974 resultados para Program Costs.
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Trabalho apresentado no âmbito do Doutoramento em Informática, como requisito parcial para obtenção do grau de Doutor em Informática
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Os crescentes custos ligados ao consumo elétrico, não apenas de cariz financeiro mas também ambiental, despertam cada vez mais para a importância da definição de estratégias de melhor utilização de recursos e eficiência energética. Esta importância tem sido reforçada pela definição de decretos-lei que vêm colocar metas e limites relativamente às despesas energéticas. Estes diplomas são também acompanhados por programas de incentivo para um setor ligado à eficiência energética. Em Portugal as medidas ligadas ao setor tem vindo a ser redirecionadas para o consumo final de energia, com a definição de metas para as instalações de maior consumo. As instalações hospitalares são grandes centros de consumo energético devido não só ao elevado número de utentes que recebem mas também pelos diversos tipos de equipamentos elétricos usados para a prestação dos serviços médicos. Como consequência disso, os investimentos e os custos operacionais são elevados, o que reforça a necessidade de gerir os gastos e consumos energéticos com a procura constante de melhoria na recolha de informação sobre todo o sistema e na adequação de intervenções com vista a uma maior eficiência energética. O Hospital Pedro Hispano vem desde algum tempo a investir no sentido de conhecer mais e melhor toda a instalação bem como os consumos energéticos a ela associados. Algumas medidas foram tomadas nesse sentido nomeadamente a instalação de analisadores de energia, de modo a obter um retrato mais fiel e fidedigno dos principais vetores de consumo. Neste momento a gestão técnica do hospital tem em análise uma grande parte da instalação recolhendo dados do consumo elétrico real do hospital. Nesta dissertação procurou-se fazer uma análise e enquadramento dos programas e metas ligados ao setor energético com ênfase nos diplomas que visão e abrangem as instalações hospitalares. Dos vários programas de incentivo à adoção de políticas de maior eficiência energética é dado especial destaque ao programa ECO.AP que visa a celebração de contratos para implementação de medidas de poupança energética ao setor público. Em colaboração com o HPH, iniciaram-se os trabalhos pelo estudo e identificação das principais fases e ferramentas utilizadas na gestão energética do edifício tendo como objetivo a reavaliação dos vetores energéticos já identificados no HPH e a criação e contabilização de novos grupos de consumo. Através de várias medições do consumo elétrico, num total superior a 650 horas de funcionamento, foi possível a criação do mapa de desagregação de consumos para o ano de 2013. A desagregação realizada conta com 3 novos vetores energéticos e com a reavaliação do peso relativo de mais 5 grupos de consumo. Das medições efetuadas destaca-se a reavaliação do consumo da central de bombagem onde a parcela considerada até à data estava 3 vezes acima do valor real medido. Com base na desagregação feita foram apontadas e estudadas medidas de implementação com o objetivo de reduzir os consumos energético em todo o hospital, destacando-se a solução apresentada para a central de bombagem. Esta medida traria um grande impacto em toda a fatura energética, não só pela sua viabilidade, mas também porque atuaria num grande centro de consumo onde até ao momento nenhuma ação do género foi implementada.
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Introduction: Coronary artery disease and aging seems to be associated with a sedentary lifestyle, contributing to increased abdominal fat and consequently metabolic complications. The exercise can break this cycle by stimulating lipolysis and the use of fatty acids. In Europe there is still a lack of cardiac rehabilitation programmes in hospitals, therefore, this study aims to demonstrate the advantages of implementing home-based exercise programmes, as well as, their effects on cardiovascular prevention. This study analyzed the effects of a home-based exercise programme, in patients with coronary artery disease (myocardial infarction for 1 year), in body composition, abdominal fat, lipid profile. Methods: An ongoing randomized controlled trial with a sample of 20 participants were randomly allocated to intervention (n = 10) and control groups (n = 10). Intervention group performed a specific exercise programme during 8 weeks, consisting of ten home based exercises taking into account flexibility, muscle endurance and strength as well as cardiovascular endurance. Skinfolds thickness were measure to calculate the percentage of total fat: Skinfolds used were suprailiac, abdominal horizontal and vertical. Body mass index calculation and blood tests for lipidic profile were performed. Results: After eight weeks the intervention group decreased significantly the percentage of total fat (p < 0.05), the suprailiac skinfold (p < 0.05), the abdominal horizontal and vertical skinfold (p < 0.05) when compared with control group. In the intervention group it was observed after 8 weeks a significant decrease in body mass index, LDL-cholesterol and triglycerides. Conclusions: Home-based exercise programme influenced body composition, abdominal fat and lipid profile. These results highlight the importance of implementing home based exercises that are easy and cheap to implement in cardiac patients, in order to promote health and reduce cardiovascular risk factors.
