750 resultados para Alcohol-related problems
Resumo:
在过去的二十年中,数据挖掘和机器学习受到了越来越多的关注。 这很大程度上是因为在互联网时代信息传播和积累的速度越来越快, 人工处理数据越来越困难,智能化及自动化的数据处理能力成为迫切的需求。 为此人们设计了很多学习算法,希望计算机能具有人类的学习能力,即只要训练一次,就 可以自动处理数据。 尽管这种学习能力已经在很多成功的应用中得到了验证,但它建立在一个重要的假设基础上,即训练数据与目标数据的一致性。 这意味着:根据训练数据得到的模型只适用于具有同样分布的目标数据。如果需要完成一个新的任务, 即使是与原任务非常相近的任务,原来训练好的模型也可能会失效。但是如果重新提供训练数据必将付出很高的成本。 因为两个任务之间存在的相似性,在新任务的训练过程中彻底丢弃原有的训练数据也是非常不合理的。 考虑到数据来源的差异性和训练数据的时效性在实际应用中普遍存在,有必要寻找更有效的解决途径。 迁移学习的提出正是为了解决上面的问题。传统的学习过程实际上是实现了从人到机器的知识迁移。 迁移学习则是研究从一个学习任务到另一个学习任务的知识迁移,以提高知识利用的效率。 这样的知识迁移将在缺乏训练数据和训练数据时效较短的情况下 大大降低学习的成本并提高学习的效率和自动化程度。 本文从跨数据域迁移学习入手,研究无监督迁移学习技术,以及在数据流环境下的有监督迁移学习技术, 在以下三个方面做出了创新性贡献: 在迁移学习中首次提出利用最大间隔方法在没有目标数据域的训练数据的情况下完成分类任务。 提出了两种算法,以迭代优化技术为基础,分别在函数层以及参数层实现了辅助任务到目标任务的知识迁移。 在多个公开的数据集中的实验表明,两种算法的分类准确率均优于现有的迁移学习算法。 在数据流分类任务中,针对概念漂移问题首次提出对概念漂移进行建模,来设计一种 可以自动适应数据分布变化的动态分类器。作为一种新的分类框架,可用于logistic regression和SVM等诸多分类模型。在实验中表明,所提出的算法有效避免了传统滑动 窗口方法导致的数据过拟合,实现了较高的分类准确率。 提出在具有多个节点的传感器网络中进行异常检测的新方法。利用主成分分析对数据空间进行变换,并根据能量阈值 对数据空间进行划分,构建异常子空间, 根据数据在异常子空间上的投影来检测异常数据点。基于数据点在异常子空间上的投影信息还可以进一步对异常来源 进行定位,并度量异常的大小。在实验中所提出的方法展现了较强的异常检测能力。
Resumo:
在电机的设计中,常常需要通过优化设计得到合理的电机结构尺寸和参数.电机的设计问题实质上是一种带约束的复杂的非线性连续函数优化问题.要得到一个满意的优化结果不仅要求算法具有较高的精度,而且要有快的收敛速度.提出一种新的混合算法对永磁电机的尺寸和整体结构进行优化设计.将混沌算法和粒子群算法相结合,以微型永磁电机为例,对槽形等多个变量进行优化,结果证明了算法的有效性和快速性,适合于同类问题求解.
