903 resultados para Gains in selection
Resumo:
RESUMO: A individualização dos cuidados de enfermagem tem sido associada a uma evolução clínica mais favorável, representando um importante parâmetro de avaliação e de desenvolvimento dos serviços de saúde. A tónica atribuída a esta problemática não só é evidenciada por diversos autores, como se enquadra nas metas de modernização do Sistema Nacional de Saúde e é destaque em vários códigos normativos da profissão nacionais e internacionais, como uma obrigação moral e deontológica. Assim, pretende-se mediante os ganhos em saúde sensíveis às intervenções de enfermagem, identificar quais indicadores do cuidado individualizado, para se efectivar a sua incorporação na formação inicial em enfermagem. Para tal efeito, construiu-se uma bateria de indicadores mediante análise de duas revisões sistemáticas da literatura, que teve por base o Modelo da Eficácia do Papel de Enfermagem, desenvolvido por Irvine et al. (1998). Para à adaptação à realidade portuguesa recorreu-se à técnica de Delphi, com duas rondas, que incluiu respectivamente, 12 e 10 peritos de enfermagem. Na análise de dados utilizou-se o nível de concordância superior ou igual a 90%, na última ronda. Na segunda fase do estudo, aplicou-se um inquérito por questionário (α de Cronbach = 0,919) para testar a sua aplicabilidade dos indicadores, a 156 enfermeiros, do mesmo hospital da área da grande Lisboa, no Serviço de Medicina e Cirurgia. Recorreu-se ao SPSS, versão 19 e realizou-se análise univariada e estatística analítica. Na bateria final de indicadores foram incorporados aqueles com ponderação positiva (≥51%). Os dados qualitativos obtidos foram submetidos a análise de conteúdo. Dos 58 indicadores iniciais, consolidaram-se 8 categorias: cuidado à pessoa em fim de vida e família, toque terapêutico, educação para a auto-gestão da saúde, cuidados de proximidade, gestão de casos, empoderamento/ literacia para a saúde, linha telefónica de apoio permanente/ tele-assistência e apoio psico-emocional, com valorização de 28 indicadores. O tempo de experiência profissional, tipo de serviço e tempo de permanência no mesmo serviço influenciou a percepção dos enfermeiros, confirmando os pressupostos de Irvine et al. (1998) e Benner (2001). A correlação total dos indicadores, no questionário, variou entre 0,248 e 0,650, para p<0,01. O facto de todas as correlações serem positivas significa que provavelmente estão associados à problemática da individualização, pelo que se sugere a sua transposição para o ensino de enfermagem. ABSTRACT: The individualization of nursing care has been associated with a more favorable clinical evolution, an important parameter for the evaluation and development of health services. The emphasis given to this problem is not only evidenced by several authors, as fits the goals of modernizing the National Health System and is featured in several normative codes of the profession nationally and internationally, as a moral and ethical obligation. Thus, it is intended by the gains in health sensitive to nursing interventions, identify indicators of individualized care and give effect to its incorporation into the initial training in nursing. For this purpose, we constructed a series of indicators by analyzing two systematic reviews of literature, which was based on the The Nursing Role Effectiveness Model developed by Irvine et al. (1998). For the adaptation to the Portuguese appealed to the Delphi technique with two rounds, which included, respectively, 10 and 12 nursing experts. In data analysis we used the level of agreement greater than or equal to 90% in the last round. In the second phase of the study, we applied a questionnaire (Cronbach's α = 0.919) to test the applicability of the indicators, the 156 nurses in the same hospital in the Greater Lisbon area, the Department of Medicine and Surgery. Done using the SPSS, version 19 and conducted a univariate analysis and analytical statistics. In the final heat of indicators were incorporated into those with positive weight (≥ 51%). Qualitative data were subjected to content analysis. Of the initial 58 indicators, eight were consolidated categories: care to the person and family life, therapeutic touch education for self-management of health care outreach, case management, empowerment / literacy to health, a telephone line permanent support / tele-assistance and psycho-emotional, with an appreciation of 28 indicators. The length of professional experience, type of service and length of stay in the same service influenced the perception of nurses, confirming the assumptions of Irvine et al. (1998) and Benner (2001). The total correlation of the indicators in the questionnaire ranged between 0.248 and 0.650, p <0.01. The fact that all correlations are positive means that are probably associated with the problem of individuation, which is suggested by its implementation in nursing education.
