933 resultados para needs assessment
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Purpose. To identify stroke survivors with symptoms of poststroke depression and the extent of psychiatry needs and care they have received while on physiotherapy rehabilitation. Participants. Fifty stroke survivors (22 females and 28 males) at the outpatient unit of Physiotherapy Department, University of Nigeria Teaching Hospital, Enugu, who gave their informed consent, were randomly selected. Their age range and mean age were 26–66 years and 54.76 ± 8.79 years, respectively. Method. A multiple case study of 50 stroke survivors for symptoms of poststroke depression was done with Beck’s Depression Inventory, mini mental status examination tool, and Modified Motor Assessment Scale. The tests were performed independently by the participants except otherwise stated and scored on a scale of 0–6. Data were analyzed using -test for proportional significance and chi-square test for determining relationship between variables, at p < 0.05. Results. Twenty-one (42.0%) stroke survivors had symptoms of PSD, which was significantly dependent on duration of stroke ( = 21.680, df = 6, and p = 0.001), yet none of the participants had a psychiatry review. Conclusions. Symptoms of PSD may be common in cold compared to new cases of stroke and may need psychiatry care while on physiotherapy rehabilitation.
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5th International Conference on Education and New Learning Technologies (Barcelona, Spain. 1-3 July, 2013)
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Planners require solutions that address routine work needs and seems essential to improving efficiency and productivity. There are a great number of different factors related to beekeeper activity as well the quality and productivity of different bee products. The spatial analysis is a powerful tool for overlap and relates various levels of information on a map, and consequently a very useful for beekeeping activity planning. This work proposes and applies a methodology to potential beekeeping assessment in Montesinho Natural Park, a region in the northwest of Portugal. The beekeeping potential maps were developed with the following data sources: legal standards, vegetation, land use, topography, water resources, roads, electromagnetic fields, and some honey physico-chemical analysis. The design and implementation of spatial analysis model based on Geographic Information System (GIS) to beekeeping planning activities has already been described by Anjos et al (2014). Spatial analysis techniques allows to define the potential beekeeper map supporting the beekeeper management in this region. Anjos O, Silva G, Roque N, Fernandez P, 2014. GIS based analysis to support the beekeeping planning. Book of abstracts of the International Symposium on Bee Products 3rd edition – Annual meeting of the International Honey Commission (IHC), Faculty of medicine, University of Rijeka, p:61
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Critical infrastructures are based on complex systems that provide vital services to the nation. The complexities of the interconnected networks, each managed by individual organisations, if not properly secured, could offer vulnerabilities that threaten other organisations’ systems that depend on their services. This thesis argues that the awareness of interdependencies among critical sectors needs to be increased. Managing and securing critical infrastructure is not isolated responsibility of a government or an individual organisation. There is a need for a strong collaboration among critical service providers of public and private organisations in protecting critical information infrastructure. Cyber exercises have been incorporated in national cyber security strategies as part of critical information infrastructure protection. However, organising a cyber exercise involved multi sectors is challenging due to the diversity of participants’ background, working environments and incidents response policies. How well the lessons learned from the cyber exercise and how it can be transferred to the participating organisations is still a looming question. In order to understand the implications of cyber exercises on what participants have learnt and how it benefits participants’ organisation, a Cyber Exercise Post Assessment (CEPA) framework was proposed in this research. The CEPA framework consists of two parts. The first part aims to investigate the lessons learnt by participants from a cyber exercise using the four levels of the Kirkpatrick Training Model to identify their perceptions on reaction, learning, behaviour and results of the exercise. The second part investigates the Organisation Cyber Resilience (OCR) of participating sectors. The framework was used to study the impact of the cyber exercise called X Maya in Malaysia. Data collected through interviews with X Maya 5 participants were coded and categorised based on four levels according to the Kirkpatrick Training Model, while online surveys distributed to ten Critical National Information Infrastructure (CNII) sectors participated in the exercise. The survey used the C-Suite Executive Checklist developed by World Economic Forum in 2012. To ensure the suitability of the tool used to investigate the OCR, a reliability test conducted on the survey items showed high internal consistency results. Finally, individual OCR scores were used to develop the OCR Maturity Model to provide the organisation cyber resilience perspectives of the ten CNII sectors.
