos de AEE, a partir do estabelecimento de critérios de caracterização desses métodos, a saber: BASF, Bayer, EcoWater, Hahn et al., Kuosmanen e Kortelainen, MIPS, NRTEE, UN ESCAP, UN, TU Delft, e WBCSD. Identificaram-se, ainda, quatro potenciais aplicações: (i) Monitoramento de processo com vistas à melhoria contínua; (ii) Selecção e classificação de produtos; (iii) Atendimento a requisitos legais e outros requisitos; e, (iv) Marketing, rotulagem de produtos e comunicação ambiental. A partir dos elementos metodológicos estabelecidos pela norma ISSO 14045 (2012) e do conhecimento obtido dos métodos de AEE, determinaram-se quatro requisitos pelos quais os métodos e os potenciais aplicações foram avaliados: (i) Tipo de indicador de desempenho ambiental; (ii) Tipo de indicador de valor de sistema de produto; (iii) Abrangência de aplicação; e, (iv) Tipo de indicador de eco eficiência. Aplicando-se estes requisitos nos métodos de AEE e nos potenciais usos, concluiu-se que quanto à aplicações em termos de monitoramento de processos com vistas à melhoria continua os métodos de AEE recomendados foram Bayer, NRTEE, WBCSD e UN. Para situações de seleção e classificação de produtos os métodos BASF, EcoWater, Kuosmanen e Kortelainen, MIPS, Hahn et al., TU Delft, UN ESCAP e UN demonstraram ter boa aderência. No que se refere a usos voltados ao atendimento de requisitos legais e/ou de outras naturezas, os métodos NRTEE, WBCSD e UN são os mais indicados. Em aplicações de marketing, rotulagem e comunicação foram indicados os métodos BASF, EcoWater e MIPS. Finalmente, concluiu-se que, para a escolha adequada da metodologia para uma AEE, conhecimento prévio das características de cada abordagem é necessário.