844 resultados para Difficulties in the intervention
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This article evaluates social implications of the "SIGA" Health Care Information System (HIS) in a public health care organization in the city of São Paulo. The evaluation was performed by means of an in-depth case study with patients and staff of a public health care organization, using qualitative and quantitative data. On the one hand, the system had consequences perceived as positive such as improved convenience and democratization of specialized treatment for patients and improvements in work organization. On the other hand, negative outcomes were reported, like difficulties faced by employees due to little familiarity with IT and an increase in the time needed to schedule appointments. Results show the ambiguity of the implications of HIS in developing countries, emphasizing the need for a more nuanced view of the evaluation of failures and successes and the importance of social contextual factors.
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DESIGN: A randomized controlled trial.OB JECTIVE: To investigate the immediate effects on pressure pain thresholds over latent trigger points (TrPs) in the masseter and temporalis muscles and active mouth opening following atlanto-occipital joint thrust manipulation or a soft tissue manual intervention targeted to the suboccipital muscles. BACKGROUND : Previous studies have described hypoalgesic effects of neck manipulative interventions over TrPs in the cervical musculature. There is a lack of studies analyzing these mechanisms over TrPs of muscles innervated by the trigeminal nerve. METHODS: One hundred twenty-two volunteers, 31 men and 91 women, between the ages of 18 and 30 years, with latent TrPs in the masseter muscle, were randomly divided into 3 groups: a manipulative group who received an atlanto-occipital joint thrust, a soft tissue group who received an inhibition technique over the suboccipital muscles, and a control group who did not receive an intervention. Pressure pain thresholds over latent TrPs in the masseter and temporalis muscles, and active mouth opening were assessed pretreatment and 2 minutes posttreatment by a blinded assessor. Mixed-model analyses of variance (ANOVA) were used to examine the effects of interventions on each outcome, with group as the between-subjects variable and time as the within-subjects variable. The primary analysis was the group-by-time interaction. RESULTS: The 2-by-3 mixed-model ANOVA revealed a significant group-by-time interaction for changes in pressure pain thresholds over masseter (P<.01) and temporalis (P =.003) muscle latent TrPs and also for active mouth opening (P<.001) in favor of the manipulative and soft tissue groups. Between-group effect sizes were small. CONCLUSIONS: The application of an atlanto-occipital thrust manipulation or soft tissue technique targeted to the suboccipital muscles led to an immediate increase in pressure pain thresholds over latent TrPs in the masseter and temporalis muscles and an increase in maximum active mouth opening. Nevertheless, the effects of both interventions were small and future studies are required to elucidate the clinical relevance of these changes. LEVEL OF EVIDENCE : Therapy, level 1b. J Orthop Sports Phys Ther 2010;40(5):310-317. doi:10.2519/jospt.2010.3257. KEYWORDSDS: cervical manipulation, muscle trigger points, neck, TMJ, upper cervical.
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A ideação paranoide é um processo cognitivo e social que pode ser considerado normativo (e.g. sentimentos de desconfiança ocasionais) ou disfuncional, constituindo-se, neste ultimo caso, como um sintoma psicopatológico (e.g. delírios paranoides). Mesmo em níveis subclínicos, a ideação paranoide pode constituir um entrave para o bom funcionamento interpessoal, na medida em que o comportamento disruptivo que dela advém pode afetar todas as esferas de funcionamento do indivíduo (e.g. relações familiares, entre pares, profissionais e/ou académicas). O presente estudo explorará a influência dos estilos parentais e o papel mediador da ideação paranoide na agressividade durante a adolescência, bem como as implicações para a prevenção e intervenção em contextos clínicos e educacionais.