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Tutkimuksen kohteena oleva yritys avasi innovaatiokeskuksen 2015 vuoden loppupuolella. Tutkimuksen tavoite on tutkia keinoja löytää asiakastarpeita innovaatiokeskuksessa sekä selvittää, kuinka asiakastarpeet sisällytetään innovaatio- ja tuotekehitysstrategiaan. Kattava prosessi asiakastarvekartoituksesta esitellään ja prosessi säädetään yritykselle sopivaksi asiakkaille tehdyn kyselyn tulosten mukaan. Lisäksi yrityksen tuotepäälliköille järjestettiin haastattelu, jotta heidän näkemyksiään asiakastarvekartoituksen kehittämisestä ja tarpeiden lisäämisestä strategiaan päästiin myös hyödyntämään. Asiakastarpeiden kartoittamiseen soveltuvaksi menetelmäksi löydettiin ryhmätyömalliin perustuva menetelmä, jossa tarpeita kerätään innovaatiokeskuksessa. Lisäksi tietokoneita hyödyntävä GDSS-kokous auttaa välttämään useita yleisiä kokousten ongelmia. Tutkimuksen mukaan asiakastarpeiden suuret kehityslinjat ja kaikista tärkeimmät tarpeet voidaan lisätä strategiaan hyödyntämällä innovaatiokenttiä, skenaarioita ja roadmappeja sekä asiakastarvetaulukkoja.
Assessment of laboratory test utilization for HIV/AIDS care in urban ART clinics of Lilongwe, Malawi
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Background The 2011 Malawi HIV guidelines promote CD4 monitoring for pre-ART assessment and considering HIVRNA monitoring for ART response assessment, while some clinics used CD4 for both. We assessed clinical ordering practices as compared to guidelines, and determined whether the samples were successfully and promptly processed. Methods We conducted a retrospective review of all patients seen in from August 2010 through July 2011,, in two urban HIV-care clinics that utilized 6-monthly CD4 monitoring regardless of ART status. We calculated the percentage of patients on whom clinicians ordered CD4 or HIVRNA analysis. For all samples sent, we determined rates of successful labprocessing, and mean time to returned results. Results Of 20581 patients seen, 8029 (39%) had at least one blood draw for CD4 count. Among pre-ART patients, 2668/2844 (93.8%) had CD4 counts performed for eligibility. Of all CD4 samples sent, 8082/9207 (89%) samples were successfully processed. Of those, mean time to processing was 1.6 days (s.d 1.5) but mean time to results being available to clinician was 9.3 days (s.d. 3.7). Regarding HIVRNA, 172 patients of 17737 on ART had a blood draw and only 118/213 (55%) samples were successfully processed. Mean processing time was 39.5 days (s.d. 21.7); mean time to results being available to clinician was 43.1 days (s.d. 25.1). During the one-year evaluated, there were multiple lapses in processing HIVRNA samples for up to 2 months. Conclusions Clinicians underutilize CD4 and HIVRNA as monitoring tools in HIV care. Laboratory processing failures and turnaround times are unacceptably high for viral load analysis. Alternative strategies need to be considered in order to meet laboratory monitoring needs.
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Dissertação de Mestrado Integrado em Medicina Veterinária
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Building's construction activities, operation and demolition are increasingly recognised as a major source of environmental impact. One strategy for reducing such impacts is most widely known by the term Building Environmental Assessment (BEA). The research is an attempt to develop a new BEA scheme for residential buildings in Brunei which focussing on identifying BEA indicators that best suit for Brunei environment, social and economy. Studies show that Brunei residential sector needs urgent attention to transform its current consumption rate in more sustainable way. Recent launch of Brunei Green Building Council, mandatory energy efficiency guidelines and declaration of ambitious energy intensity reduction target, a new BEA scheme will help contribute sustainability target in residential sector. However the issues of developing a new BEA schemes using existing methods may face constraints in their effectiveness. In this regard, a consensus-forming technique-Delphi method-helps improve greater communication and gain consensus from experts in the construction industry through series of questionnaires. As a result, the final framework is produced comprises of 7 key categories and 37 applicable criteria that achieved high degree of consensus and importance.