Resumo:
A área da “política e administração da saúde”, tem merecido um interesse crescente nas últimas décadas. Provavelmente em consequência do substancial aumento das despesas de saúde que tem ocorrido em todo o mundo mas, também porque se tem verificado uma sensível melhoria da situação de saúde das populações, o que faz com que, “policy makers”, académicos, analistas do setor e “media” tragam as questões de saúde para as primeiras páginas, valorizando-as e tentando melhorar a compreensão sobre o muito complexo processo de prestação em saúde.Não se trata no entanto de uma melhoria que usualmente seja quantificada, ocorrendo até que, se são frequentes, as tentativas de medir os custos e a produção da saúde, setor que tem uma importante dimensão económica, o mesmo não se verifica em relação aos seus resultados (o impacto que os cuidados tiveram na saúde das populações) e ainda menos em relação aos chamados “ganhos em saúde”, afinal o objectivo maior dos sistemas de saúde.Assim, entre a subida das despesas e a melhoria dos resultados, há uma falta de relacionamento que torna difícil fazer um balanço, pelo que é urgente adotar modelos de avaliação da prestação e dos seus resultados que sejam explícitos e ajudem a validar a efetividade da prestação e dos resultados obtidos. O presente trabalho pretende ser um contributo para clarificar esta questão e procurar um indicador corrente que possa ser utilizado para objetivar os “ganhos em saúde” e que, por ser quantificável, possa permitir a definição de medidas de efetividade dos resultados obtidos e de avaliação da performance dos sistemas de saúde.Não será mais uma medida de medição da produção (outputs) mas que pode resolver muitos problemas de há longos anos, e dar suporte ao confronto recursos/resultados e permitindo avaliar a performance de sistemas de saúde, com consistência face aos seus objectivos e fiabilidade, sendo capaz de detetar as mudanças e de mostrar as diferenças.
Resumo:
In seeking to maximize athletic performance, optimizing the improvement of players, we find a line of study that focuses on the detection, selection and talent development. The talent is one of the fundamental constraints to access to excellence in competitive sport. Its identification is the first step to select individuals with the characteristics required to achieve the improvement sports through a complex process of expertise. The aim of this work is essentially to realize how it is made detection and selection of talent in Handball and understand how countries reference to the sport develop their work. In this sense, we choose in addition to Portugal, France, Spain and Denmark. We want to see how these four countries invest and develop detection and talent selection, taking into account the different characteristics of countries in many different contexts. So we can see that each country invests in talent selection and detection taking into account the financial capacity, the development and popularity of the sport. In all three countries, with the exception of Portugal, the Handball is a sport with great impact not only through their championships as well as the level of selections. All invest in detection and selection of talents initially by direct observation and collection of anthropometric data, and organize their structure depending on the size of your country. With the exception of France all other countries after detecting the taletos, fits us in selection schemes open. France chooses to create training centers where these young people will develop their skills. These centers are autonomous although the supervision and guidance of the technical staff of the federation. All countries except Portugal, opt to develop regional selections, thereby widening the recruitment base within a competitive framework extra club.