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To meet the increasing demands of the complex inter-organizational processes and the demand for continuous innovation and internationalization, it is evident that new forms of organisation are being adopted, fostering more intensive collaboration processes and sharing of resources, in what can be called collaborative networks (Camarinha-Matos, 2006:03). Information and knowledge are crucial resources in collaborative networks, being their management fundamental processes to optimize. Knowledge organisation and collaboration systems are thus important instruments for the success of collaborative networks of organisations having been researched in the last decade in the areas of computer science, information science, management sciences, terminology and linguistics. Nevertheless, research in this area didn’t give much attention to multilingual contexts of collaboration, which pose specific and challenging problems. It is then clear that access to and representation of knowledge will happen more and more on a multilingual setting which implies the overcoming of difficulties inherent to the presence of multiple languages, through the use of processes like localization of ontologies. Although localization, like other processes that involve multilingualism, is a rather well-developed practice and its methodologies and tools fruitfully employed by the language industry in the development and adaptation of multilingual content, it has not yet been sufficiently explored as an element of support to the development of knowledge representations - in particular ontologies - expressed in more than one language. Multilingual knowledge representation is then an open research area calling for cross-contributions from knowledge engineering, terminology, ontology engineering, cognitive sciences, computational linguistics, natural language processing, and management sciences. This workshop joined researchers interested in multilingual knowledge representation, in a multidisciplinary environment to debate the possibilities of cross-fertilization between knowledge engineering, terminology, ontology engineering, cognitive sciences, computational linguistics, natural language processing, and management sciences applied to contexts where multilingualism continuously creates new and demanding challenges to current knowledge representation methods and techniques. In this workshop six papers dealing with different approaches to multilingual knowledge representation are presented, most of them describing tools, approaches and results obtained in the development of ongoing projects. In the first case, Andrés Domínguez Burgos, Koen Kerremansa and Rita Temmerman present a software module that is part of a workbench for terminological and ontological mining, Termontospider, a wiki crawler that aims at optimally traverse Wikipedia in search of domainspecific texts for extracting terminological and ontological information. The crawler is part of a tool suite for automatically developing multilingual termontological databases, i.e. ontologicallyunderpinned multilingual terminological databases. In this paper the authors describe the basic principles behind the crawler and summarized the research setting in which the tool is currently tested. In the second paper, Fumiko Kano presents a work comparing four feature-based similarity measures derived from cognitive sciences. The purpose of the comparative analysis presented by the author is to verify the potentially most effective model that can be applied for mapping independent ontologies in a culturally influenced domain. For that, datasets based on standardized pre-defined feature dimensions and values, which are obtainable from the UNESCO Institute for Statistics (UIS) have been used for the comparative analysis of the similarity measures. The purpose of the comparison is to verify the similarity measures based on the objectively developed datasets. According to the author the results demonstrate that the Bayesian Model of Generalization provides for the most effective cognitive model for identifying the most similar corresponding concepts existing for a targeted socio-cultural community. In another presentation, Thierry Declerck, Hans-Ulrich Krieger and Dagmar Gromann present an ongoing work and propose an approach to automatic extraction of information from multilingual financial Web resources, to provide candidate terms for building ontology elements or instances of ontology concepts. The authors present a complementary approach to the direct localization/translation of ontology labels, by acquiring terminologies through the access and harvesting of multilingual Web presences of structured information providers in the field of finance, leading to both the detection of candidate terms in various multilingual sources in the financial domain that can be used not only as labels of ontology classes and properties but also for the possible generation of (multilingual) domain ontologies themselves. In the next paper, Manuel Silva, António Lucas Soares and Rute Costa claim that despite the availability of tools, resources and techniques aimed at the construction of ontological artifacts, developing a shared conceptualization of a given reality still raises questions about the principles and methods that support the initial phases of conceptualization. These questions become, according to the authors, more complex when the conceptualization occurs in a multilingual setting. To tackle these issues the authors present a collaborative platform – conceptME - where terminological and knowledge representation processes support domain experts throughout a conceptualization framework, allowing the inclusion of multilingual data as a way to promote knowledge sharing and enhance conceptualization and support a multilingual ontology specification. In another presentation Frieda Steurs and Hendrik J. Kockaert present us TermWise, a large project dealing with legal terminology and phraseology for the Belgian public services, i.e. the translation office of the ministry of justice, a project which aims at developing an advanced tool including expert knowledge in the algorithms that extract specialized language from textual data (legal documents) and whose outcome is a knowledge database including Dutch/French equivalents for legal concepts, enriched with the phraseology related to the terms under discussion. Finally, Deborah Grbac, Luca Losito, Andrea Sada and Paolo Sirito report on the preliminary results of a pilot project currently ongoing at UCSC Central Library, where they propose to adapt to subject librarians, employed in large and multilingual Academic Institutions, the model used by translators working within European Union Institutions. The authors are using User Experience (UX) Analysis in order to provide subject librarians with a visual support, by means of “ontology tables” depicting conceptual linking and connections of words with concepts presented according to their semantic and linguistic meaning. The organizers hope that the selection of papers presented here will be of interest to a broad audience, and will be a starting point for further discussion and cooperation.
