880 resultados para Small-sized hospitals


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The impact noise reduction provided by floor coverings is usually obtained in laboratory, using the methodology described in the standard EN ISO 140-8, which requires the use of standard acoustic chambers. The construction of such chambers, following the requirements described in the EN ISO 140-1, implies a significant investment, and therefore only a limited number exists in each country. Alternatives to these standard methodologies, that allow a sufficiently accurate evaluation and require lower resources, have been interesting many researchers and manufacturers. In this paper, one such strategy is discussed, where a reduced sized slab is used to determine the noise reduction provided by floor coverings, following the procedure described in the ISO/CD 16251-1 technical document. Several resilient coverings, floating floors and floating slabs are tested and the results are compared with those obtained using the procedures described in the standards EN ISO 140-8 and EN ISO 717-2.

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Thesis (Ph.D.)--University of Washington, 2016-06

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Objectives: To find out the effect of early neurological consultation using a real time video link on the care of patients with neurological symptoms admitted to hospitals without neurologists on site. Methods: A cohort study was performed in two small rural hospitals: Tyrone County Hospital (TCH), Omagh, and Erne Hospital, Enniskillen. All patients over 12 years of age who had been admitted because of neurological symptoms, over a 24 week period, to either hospital were studied. Patients admitted to TCH, in addition to receiving usual care, were offered a neurological consultation with a neurologist 120 km away at the Neurology Department of the Royal Victoria Hospital, Belfast, using a real time video link. The main outcome measure was length of hospital stay; change of diagnosis, mortality at 3 months, inpatient investigation, and transfer rate and use of healthcare resources within 3 months of admission were also studied. Results: Hospital stay was significantly shorter for those admitted to TCH (hazard ratio 1.13; approximate 95% Cl 1.003 to 1.282; p = 0.045). No patients diagnosed by the neurologist using the video link subsequently had their diagnosis changed at follow up. There was no difference in overall mortality between the groups. There were no differences in the use of inpatient hospital resources and medical services in the follow up period between TCH and Erne patients. Conclusions: Early neurological assessment reduces hospital stay for patients with neurological conditions outside of neurological centres. This can be achieved safely at a distance using a real time video link.

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O associativismo empresarial aparece como forma de desenvolvimento regional, seja este econômico, social ou cultural, e é grande aliado para o surgimento e crescimento das micro e pequenas empresas. É um tema já vivenciado e estudado por vários países do mundo, entre eles europeus e especificamente italianos, mas ainda pouco estudado e conhecido no Brasil. A presente pesquisa objetivou analisar o associativismo empresarial entre micro e pequenas empresas (MPEs) na região do Grande ABC (GABC) pelo Projeto Empreender (SEBRAE) relacionando seus dados com os publicados do relatório 2003/5 de autoria do Observatório Europeu de estudos sobre pequenas e médias empresas europeias, analisando as formas de associativismo aqui ocorridas, além de identificar o perfil das empresas e empresários envolvidos no projeto. Para tal análise foram coletados dados de um total de 63 empresas do Projeto Empreender, nos núcleos de Santo André, São Caetano do Sul e Ribeirão Pires. Do GABC foram coletados dados utilizando o instrumento desenvolvido pelo Observatório Europeu de estudos sobre pequenas e médias empresas. A análise dos dados coletados no GABC em relação aos dados europeus se fez necessária para que pudessem ser encontrados pontos de divergências e convergências em cada uma das experiências, objetivando o aprendizado e evolução do tema. A escolha do GABC foi motivada pelo fato da região passar por mudanças no seu perfil econômico, passando de berço e grande pólo das grandes indústrias para um grande centro de pequenas empresas prestadoras de serviços. Após coleta e análise dos dados, percebeu-se que a experiência do GABC e a ocorrida na Itália se parecem em muitos aspectos, porém tem grandes diferenças estruturais. Enquanto o projeto europeu é de responsabilidade de um órgão da União Europeia, aqui o projeto é de autoria do SEBRAE e sofre grandes conflitos com as Associações Comerciais e Industriais (ACIs) da região quando o tema é custeio das despesas das pessoas e estrutura que envolve a implantação do projeto. Além disso, conclui-se que é necessária uma maior aproximação dos municípios com o projeto, tendo em vista que isto poderia ser fator de incentivo a entrada de novas empresas além de fator de aumento de seriedade do sistema. Mais dois dados merecem destaque. Primeiro o fato do Projeto Empreender ter pouca visibilidade regional, ou seja, ser muito pouco divulgado, e o fato da agência de desenvolvimento do GABC não ter aproximação alguma com o projeto. Por último, surgem dados no decorrer da pesquisa que rompem a barreira das teorias administrativas conhecidas, tais como a amizade como fator de associativismo. Portanto, os resultados obtidos com essa pesquisa apontam para a influência no incentivo ao desenvolvimento do processo associativista na região do GABC, além de servir como incentivador para a aproximação de outros atores sociais no processo.(AU)

