Calidad de atención percibida y calidad de vida relacionada con la salud en pacientes participantes de estudios clínicos de la ips idearg sas.

La presente investigación surge en el programa de Bienestar y Calidad de Vida suscrito a la Línea de Liderazgo en la Escuela de Administración de la Universidad del Rosario, con el objetivo de describir si las subdimensiones de la calidad de la atención percibida guardan relación con la calidad de vida relacionada con la salud en los pacientes participantes en Estudios Clínicos en la Institución Prestadora de Servicios de Salud IDEARG SAS, considerando si los factores sociodemográficos se constituyen en mediadores de esta relación. Esta investigación plantea un estudio descriptivo correlacional, en el que a partir de la utilización de los cuestionarios PECASUSS, Percepción de la Calidad según Usuarios del Servicio de Salud, y SF36 de Calidad de Vida Relacionada con la Salud, se lleve a cabo un procesamiento estadístico descriptivo en el software SPSS 21, y con ello se evidencie la correlación entre la calidad de atención percibida y la calidad de vida en salud. Para su desarrollo se abordaran cinco capítulos. El primero engloba el proyecto de trabajo de grado propuesto, el segundo capítulo refiere a la descripción de las subdimensiones que componen la Calidad de la Atención Percibida y de los índices y dominios que a la Calidad de Vida relacionada con la Salud atañen; en el tercer capítulo se evidencia la relación entre los datos sociodemográficos de los participantes y, por un lado, la Calidad de la Atención Percibida y, por otro lado, la Calidad de Vida Relacionada con la Salud; enseguida en el cuarto capítulo se describen las relaciones emergentes entre los dominios de la calidad de vida relacionados con la salud y las subdimensiones de la calidad de la atención en salud percibida; en un quinto capítulo se discuten las correlaciones que describen la existencia de relación entre la Calidad de la Atención Percibida y la Calidad de Vida Relacionada con la Salud; y finalmente se da cierre al trabajo con las conclusiones y recomendaciones.

Realismo, ideologia e (re)construção da identidade docente através das representações imagéticas discentes na rede estadual de ensino da cidade de Jurema / PE

Esta pesquisa caracteriza-se como um estudo de caráter exploratório e tem como foco averiguar de que maneira o professor é significado na sociedade atual, analisando a importância da sua imagem através da representatividade social formulada e refletida no espaço escolar. Para tal evidência, partimos da afirmativa de que o bom professor, (professor ideal), tem relevância para a relação interpessoal no ambiente escolar, bem como, na vida escolar e intelectual do discente, culminando posteriormente em sua vida social e profissional. Com base nestes aspectos, decidiu-se fazer um estudo acerca deste temário. A coleta de dados realizou-se em uma escola pública estadual do Ensino Médio de Pernambuco/Brasil. A população alvo deste estudo refere-se a 112 alunos que totalizaram 03 salas de aulas de Ensino Médio dos períodos diurno e noturno da respectiva escola pública. O procedimento de coleta de dados foi composto por duas etapas: A primeira etapa da pesquisa consistiu na natureza exploratória com o objetivo de oferecer uma explicação geral sobre o temário através de delimitação do estudo e levantamento bibliográfico. A segunda etapa da pesquisa se constituiu pela aplicação de questionários, cujos resultados foram exportados para o software SPSS, haja vista de se tratar de dados quantitativos. Os aspectos investigados sobre o professor real e ideal se alicerçaram em torno das análises relacionadas às características pessoais e de personalidade, de relacionamento e das características profissionais que os professores possuem. Os dados levantados evidenciaram que na percepção dos alunos participantes da investigação, estes aspectos estão interligados, não sendo possível concebê-los de forma separada, pois juntos, contribuem para que o professor ―ideal seja responsável por encaminhamentos significativos que abarquem descobertas decisivas, momentos iluminadores, instigantes, hilários e ampliantes.