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Sandpit exploitation near Lisbon allowed collecting of many Miocene, non marine fossils. These sands are part of the mostly marine Miocene series in the Lower Tagus basin. The particularly favourable situation led several researchers to deal with marine-continental correlations. Difficulties often concern methodologic aspects. Some poorly based interpretations exerced a lasting influence. A critical approach is presented. Analysis requires data. Methods based upon models often lead to the temptation of fitting data in order to confirm a priori conclusions, or of mixing up data as if of equal statistic value while they have not at all the same weight. Erroneous interpretations' uncritical repetition for many years "upgraded" them into absolute truth. Another point is endemism vs. europeism. Miocene mammals from Lisbon compared well with corresponding French, contemporaneous taxa, while this was apparently not true for Spanish ones. Too much accent had been put on the endemic character of Spanish, or even regional, mammalian faunas. Nationalist bias and sensationalism also weigh, albeit negatively. Meanwhile nearly all the more evident examples as the rhinoceros Hispanotherium are discredited as Iberian endemisms. Taxa may appear as endemic just because they have not yet been found elsewhere. At least for the medium to large-sized mammals, with their huge geographic distribution, faunal differences depend much more on ecology, climate and environmental conditions. Emphasis on differences may also result from researchers that are often in a precarious situation and need very much to achieve short-term, preferably sensational results. Overvalued differences may mask real similarities. Unethic and not scientific behaviour are further enhanced by "nomina nuda" tricks that may simply be a way to circunvent or cheat the Priority Rule. On the other hand, access to communication networks may present as sensational novelties items that are not new at all, misleading the audience. A new class of "science people" arose, created by the media and not by the value of their real achievements. Discussion is presented on sedimentation processes and discontinuities that are often regarded as absolute precision dating tools, as well as on some geochemical and paleomagnetic interpretations. A very good chronologie frame has been obtained for the basin under study on the basis of an impressive set of data, providing a rather detailed and accurate frame for Miocene marine-continental correlations.
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Several cases of primary HIV-1 infection are not identified, either because the diagnosis is not suspected or because they test negative for HIV-1 antibody. This work presents an uncommon case of primary HIV-1 infection in an young parenteral drug abuser man, who presented symptoms of acute hepatitis. During the initial acute phase the serum sample of the patient tested negative for the presence of antibodies against several viruses, including HIV-1. Nevertheless, the diagnosis of primary HIV-1 infection was suspected by using an alternative method for"in vitro" induced antibody production (IVIAP), and confirmed by p24 antigen serum positivity and seroconversion in serial plasma samples of the patient. The authors suggest the use of the IVIAP and others complementary assays to help the diagnosis of acute HIV-1 infection in persons at high risk conditions.
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Dissertation submitted in partial fulfilment of the requirements for the Degree of Master of Science in Geospatial Technologies.
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Various species of Anopheles (Nyssorhynchus) were studied in the Amazon with the objective of determining their importance as malaria vectors. Of the 33 known Anopheles species occurring in the Amazon, only 9 were found to be infected with Plasmodium. The different species of this subgenus varied both in diversity and density in the collection areas. The populations showed a tendency towards lower density and diversity in virgin forest than in areas modified by human intervention. The principal vector, An. darlingi, is anthropophilic with a continuous activity cycle lasting the entire night but peaking at sunset and sunrise. These species (Nyssorhynchus) are peridomiciliary, entering houses to feed on blood and immediately leaving to settle on nearby vegetation. Anopheles nuneztovari proved to be zoophilic, crepuscular and peridomiciliary. These habits may change depending on a series of external factors, especially those related to human activity. There is a possibility that sibling species exist in the study area and they are being studied with reference to An. darlingi, An. albitarsis and An. nuneztovari. The present results do not suggest the existence of subpopulations of An. darlingi in the Brazilian Amazon.
