The effect of altering a single component of a rehabilitation programme on the functional recovery of stroke patients: a systematic review and meta-analysis

OBJECTIVE: To evaluate the effect of altering a single component of a rehabilitation programme (e.g. adding bilateral practice alone) on functional recovery after stroke, defined using a measure of activity.

DATA SOURCES: A search was conducted of Medline/Pubmed, CINAHL and Web of Science.

REVIEW METHODS: Two reviewers independently assessed eligibility. Randomized controlled trials were included if all participants received the same base intervention, and the experimental group experienced alteration of a single component of the training programme. This could be manipulation of an intrinsic component of training (e.g. intensity) or the addition of a discretionary component (e.g. augmented feedback). One reviewer extracted the data and another independently checked a subsample (20%). Quality was appraised according to the PEDro scale.

RESULTS: Thirty-six studies (n = 1724 participants) were included. These evaluated nine training components: mechanical degrees of freedom, intensity of practice, load, practice schedule, augmented feedback, bilateral movements, constraint of the unimpaired limb, mental practice and mirrored-visual feedback. Manipulation of the mechanical degrees of freedom of the trunk during reaching and the addition of mental practice during upper limb training were the only single components found to independently enhance recovery of function after stroke.

CONCLUSION: This review provides limited evidence to support the supposition that altering a single component of a rehabilitation programme realises greater functional recovery for stroke survivors. Further investigations are required to determine the most effective single components of rehabilitation programmes, and the combinations that may enhance functional recovery.

Dimensioning of multilayer optical networks

Este trabalho apresenta um estudo sobre o dimensionamento de redes ópticas, com vistas a obter um modelo de dimensionamento para redes de transporte sobreviventes. No estudo utilizou-se uma abordagem estatística em detrimento à determinística. Inicialmente, apresentam-se as principais tecnologias e diferentes arquitecturas utilizadas nas redes ópticas de transporte. Bem como os principais esquemas de sobrevivência e modos de transporte. São identificadas variáveis necessárias e apresenta-se um modelo dimensionamento para redes de transporte, tendo-se dado ênfase às redes com topologia em malha e considerando os modos de transporte opaco, transparente e translúcido. É feita uma análise rigorosa das características das topologias de redes de transporte reais, e desenvolve-se um gerador de topologias de redes de transporte, para testar a validade dos modelos desenvolvidos. Também é implementado um algoritmo genético para a obtenção de uma topologia optimizada para um dado tráfego. São propostas expressões para o cálculo de variáveis não determinísticas, nomeadamente, para o número médio de saltos de um pedido, coeficiente de protecção e coeficiente de restauro. Para as duas últimas, também é analisado o impacto do modelo de tráfego. Verifica-se que os resultados obtidos pelas expressões propostas são similares às obtidas por cálculo numérico, e que o modelo de tráfego não influencia significativamente os valores obtidos para os coeficientes. Finalmente, é demonstrado que o modelo proposto é útil para o dimensionamento e cálculo dos custos de capital de redes com informação incompleta.

Kostenanalyse zur Digitalisierung von Herbarbelegen im Botanischen Garten/ Botanischen Museum in Berlin-Dahlem

Die vorliegende Arbeit ermittelt die Ist-Kosten für den Prozess der Herbarbeleg Digitalisierung im Botanischen Garten/ Botanischen Museum in Berlin-Dahlem. Dabei werden die Kosten durch drei verschiedene Vorgehensweisen aufgezeigt. Die erste Vorgehensweise ermittelt die Kosten für die Digitalisierung anhand der Gesamtaufwendungen im Botanischen Garten/ Botanischen Museum. In dieser Betrachtung werden die Kosten abgegrenzt, die nur der Digitalisierung zuzuordnen sind. Eine weitere Methode erfasst alle Einzelkosten die für die Digitalisierung von Herbarbelegen anfallen und stellt abschließend die Gesamtkosten für die Digitalisierung dar. Als weitere Vorgehensweise zur Kostenbestimmung wurde eine Projektbetrachtung gewählt. In dieser sind die Digitalisierungskosten anhand eines durchgeführten Projektes im Botanischen Garten/ Botanischen Museum veranschaulicht.