Life-cycle simulations of shallow frontal waves and the impact of deformation strain

The life-cycle of shallow frontal waves and the impact of deformation strain on their development is investigated using the idealised version of the Met Office non-hydrostatic Unified Model which includes the same physics and dynamics as the operational forecast model. Frontal wave development occurs in two stages; first, a deformation strain is applied to a front and a positive potential vorticity (PV) strip forms, generated by latent heat release in the frontal updraft; second, as the deformation strain is reduced the PV strip breaks up into individual anomalies. The circulations associated with the PV anomalies cause shallow frontal waves to form. The structure of the simulated frontal waves is consistent with the conceptual model of a frontal cyclone. Deeper frontal waves are simulated if the stability of the atmosphere is reduced. Deformation strain rates of different strengths are applied to the PV strip to determine whether a deformation strain threshold exists above which frontal wave development is suppressed. An objective method of frontal wave activity is defined and frontal wave development was found to be suppressed by deformation strain rates $\ge 0.4\times10^{-5}\mbox{s}^{-1}$. This value compares well with observed deformation strain rate thresholds and the analytical solution for the minimum deformation strain rate needed to suppress barotropic frontal wave development. The deformation strain rate threshold is dependent on the strength of the PV strip with strong PV strips able to overcome stronger deformation strain rates (leading to frontal wave development) than weaker PV strips.

Life and death in a civitas capital: metabolic disease and trauma in the children from late Roman Dorchester, Dorset

The impact that “Romanization” and the development of urban centers had on the health of the Romano-British population is little understood. A re-examination of the skeletal remains of 364 nonadults from the civitas capital at Roman Dorchester (Durnovaria) in Dorset was carried out to measure the health of the children living in this small urban area. The cemetery population was divided into two groups; the first buried their dead organized within an east–west alignment with possible Christian-style graves, and the second with more varied “pagan” graves, aligned north–south. A higher prevalence of malnutrition and trauma was evident in the children from Dorchester than in any other published Romano-British group, with levels similar to those seen in postmedieval industrial communities. Cribra orbitalia was present in 38.5% of the children, with rickets and/or scurvy at 11.2%. Twelve children displayed fractures of the ribs, with 50% of cases associated with rickets and/or scurvy, suggesting that rib fractures should be considered during the diagnosis of these conditions. The high prevalence of anemia, rickets, and scurvy in the Poundbury children, and especially the infants, indicates that this community may have adopted child-rearing practices that involved fasting the newborn, a poor quality weaning diet, and swaddling, leading to general malnutrition and inadequate exposure to sunlight. The Pagan group showed no evidence of scurvy or rib fractures, indicating difference in religious and child-rearing practices but that both burial groups were equally susceptible to rickets and anemia suggests a shared poor standard of living in this urban environment.

"Racism in a Melting Pot...?" Trinidadian mid-life transnational migrants' views on race and colour-class on return to their homes of descent

This paper deals with second-generation, one-and-a-half generation and ‘‘prolonged sojourner” Trinidadian transnational migrants, who have decided to ‘return’ to the birthplace of their parents. Based on 40 in-depth interviews, the paper considers both the positive and critical things that these youthful transnational migrants report about returning to, and living in, this multi-ethnic plural society and the salience of racial and colour-class stratification as part of their return migration experiences. Our qualitative analysis is based on the narratives provided by these youthful returnees, as relayed ‘‘in their own words”, presenting critical reflections on racism, racial identities and experiences as transnational Trinidadians. It is clear that it is contexts such as contemporary working environments, family and community that act as the reference points for the adaptation ‘‘back home” of this strongly middle-class cohort. We accordingly encounter a diverse, sometimes contesting set of racial issues that emerge as salient concerns for these returnees. The consensus is that matters racial remain as formidable legacies in the hierarchical stratification of Trinidadian society for a sizeable number. Many of our respondents reported the positive aspects of racial affirmation on return. But for another sub-set, the fact that multi-ethnic and multi-cultural mixing are proudly embraced in Trinidad meant that it was felt that return experiences were not overly hindered, or blighted by obstacles of race and colour-class. For these returnees, Trinidad and Tobago is seen as representing a 21st century ‘‘Melting Pot”. But for others the continued existence of racial divisions within society – between ethnic groups and among those of different skin shades – was lamented. In the views of these respondents, too much racial power is still ascribed to ‘near-whiteness’. But for the most part, the returnees felt that where race played a part in their new lives, this generally served to advantage them. However, although the situation in Trinidad appears to have been moderated by assumptions that it remains a racial ‘Melting Pot’, the analysis strongly suggests that the colour-class system of stratification is still playing an essential role, along with racial stereotyping in society at large.