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Dissertation to obtain a Master Degree in Biotechnology
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The use of appropriate acceptance criteria in the risk assessment process for occupational accidents is an important issue but often overlooked in the literature, particularly when new risk assessment methods are proposed and discussed. In most cases, there is no information on how or by whom they were defined, or even how companies can adapt them to their own circumstances. Bearing this in mind, this study analysed the problem of the definition of risk acceptance criteria for occupational settings, defining the quantitative acceptance criteria for the specific case study of the Portuguese furniture industrial sector. The key steps to be considered in formulating acceptance criteria were analysed in the literature review. By applying the identified steps, the acceptance criteria for the furniture industrial sector were then defined. The Cumulative Distribution Function (CDF) for the injury statistics of the industrial sector was identified as the maximum tolerable risk level. The acceptable threshold was defined by adjusting the CDF to the Occupational, Safety & Health (OSH) practitioners’ risk acceptance judgement. Adjustments of acceptance criteria to the companies’ safety cultures were exemplified by adjusting the Burr distribution parameters. An example of a risk matrix was also used to demonstrate the integration of the defined acceptance criteria into a risk metric. This work has provided substantial contributions to the issue of acceptance criteria for occupational accidents, which may be useful in overcoming the practical difficulties faced by authorities, companies and experts.
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Nonlinear Dynamics, chaos, Control, and Their Applications to Engineering Sciences: Vol. 6 - Applications of nonlinear phenomena
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Redundant manipulators have some advantages when compared with classical arms because they allow the trajectory optimization, both on the free space and on the presence of abstacles, and the resolution of singularities. For this type of manipulators, several kinetic algorithms adopt generalized inverse matrices. In this line of thought, the generalized inverse control scheme is tested through several experiments that reveal the difficulties that often arise. Motivated by theseproblems this paper presents a new method that ptimizes the manipulability through a least squre polynomialapproximation to determine the joints positions. Moreover, the article studies influence on the dynamics, when controlling redundant and hyper-redundant manipulators. The experiment confirm the superior performance of the proposed algorithm for redundant and hyper-redundant manipulators, revealing several fundamental properties of the chaotic phenomena, and gives a deeper insight towards the future development of superior trajectory control algorithms.
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The objective of the paper is to help to understand recent changes in the structure of R&D activities, by analyzing data on the expenditure of the business sector in research and development (R&D). The results are framed in an international context, through comparison with indicators from the most developed countries, divided by technological intensity and economic activity. The study reveals that the indicators of Portuguese R&D expenditure in the business sector are closely linked both to fiscal policy and to high foreign direct investment in knowledge-intensive industries. It also links these indicators to phenomena such as the abundance of skilled labor in pharmaceutical industries and the government intervention in some sectors of the economy (namely health and rail transportation).
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PURPOSE: The Genous™ stent (GS) is designed to accelerate endothelization, which is potentially useful in the pro-thrombotic environment of ST-elevation acute myocardial infarction (STEMI). We aimed to evaluate the safety and effectiveness of the GS in the first year following primary percutaneous coronary intervention (PCI) and to compare our results with the few previously published studies. METHODS AND MATERIALS: All patients admitted to a single center due to STEMI that underwent primary PCI using exclusively GS, between May 2006 and January 2012, were enrolled. The primary study endpoints were major adverse cardiac events (MACEs), defined as the composite of cardiac death, acute myocardial infarction and target vessel revascularization, at one and 12months. RESULTS: In the cohort of 109 patients (73.4% male, 59 ±12years), 24.8% were diabetic. PCI was performed in 116 lesions with angiographic success in 99.1%, using 148 GS with median diameter of 3.00mm (2.50-4.00) and median length of 15mm (9-33). Cumulative MACEs were 2.8% at one month and 6.4% at 12months. Three stent thromboses (2.8%), all subacute, and one stent restenosis (0.9%) occurred. These accounted for the four target vessel revascularizations (3.7%). At 12months, 33.9% of patients were not on dual antiplatelet therapy. CONCLUSIONS: GS was safe and effective in the first year following primary PCI in STEMI, with an apparently safer profile comparing with the previously published data. SUMMARY: We report the safety and effectiveness of the Genous™ stent (GS) in the first year following primary percutaneous coronary intervention in ST-elevation acute myocardial infarction. A comprehensive review of the few studies that have been published on this subject was included and some suggest a less safe profile of the GS. Our results and the critical review included may add information and reinforce the safety and effectiveness of the GS in ST-elevation in acute myocardial infarction.
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Dissertação para obtenção do Grau de Mestre em Conservação e Restauro