990 resultados para Internal standard


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This paper investigates the gold bloc operated between France, the Netherlands, Switzerland and Belgium, especially over the period after the USA left the gold standard in March 1933 to its end in September 1936. It enquires into the effect of military-political developments in Germany and Italy on the sustainability of the gold bloc between its members. Juxtaposed is the view of leading political scientists, such as Henry Kissinger, who see impending war in Europe as deeply and adversely affecting psychology in Europe, and what may be called the standard "economists' view" that sees the demise of the gold bloc as being caused almost exclusively by economic factors. Developing concepts of external and internal inconsistency of the gold bloc, this investigation concludes that both economic and military-political developments played important roles in destroying the last vestiges of the gold standard.

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Background: Poor communication among health care providers is cited as the most common cause of sentinel events involving patients. Sign-out of patient data at the change of clinician shifts is a component of communication that is especially vulnerable to errors. Sign-outs are particularly extensive and complex in intensive care units (ICUs). There is a paucity of validated tools to assess ICU sign-outs. ^ Objective: To design a valid and reliable survey tool to assess the perceptions of Pediatric ICU (PICU) clinicians about sign-out. ^ Design: Cross-sectional, web-based survey ^ Setting: Academic hospital, 31-bed PICU ^ Subjects: Attending faculty, fellows, nurse practitioners and physician assistants. ^ Interventions: A survey was designed with input from a focus group and administered to PICU clinicians. Test-retest reliability, internal consistency and validity of the survey tool were assessed. ^ Measurements and Main Results: Forty-eight PICU clinicians agreed to participate. We had 42(88%) and 40(83%) responses in the test and retest phases. The mean scores for the ten survey items ranged from 2.79 to 3.67 on a five point Likert scale with no significant test-retest difference and a Pearson correlation between pre and post answers of 0.65. The survey item scores showed internal consistency with a Cronbach's Alpha of 0.85. Exploratory factor analysis revealed three constructs: efficacy of sign-out process, recipient satisfaction and content applicability. Seventy eight % clinicians affirmed the need for improvement of the sign-out process and 83% confirmed the need for face- to-face verbal sign-out. A system-based sign-out format was favored by fellows and advanced level practitioners while attendings preferred a problem-based format (p=0.003). ^ Conclusions: We developed a valid and reliable survey to assess clinician perceptions about the ICU sign-out process. These results can be used to design a verbal template to improve and standardize the sign-out process.^

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The Andaman Sea and other macrotidal semi-enclosed tropical seas feature large amplitude internal waves (LAIW). Although LAIW induce strong fluctuations i.e. of temperature, pH, and nutrients, their influence on reef development is so far unknown. A better-known source of disturbance is the monsoon affecting corals due to turbulent mixing and sedimentation. Because in the Andaman Sea both, LAIW and monsoon, act from the same westerly direction their relative contribution to reef development is difficult to discern. Here, we explore the framework development in a number of offshore island locations subjected to differential LAIW- and SW-monsoon impact to address this open question. Cumulative negative temperature anomalies - a proxy for LAIW impact - explained a higher percentage of the variability in coral reef framework height, than sedimentation rates which resulted mainly from the monsoon. Temperature anomalies and sediment grain size provided the best correlation with framework height suggesting that so far neglected subsurface processes (LAIW) play a significant role in shaping coral reefs.