Resumo:
Accurate estimation of the soil water balance (SWB) is important for a number of applications (e.g. environmental, meteorological, agronomical and hydrological). The objective of this study was to develop and test techniques for the estimation of soil water fluxes and SWB components (particularly infiltration, evaporation and drainage below the root zone) from soil water records. The work presented here is based on profile soil moisture data measured using dielectric methods, at 30-min resolution, at an experimental site with different vegetation covers (barley, sunflower and bare soil). Estimates of infiltration were derived by assuming that observed gains in the soil profile water content during rainfall were due to infiltration. Inaccuracies related to diurnal fluctuations present in the dielectric-based soil water records are resolved by filtering the data with adequate threshold values. Inconsistencies caused by the redistribution of water after rain events were corrected by allowing for a redistribution period before computing water gains. Estimates of evaporation and drainage were derived from water losses above and below the deepest zero flux plane (ZFP), respectively. The evaporation estimates for the sunflower field were compared to evaporation data obtained with an eddy covariance (EC) system located elsewhere in the field. The EC estimate of total evaporation for the growing season was about 25% larger than that derived from the soil water records. This was consistent with differences in crop growth (based on direct measurements of biomass, and field mapping of vegetation using laser altimetry) between the EC footprint and the area of the field used for soil moisture monitoring. Copyright (c) 2007 John Wiley & Sons, Ltd.
Resumo:
The use of high-melting fibres as linear nuclei for quiescent polymeric melts is instrumental in providing the superior mechanical properties of polymeric self-composites. It also has inherent advantages in the elucidation of fundamental aspects of polymeric crystallization and self-organization, not least in allowing systematic microscopic studies of polymeric crystallization from nucleation through to the growth interface. This has demonstrated explicitly that lamellae develop in two distinct ways, for slower and faster growth, depending on whether fold packing has or has not time to order before the next molecular layer is added with only the former leading to banded growth in linear polyethylene. Other gains in understanding concern cellulation and morphological instability, internuclear interference, isothermal lamellar thickening and banded growth being a consequence of the partial relief of initial surface stress. (c) 2006 Elsevier Ltd. All rights reserved.
Resumo:
This article reports on part of a larger study of the impact of strategy training in listening on learners of French, aged 16 to 17. One aim of the project was to investigate whether such training might have a positive effect on the self-efficacy of learners, by helping them see the relationship between the strategies they employed and what they achieved. One group of learners, as well as receiving strategy training, also received detailed feedback on their listening strategy use and on the reflective diaries they were asked to keep, in order to draw their attention to the relationship between strategies and learning outcomes. Another group received strategy training without feedback or reflective diaries, while a comparison group received neither strategy training nor feedback. As a result of the training, there was some evidence that students who had received feedback had made the biggest gains in certain aspects of self-efficacy for listening; although their gains as compared to the non-feedback group were not as great as had been anticipated. Reasons for this are discussed. The article concludes by suggesting changes in how teachers approach listening comprehension that may improve learners' view of themselves as listeners.
Resumo:
The general packet radio service (GPRS) has been developed to allow packet data to be transported efficiently over an existing circuit-switched radio network, such as GSM. The main application of GPRS are in transporting Internet protocol (IP) datagrams from web servers (for telemetry or for mobile Internet browsers). Four GPRS baseband coding schemes are defined to offer a trade-off in requested data rates versus propagation channel conditions. However, data rates in the order of > 100 kbits/s are only achievable if the simplest coding scheme is used (CS-4) which offers little error detection and correction (EDC) (requiring excellent SNR) and the receiver hardware is capable of full duplex which is not currently available in the consumer market. A simple EDC scheme to improve the GPRS block error rate (BLER) performance is presented, particularly for CS-4, however gains in other coding schemes are seen. For every GPRS radio block that is corrected by the EDC scheme, the block does not need to be retransmitted releasing bandwidth in the channel and improving the user's application data rate. As GPRS requires intensive processing in the baseband, a viable field programmable gate array (FPGA) solution is presented in this paper.
Resumo:
The use of expert system techniques in power distribution system design is examined. The selection and siting of equipment on overhead line networks is chosen for investigation as the use of equipment such as auto-reclosers, etc., represents a substantial investment and has a significant effect on the reliability of the system. Through past experience with both equipment and network operations, most decisions in selection and siting of this equipment are made intuitively, following certain general guidelines or rules of thumb. This heuristic nature of the problem lends itself to solution using an expert system approach. A prototype has been developed and is currently under evaluation in the industry. Results so far have demonstrated both the feasibility and benefits of the expert system as a design aid.