Resumo:
Transfer of learning is one of the major concepts in educational psychology. As cognitive psychology develops, many researchers have found that transfer plays an important part in problem solving, and the awareness of the similarity of related problems is important in transfer. So they become more interested in researching the problem of transfer. But in the literature of transfer research, it has been found that many researchers do not hold identical conclusions about the influence of awareness of related problems during problem solving transfer. This dissertation is written on the basic of much of sub-research work, such as looking up literature concerning transfer of problem solving research, comparing the results of research work done recently and experimental researches. The author of this dissertation takes middle school students as subjects, geometry as materials, and adopts factorial design in his experiments. The influence of awareness of related problems on problem solving transfer is examined from three dimensions which are the degree of difficulty of transfer problems, the level of awareness of related problems and the characteristics of subjects themselves. Five conclusions have been made after the experimental research: (1) During the process of geometry problem solving, the level of awareness of related problems is one of the major factors that influence the effect of problem solving transfer. (2) Either more difficult or more easy of the transfer problems will hinder the influence of awareness of related problems during problem solving transfer, and the degree of difficulty of the transfer problems have interactions with the level of awareness of related problems in affecting transfer. (3) During geometry problems solving transfer, the level of awareness of related problems has interactions with the degree of student achievement. Compared with the students who have lower achievement, the influence of the level of the awareness is bigger in the students who have higher achievement. (4) There is positive correlation between geometry achievement and reasoning ability of the middle school students. The student who has higher reasoning ability has higher geometry achievement, while the level of awareness is raised, the transfer achievement of both can be raised significantly. (5) There is positive correlation between geometry achievement and cognitive style of the middle school students. The student who has independent field tendency of cognitive style has higher geometry achievement, while the level of awareness is raised, the transfer achievement of both can be raised significantly. At the end of the dissertation, the researcher offers two proposals concerning Geometry teaching on the basis of the research findings.
Resumo:
Projeto de Pós-Graduação/Dissertação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Ciências Farmacêuticas
Resumo:
Practical realisation of quantum information science is a challenge being addressed by researchers employing various technologies. One of them is based on quantum dots (QD), usually referred to as artificial atoms. Being capable to emit single and polarization entangled photons, they are attractive as sources of quantum bits (qubits) which can be relatively easily integrated into photonic circuits using conventional semiconductor technologies. However, the dominant self-assembled QD systems suffer from asymmetry related problems which modify the energetic structure. The main issue is the degeneracy lifting (the fine-structure splitting, FSS) of an optically allowed neutral exciton state which participates in a polarization-entanglement realisation scheme. The FSS complicates polarization-entanglement detection unless a particular FSS manipulation technique is utilized to reduce it to vanishing values, or a careful selection of intrinsically good candidates from the vast number of QDs is carried out, preventing the possibility of constructing vast arrays of emitters on the same sample. In this work, site-controlled InGaAs QDs grown on (111)B oriented GaAs substrates prepatterned with 7.5 μm pitch tetrahedrons were studied in order to overcome QD asymmetry related problems. By exploiting an intrinsically high rotational symmetry, pyramidal QDs were shown as polarization-entangled photon sources emitting photons with the fidelity of the expected maximally entangled state as high as 0.721. It is the first site-controlled QD system of entangled photon emitters. Moreover, the density of such emitters was found to be as high as 15% in some areas: the density much higher than in any other QD system. The associated physical phenomena (e.g., carrier dynamic, QD energetic structure) were studied, as well, by different techniques: photon correlation spectroscopy, polarization-resolved microphotoluminescence and magneto-photoluminescence.
Resumo:
Introduction: Older individuals are particularly vulnerable to potentially inappropriate prescribing (PIP), drug related problems (DRPs) and adverse drug reactions (ADRs). A number of different interventions have been proposed to address these issues. However to-date there is a paucity of well-designed trials examining the impact of such interventions. Therefore the aims of this work were to: (i) establish a baseline PIP prevalence both nationally and internationally using the STOPP, Beers and PRISCUS criteria, (ii) identify the most comprehensive method of assessing PIP in older individuals, (iii) develop a structured pharmacist intervention supported by a computer decisions support system (CDSS) and (iv) examine the impact of this intervention on prescribing and incidence of ADRs. Results: This work identified high rates of PIP across all three healthcare settings in Ireland, 84.7% in the long term care, 70.7% in secondary care and 43.3% in primary care being reported. This work identified that for a comprehensive assessment of prescribing to be undertaken, an amalgamation of all three criteria should be deployed simultaneously. High prevalences of DRPs and PIP in older hospitalised individuals were identified. With 82.0% and 76.3% of patients reported to have at least one DRP or PIP instance respectively. The structured pharmacist intervention demonstrated a positive impact on prescribing, with a significant reduction MAI scores being reported. It also resulted in the intervention patients’ having a reduced risk of experiencing an ADR when compared to the control patients (absolute risk reduction of 6.8 (95% CI 1.5% - 12.3%)) and the number needed to treat = 15 (95% CI 8 - 68). However the intervention was found to have no significant effect on length of stay or mortality rate. Conclusion: This work shows that PIP is highly prevalent in older individuals across three healthcare settings in Ireland. This work also demonstrates that a structured pharmacist intervention support by a dedicated CDSS can significantly improve the appropriateness of prescribing and reduce the incidence of ADRs in older acutely ill hospitalised individuals.