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Introdução: As precauções-padrão (PP) constituem um conjunto de medidas que têm como finalidade minimizar o risco de transmissão ocupacional de patógenos, sendo indispensável sua utilização por profissionais de saúde, sobretudo pelos enfermeiros. No entanto, a não adesão às PP constitui problemática amplamente discutida em todo o mundo. Embora haja diversos estudos brasileiros que visem avaliar a adesão às PP , ainda tem-se observado grande fragilidade no processo de construção e de validação dos instrumentos utilizados para avaliação deste construto. Objetivo: Realizar a adaptação cultural e validação da Compliance with Standard Precautions Scale (CSPS) para enfermeiros brasileiros. Metodologia: Trata-se de um estudo metodológico para a adaptação e validação da CSPS. Essa escala é composta por 20 itens com quatro opções de respostas, e destina-se a avaliar a adesão às PP. O processo de adaptação consistiu em Tradução, Consenso entre Juízes, Retrotradução e Validação Semântica. A primeira etapa foi a tradução do idioma original para o português do Brasil. Após foi realizado um comitê composto por sete juízes, a versão de consenso obtida na etapa anterior foi traduzida novamente para o idioma de origem. Foram avaliadas as propriedades psicométricas do instrumento, considerando-se as validades de face e de conteúdo, a validade de construto e a confiabilidade. A versão para o Português do Brasil da CSPS (CSPS-PB) foi aplicada em uma amostra de 300 enfermeiros que atuam na assistência a pacientes em um hospital localizado na cidade de São Paulo/SP. A confiabilidade foi avaliada por meio da consistência interna (alfa de Cronbach) e teste reteste (coeficiente de correlação intraclasse - ICC). Para a validação de construto, foi utilizada a comparação entre grupos diferentes, análise fatorial exploratória e análise fatorial confirmatória, segundo o Modelo de Equações Estruturais (SEM). Utilizou-se o software IBM® SPSS, 19.0. Para a análise fatorial confirmatória foi utilizado o módulo específico Analysis of Moment Structures (IBM® SPSS AMOS). Para a análise paralela utilizou-se o programa RanEigen Syntax. O nível de significância adotado foi ? = 0,05. Todos os aspectos éticos foram contemplados. Resultados: A tradução realizada por tradutores juramentados garantiu qualidade a esse processo. A validação de face e de conteúdo possibilitou a realização de modificações pertinentes e imperativas a fim de atender aos critérios de equivalências conceituais, idiomáticas, culturais e semânticas. Obteve-se ?=0,61 na avaliação da consistência interna, indicando confiabilidade satisfatória. O ICC indicou uma correlação de 0,87 quase perfeita para o teste reteste duas semanas após a primeira abordagem, conferindo estabilidade satisfatória. A validade de construto mostrou que a CSPS-PB foi capaz de discriminar as médias de adesão às PP entre grupos distintos referente à idade (F=5,15 p<=0,01), ao tempo de experiência clínica (F = 8,9 p<= 0,000) e a ter recebido treinamento (t = 2,48 p<=0,01). Na análise fatorial confirmatória, o modelo foi subidentificado. A análise fatorial exploratória indicou que todos os itens apresentaram cargas fatoriais adequadas (>=0,30), sendo identificados quatro fatores pela análise paralela. O total de variância explicada foi de 35,48%. Conclusão: A CSPS-PB, trata-se de um instrumento adequado, confiável e válido para medir a adesão às PP entre enfermeiros brasileiros

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This paper makes four propositions. First, it argues that the euro’s institutional design makes it function like the interwar gold exchange standard during periods of stress. Just like the gold exchange standard during the 1930s, the euro created a ‘core’ of surplus countries and a ‘periphery’ of deficit countries. The latter have to sacrifice their internal domestic economic equilibrium in order to restore their external equilibrium, and therefore have no choice but to respond to balance of payments crises by a series of deflationary spending, price and wage cuts. The paper’s second claim is that the euro’s institutional design and the EU’s response to its ‘sovereign debt crisis’ during 2010-13 deepened the recession in the Eurozone periphery, as EMU leaders focused almost exclusively on austerity measures and structural reforms and paid only lip service to the need to rebalance growth between North and South. As Barry Eichengreen argued in Golden Fetters, the rigidity of the gold standard contributed to the length and depth of the Great Depression during the 1930s, but also underscored the incompatibility of the system with legitimate national democratic government in places like Italy, Germany, and Spain, which is the basis for the paper’s third proposition: the euro crisis instigated a crisis of democratic government in Southern Europe underlining that democratic legitimacy still mainly resides within the borders of nation states. By adopting the euro, EMU member states gave up their ability to control major economic policy decisions, thereby damaging their domestic political legitimacy, which in turn dogged attempts to enact structural reforms. Evidence of the erosion of national democracy in the Eurozone periphery can be seen in the rise of anti-establishment parties, and the inability of traditional center-left and center-right parties to form stable governments and implement reforms. The paper’s fourth proposition is that the euro’s original design and the Eurozone sovereign debt crisis further widened the existing democratic deficit in the European Union, as manifested in rising anti-EU and anti-euro sentiment, as well as openly Eurosceptic political movements, not just in the euro periphery, but also increasingly in the euro core.