Resumo:
This paper examines one of the central issues in the formulation of a sector/regional real estate portfolio strategy, i.e. whether the means, standard deviations and correlations between the returns are sufficiently stable over time to justify using ex-post measures as proxies of the ex-ante portfolio inputs required for MPT. To investigate these issues this study conducts a number of tests of the inter-temporal stability of the total returns of the 19 sector/regions in the UK of the IPDMI. The results of the analysis reveal that the theoretical gains in sector and or regional diversification, found in previous work, could not have been readily achieved in practice without almost perfect foresight on the part of an investor as means, standard deviations and correlations, varied markedly from period to period.
Resumo:
The study explores what happens to teachers practice and ’ professional identity when they adopt a collaborative action research approach to teaching and involve external creative partners and a university mentor. The teachers aim to nurture and develop the creative potential of their learners through empowering them to make decisions for themselves about their own progress and learning directions. The teachers worked creatively and collaboratively designing creative teaching and learning methods in support of pupils with language and communication difficulties. The respondents are from an English special school, primary school and girls secondary school. A mixed methods methodology is adopted. Gains in teacher confidence and capability were identified in addition to shifts in values that impacted directly on their self-concept of what it is to be an effective teacher promoting effective learning. The development of their professional identities within a team ethos included them being able to make decisions about learning that are based on the educational potential of learners that they proved resulted in elevated standards achieved by this group of learners. They were able to justify their actions on established educational principles. Tensions however were revealed between what they perceived as their normal required professionalism imposed by external agencies and the enhanced professionalism experienced working through the project where they were able to integrate theory and practice.
Resumo:
The nature of the climate–carbon cycle feedback depends critically on the response of soil carbon to climate, including changes in moisture. However, soil moisture–carbon feedback responses have not been investigated thoroughly. Uncertainty in the response of soil carbon to soil moisture changes could arise from uncertainty in the relationship between soil moisture and heterotrophic respiration. We used twelve soil moisture–respiration functions (SMRFs) with a soil carbon model (RothC) and data from a coupled climate–carbon cycle general circulation model to investigate the impact of direct heterotrophic respiration dependence on soil moisture on the climate carbon cycle feedback. Global changes in soil moisture acted to oppose temperature‐driven decreases in soil carbon and hence tended to increase soil carbon storage. We found considerable uncertainty in soil carbon changes due to the response of soil respiration to soil moisture. The use of different SMRFs resulted in both large losses and small gains in future global soil carbon stocks, whether considering all climate forcings or only moisture changes. Regionally, the greatest range in soil carbon changes across SMRFs was found where the largest soil carbon changes occurred. Further research is needed to constrain the soil moisture–respiration relationship and thus reduce uncertainty in climate–carbon cycle feedbacks. There may also be considerable uncertainty in the regional responses of soil carbon to soil moisture changes since climate model predictions of regional soil moisture changes are less coherent than temperature changes.
Resumo:
Our digital universe is rapidly expanding,more and more daily activities are digitally recorded, data arrives in streams, it needs to be analyzed in real time and may evolve over time. In the last decade many adaptive learning algorithms and prediction systems, which can automatically update themselves with the new incoming data, have been developed. The majority of those algorithms focus on improving the predictive performance and assume that model update is always desired as soon as possible and as frequently as possible. In this study we consider potential model update as an investment decision, which, as in the financial markets, should be taken only if a certain return on investment is expected. We introduce and motivate a new research problem for data streams ? cost-sensitive adaptation. We propose a reference framework for analyzing adaptation strategies in terms of costs and benefits. Our framework allows to characterize and decompose the costs of model updates, and to asses and interpret the gains in performance due to model adaptation for a given learning algorithm on a given prediction task. Our proof-of-concept experiment demonstrates how the framework can aid in analyzing and managing adaptation decisions in the chemical industry.