Resumo:
In this paper the many to many location routing problem is introduced, and its relationship to various problems in distribution management is emphasised. Useful mathematical formulations which can be easily extended to cater for other related problems are produced. Techniques for tackling this complex distribution problem are also outlined.
Resumo:
• Summary: During the last decade increasing attention has been paid to the impact of the Troubles1 on social work in Northern Ireland. In this paper, the authors describe the first survey used to test some of the assumptions which exist in the literature. An 87-item questionnaire was applied to a range of social work staff currently working in, or associated with, mental health settings. One hundred and one questionnaires were returned: it is estimated that this represented over 70 per cent of mental health social workers in Northern Ireland. • Findings: The design of the questionnaire elicited both qualitative and quantitative data. The findings reveal a workforce with complex religious and national identities and many of the respondents have experienced relatively high levels of Troubles-related incidents whilst carrying out their duties in a variety of organizational and geographical settings. High proportions of respondents received minimal agency support and training to equip them to deal with Troubles-related problems faced by them during this period. • Applications: The authors conclude that the profession and employing agencies should pay greater attention to past and present effects of the Troubles on social work practice and develop appropriate strategies for supporting, training and resourcing staff in this neglected area.
Resumo:
Raised risks of several cancers have been found in patients with type II diabetes, but there are few data on cancer risk in type I diabetes. We conducted a cohort study of 28 900 UK patients with insulin-treated diabetes followed for 520 517 person-years, and compared their cancer incidence and mortality with national expectations. To analyse by diabetes type, we examined risks separately in 23 834 patients diagnosed with diabetes under the age of 30 years, who will almost all have had type I diabetes, and 5066 patients diagnosed at ages 30 - 49 years, who probably mainly had type II. Relative risks of cancer overall were close to unity, but ovarian cancer risk was highly significantly raised in patients with diabetes diagnosed under age 30 years ( standardised incidence ratio ( SIR) = 2.14; 95% confidence interval (CI) 1.22 - 3.48; standardised mortality ratio (SMR) = 2.90; 95% CI 1.45 - 5.19), with greatest risks for those with diabetes diagnosed at ages 10 - 19 years. Risks of cancer at other major sites were not substantially raised for type I patients. The excesses of obesity- and alcohol-related cancers in type II diabetes may be due to confounding rather than diabetes per se.
Resumo:
Inconsistent evidence of the hypothesized favorable effects of high job control on health may have resulted from a failure to treat job control as a multifactor concept. The authors studied whether the 2 components of job control, decision authority and skill discretion, were differentially associated with cause-specific mortality in 13,510 Finnish forest company employees with no history of severe illness. Surveys on work characteristics were carried out in 1986 and 1996, and the respondents were followed up until the end of 2005 by use of the Statistics Finland National Death Registry. During a mean follow-up of 15.5 years, 981 participants died. In the analyses adjusted for confounders, employees with high and intermediate levels of skill discretion had a lower all-cause mortality risk than those with low skill discretion, with hazard ratios of 0.84 (95% confidence interval (CI): 0.69, 1.02) and 0.81 (95% CI: 0.69, 0.96), respectively. In contrast, high decision authority was associated with elevated risks of all-cause, cardiovascular, and alcohol-related mortality, with hazard ratios of 1.28 (95% CI: 1.06, 1.54), 1.49 (95% CI: 1.11, 2.02), and 2.03 (95% CI: 1.03, 4.00), respectively. The results suggest that job control is not an unequivocal concept in relation to mortality; decision authority and skill discretion show different and to some extent opposite associations.