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Bio-logging studies suffer from the lack of real controls. However, it is still possible to compare indirect parameters between control and equipped animals to assess the level of global disturbance due to instrumentation. In addition, it is also possible to compare the behaviour of free-ranging animals between individuals equipped with different techniques or instruments to determine the less deleterious approach. We instrumented Adelie Penguins (Pygoscelis adeliae) with internal or external time-depth recorders and monitored them in parallel with a control group during the first foraging trip following instrumentation. Foraging trip duration was significantly longer in the internally-equipped group. This difference was due to a larger number of dives, reflecting a lower foraging ability or a higher food demand, and longer periods of recovery at the surface. These longer recovery periods were likely to be due to a reduced efficiency to ventilate at the surface, probably because the implanted devices pressurised adjacent organs such as air sacs. Moreover, descent and ascent rates were slightly lower in externally-equipped penguins, presumably because external instrumentation increased the bird drag. Looking at our results, implantation appears more disadvantageous - at least for short-term deployment - than external equipment in Adelie Penguins, while this method has been described to induce no negative effects in long-term studies. This underlines the need to control for potential effects due to methodological aspects in any study using data loggers in free-ranging animals, to minimise disturbance and collect reliable data.

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Tropical scleractinian corals are particularly vulnerable to global warming as elevated sea surface temperatures (SST) disrupt the delicate balance between the coral host and their algal endosymbionts, leading to symbiont expulsion, mass bleaching and mortality. While satellite sensing of SST has proven a good predictor of coral bleaching at the regional scale, there are large deviations in bleaching severity and mortality on the local scale, which are only poorly understood. Here, we show that internal waves play a major role in explaining local coral bleaching and mortality patterns in the Andaman Sea. In spite of a severe region-wide SST anomaly in May 2010, frequent upslope intrusions of cold sub-pycnocline waters due to breaking large amplitude internal waves (LAIW) alleviated heating and mitigated coral bleaching and mortality in shallow LAIW-exposed waters. In LAIW-sheltered waters, by contrast, bleaching susceptible species suffered severe bleaching and total mortality. These findings suggest that LAIW, which are ubiquitous in tropical stratified waters, benefit coral reefs during thermal stress and provide local refugia for bleaching susceptible corals. The swash zones of LAIW may thus be important, so far overlooked, conservation areas for the maintainance of coral diversity in a warming climate. The consideration of LAIW can significantly improve coral bleaching predictions and can provide a valuable tool for coral reef conservation and management.

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This thesis contributes to the paucity of marketing research into the area of internal marketing. Drawing from knowledge developed in a diverse range of marketing and management literatures, the domaill of internal marketing is clarified Gild a new concept, internal market orientation is developed. A new instrument, measuring the internal market orientation, is developed and subjected to standard scale development procedures. Six dimensions of the construct are confirmed; collegial interaction, group interaction, jorlllal interaction, external envirollment, wage flexibility and job flexibility. A sample of 766 UK retail store managers are surveyed to identify levels of internal market orientation and external market orientation in large UK multi-product, multi-site retailers and the structural relationships between internal market orientation, extemal market orientation alld company performance are examined. The external market orientation construct is applied to the local retail market and established measurement instruments adapted to this pwpose. Three measures of performance are employed ill this study. The structural relationships between the six dimensions of internal market orientation and the three dimensions of external market orientation are examined employing structural equations methodology, using LISREL 8.3. alld the impact of internal market orientation Oil external market orientation and company performance is measured. The study finds no direct link between internal market orientation and financial performance but does identify the moderated role of internal market orientation on financial performance. Significant relationships between three of the six dimensions of internal market orientation and the three dimensions of external market orientation are identified and the impact of internal market orientation on the retention of employees and their behaviour is also identified. The research findings contribute to marketing theory by providing empirical evidence to support the long held assumption that internal marketing has an impact on marketing success and offers an explanation of the mechanism by which this influence operates. For marketing practitioners, the research findings offer additional information on which services marketing strategies may be formulated.