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This is a set of resources aimed at promoting the development of the skills required to successfully identify and generate organic mechanisms in order to demonstrate a good understanding of the underlying chemical principles. Students complete a task independently, and then mark their own work as they watch talking mark scheme videos where an expert explains how to get to the correct answers. Our research has shown that engagement with these resources is perceived to be highly beneficial by students, and leads to an increase in their confidence to tackle mechanistic problems. If you are a non-UK (or non-A-level) teacher, the terms AS and A2 may be meaningless to you, but the resources should still be useful for anyone studying organic reaction mechanisms. The worksheets are available in Word format, and you should feel free to edit these to meet the needs of your students and the course you are teaching. You can download the files individually by selecting them on the left and clicking download. Please watch the short briefing video on You Tube and read the teachers' notes carefully. Contact me on d.read@soton.ac.uk if you have and questions or comments. Additionally, I would like to thank Henry Pearson for suggesting the format of the alternative self-assessment proformas which you may choose to use with your students.
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Background The evaluation of the elderly’s ability to manage medication through the use of a validated tool can be a significant step in identifying inabilities and needs, with the objective of increasing their self-care skills, and promoting successful aging. Aim of the review To identify studies assessing the elderly’s functional ability to manage their own medication. Method For the search strategy, the PICO method was used: P—Population(elderly), I—Instruments (tools for assessing medication management ability), C—Context (community) and O—Outcomes (functional ability to manage medication). Thefinal search query was run in MEDLINE/PubMed,CINAHL Plus, ISI Web of Science and Scopus. The whole process was developed according to the PRISMA statement. Results The search retrieved 8051 records. In each screening stage, the selection criteria were applied to eliminate records where at least one of the exclusion criteria was verified. At the end of this selection, we obtained a total of 18 papers (17 studies). The results allow the conclusion to be drawn that studies use several different instruments, most of them not validated. The authors agree that medication management abilities decrease as cognitive impairment increases, even if a lot of studies assess only the physical dimension. DRUGS was the instrument most often used. Conclusion Older adults’ ability to manage their medication should be assessed using tools specifically built and validate for the purpose. DRUGS (which uses the real regimen taken by the elderly) was the most widely used assessment instrument in the screened studies.
Cognitive Assessment System (CAS): Psychometric studies with Portuguese children from 7 to 15 years.
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The Cognitive Assessment System (CAS) is a new measure of cognitive abilities based on the Planning, Attention, Simultaneous and Successive (PASS) Theory. This theory is derived from research in neuropsychological and cognitive Psychology with particular emphasis on the work of Luria (1973). According to Naglieri (1999) and Naglieri and Das (1997), the PASS cognitive processes are the basic building blocks of human intellectual functioning. Planning processes provide cognitive control, utilization of processes and knowledge, intentionality, and self-regulation to achieve a desired goal; Attention processes provide focused, selective cognitive activity and resistance to distraction; and, Simultaneous and Successive processes are the two forms of operating on information. The PASS theory has had a strong empirical base prior to the publication of the CAS (see Das, Naglieri & Kirby, 1994), and its research foundation remains strong (see Naglieri, 1999; Naglieri & Das, 1997). The four basic psychological processes can be used to (1) gain an understanding of how well a child thinks; (2) discover the child’s strengths and needs, which can then be used for effective differential diagnosis; (3) conduct fair assessment; and (4) select or design appropriate interventions. Compared to the traditional intelligence tests, including IQ tests, the Cognitive Assessment System (CAS) has the great advantage of relying on a modern theory of cognitive functioning, linking theory with practice.
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The evaluation of school students has always attempted to estimate the effort, abilities and learning of students. However, at the beginning, evaluation consisted in measuring the progress of the student’s behavior compared to a desirable behavior. Later on, different changes in evaluation benefited the processes addressed to assessing the academic achievement of students and learning itself. Today, the demands of the contemporary society are vast and numerous: students not only require knowledge, they need to develop skills, values and postures. Postmodern education requires individuals to develop different talents and competencies to grow in every way. Therefore, evaluation should respond to such needs promoting an ethical, technical, reliable assessment of the student’s competencies, thus providing more fair and objective, qualitative and quantitative judgments. This dissertation project is the result of a literature review of several authors and the daily work of teachers in the Centros de Educación Media Superior a Distancia [High School Distance Centers] of Morelos, Mexico.