Resumo:
ABSTRACT: BACKGROUND: Chronic diseases are rapidly increasing and are currently the major cause of death and disability worldwide. Patients with chronic diseases experience many challenges including medicine-related problems. However, there is limited information about the home management of medicines among these patients. This study therefore was to determine home medication management practices and associated factors among patients with chronic diseases seeking care in a community pharmacy in Uganda. METHODS: A cross-sectional study was conducted in a community pharmacy in Kampala from June to July 2010. A total of 207 consenting chronic disease patients or caregivers of children with chronic disease were consecutively sampled. The patients were visited at home to evaluate their drug management practices and to check their medical forms for disease types and drugs prescribed. An interviewer-administered questionnaire and an observation checklist were used to collect the data. RESULTS: Overall home medication management was inappropriate for 70% (n = 145) of the participants (95% CI = 63.3-76.2) and was associated with perceived severity of disease (not severe OR =0.40, moderately severe OR = 0.35), duration of disease >5 years (OR = 2.15), and health worker not assessing for response to treatment (OR = 2.53). About 52% (n = 107) had inappropriate storage which was associated with inadequate information about the disease (OR = 2.39) and distance to the health facility >5 kilometres (OR = 2.82). Fifteen percent (n = 31) had no drug administration schedule and this was associated with increasing age (OR = 0.97), inadequate information about the disease (OR = 2.96), and missing last appointment for medical review (OR = 6.55). About 9% (n = 18) had actual medication duplication; 1.4% (n = 3) had expired medicines; while 18.4% (n = 38) had drug hoarding associated with increasing number of prescribers (OR = 1.34) and duration of disease (OR = 2.06). About 51% (n = 105) had multiple prescribers associated with perceiving the disease to be non severe (OR = 0.27), and having more than one chronic disease (OR = 2.37). CONCLUSIONS: Patients with chronic disease have poor home management of medicines. In order to limit the occurrence of poor outcomes of treatment or drug toxicity, health providers need to strengthen the education of patients with chronic disease on how to handle their medicines at home.
Resumo:
This study investigated the demographic and psychosocial characteristics of patients attending a residential treatment program for children with asthma. Measures of background information and standardized psychosocial variables were administered to 54 inpatients over an 18-month period. Typically, our patients presented with moderate to severe chronic asthma, mostly diagnosed before 3 years of age and often associated with atopic dermatitis. The families exhibited normal levels of emotional bonding and flexibility in response to stress. Psychosocially, most children were experiencing behavioral and school-related problems, with 6-11-year-old boys exhibiting global social competency problems as well. Girls exhibited lower self-esteem. Locus of control was within the normal range for all age groups. Half the children had not previously attended an asthma education program and two-thirds of the family members either smoked and/or had a pet. The treatment implications of these characteristics of our asthma population were considered.
Resumo:
Background
Inappropriate polypharmacy is a particular concern in older people and is associated with negative health outcomes. Choosing the best interventions to improve appropriate polypharmacy is a priority, hence interest in appropriate polypharmacy, where many medicines may be used to achieve better clinical outcomes for patients, is growing.
Objectives
This review sought to determine which interventions, alone or in combination, are effective in improving the appropriate use of polypharmacy and reducing medication-related problems in older people.
Search methods
In November 2013, for this first update, a range of literature databases including MEDLINE and EMBASE were searched, and handsearching of reference lists was performed. Search terms included 'polypharmacy', 'medication appropriateness' and 'inappropriate prescribing'.
Selection criteria
A range of study designs were eligible. Eligible studies described interventions affecting prescribing aimed at improving appropriate polypharmacy in people 65 years of age and older in which a validated measure of appropriateness was used (e.g. Beers criteria, Medication Appropriateness Index (MAI)).
Data collection and analysis
Two review authors independently reviewed abstracts of eligible studies, extracted data and assessed risk of bias of included studies. Study-specific estimates were pooled, and a random-effects model was used to yield summary estimates of effect and 95% confidence intervals (CIs). The GRADE (Grades of Recommendation, Assessment, Development and Evaluation) approach was used to assess the overall quality of evidence for each pooled outcome.