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In the last years the need to develop more environmentally friendly and efficient cars as led to the development of several technologies to improve the performance of internal combustion engines, a large part of the innovations are focused in the auxiliary systems of the engine, including, the oil pump, this is an element of great importance in the dynamics of the engine as well a considerable energy consumer. Most solutions for oil pumps to this day are fixed displacement, for medium and high speeds, the pump flow rate is higher than the needs of the engine, this excess flow leads to the need for recirculation of the fluid which represents a waste of energy. Recently, technological advances in this area have led to the creation of variable displacement oil pumps, these have become a 'must have' due to the numerous advantages they bring, although the working principle of vane or piston pumps is relatively well known, the application of this technology for the automotive industry is new and brings new challenges. The focus of this dissertation is to develop a new concept of variable displacement system for automotive oil pumps. The main objective is to obtain a concept that is totally adaptable to existing solutions on the market (engines), both dimensionally as in performance specifications, having at the same time an innovative mechanical system for obtaining variable displacement. The developed design is a vane pump with variable displacement going in line with existing commercial solutions, however, the variation of the eccentricity commonly used to provide an variable displacement delivery is not used, the variable displacement is achieved without varying the eccentricity of the system but with a variation of the length of the pumping chamber. The principle of operation of the pump is different to existing solutions while maintaining the ability to integrate standard parts such as control valves and mechanical safety valves, the pump is compatible with commercial solutions in terms of interfaces for connection between engine systems and pump. A concept prototype of the product was obtained in order to better evaluate the validity of the concept. The developed concept represents an innovation in oil pumps design, being unique in its mechanical system for variable displacement delivery.

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Background: Aspergillosis has been identified as one of the hospital acquired infections but the contribution of water and inhouse air as possible sources of Aspergillus infection in immunocompromised individuals like HIV-TB patients have not been studied in any hospital setting in Nigeria. Objective: To identify and investigate genetic relationship between clinical and environmental Aspergillus species associated with HIV-TB co infected patients. Methods: DNA extraction, purification, amplification and sequencing of Internal Transcribed Spacer (ITS) genes were performed using standard protocols. Similarity search using BLAST on NCBI was used for species identification and MEGA 5.0 was used for phylogenetic analysis. Results: Analyses of sequenced ITS genes of selected fourteen (14) Aspergillus isolates identified in the GenBank database revealed Aspergillus niger (28.57%), Aspergillus tubingensis (7.14%), Aspergillus flavus (7.14%) and Aspergillus fumigatus (57.14%). Aspergillus in sputum of HIV patients were Aspergillus niger, A. fumigatus, A. tubingensis and A. flavus. Also, A. niger and A. fumigatus were identified from water and open-air. Phylogenetic analysis of sequences yielded genetic relatedness between clinical and environmental isolates. Conclusion: Water and air in health care settings in Nigeria are important sources of Aspergillus sp. for HIV-TB patients.

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In the last sixty years a steadily maintained process of convergence towards the Castilian national standard has been occurring in Southern Spain affecting urban middle-class speakers’ varieties, particularly phonology and lexis. As a consequence, unmarked features characterising innovative southern pronunciation have become less frequent and, at the same time, certain standard marked features have been adapted to the southern phonemic inventory. Then, urban middle-class varieties have progressively been stretching out the distance separating them from working-class and rural varieties, and bringing them closer to central Castilian varieties. Intermediate, yet incipient koineised varieties have been described including also transitional Murcia and Extremadura dialects (Hernández & Villena 2009, Villena, Vida & von Essen 2015). (1) Some of the standard phonologically marked features have spread out among southern speakers exclusively based on their mainstream social prestige and producing not only changes in obstruent phoneme inventory –i.e. acquisition of /s/ vs. /θ/ contrast, but also standstill and even reversion of old consonant push- or pull-chain shifts –e.g. /h/ or /d/ fortition, affricate /ʧ/, etc. as well as traditional lexis shift (Villena et al. 2016). Internal (grammar and word frequency) and external (stratification, network and style) factors constraining those features follow similar patterns in the Andalusian speech communities analysed so far (Granada, Malaga) but when we zoom in on central varieties, which are closer to the national standard and then more conservative, differences in frequency increase and conflict sites emerge. (2) Unmarked ‘natural’ phonological features characterising southern dialects, particularly deletion of syllable-final consonant, do not keep pace with this trend of convergence towards the standard. Thus a combination of southern innovative syllable-final and standard conservative onset-consonant features coexist. (3). The main idea is that this intermediate variety is formed through changes suggesting that Andalusian speakers look for the best way of accepting marked prestige features without altering coherence within their inventory. Either reorganisation of the innovative phonemic system in such a way that it may include Castilian and standard /s/ vs. /θ/ contrast or re-syllabification of aspirated /s/ before dental stop are excellent examples of how and why linguistic features are able to integrate intermediate varieties between the dialect-standard continuum.