Local adaptation in moss life histories: population-level variation and a reciprocal transplant experiment

We examine the extent of population-level differentiation in life history traits of Pogonatum aloides, Polytrichum commune and Polytrichum juniperinum (Polytrichaceae) between upland and lowland localities within Britain. Reciprocal transplant studies are used to estimate the relative importance of genetic versus environmental effects on observed differences. We demonstrate significant life history differentiation between moss populations, and show that at least some of these are genetically determined, although environment and phenotypic plasticity are also significant components of the observed variation. The transplant experiments indicate divergence among populations in plasticity of male reproductive effort and of investment in vegetative shoots by females. Two tradeoffs are identified; one between the number and the size of spores, and the second between reproduction by spores versus vegetative reproduction. The patterns of life history variation observed between populations of Polytrichum juniperinum are consistent with selection along these implied tradeoff curves, and we propose that they reflect selective pressures arising from the spatial and demographic distribution of mortality at upland versus lowland sites. The results underscore the need for more studies of intra-specific life history variation in mosses.

The influence of larval density, food availability and habitat longevity on the life history and population growth rate of the midge Chironomus riparius

Despite long-standing interest in the forms and mechanisms of density dependence, these are still imperfectly understood. However, in a constant environment an increase in density must reduce per capita resource availability, which in turn leads to reduced survival, fecundity and somatic growth rate. Here we report two population experiments examining the density dependent responses under controlled conditions of an important indicator species, Chironomus riparius. The first experiment was run for 35 weeks and was started at low density with replicate populations being fed three different rations. Increased ration reduced generation time and increased population growth rate (pgr) but had no effect on survival, fecundity and female body weight in the first generation. In the second generation there was a six-fold increase in generation time, presumably due to the greatly reduced per capita resource availability as the estimated initial densities of the second generation were 300 times greater than the first. Juvenile survival to emergence, fecundity, adult body weight and pgr declined by 90%, 75%, 35% and 99%, respectively. These large between-generation effects may have obscured the effects of the threefold variation in ration, as only survival to emergence significantly increased with ration in the second generation. These results suggest that some chironomid larvae survive a reduction in resource availability by growing more slowly. In the ephemeral habitats sometimes occupied by C. riparius, the effects of population density may depend crucially on the longevity of the environment. A second experiment was therefore performed to measure pgr from six different starting densities over an eight-week period. The relationship between pgr and density was concave, viewed from above. At densities above 16 larvae per cm(2), less than 1% of the population emerged and no offspring were produced. Under the conditions of experiment 2 - an 8-week habitat lifespan carrying capacity was estimated as 8 larvae per cm(2).

Vision 2020 - A whole life-cycle information management system for built environments

A whole life-cycle information management vision is proposed, the organizational requirements for the realization of the scenario is investigated. Preliminary interviews with construction professionals are reported. Discontinuities at information transfer throughout life-cycle of built environments are resulting from lack of coordination and multiple data collection/storage practices. A more coherent history of these activities can improve the work practices of various teams by augmenting decision making processes and creating organizational learning opportunities. Therefore, there is a need for unifying these fragmented bits of data to create a meaningful, semantically rich and standardized information repository for built environment. The proposed vision utilizes embedded technologies and distributed building information models. Two diverse construction project types (large one-off design, small repetitive design) are investigated for the applicability of the vision. A functional prototype software/hardware system for demonstrating the practical use of this vision is developed and discussed. Plans for case-studies for validating the proposed model at a large PFI hospital and housing association projects are discussed.

