859 resultados para Design for flexibility in use


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Workflow technology is currently being deployed in quite diverse domains. However, the element of change is present in some degree and form in almost all domains. A workflow implementation that does not support the process of change will not benefit the organization in the long run. Change can be manifested in different forms in workflow processes. In this paper, we first present a categorization of workflow change characteristics and divide workflow processes into dynamic, adaptive and flexible processes. We define flexibility as the ability of the workflow process to execute on the basis of a loosely, or partially specified model, where the full specification of the model is made at runtime, and may be unique to each instance. To provide a modeling framework that offers true flexibility, we need to consider the factors, which influence the paths of (unique) instances together with the process definition. We advocate an approach that aims at making the process of change part of the workflow process itself. We introduce the notion of an open instance that consists of a core process and several pockets of flexibility, and present a framework based on this notion, which makes use of special build activities that provide the functionality to integrate the process of defining a change, into the open workflow instance.

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Objective - To evaluate behavioural components and strategies associated with increased uptake and effectiveness of screening for coronary heart disease and diabetes with an implementation science focus. Design - Realist review. Data sources - PubMed, Web of Knowledge, Cochrane Database of Systematic Reviews, Cochrane Controlled Trials Register and reference chaining. Searches limited to English language studies published since 1990. Eligibility criteria - Eligible studies evaluated interventions designed to increase the uptake of cardiovascular disease (CVD) and diabetes screening and examined behavioural and/or strategic designs. Studies were excluded if they evaluated changes in risk factors or cost-effectiveness only. Results - In 12 eligible studies, several different intervention designs and evidence-based strategies were evaluated. Salient themes were effects of feedback on behaviour change or benefits of health dialogues over simple feedback. Studies provide mixed evidence about the benefits of these intervention constituents, which are suggested to be situation and design specific, broadly supporting their use, but highlighting concerns about the fidelity of intervention delivery, raising implementation science issues. Three studies examined the effects of informed choice or loss versus gain frame invitations, finding no effect on screening uptake but highlighting opportunistic screening as being more successful for recruiting higher CVD and diabetes risk patients than an invitation letter, with no differences in outcomes once recruited. Two studies examined differences between attenders and non-attenders, finding higher risk factors among non-attenders and higher diagnosed CVD and diabetes among those who later dropped out of longitudinal studies. Conclusions - If the risk and prevalence of these diseases are to be reduced, interventions must take into account what we know about effective health behaviour change mechanisms, monitor delivery by trained professionals and examine the possibility of tailoring programmes according to contexts such as risk level to reach those most in need. Further research is needed to determine the best strategies for lifelong approaches to screening.

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In this thesis, we deal with the design of experiments in the drug development process, focusing on the design of clinical trials for treatment comparisons (Part I) and the design of preclinical laboratory experiments for proteins development and manufacturing (Part II). In Part I we propose a multi-purpose design methodology for sequential clinical trials. We derived optimal allocations of patients to treatments for testing the efficacy of several experimental groups by also taking into account ethical considerations. We first consider exponential responses for survival trials and we then present a unified framework for heteroscedastic experimental groups that encompasses the general ANOVA set-up. The very good performance of the suggested optimal allocations, in terms of both inferential and ethical characteristics, are illustrated analytically and through several numerical examples, also performing comparisons with other designs proposed in the literature. Part II concerns the planning of experiments for processes composed of multiple steps in the context of preclinical drug development and manufacturing. Following the Quality by Design paradigm, the objective of the multi-step design strategy is the definition of the manufacturing design space of the whole process and, as we consider the interactions among the subsequent steps, our proposal ensures the quality and the safety of the final product, by enabling more flexibility and process robustness in the manufacturing.

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The nature of concepts is a matter of intense debate in cognitive sciences. While traditional views claim that conceptual knowledge is represented in a unitary symbolic system, recent Embodied and Grounded Cognition theories (EGC) submit the idea that conceptual system is couched in our body and influenced by the environment (Barsalou, 2008). One of the major challenges for EGC is constituted by abstract concepts (ACs), like fantasy. Recently, some EGC proposals addressed this criticism, arguing that the ACs comprise multifaced exemplars that rely on different grounding sources beyond sensorimotor one, including interoception, emotions, language, and sociality (Borghi et al., 2018). However, little is known about how ACs representation varies as a function of life experiences and their use in communication. The theoretical arguments and empirical studies comprised in this dissertation aim to provide evidence on multiple grounding of ACs taking into account their varieties and flexibility. Study I analyzed multiple ratings on a large sample of ACs and identified four distinct subclusters. Study II validated this classification with an interference paradigm involving motor/manual, interoceptive, and linguistic systems during a difficulty rating task. Results confirm that different grounding sources are activated depending on ACs kind. Study III-IV investigate the variability of institutional concepts, showing that the higher the law expertise level, the stronger the concrete/emotional determinants in their representation. Study V introduced a novel interactive task in which abstract and concrete sentences serve as cues to simulate conversation. Analysis of language production revealed that the uncertainty and interactive exchanges increase with abstractness, leading to generating more questions/requests for clarifications with abstract than concrete sentences. Overall, results confirm that ACs are multidimensional, heterogeneous, and flexible constructs and that social and linguistic interactions are crucial to shaping their meanings. Investigating ACs in real-time dialogues may be a promising direction for future research.