Executive budget, state of South Carolina Fiscal Year 2016-17

Each year the Office of the Governor presents an Executive Budget to the General Assembly, consisting of a "complete and itemized plan of all proposed expenditures for each state department, bureau, division, officer, board, commission, institution, or other agency or undertaking."

Protection to farmers : speech of Hon. D. Wyatt Aiken, of South Carolina, in the House of Representatives, Tuesday, March 6, 1882, upon the Agricultural Appropriation Bill

This speech is about the Agricultural Appropriation Bill, which is a bill making appropriations for the Agricultural Department of the Government for the fiscal year ending in June 30,1883. Mr. Aiken is approved by the chairman to speak and he goes on to explain that he agrees with the majority of the bill with the exception of two or three clauses. He gives the reasoning behind his objections in the rest of the speech.

Annual message of his excellency Robert K. Scott, Governor of South Carolina, to the General Assembly, at the regular session, commencing November 28, 1871

This speech was delivered to by the Governor to give the general assembly information of the condition of the state and give them recommendations to consider measures that the Governor deems necessary or expedient. He provides the information regarding the state debt, taxes, and bonded debt. He describes the financial agent of the state as well as the expenditures of the state government.

Wildfire susceptibility modelling in mainland Portugal

Tese de doutoramento, Geografia (Geografia Física), Universidade de Lisboa, Instituto de Geografia e Ordenamento do Território, 2015

Does Cost-Effectiveness Analysis Have a Role in US Managed Care Drug Formularies? An Empirical Study of Utilization, Costs, Outcomes, and Elasticity of Demand of a Value-Based Formulary

Thesis (Ph.D.)--University of Washington, 2015

Chancen und herausforderungen der rückversicherung in der gesetzlichen krankenversicherung (Chances and challenges of reinsurance in the social health scheme)

In 2009 a so-called morbidity orientated risk structure equalization scheme was installed for the German statutory health insurance in order to minimize structural differences between different providers with respect to revenue and expenditures. Even with this mechanism some risks to the individual health insurance providers remain. Reinsurance could be a way to mitigate these risks, but so far only very few contracts have been signed. Moreover the existing reinsurance contracts only focus on the periphery of the statutory health insurance system such as travel health insurance. In this article we therefore analyse existing risks for individual health insurance providers and evaluate their (re-)insurability. Hereafter the potential for reinsurance solutions in the German statutory health insurance itself as well as in newer forms of healthcare provision (e.g. integrated health care and managed care) is discussed. We find that reinsurance may be a reasonable solution for many of the risks in the statutory health insurance scheme. But as research in this area is very young further analysis of the nature of risks is necessary.

Macroeconomic information, structural change, and the prediction of fiscal aggregates

Previous research on the prediction of fiscal aggregates has shown evidence that simple autoregressive models often provide better forecasts of fiscal variables than multivariate specifications. We argue that the multivariate models considered by previous studies are small-scale, probably burdened by overparameterization, and not robust to structural changes. Bayesian Vector Autoregressions (BVARs), on the other hand, allow the information contained in a large data set to be summarized efficiently, and can also allow for time variation in both the coefficients and the volatilities. In this paper we explore the performance of BVARs with constant and drifting coefficients for forecasting key fiscal variables such as government revenues, expenditures, and interest payments on the outstanding debt. We focus on both point and density forecasting, as assessments of a country’s fiscal stability and overall credit risk should typically be based on the specification of a whole probability distribution for the future state of the economy. Using data from the US and the largest European countries, we show that both the adoption of a large system and the introduction of time variation help in forecasting, with the former playing a relatively more important role in point forecasting, and the latter being more important for density forecasting.

Responsabilidade ambiental: análise das divulgações ambientais das empresas do PSI-20 comparativamente com empresas não cotadas

Orientador: Mestre, António Pinto Marques

Introdução e difusão de novas tecnologias : impacto do financiamento e do estatuto jurídico hospitalar

