982 resultados para community strategic engament


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This study aims to be a contribution to a theoretical model that explains the effectiveness of the learning and decision-making processes by means of a feedback and mental models perspective. With appropriate mental models, managers should be able to improve their capacity to deal with dynamically complex contexts, in order to achieve long-term success. We present a set of hypotheses about the influence of feedback information and systems thinking facilitation on mental models and management performance. We explore, under controlled conditions, the role of mental models in terms of structure and behaviour. A test based on a simulation experiment with a system dynamics model was performed. Three out of the four hypotheses were confirmed. Causal diagramming positively influences mental model structure similarity, mental model structure similarity positively influences mental model behaviour similarity, and mental model behaviour similarity positively influences the quality of the decision

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Seventy four asthmatic children aged 7 to 11 years were examined along with controls matched by age and sex. Clinical and laboratory investigations preceded a 28-day follow-up where data about morning and evening peak expiratory flow rate (PEF), symptoms and treatment were recorded. The coefficient of variation of PEF was found to be an objective measurement of asthma severity that has statistically significant correlation with both symptoms (r s= .36) and treatment (r s= .60). Moreover, it separates mild and severe asthmatics, as confirmed by statistically significant differences (p= .008 or less) in symptoms, treatment, skin allergy and airways response to exercise. Skin allergy and airways responsiveness to exercise were found to be predictors of both disease and severity. By means of logistic regression analysis it was possible to establish the probabilities for both asthma and severe asthma when children presenting and not presenting these characteristics are compared. One single positive skin test represent a probability of 88% for the development of asthma and a probability of 70% for severe disease. A PEF reduction of 10% after an exercise test implies a probability of 73% for disease and a probability of 64% for severe disease. Increases in these variables imply geometrically increased risks and their presence together have a multiplicative effect in the final risk.

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Nowadays, the Portuguese insurance industry operates in a market with a much more aggressive structure than a few decades ago. Markets and the economy have become globalised since the last decade of the 20th century. Market forces have gradually shifted – power is now mainly on the demand side. In order to meet the new requirements, the insurance industry must develop a strong strategic ability to respond to constant changes of the new international economic order.One of the basic aspects of this strategic development will focus on the ability to predict the future. We introduce the subject by briefly describing the sector, its organisational structure in the Portuguese market, and challenges arising from the development of the European Union. We then analyse the economic and financial structure of the sector. From this point of view, we aim at the possibility of designing models that could explain the demand for insurance, claims and technical reserves evolution. Such models, (even if based on the past), would resolve, at least partly, one of the greatest difficulties experienced by insurance companies when estimating the budget. Thus, we examine the existence of variables that explain the previous points, which are capable of forming a basis for designing models that are simple but efficient, and can be used for strategic planning.

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A cohort study on acute respiratory infections, involving 270 children observed by pediatricians in their homes every 10 days over a period of 32 months, gave the opportunity to experience logistic and methodological problems seldom described in the literature. The purpose of this article is to alert researchers as to the difficulties faced when performing community-based studies in developing countries. Although a carefully planned project was undertaken, problem areas included the establishment of the target population, population dynamics, field related problems, laboratory aspects and data management. It is hoped that other investigators may benefit from the extensive experience gained from our program in foreseeing and coping with the difficulties involved.

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Since the number and proportion of old people increases worldwide, health professionals and systems should be made aware and prepared to deal with their problems. Cognitive deficit and symptoms of depression are commom among the elderly, and may occur in relation to various risk factors such as health conditions and psychosocial variables. In order to study cognitive deficit and the presence of signs and symptoms of depression, 62 elderly community subjects enrolled at a Community Health Unit in Porto Alegre, southern Brazil, were interviewed. They were evaluated by means of the Mini Mental State Exam, the Montgomery-Asberg Depression rating scale, and a questionnaire on health conditions, living arrangements and social variables. Higher levels of symptoms of depression were observed among subjects exposed to major risk factors for cerebrovascular diseases (diabetes and coronary disease), while impaired cognitive performance was seen among individuals who could not count on the presence of a confidant (social network variable). The results suggest that the early identification of major risk groups among old people can help to prevent institutionalization and keep individuals in the community.