Main results
Two studies were added to this review to bring the total number of included studies to 12. One intervention consisted of computerised decision support; 11 complex, multi-faceted pharmaceutical approaches to interventions were provided in a variety of settings. Interventions were delivered by healthcare professionals, such as prescribers and pharmacists. Appropriateness of prescribing was measured using validated tools, including the MAI score post intervention (eight studies), Beers criteria (four studies), STOPP criteria (two studies) and START criteria (one study). Interventions included in this review resulted in a reduction in inappropriate medication usage. Based on the GRADE approach, the overall quality of evidence for all pooled outcomes ranged from very low to low. A greater reduction in MAI scores between baseline and follow-up was seen in the intervention group when compared with the control group (four studies; mean difference -6.78, 95% CI -12.34 to -1.22). Postintervention pooled data showed a lower summated MAI score (five studies; mean difference -3.88, 95% CI -5.40 to -2.35) and fewer Beers drugs per participant (two studies; mean difference -0.1, 95% CI -0.28 to 0.09) in the intervention group compared with the control group. Evidence of the effects of interventions on hospital admissions (five studies) and of medication-related problems (six studies) was conflicting.
Authors' conclusions
It is unclear whether interventions to improve appropriate polypharmacy, such as pharmaceutical care, resulted in clinically significant improvement; however, they appear beneficial in terms of reducing inappropriate prescribing.
Resumo:
Background
The incidence of chronic illnesses is increasing globally. Non-adherence to medications and other medication-related problems are common among patients receiving long-term medications. Medication use review (MUR) is a service provision with an accredited pharmacist undertaking structured, adherence-centered reviews with patients receiving multiple medications. MUR services are not yet available in community pharmacies in Qatar.
Objective
The current study aims to evaluate community pharmacists' knowledge, attitudes, and perception towards establishing MUR as an extended role in patient care.
Setting
Private community pharmacies in Qatar including chains and independent pharmacies.
Methodology
A cross-sectional survey using a self-administered questionnaire was conducted among licensed community pharmacists from December 2012 to January 2013. Data analysis was conducted using descriptive and inferential statistics.
Main outcome measures
Knowledge, attitudes, and practices related to MUR concept and services.
Results A total of 123 participants responded to the survey (response rate 56 %). The mean total knowledge score was 71.4 ± 14.7 %. An overwhelming proportion of the participants (97 %) were able to identify the scope of MUR in relation to chronic illnesses and at enhancing the quality of pharmaceutical care. Furthermore, 80 % of the respondents were able to identify patients of priority for inclusion in an MUR program. However, only 43 % of the participants knew that acute medical conditions were not the principal focus of an MUR service, while at least 97 % acknowledged that the provision of MUR services is a great opportunity for an extended role of community pharmacists and that MUR makes excellent use of the pharmacist's professional skills in the community. The participants generally reported concerns about time, dedicated consultation area, and support staff as significant barriers towards MUR implementation.
Conclusion
This study suggests that community pharmacists in Qatar had sufficient knowledge about the concept of MUR and its scope, but there were still important deficiencies that warrant further education. The findings have important implications on policy and practice pertaining to the implementation of MUR as an extended role of pharmacists and as part of Qatar's National Health Strategy to move primary health care forward.
Resumo:
Leniency (amnesty) plus is one of the tools used in the fight against anticompetitive agreements. It allows a cartelist who did not manage to secure complete immunity under general leniency, to secure an additional reduction of sanctions in exchange for cooperation with the authorities with respect to operation of another prohibited agreement on an unrelated market. The instrument was developed in the United States and, in recent years, it was introduced in a number of jurisdictions. This article contextualises the operation of and rationale behind leniency plus, forewarning about its potential procollusive effects and the possibility of its strategic (mis)use by cartelists. It discusses theoretical, moral, and systemic (deterrence-related) problems surrounding this tool. It also provides a comparison of leniency plus in eleven jurisdictions, identifying common design flaws. This piece argues that leniency plus tends to be a problematic and poorly transplanted US legal innovation. Policy-makers considering its introduction should analyse it in light of institutional limits and local realities. Some of the regimes which already introduced it would be better off abandoning it.