Resumo:
Background Cluttering is a fluency disorder characterised by overly rapid or jerky speech patterns that compromise intelligibility. The neural correlates of cluttering are unknown but theoretical accounts implicate the basal ganglia and medial prefrontal cortex. Dysfunction in these brain areas would be consistent with difficulties in selection and control of speech motor programs that are characteristic of speech disfluencies in cluttering. There is a surprising lack of investigation into this disorder using modern imaging techniques. Here, we used functional MRI to investigate the neural correlates of cluttering. Method We scanned 17 adults who clutter and 17 normally fluent control speakers matched for age and sex. Brain activity was recorded using sparse-sampling functional MRI while participants viewed scenes and either (i) produced overt speech describing the scene or (ii) read out loud a sentence provided that described the scene. Speech was recorded and analysed off line. Differences in brain activity for each condition compared to a silent resting baseline and between conditions were analysed for each group separately (cluster-forming threshold Z > 3.1, extent p < 0.05, corrected) and then these differences were further compared between the two groups (voxel threshold p < 0.01, extent > 30 voxels, uncorrected). Results In both conditions, the patterns of activation in adults who clutter and control speakers were strikingly similar, particularly at the cortical level. Direct group comparisons revealed greater activity in adults who clutter compared to control speakers in the lateral premotor cortex bilaterally and, as predicted, on the medial surface (pre-supplementary motor area). Subcortically, adults who clutter showed greater activity than control speakers in the basal ganglia. Specifically, the caudate nucleus and putamen were overactive in adults who clutter for the comparison of picture description with sentence reading. In addition, adults who clutter had reduced activity relative to control speakers in the lateral anterior cerebellum bilaterally. Eleven of the 17 adults who clutter also stuttered. This comorbid diagnosis of stuttering was found to contribute to the abnormal overactivity seen in the group of adults who clutter in the right ventral premotor cortex and right anterior cingulate cortex. In the remaining areas of abnormal activity seen in adults who clutter compared to controls, the subgroup who clutter and stutter did not differ from the subgroup who clutter but do not stutter. Conclusions Our findings were in good agreement with theoretical predictions regarding the neural correlates of cluttering. We found evidence for abnormal function in the basal ganglia and their cortical output target, the medial prefrontal cortex. The findings are discussed in relation to models of cluttering that point to problems with motor control of speech.
Resumo:
Dynamic electricity pricing can produce efficiency gains in the electricity sector and help achieve energy policy goals such as increasing electric system reliability and supporting renewable energy deployment. Retail electric companies can offer dynamic pricing to residential electricity customers via smart meter-enabled tariffs that proxy the cost to procure electricity on the wholesale market. Current investments in the smart metering necessary to implement dynamic tariffs show policy makers’ resolve for enabling responsive demand and realizing its benefits. However, despite these benefits and the potential bill savings these tariffs can offer, adoption among residential customers remains at low levels. Using a choice experiment approach, this paper seeks to determine whether disclosing the environmental and system benefits of dynamic tariffs to residential customers can increase adoption. Although sampling and design issues preclude wide generalization, we found that our environmentally conscious respondents reduced their required discount to switch to dynamic tariffs around 10% in response to higher awareness of environmental and system benefits. The perception that shifting usage is easy to do also had a significant impact, indicating the potential importance of enabling technology. Perhaps the targeted communication strategy employed by this study is one way to increase adoption and achieve policy goals.
Resumo:
The core processing step of the noise reduction median filter technique is to find the median within a window of integers. A four-step procedure method to compute the running median of the last N W-bit stream of integers showing area and time benefits is proposed. The method slices integers into groups of B-bit using a pipeline of W/B blocks. From the method, an architecture is developed giving a designer the flexibility to exchange area gains for faster frequency of operation, or vice versa, by adjusting N, W and B parameter values. Gains in area of around 40%, or in frequency of operation of around 20%, are clearly observed by FPGA circuit implementations compared to latest methods in the literature.