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Some specific characteristics of the aging of the Brazilian population in different areas, states and communities all over the country, have shown significant variations. Historical series of demographic and health indicators for the population in their sixties and over in Brazil, state of S. Paulo and in the municipal district of Araraquara are listed as follows: level of education and urban population growth rate, income distribution, mortality rates and main causes of death. In 1991 the aged constituled were 7,8% of the Brazilian population and 9,7% in Araraquara community. The elderly population (of 70 years of aged and above) as a proportion of the whole, has increased and already stands for 40%. The same trend holds good for both the proportion of aged within the urban population and their level of education wich increased to 90% in 1991. The main causes of death are chronic degenerative diseases which have replaced the infectious illness: firts, the diseases of the circulatory sistem (which account for more than 40% of all deaths) and the neoplasms (which let to 15% of the deaths). On the basis of these health and demographic data relating to people of 60 years of age and over, this study suggests some procedures for the improvement of the quality of the assistance given to the target population: a) the assistance give to the aged should be improved by providing gerontological training for general physicians and nurses, both of public and private clinics; b) the already exixting educational activities for the aged, for health workers and for teachers of secundary education should be further developed; c) the number of day-hospitals should be increased for the purpose of avoiding unnecessary confinement so as maintain the low rate of institutionalization in homes for the elderly (0,7% in Araraquara). It is reported that at least 35% of the aged population in this area is entitled to private health assistance, wich brings out the importance of including such services in the local health programs for this group.

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Nowadays, the cooperative intelligent transport systems are part of a largest system. Transportations are modal operations integrated in logistics and, logistics is the main process of the supply chain management. The supply chain strategic management as a simultaneous local and global value chain is a collaborative/cooperative organization of stakeholders, many times in co-opetition, to perform a service to the customers respecting the time, place, price and quality levels. The transportation, like other logistics operations must add value, which is achieved in this case through compression lead times and order fulfillments. The complex supplier's network and the distribution channels must be efficient and the integral visibility (monitoring and tracing) of supply chain is a significant source of competitive advantage. Nowadays, the competition is not discussed between companies but among supply chains. This paper aims to evidence the current and emerging manufacturing and logistics system challenges as a new field of opportunities for the automation and control systems research community. Furthermore, the paper forecasts the use of radio frequency identification (RFID) technologies integrated into an information and communication technologies (ICT) framework based on distributed artificial intelligence (DAI) supported by a multi-agent system (MAS), as the most value advantage of supply chain management (SCM) in a cooperative intelligent logistics systems. Logistical platforms (production or distribution) as nodes of added value of supplying and distribution networks are proposed as critical points of the visibility of the inventory, where these technological needs are more evident.

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INTRODUCTION: Morbidity information is easily available from medical records but its scope is limited to the population attended by the health services. Information on the prevalence of diseases requires community surveys, which are not always feasible. These two sources of information represent two alternative assessments of disease occurrence, namely demand morbidity and perceived morbidity. The present study was conceived so as to elicit a potential relationship between them so that the former could be used in the absence of the latter. METHODS: A community of 13,365 families on the outskirts of S. Paulo, Brazil, was studied during the period from 15/Nov/1994 to 15/Jan/1995. Data regarding children less than 5 years old were collected from a household survey and from the 2 basic health units in the area. Prevalence of diseases was ascertained from perceived morbidity and compared to estimates computed from demand morbidity. RESULTS: Data analysis distinguished 2 age groups, infants less than 1 year old and children 1 to less than 5. The most important groups of diseases were respiratory diseases, diarrhoea, skin problems and infectious & parasitical diseases. Basic health units presented a better coverage for infants. Though disease frequencies were not different within or outside these units, a better coverage was found for diarrhoea and infectious & parasitical diseases in the infant group, and for diarrhoea in the older age group. Equivalence between the two types of morbidity was found to be limited to the infant group and concerned only the best covered diseases. The odds of a disease being seen at the health service should be of at least 4:10 to ensure this equivalence. CONCLUSION: It was concluded that, provided that health service coverage is good, demand morbidity can be taken as a reliable estimate of community morbidity.