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Based on a previously developed mathematical model for fuel consumption of a modular car, here we discuss the cross impacts of engineering scenarios vs. flexibility in use for modular vehicle architectures to achieve the reduction of CO2 emissions targeted by the European Union, in 2009. A systems perspective is adopted in conceptualizing a modular architecture of vehicles. From a theoretical viewpoint, we found modular architecture of vehicles a potential design strategy to minimize fuel inefficiencies and, thus, a strategy for design for environment.

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We study the effects of product differentiation in a Stackelberg model with demand uncertainty for the first mover. We do an ex-ante and ex-post analysis of the profits of the leader and of the follower firms in terms of product differentiation and of the demand uncertainty. We show that even with small uncertainty about the demand, the follower firm can achieve greater profits than the leader, if their products are sufficiently differentiated. We also compute the probability of the second firm having higher profit than the leading firm, subsequently showing the advantages and disadvantages of being either the leader or the follower firm.

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We consider a Stackelberg model with demand uncertainty, only for the first mover. We study the advantages of leadership and flexibility with the variation of the demand uncertainty. Liu proved for demand uncertainty parameter greater than three that the follower firm can have an advantage with respect to the leading firm for some realizations of the demand intercept. Here, we prove that for demand uncertainty parameter less than three the leading firm is always in advantage.

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The spectrum of neurological complications associated with human immunodeficiency virus type 1 (HIV-1) infection is broad. The most frequent etiologies include primary diseases (caused by HIV itself) or secondary diseases (opportunistic infections or neoplasms). Despite these conditions, HIV-infected patients are susceptible to other infections observed in patients without HIV infection. Here we report a rare case of a brain abscess caused by Staphylococcus aureus in an HIV-infected patient. After drainage of the abscess and treatment with oxacilin, the patient had a favorable outcome. This case reinforces the importance of a timely neurosurgical procedure that supported adequate management of an unusual cause of expansive brain lesions in HIV-1 infected patients.

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The problem of work-related musculoskeletal disorders is a rising concern in the companies. Thus, occupational gym has emerged as a possible solution to this problem because it leads to changes in the lifestyle by promoting health and physical activity. In this regard, this study purposes to evaluate the impact of an occupational gym program in the neck and shoulder flexibility in office workers. In order to evaluate the levels of flexibility, a universal goniometer was used for pre and post occupational gym program implementation. The program had an extension of three months, with 15 minutes sessions twice a week. The sample consisted in an intervention group comprised of 30 elements and a control group composed of 8 elements. The results suggest that there were improvements in flexibility at the cervical spine and shoulder segments levels. The increase on flexibility between the two time points in the intervention group was significant, unlike the control group that presented only slight improvements.

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INTRODUCTION: There is a lack of data on potential gender differences in the use of interventions to prevent and treat cardiovascular disease (CVD) in HIV-positive individuals. We investigated whether such differences exist in the D:A:D study. MATERIALS AND METHODS: Follow-up was from 01/02/99 until the earliest of death, 6 months after last visit or 01/02/13. Rates of initiation of lipid-lowering drugs (LLDs), angiotensin-converting enzyme inhibitors (ACEIs), anti-hypertensives and receipt of invasive cardiovascular procedures (ICPs; bypass, angioplasty, endarterectomy) were calculated in those without a myocardial infarction (MI) or stroke at baseline, overall and in groups known to be at higher CVD risk: (i) age >50, (ii) total cholesterol >6.2 mmol/l, (iii) triglyceride >2.3 mmol/l, (iv) hypertension, (v) previous MI, (vi) diabetes, or (vii) predicted 10-year CVD risk >10%. Poisson regression was used to assess whether rates of initiation were higher in men than women, after adjustment for these factors. RESULTS: At enrolment, women (n=13,039; median (interquartile range) 34 (29-40) years) were younger than men (n=36,664, 39 (33-46) years, p=0.001), and were less likely to be current smokers (29% vs. 39%, p=0.0001), to have diabetes (2% vs. 3%, p=0.0001) or to have hypertension (7% vs. 11%, p=0.0001). Of 49,071 individuals without a MI/stroke at enrolment, 0.6% women vs. 2.1% men experienced a MI while 0.8% vs. 1.3% experienced a stroke. Overall, women received ICPs at a rate of 0.07/100 person-years (PYRS) compared to 0.29/100 PYRS in men. Similarly, the rates of initiation of LLDs (1.28 vs. 2.46), anti-hypertensives (1.11 vs. 1.38) and ACEIs (0.82 vs. 1.37) were all significantly lower in women than men (Table 1). As expected, initiation rates of each intervention were higher in the groups determined to be at moderate/high CVD risk; however, within each high-risk group, initiation rates of most interventions (with the exception of anti-hypertensives) were generally lower in women than men. These gender differences persisted after adjustment for potential confounders (Table 1). CONCLUSION: Use of most CVD interventions was lower among women than men in the D:A:D study. Our findings suggest that actions should be taken to ensure that both men and women are monitored for CVD and, if eligible, receive appropriate CVD interventions.