Case study on the whole life carbon cycle in buildings

Global temperatures are expected to rise by between 1.1 and 6.4oC this century, depending, to a large extent, on the amount of carbon we emit to the atmosphere from now onwards. This warming is expected to have very negative effects on many peoples and ecosystems and, therefore, minimising our carbon emissions is a priority. Buildings are estimated to be responsible for around 50% of carbon emissions in the UK. Potential reductions involve both operational emissions, produced during use, and embodied emissions, produced during manufacture of materials and components, and during construction, refurbishments and demolition. To date the major effort has focused on reducing the, apparently, larger operational element, which is more readily quantifiable and reduction measures are relatively straightforward to identify and implement. Various studies have compared the magnitude of embodied and operational emissions, but have shown considerable variation in the relative values. This illustrates the difficulties in quantifying embodied, as it requires a detailed knowledge of the processes involved in the different life cycle phases, and requires the use of consistent system boundaries. However, other studies have established the interaction between operational and embodied, which demonstrates the importance of considering both elements together in order to maximise potential reductions. This is borne out in statements from both the Intergovernmental Panel on Climate Change and The Low Carbon Construction Innovation and Growth Team of the UK Government. In terms of meeting the 2020 and 2050 timeframes for carbon reductions it appears to be equally, if not more, important to consider early embodied carbon reductions, rather than just future operational reductions. Future decarbonisation of energy supply and more efficient lighting and M&E equipment installed in future refits is likely to significantly reduce operational emissions, lending further weight to this argument. A method of discounting to evaluate the present value of future carbon emissions would allow more realistic comparisons to be made on the relative importance of the embodied and operational elements. This paper describes the results of case studies on carbon emissions over the whole lifecycle of three buildings in the UK, compares four available software packages for determining embodied carbon and suggests a method of carbon discounting to obtain present values for future emissions. These form the initial stages of a research project aimed at producing information on embodied carbon for different types of building, components and forms of construction, in a simplified form, which can be readily used by building designers in optimising building design in terms of minimising overall carbon emissions. Keywords: Embodied carbon; carbon emission; building; operational carbon.

Methodology To model the energy and greenhouse gas emissions of electronic software distributions

A new electronic software distribution (ESD) life cycle analysis (LCA)methodology and model structure were constructed to calculate energy consumption and greenhouse gas (GHG) emissions. In order to counteract the use of high level, top-down modeling efforts, and to increase result accuracy, a focus upon device details and data routes was taken. In order to compare ESD to a relevant physical distribution alternative,physical model boundaries and variables were described. The methodology was compiled from the analysis and operational data of a major online store which provides ESD and physical distribution options. The ESD method included the calculation of power consumption of data center server and networking devices. An in-depth method to calculate server efficiency and utilization was also included to account for virtualization and server efficiency features. Internet transfer power consumption was analyzed taking into account the number of data hops and networking devices used. The power consumed by online browsing and downloading was also factored into the model. The embedded CO2e of server and networking devices was proportioned to each ESD process. Three U.K.-based ESD scenarios were analyzed using the model which revealed potential CO2e savings of 83% when ESD was used over physical distribution. Results also highlighted the importance of server efficiency and utilization methods.