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This paper formulates several mathematical models for determining the optimal sequence of component placements and assignment of component types to feeders simultaneously or the integrated scheduling problem for a type of surface mount technology placement machines, called the sequential pick-andplace (PAP) machine. A PAP machine has multiple stationary feeders storing components, a stationary working table holding a printed circuit board (PCB), and a movable placement head to pick up components from feeders and place them to a board. The objective of integrated problem is to minimize the total distance traveled by the placement head. Two integer nonlinear programming models are formulated first. Then, each of them is equivalently converted into an integer linear type. The models for the integrated problem are verified by two commercial packages. In addition, a hybrid genetic algorithm previously developed by the authors is adopted to solve the models. The algorithm not only generates the optimal solutions quickly for small-sized problems, but also outperforms the genetic algorithms developed by other researchers in terms of total traveling distance.

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This paper focuses on minimizing printed circuit board (PCB) assembly time for a chipshootermachine, which has a movable feeder carrier holding components, a movable X–Y table carrying a PCB, and a rotary turret with multiple assembly heads. The assembly time of the machine depends on two inter-related optimization problems: the component sequencing problem and the feeder arrangement problem. Nevertheless, they were often regarded as two individual problems and solved separately. This paper proposes two complete mathematical models for the integrated problem of the machine. The models are verified by two commercial packages. Finally, a hybrid genetic algorithm previously developed by the authors is presented to solve the model. The algorithm not only generates the optimal solutions quickly for small-sized problems, but also outperforms the genetic algorithms developed by other researchers in terms of total assembly time.

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Meta-analysis was used to quantify how well the Theories of Reasoned Action and Planned Behaviour have predicted intentions to attend screening programmes and actual attendance behaviour. Systematic literature searches identified 33 studies that were included in the review. Across the studies as a whole, attitudes had a large-sized relationship with intention, while subjective norms and perceived behavioural control (PBC) possessed medium-sized relationships with intention. Intention had a medium-sized relationship with attendance, whereas the PBC-attendance relationship was small sized. Due to heterogeneity in results between studies, moderator analyses were conducted. The moderator variables were (a) type of screening test, (b) location of recruitment, (c) screening cost and (d) invitation to screen. All moderators affected theory of planned behaviour relationships. Suggestions for future research emerging from these results include targeting attitudes to promote intention to screen, a greater use of implementation intentions in screening information and examining the credibility of different screening providers.

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A set of 38 epitopes and 183 non-epitopes, which bind to alleles of the HLA-A3 supertype, was subjected to a combination of comparative molecular similarity indices analysis (CoMSIA) and soft independent modeling of class analogy (SIMCA). During the process of T cell recognition, T cell receptors (TCR) interact with the central section of the bound nonamer peptide; thus only positions 4−8 were considered in the study. The derived model distinguished 82% of the epitopes and 73% of the non-epitopes after cross-validation in five groups. The overall preference from the model is for polar amino acids with high electron density and the ability to form hydrogen bonds. These so-called “aggressive” amino acids are flanked by small-sized residues, which enable such residues to protrude from the binding cleft and take an active role in TCR-mediated T cell recognition. Combinations of “aggressive” and “passive” amino acids in the middle part of epitopes constitute a putative TCR binding motif

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The subtropical hardwood forests of southern Florida are formed by 120 frost-sensitive, broadleaved angiosperm species that range throughout the Caribbean. Previous work on a series of small sized forest component patches of a 20 km2, forest preserve in northern Key Largo indicate that a shift in species composition was associated with a 100 year forest developmental sequence, and this shift was associated with an increasingly evergreen canopy. This document investigates the underlying differences of the biology of trees that live in this habitat, and is specifically focused on the impact of leaf morphology on changing nutrient cycling patterns. Measurements of the area, thickness, dry mass, nutrient content and longevity of several leaves from 3-4 individuals of ten species were conducted in combination with a two-year leaf litter collection and nutrient analysis to determine that species with thicker, denser leaves cycled scarce nutrients up to 2-3 times more efficiently than thin leaved tree species, and the leaf thickness/density index predicts role in forest development in a parallel direction as the index predicts nutrient cycling efficiency. A three year set of observations on the relative abundance of new leaves, flowers and fruits of the same tree species provides an opportunity to evaluate the consequences the leaf morphology/nutrient cycling/forest development relationship to forest habitat quality. Results of the three documents support a mechanistic link between forest development and nutrient cycling, and suggests that older forests are likely to be better habitats based on the availability of valuable forest products like new leaves, flowers, and fruits throughout the year.