RESUMO - Os gastos com a saúde, em Portugal, como nos países da União Europeia e da OCDE, têm crescido a um ritmo superior ao do crescimento económico, assumindo uma importância crescente face ao PIB. Entre estes factores surge a velocidade da introdução da inovação e dos desenvolvimentos tecnológicos dos domínios do diagnóstico e da terapêutica. Uma das mais difíceis e importantes questões para as políticas de saúde é a relação entre a saúde e os gastos com a prestação de cuidados de saúde. Estudos recentes sugerem que os cuidados de saúde ocupam um papel importante na melhoria da saúde da população, e que os recentes avanços tecnológicos são custo-efectivos aceites na generalidade por cada ano de vida ganho. Este trabalho visa estudar a influência que o financiamento e o estatuto jurídico hospitalar têm na introdução e adopção de novas tecnologias em saúde. Para isso, além da revisão bibliográfica, foi realizada uma análise a uma base de dados, cujos elementos se cingem a pacientes com doenças cardiovasculares atendidos num dos hospitais do Serviço Nacional de Saúde, entre 2000 e 2006. --- ------------------------------------ABSTRACT - Health expenditures in Portugal, as in EU countries and in the OECD, have developed at a higher rate than economic growth, assuming an increasing importance to the GDP. Among these factors appears the speed of the introduction of innovation and technological development in diagnosis and therapy areas. One of the most difficult and most important questions for health policy is the relationship of health to health care spending. Studies now suggest that medical care has played an important role in improving the health of the population, and recent technical advances are cost-effective at generally accepted values of an added year of life. This work aims to study the influence that the prospective payment and the hospital’s legal status have in introduction and adoption of new technologies in health. For this, besides the literature review, an analysis was made to a database, whose elements are confined to patients with cardiovascular disease treated in the hospitals of t

Conceção e implementação do método das secções homogéneas numa empresa industrial de metalomecânica

Trabalho de projeto apresentado ao Instituto Superior de Contabilidade e Administração do Porto para a obtenção do grau de Mestre em Contabilidade e Finanças, sob a orientação do Mestre Paulino Manuel Leite da Silva

Eficiência energética na iluminação pública

O presente trabalho aborda a temática da eficiência energética em sistemas de iluminação pública. A principal motivação prende-se com o peso significativo que a parcela energética destes sistemas ocupa na economia mundial. O uso eficiente de energia é uma crescente preocupação devido à diminuição de recursos, às consequências climáticas cada vez mais marcadas e ao elevado custo da energia, representando ainda um papel fundamental ao nível económico e de competitividade. A Iluminação Pública (IP) representa um peso importante nas despesas correntes dos municípios. É assim importante encontrar uma solução que permita manter níveis de segurança e conforto necessários às populações e que proporcione uma redução substancial do peso da IP nas despesas municipais. Neste sentido, este trabalho propõe-se estudar esta problemática, apresentando uma sistematização de soluções eficientes, quer a nível de lâmpadas e luminárias como também ao nível de tecnologias que auxiliem e complementem a eficiência de uma instalação de iluminação pública. A dissertação está dividida em duas partes. A primeira parte sistematiza os consumos verificados em Portugal, a vários níveis (consumo de energia elétrica, evolução do consumo energético de iluminação pública, etc.) abordando as políticas de eficiência energética, e são descritos alguns procedimentos que possibilitam a poupança energética na iluminação pública, aliada a instalações eficientes. A segunda parte da dissertação contempla o estudo de um caso prático cujo objetivo é propor soluções técnicas que permitam melhorar a eficiência energética na iluminação pública de Esposende, face à situação atual do concelho. Serão propostas várias soluções, tais como luminárias LED, balastros electrónicos reguláveis, lâmpadas de menor consumo e até mesmo o uso da telegestão.

Accounting accruals and information asymmetry in Europe

We investigate whether the positive relation between accounting accruals and information asymmetry documented for U.S. stock markets also holds for European markets, considered as a whole and at the country level. This research is relevant because this relation is likely to be affected by differences in accounting standards used by companies for financial reporting, in the traditional use of the banking system or capital markets for firm financing, in legal systems and cultural environment. We find that in European stock markets discretionary accruals are positively related with the Corwin and Schultz high-low spread estimator used as a proxy for information asymmetry. Our results suggest that the earnings management component of accruals outweighs the informational component, but the significance of the relation varies across countries. Further, such association tends to be stronger for firms with the highest levels of positive discretionary accruals. Consistent with the evidence provided by the authors, our results also suggest that the high-low spread estimator is more efficient than the closing bid-ask spread when analysing the impact of information quality on information asymmetry.