An integrated dynamic whole life costing analysis for air distribution systems

Air distribution systems are one of the major electrical energy consumers in air-conditioned commercial buildings which maintain comfortable indoor thermal environment and air quality by supplying specified amounts of treated air into different zones. The sizes of air distribution lines affect energy efficiency of the distribution systems. Equal friction and static regain are two well-known approaches for sizing the air distribution lines. Concerns to life cycle cost of the air distribution systems, T and IPS methods have been developed. Hitherto, all these methods are based on static design conditions. Therefore, dynamic performance of the system has not been yet addressed; whereas, the air distribution systems are mostly performed in dynamic rather than static conditions. Besides, none of the existing methods consider any aspects of thermal comfort and environmental impacts. This study attempts to investigate the existing methods for sizing of the air distribution systems and proposes a dynamic approach for size optimisation of the air distribution lines by taking into account optimisation criteria such as economic aspects, environmental impacts and technical performance. These criteria have been respectively addressed through whole life costing analysis, life cycle assessment and deviation from set-point temperature of different zones. Integration of these criteria into the TRNSYS software produces a novel dynamic optimisation approach for duct sizing. Due to the integration of different criteria into a well- known performance evaluation software, this approach could be easily adopted by designers in busy nature of design. Comparison of this integrated approach with the existing methods reveals that under the defined criteria, system performance is improved up to 15% compared to the existing methods. This approach is interpreted as a significant step forward reaching to the net zero emission building in future.

A conceptual life event framework for government-to-citizen electronic service provision

In recent years, life event approach has been widely used by governments all over the world for designing and providing web services to citizens through their e-government portals. Despite the wide usage of this approach, there is still a challenge of how to use this approach to design e-government portals in order to automatically provide personalised services to citizens. We propose a conceptual framework for e-government service provision based on life event approach and the use of citizen profile to capture the citizen needs, since the process of finding Web services from a government-to-citizen (G2C) system involves understanding the citizens’ needs and demands, selecting the relevant services, and delivering services that matches the requirements. The proposed framework that incorporates the citizen profile is based on three components that complement each other, namely, anticipatory life events, non-anticipatory life events and recurring services.

Effects of second language on cognition in English users of L2 Japanese

It is now established that certain cognitive processes such as categorisation are tightly linked to the concepts encoded in language. Recent studies have shown that bilinguals with languages that differ in their concepts may show a shift in their cognition towards the L2 pattern primarily as a function of their L2 proficiency. This research has so far focused predominantly on L2 users who started learning the L2 in childhood or early puberty. The current study asks whether similar effects can be found in adult L2 learners. English speakers of L2 Japanese were given an object classification task involving real physical objects, and an online classification task involving artificial novel objects. Results showed a shift towards the L2 pattern, indicating that some degree of cognitive plasticity exists even when a second language is acquired later in life. These results have implications for theories of L2 acquisition and bilingualism, and contribute towards our understanding of the nature of the relationship between language and cognition in the L2 user’s mind.

An overview of mixed-effects statistical models for second language researchers

As in any field of scientific inquiry, advancements in the field of second language acquisition (SLA) rely in part on the interpretation and generalizability of study findings using quantitative data analysis and inferential statistics. While statistical techniques such as ANOVA and t-tests are widely used in second language research, this review article provides a review of a class of newer statistical models that have not yet been widely adopted in the field, but have garnered interest in other fields of language research. The class of statistical models called mixed-effects models are introduced, and the potential benefits of these models for the second language researcher are discussed. A simple example of mixed-effects data analysis using the statistical software package R (R Development Core Team, 2011) is provided as an introduction to the use of these statistical techniques, and to exemplify how such analyses can be reported in research articles. It is concluded that mixed-effects models provide the second language researcher with a powerful tool for the analysis of a variety of types of second language acquisition data.

Prescription software for recovery and rehabilitation using Microsoft Kinect

Brain injuries, including stroke, can be debilitating incidents with potential for severe long term effects; many people stop making significant progress once leaving in-patient medical care and are unable to fully restore their quality of life when returning home. The aim of this collaborative project, between the Royal Berkshire NHS Foundation Trust and the University of Reading, is to provide a low cost portable system that supports a patient's condition and their recovery in hospital or at home. This is done by providing engaging applications with targeted gameplay that is individually tailored to the rehabilitation of the patient's symptoms. The applications are capable of real-time data capture and analysis in order to provide information to therapists on patient progress and to further improve the personalized care that an individual can receive.