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The aim of this study was to use mechanical and photoelastic tests to compare the performance of cannulated screws with other fixation methods in mandibular symphysis fractures. Ten polyurethane mandibles were allocated to each group and fixed as follows: group PRP, 2 perpendicular miniplates; group PLL, 1 miniplate and 1 plate, parallel; and group CS, 2 cannulated screws. Vertical linear loading tests were performed. The differences between mean values were analyzed with the Tukey test. The photoelastic test was carried out using a polariscope. The results revealed differences between the CS and PRP groups at 1, 3, 5, and 10 millimeters of displacement. The photoelastic test confirmed higher stress concentration in all groups close to the mandibular base, whereas the CS group showed it throughout the region assessed. Conical cannulated screws performed well in mechanical and photoelastic tests.
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Nearly 50% of patients with heart failure (HF) have preserved LV ejection fraction, with interstitial fibrosis and cardiomyocyte hypertrophy as early manifestations of pressure overload. However, methods to assess both tissue characteristics dynamically and noninvasively with therapy are lacking. We measured the effects of mineralocorticoid receptor blockade on tissue phenotypes in LV pressure overload using cardiac magnetic resonance (CMR). Mice were randomized to l-nitro-ω-methyl ester (l-NAME, 3 mg/mL in water; n=22), or l-NAME with spironolactone (50 mg/kg/day in subcutaneous pellets; n=21). Myocardial extracellular volume (ECV; marker of diffuse interstitial fibrosis) and the intracellular lifetime of water (τic; marker of cardiomyocyte hypertrophy) were determined by CMR T1 imaging at baseline and after 7 weeks of therapy alongside histological assessments. Administration of l-NAME induced hypertensive heart disease in mice, with increases in mean arterial pressure, LV mass, ECV, and τic compared with placebo-treated controls, while LV ejection fraction was preserved (>50%). In comparison, animals receiving both spironolactone and l-NAME (l-NAME+S) showed less concentric remodeling, and a lower myocardial ECV and τic, indicating decreased interstitial fibrosis and cardiomyocyte hypertrophy (ECV: 0.43 ± 0.09 for l-NAME versus 0.25 ± 0.03 for l-NAME+S, P<0.001; τic: 0.42 ± 0.11 for l-NAME groups versus 0.12 ± 0.05 for l-NAME+S group). Mice treated with a combination of l-NAME and spironolactone were similar to placebo-treated controls at 7 weeks. Spironolactone attenuates interstitial fibrosis and cardiomyocyte hypertrophy in hypertensive heart disease. CMR can phenotype myocardial tissue remodeling in pressure-overload, furthering our understanding of HF progression.
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The aim of this cephalometric study was to evaluate the influence of the sagittal skeletal pattern on the 'Y-axis of growth' measurement in patients with different malocclusions. Lateral head films from 59 patients (mean age 16y 7m, ranging from 11 to 25 years) were selected after a subjective analysis of 1630 cases. Sample was grouped as follows: Group 1 - class I facial pattern; group 2 - class II facial pattern; and Group 3 - class III facial pattern. Two angular measurements, SNGoGn and SNGn, were taken in order to determine skeletal vertical facial pattern. A logistic regression with errors distributed according to a binomial distribution was used to test the influence of the sagittal relationship (Class I, II, III facial patterns) on vertical diagnostic measurement congruence (SNGoGn and SNGn). RESULTS show that the probability of congruence between the patterns SNGn and SNGoGn was relatively high (70%) for group 1, but for groups II (46%) and III (37%) this congruence was relatively low. The use of SNGn appears to be inappropriate to determine the vertical facial skeletal pattern of patients, due to Gn point shifting throughout sagittal discrepancies. Clinical Significance: Facial pattern determined by SNGn must be considered carefully, especially when severe sagittal discrepancies are present.