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The objective of the PhD thesis was to research technologies and strategies to reduce fuel consumption and pollutants emission produced by internal combustion engines. In order to meet this objective my activity was focused on the research of advanced controls based on cylinder pressure feedback. These types of control strategies were studied because they present promising results in terms of engine efficiency enhancement. In the PhD dissertation two study cases are presented. The first case is relative to a control strategy to be used at the test bench for the optimisation of the spark advance calibration of motorcycle Engine. The second case is relative to a control strategy to be used directly on board of mining engines with the objective or reducing the engine consumption and correct ageing effects. In both cases the strategies proved to be effective but their implementation required the use of specific toolchains for the measure of the cylinder pressure feedback that for a matter of cost makes feasible the strategy use only for applications: • At test bench • In small-markets like large off-road engines The major bottleneck that prevents the implementation of these strategies on mass production is the cost of cylinder pressure sensor. In order to tackle this issue, during the PhD research, the development of a low-cost sensor for the estimation of cylinder pressure was studied. The prototype was a piezo-electric washer designed to replace the standard spark-plug washer or high-pressure fuel injectors gasket. From the data analysis emerged the possibility to use the piezo-electric prototype signal to evaluate with accuracy several combustion metrics compatible for the implementation of advanced control strategies in on-board applications. Overall, the research shows that advanced combustion controls are feasible and beneficial, not only at the test bench or on stationary engines, but also in mass-produced engines.

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The pursuit of decarbonization and increased efficiency in internal combustion engines (ICE) is crucial for reducing pollution in the mobility sector. While electrification is a long-term goal, ICE still has a role to play if coupled with innovative technologies. This research project explores various solutions to enhance ICE efficiency and reduce emissions, including Low Temperature Combustion (LTC), Dual fuel combustion with diesel and natural gas, and hydrogen integration. LTC methods like Dual fuel and Reactivity Controlled Compression Ignition (RCCI) show promise in lowering emissions such as NOx, soot, and CO2. Dual fuel Diesel-Natural Gas with hydrogen addition demonstrates improved efficiency, especially at low loads. RCCI Diesel-Gasoline engines offer increased Brake Thermal Efficiency (BTE) compared to standard diesel engines while reducing specific NOx emissions. The study compares 2-Stroke and 4-Stroke engine layouts, optimizing scavenging systems for both aircraft and vehicle applications. CFD analysis enhances specific power output while addressing injection challenges to prevent exhaust short circuits. Additionally, piston bowl shape optimization in Diesel engines running on Dual fuel (Diesel-Biogas) aims to reduce NOx emissions and enhance thermal efficiency. Unconventional 2-Stroke architectures, such as reverse loop scavenged with valves for high-performance cars, opposed piston engines for electricity generation, and small loop scavenged engines for scooters, are also explored. These innovations, alongside ultra-lean hydrogen combustion, offer diverse pathways toward achieving climate neutrality in the transport sector.

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The aim of this investigation was to compare the skeletal stability of three different rigid fixation methods after mandibular advancement. Fifty-five class II malocclusion patients treated with the use of bilateral sagittal split ramus osteotomy and mandibular advancement were selected for this retrospective study. Group 1 (n = 17) had miniplates with monocortical screws, Group 2 (n = 16) had bicortical screws and Group 3 (n = 22) had the osteotomy fixed by means of the hybrid technique. Cephalograms were taken preoperatively, 1 week within the postoperative care period, and 6 months after the orthognathic surgery. Linear and angular changes of the cephalometric landmarks of the chin region were measured at each period, and the changes at each cephalometric landmark were determined for the time gaps. Postoperative changes in the mandibular shape were analyzed to determine the stability of fixation methods. There was minimum difference in the relapse of the mandibular advancement among the three groups. Statistical analysis showed no significant difference in postoperative stability. However, a positive correlation between the amount of advancement and the amount of postoperative relapse was demonstrated by the linear multiple regression test (p < 0.05). It can be concluded that all techniques can be used to obtain stable postoperative results in mandibular advancement after 6 months.

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In Brazil, the consumption of extra-virgin olive oil (EVOO) is increasing annually, but there are no experimental studies concerning the phenolic compound contents of commercial EVOO. The aim of this work was to optimise the separation of 17 phenolic compounds already detected in EVOO. A Doehlert matrix experimental design was used, evaluating the effects of pH and electrolyte concentration. Resolution, runtime and migration time relative standard deviation values were evaluated. Derringer's desirability function was used to simultaneously optimise all 37 responses. The 17 peaks were separated in 19min using a fused-silica capillary (50μm internal diameter, 72cm of effective length) with an extended light path and 101.3mmolL(-1) of boric acid electrolyte (pH 9.15, 30kV). The method was validated and applied to 15 EVOO samples found in Brazilian supermarkets.