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INTRODUCTION: Population aging in Brazil has increased the prevalence of neurodegenerative diseases (Parkinson's and Alzheimer's disease) and affective disorders (anxiety, depression), all common in old age. A retrospective study was carried out with the purpose of ascertaining if there is an association between falls and psychoactive medication use among older residents of a community in Brazil. METHODS: All residents aged 65+ (n=161) of one neighborhood of Campo Belo, Brazil (population of 48,000) were evaluated regarding the use of psychoactive drugs and the occurrence of falls in the 12 months preceding the study. Vision and hearing screenings were also performed. RESULTS: From the study population, 9.3% were taking prolonged half-life benzodiazepines, 4.4% anticonvulsants (mostly barbiturates), 2.5% antidepressants (all cyclics) and 8.1% alpha-methyldopa. No subject reported use of hypnotics, neuroleptics or drugs to treat Alzheimer's or Parkinson's diseases (except biperiden). As a whole, drugs that increase the risk of falls were used by 1/5 of this population. In the 12-month period preceding the study, 27 residents (16.8%) experienced falls and, of those, 4 (14.8%) had fracture(s). There was an independent association between psychoactive drug use and falls when variables such as age, gender, vision and hearing were controlled (p=0.02). CONCLUSIONS: Although the population of this neighborhood must be considered young (only 4% are 65 years old or more), there are already problems related to the use of psychoactive drugs among people. Prescribed anxiolytics, anticonvulsants, antidepressants and antihypertensives are not appropriate for this age group and their use is associated with falls.

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INTRODUCTION: After the era of rubella vaccine, cytomegalovirus (CMV) infection is one of the most frequently causes of mental retardation and congenital deafness. Seroepidemiological studies are necessary to understand the transmission dynamics of the disease. The purpose of the study was to quantify the transmission rate of CMV disease in a community in the state of São Paulo, Brazil. METHODS: Using ELISA test (IgG), a retrospective serological survey looking for CMV antibodies was performed in an non-immunized community. Frozen sera from 443 individuals, randomly selected by cluster sampling technique in the town of Caieiras, São Paulo, were collected from November 1990 to January 1991. Seroprevalence was stratified by age (0-40 years). Mathematical techniques were applied to determine the age-dependent decay function of maternal antibodies during the first year of life, the age-dependent seroprevalence function and the force of infection for CMV in this community. RESULTS: It was observed a descending phase of seropositivity in the first 9 months, but changes in antibody titration were observed between 8 months old and one year of age. The average age of the first infection was 5.02 months of age and 19.84 years, when the age-dependent seroprevalence and the force of infection were analyzed between 10 months of age and 10 years of age and from 10 to 40 years old, respectively. CONCLUSION: CMV infection is highly prevalent among the population studied and infection occurs in the first year of life. This study shows that most women at reproductive age are vulnerable to the first infection, increasing the risk for congenital infection.

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Metalearning is a subfield of machine learning with special pro-pensity for dynamic and complex environments, from which it is difficult to extract predictable knowledge. The field of study of this work is the electricity market, which due to the restructuring that recently took place, became an especially complex and unpredictable environment, involving a large number of different entities, playing in a dynamic scene to obtain the best advantages and profits. This paper presents the development of a metalearner, applied to the decision support of electricity markets’ negotia-tion entities. The proposed metalearner takes advantage on several learning algorithms implemented in ALBidS, an adaptive learning system that pro-vides decision support to electricity markets’ participating players. Using the outputs of each different strategy as inputs, the metalearner creates its own output, considering each strategy with a different weight, depending on its individual quality of performance. The results of the proposed meth-od are studied and analyzed using MASCEM - a multi-agent electricity market simulator that models market players and simulates their operation in the market. This simulator provides the chance to test the metalearner in scenarios based on real electricity market´s data.