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This investigation aimed to design a strategy for echinococcosis control in Santana do Livramento county, an endemic area in state of Rio Grande do Sul (Brazil). Fecal samples from 65 dogs were obtained from urban, suburban and rural areas. Purging with Arecoline Bromhidrate (AB) was done to visualize Echinococcus granulosus, and Enzyme Linked Immunosorbent Assay (ELISA) was performed to detect parasite coproantigen. Samples were obtained at the beginning and at the end of treatment with Praziquantel. A third fecal sampling was also done in rural areas four months after the end of treatment. Each dog was treated immediately after the first purging and every 30 days for eight months. In urban and suburban areas no infected dogs were found. In rural areas, first evaluation showed 11.36% and 27.69% of infected dogs by AB and ELISA, respectively. No infected dogs were diagnosed in the second evaluation and in the third evaluation 36.84% and 47.37% infected dogs were identified by AB and ELISA, respectively. Medication program to combat dog infection resulted in successful interruption of parasite transmission, but the project failed to create awareness of the need for dog prophylaxis among rural populations as well as to establish a permanent control program in this municipality.
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IEEE International Conference on Pervasive Computing and Communications (PerCom). 23 to 26, Mar, 2015, PhD Forum. Saint Louis, U.S.A..
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The introduction of new procedures in surgery usually implies the costs of the so called learning curve. However patients should not suffer the negative effects of surgeon's learning curves. We report our results with the first 15 Ross procedures, a single surgeon and institution experience, and how it was possible to build a safe learning curve without major consequences for the patients. We emphasize the need for a continuous program of surgical performance assessment throughout the learning curve period, as was demonstrated in our series.
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OBJECTIVE: Describe implementation of a successful program to reduce doses (cefazolin 2 to 1 g) used for antimicrobial prophylaxis. METHODS: Evaluation of an intervention program to reduce prophylactic antimicrobial doses. The intervention included weekly staff discussions, automatic dispensation of 1g-vial of cefazolin by the pharmacy unless expressly requested by surgeon and increase in post-discharge surveillance as a strategy to reassure surgeons of the safety of the reduction. In the pre and post intervention periods, a prospective study of antimicrobial consumption and surgical site infections were measured. RESULTS: There were 5,164 and 5,204 deliveries in 2001-2002 and 2003-2004, respectively; 1,524 (29.5%) and 1,363 (26%) were cesarean sections. There was a 45% decrease in cefazolin vials used on average per cesarean section (2.29 to 1.25). Patients evaluated increased from 16% to 67% and the SSI rates in both periods were 3.34% to 2.42%, respectively. CONCLUSION: An ample intervention, including administrative and educational measures, led to high compliance with dose reduction and saved more than US$4,000 in cefazolin, considered important because government reimbursement in Brazil for cesarean section is $80.
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We consider two firms, located in different countries, selling the same homogeneous good in both countries. In each country there is a non negative tariff on imports of the good produced in the other country. We suppose that each firm has two different technologies, and uses one of them according to a certain probability distribution. The use of either one or the other technology affects the unitary production cost. We analyse the effect of the production costs uncertainty on the profits of the firms and also on the welfare of the governments.
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We consider a trade policy model, where the costs of the home firm are private information but can be signaled through the output levels of the firm to a foreign competitor and a home policymaker. We compute the separating equilibrium and the Bayesian Nash equilibrium, and we compare the subsidies, firms’ expected profits and home government’s welfare in both equilibria, for different values of the own price effect parameter.