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Electricity markets are complex environments, involving numerous entities trying to obtain the best advantages and profits while limited by power-network characteristics and constraints.1 The restructuring and consequent deregulation of electricity markets introduced a new economic dimension to the power industry. Some observers have criticized the restructuring process, however, because it has failed to improve market efficiency and has complicated the assurance of reliability and fairness of operations. To study and understand this type of market, we developed the Multiagent Simulator of Competitive Electricity Markets (MASCEM) platform based on multiagent simulation. The MASCEM multiagent model includes players with strategies for bid definition, acting in forward, day-ahead, and balancing markets and considering both simple and complex bids. Our goal with MASCEM was to simulate as many market models and player types as possible. This approach makes MASCEM both a short- and mediumterm simulation as well as a tool to support long-term decisions, such as those taken by regulators. This article proposes a new methodology integrated in MASCEM for bid definition in electricity markets. This methodology uses reinforcement learning algorithms to let players perceive changes in the environment, thus helping them react to the dynamic environment and adapt their bids accordingly.

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The very particular characteristics of electricity markets, require deep studies of the interactions between the involved players. MASCEM is a market simulator developed to allow studying electricity market negotiations. This paper presents a new proposal for the definition of MASCEM players’ strategies to negotiate in the market. The proposed methodology is implemented as a multiagent system, using reinforcement learning algorithms to provide players with the capabilities to perceive the changes in the environment, while adapting their bids formulation according to their needs, using a set of different techniques that are at their disposal. This paper also presents a methodology to define players’ models based on the historic of their past actions, interpreting how their choices are affected by past experience, and competition.

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Whilst their 'death' has often been certified, books remain highly important to most professions and academic disciplines. Analyses of citations received by epidemiologic texts may complement other views on epidemiology. The objective was to assess the number of citations received by some books of epidemiology and public health, as a first step towards studying the influence of epidemiological thought and thinking in academia. For this purpose, Institute for Scientific Information/ Thomson Scientific - Web of Science/ Web of Knowledgedatabase was consulted, in May 2006. The book by Rothman & Greenland appeared to have received the highest number of citations overall (over 8,000) and per year. The books by Kleinbaum et al, and by Breslow & Day received around 5,000 citations. In terms of citations per year the book by Sackett et al ranks 3rd, and the one by Rose, 4th of those included in this preliminary study. Other books which were influential in the classrooms collected comparatively less citations. Results offer a rich picture of the academic influences and trends of epidemiologic methods and reasoning on public health, clinical medicine and the other health, life and social sciences. They may contribute to assess epidemiologists' efforts to demarcate epidemiology and to assert epistemic authority, and to analyze some historical influences of economic, social and political forces on epidemiological research.

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Studies on the feeding habits of aquatic organisms are a requirement for the management and sustainable use of marine ecosystems. The aim of the present research was to analyze the habits and trophic similarities of decapods, starfish and fish in order to propose trophic relationships between taxa, using Hennigian methods of phylogenetic systematics. This new grouping hypothesis, based on shared and exclusive food items and food types, corresponds to the broad taxonomic groups used in the analysis. Our results indicate that algae, Mollusca, Polychaeta, Crustacea, Echinodermata and Actinopterygii are the most exploited common resources among the species studied. Starfish were differentiated from other organisms for being stenophagic, and were grouped for feeding on bivalve mollusks. A larger group of fish and crustaceans shares algae and mainly crustaceans as food items. A third group united all eight species of Actinopterygii. This largest subgroup of fish is typically carnivorous, feeding on Anthozoa and a great quantity of Crustacea. Synodus foetens has a special position among fishes, due to its unique feeding on nematodes. A Euclidean distance dendrogram obtained in a previous publication grouped S. foetens with starfish. That result was based on a few non-exclusive shared similarities in feeding modes, as well as on shared absences of items, which are not an adequate grouping factor. Starfish are stenophagic, eating bivalves almost exclusively. Synodus foetens and Isopisthus parvipinnis have restricted food items, and are thus intermediary in relation to starfish, decapods, and other fish, which are euryphagous. The trophic cladogram displays details of food items, whether or not shared by all species. The resulting trophic analysis is consistent with known historical relationships.