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O âmbito deste trabalho envolve o teste do modelo BIM numa obra em construção pela Mota-Engil – Engenharia, na extração experimental de peças desenhadas de preparação e apoio à execução de obra. No capítulo 1 deste relatório são definidos o âmbito e os objetivos deste trabalho, é feito um enquadramento histórico do tema e abordados conceitos e atividades da preparação de obra, na sua forma tradicional. O estado do conhecimento da preparação de obras e mais em concreto da tecnologia BIM a nível nacional e internacional é abordado no capítulo 2. Nesse sentido procura-se definir os conceitos principais inerentes a esta nova metodologia, que passa por identificar e caraterizar a tecnologia envolvida e o seu nível de desenvolvimento. Com suporte em casos práticos de preparação de obra na sua forma tradicional, identificados e desenvolvidos no capítulo 3, foi compilado um processo tipo de peças desenhadas de suporte identificadas e caracterizadas no capítulo 4, frequentes e comuns à execução de diversos tipos de obras de edifícios. Assente na compilação baseada em casos práticos e no estudo do projeto de execução da empreitada que sustenta o presente trabalho, com base no qual o modelo BIM foi concebido, identificou-se um conjunto de peças desenhadas de preparação e apoio à execução dos trabalhos, em 2D, a extrair do modelo. No capítulo 5, é feita uma descrição do modo como foi estudado o projeto da obra, com evidência para os fatores mais relevantes, especificando os desenhos a extrair. Suportada pelo programa de modelação ArchiCAD, a extração do conjunto de desenhos identificados anteriormente foi conseguida com recurso às funcionalidades disponíveis no software, que permite a criação de desenhos 2D atualizáveis ou não automaticamente a partir do modelo. Qualquer alteração introduzida no modelo virtual é automaticamente atualizada nos desenhos bidimensionais, caso o utilizador assim o pretenda. Ao longo desse trabalho foram detetados e analisados os condicionalismos inerentes ao processo de extração, referidos no capítulo 6, para estabelecimento de regras de modelação padrão a adotar em futuras empreitadas, que possam simplificar a obtenção dos elementos desenhados de preparação necessários à sua execução. No ponto 6.3 são identificadas melhorias a introduzir no modelo. Em conclusão no capítulo 7 são abordadas especificidades do setor da construção que sustentam e evidenciam cada vez mais a necessidade de utilizar as novas tecnologias com vista à adoção de práticas e ferramentas padrão de apoio à execução de obras. Sendo a tecnologia BIM, transversal a todo o setor, a sua utilização com regras padrão na conceção dos modelos e na extração de dados, potencia a otimização dos custos, do tempo, dos recursos e da qualidade final de um empreendimento, ao longo de todo o seu ciclo de vida, para além de apoiar com elevada fiabilidade as tomadas de decisão ao longo desse período. A tecnologia BIM, possibilita a antevisão do edifício a construir com um elevado grau de pormenor, com todas as vantagens que daí advêm.
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Giardia intestinalis infection is prevalent throughout the world and widely distributed in developing countries. In general, children display serious consequences to their state of health, including slow height-weight development; therefore, the main aim of this study was to determine the association between Giardia infection and the nutritional status of children who participate in the program of complementary feeding (Mejoramiento Alimentario y Nutricional de Antioquia (MANA) - Instituto Colombiano de Bienestar Familiar (ICBF)). A cross-sectional study examining the association of giardiasis with nutritional status was conducted. A total of 2035 children aged eight months to six years-old were studied. Data were collected using structured questionnaires, anthropometric measurements and laboratory analysis of blood and stool samples. Analysis of the results showed that 27.6% of children were infected with G. intestinalis, while 8.1% and 1.9% were mildly and significantly underweight, respectively, and 14.1% presented stunting. Giardiasis was statistically identified as a strong predictor of stunting in this study population.
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ABSTRACT This study was conducted to assess mental health knowledge, attitude and practices among health care workers in Belize before and immediately after a competency based training program in mental health. A baseline Knowledge, Attitudes and Practices (KAP) survey was given to health personnel, mainly nurses, working primary and secondary care. The intervention was a 13-week face-to-face training course for health care professionals with the objective of increasing their competency in mental health and reducing stigma. After the training a post intervention KAP survey was conducted among the original respondents. 88 health care workers completed the baseline survey and 61 of those respondents completed the post-intervention questionnaire. The results showed that the level of knowledge of the participants had improved by the training intervention and that in general, the intervention was effective in correcting some misconceptions about mental illness and reducing stigmatizing attitudes among the participants.
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The integration of wind power in eletricity generation brings new challenges to unit commitment due to the random nature of wind speed. For this particular optimisation problem, wind uncertainty has been handled in practice by means of conservative stochastic scenario-based optimisation models, or through additional operating reserve settings. However, generation companies may have different attitudes towards operating costs, load curtailment, or waste of wind energy, when considering the risk caused by wind power variability. Therefore, alternative and possibly more adequate approaches should be explored. This work is divided in two main parts. Firstly we survey the main formulations presented in the literature for the integration of wind power in the unit commitment problem (UCP) and present an alternative model for the wind-thermal unit commitment. We make use of the utility theory concepts to develop a multi-criteria stochastic model. The objectives considered are the minimisation of costs, load curtailment and waste of wind energy. Those are represented by individual utility functions and aggregated in a single additive utility function. This last function is adequately linearised leading to a mixed-integer linear program (MILP) model that can be tackled by general-purpose solvers in order to find the most preferred solution. In the second part we discuss the integration of pumped-storage hydro (PSH) units in the UCP with large wind penetration. Those units can provide extra flexibility by using wind energy to pump and store water in the form of potential energy that can be generated after during peak load periods. PSH units are added to the first model, yielding a MILP model with wind-hydro-thermal coordination. Results showed that the proposed methodology is able to reflect the risk profiles of decision makers for both models. By including PSH units, the results are significantly improved.