Demanda por seguro de salud y uso de servicios médicos bajo un esquema de seguro obligatorio. Diferencias entre trabajadores dependientes ytrabajadores independientes

Este trabajo estudia el efecto del estado de salud sobre la afiliación al Régimen Contributivo y el efecto del seguro público (Régimen Contributivo) y el seguro privado sobre el uso de servicios de salud (Consulta externa).

Comparación de parámetros de atención en una escala de triage de 5 niveles con los parámetros estándar

Introducción: La escala de severidad en emergencias es una herramienta que ofrece seguridad a pacientes en servicios de urgencias. Este trabajo evalúa la aplicación de la escala ESI 4.0 en términos de oportunidad de atención y consumo de recursos en la Fundación Santa Fé de Bogotá, para comparar los resultados con parámetros estándar. Metodología Estudio observacional analítico de corte transversal. Se incluyeron 385 pacientes aleatorizados por nivel de atención. Se tomaron datos demográficos y variables como consumo de recursos y destino del paciente para su descripción y análisis. Resultados: El promedio de edad fue 44.9 años IC95%42.9–46.9, el 54.5% fueron mujeres. Se encontró un tiempo promedio de espera para nivel 1 de 1.39 min, para el nivel 2 de 22.9 min 2, para el nivel 3 de 41.9 min, para el nivel 4 de 56.9 min y para el nivel 5 de 52.1 min. El tiempo promedio de estancia en urgencias fue 5.9 horas y el 78.9% consumió recursos. Al comparar los tiempos con estándares mundiales en el nivel 1, 2 y 3 son significativamente mayores (P<0,05), en el nivel 4 es similar (p0,51) y en el nivel 5 es significativamente menor (p=0,00) Discusión: La escala ESI 4.0 es una herramienta segura, con un comportamiento similar en oportunidad de atención y consumo de recursos con respecto a los estándares de cuidado en los servicios de urgencias.

Preditores da satisfação no trabalho dos professores do ensino básico e secundário português : remuneração, valores de trabalho e stress

O papel do professor é crucial numa sociedade, e o sucesso da sua missão depende da sua satisfação no trabalho. Este estudo tem como objectivo avaliar a satisfação no trabalho dos professores do ensino público português não superior. Uma amostra de 637 professores respondeu a um questionário online sobre satisfação no trabalho, valores de trabalho, e stress. Verificou-se que os professores, em média, se encontram insatisfeitos com o seu trabalho; que os do sexo masculino se encontram mais insatisfeitos que os do sexo feminino; que a variação da remuneração dentro da profissão não tem impacto sobre a satisfação no trabalho nos professores; que o stress é o principal preditor da satisfação, tendo um claro impacto negativo; e que tanto os valores intrínsecos de locus de controlo interno como os valores sociais influenciam (positivamente) a satisfação de modo independente.

The Geostationary Earth Radiation Budget Project

This paper reports on a new satellite sensor, the Geostationary Earth Radiation Budget (GERB) experiment. GERB is designed to make the first measurements of the Earth's radiation budget from geostationary orbit. Measurements at high absolute accuracy of the reflected sunlight from the Earth, and the thermal radiation emitted by the Earth are made every 15 min, with a spatial resolution at the subsatellite point of 44.6 km (north–south) by 39.3 km (east–west). With knowledge of the incoming solar constant, this gives the primary forcing and response components of the top-of-atmosphere radiation. The first GERB instrument is an instrument of opportunity on Meteosat-8, a new spin-stabilized spacecraft platform also carrying the Spinning Enhanced Visible and Infrared (SEVIRI) sensor, which is currently positioned over the equator at 3.5°W. This overview of the project includes a description of the instrument design and its preflight and in-flight calibration. An evaluation of the instrument performance after its first year in orbit, including comparisons with data from the Clouds and the Earth's Radiant Energy System (CERES) satellite sensors and with output from numerical models, are also presented. After a brief summary of the data processing system and data products, some of the scientific studies that are being undertaken using these early data are described. This marks the beginning of a decade or more of observations from GERB, as subsequent models will fly on each of the four Meteosat Second Generation satellites.

Private industrial project management: a systems-based case study

The technique of linear responsibility analysis is used for a retrospective case study of a private industrial development consisting of an extension to existing buildings to provide a warehouse, services block and packing line. The organizational structure adopted on the project is analysed using concepts from systems theory which are included in Walker's theoretical model of the structure of building project organizations (Walker, 1981). This model proposes that the process of building provision can be viewed as systems and subsystems which are differentiated from each other at decision points. Further to this, the subsystems can be viewed as the interaction of managing system and operating system. Using Walker's model, a systematic analysis of the relationships between the contributors gives a quantitative assessment of the efficacy of the organizational structure used. The causes of the client's dissatisfaction with the outcome of the project were lack of integration and complexity of the managing system. However, there was a high level of satisfaction with the completed project and this is reflected by the way in which the organization structure corresponded to the model's propositions.

A project managed by a multi disciplinary practice: a systems based case study.

The technique of linear responsibility analysis is used for a retrospective case study of a private industrial development consisting of an engineering factory and offices. A multi-disciplinary professional practice was used to manage and design the project. The organizational structure adopted on the project is analysed using concepts from systems theory which are included in Walker's theoretical model of the structure of building project organizations (Walker, 1981). This model proposes that the process of buildings provision can be viewed as systems and sub-systems which are differentiated form each other at decision points. Further to this, the sub-systematic analysis of the relationship between the contributors gives a quantitative assessment of the efficiency of the organizational structure used. There was a high level of satisfaction with the completed project and this is reflected by the way in which the organization structure corresponded to the model's proposition. However, the project was subject to string environmental forces which the project organization was not capable of entirely overcoming.

The CAFS system today and tomorrow

The CAFS search engine is a real machine in a virtual machine world; it is the hardware component of ICL's CAFS system. The paper is an introduction and prelude to the set of papers in this volume on CAFS applications. It defines The CAFS system and its context together with the function of its hardware and software components. It examines CAFS' role in the broad context of application development and information systems; it highlights some techniques and applications which exploit the CAFS system. Finally, it concludes with some suggestions for possible further developments. 'Search out thy wit for secret policies And we will make thee famous through the world' Henry VI, 1:3

Issues of water supply and contemporary urban society: the case of Greater Amman, Jordan

Over the last two decades, Jordan has suffered a chronic water crisis, and is the tenth most water-scarce nation on Earth. Such water stress has been well illustrated in the case of Greater Amman, the capital, which has grown dramatically from a population of around 2000 in the 1920s, to 2.17 million today. One of the distinctive characteristics of the water supply regime of Greater Amman is that since 1987 it has been based on a system of rationing, with households receiving water once a week for various durations. Amman is highly polarized socio-economically, and by means of household surveys, both quantitative and qualitative, conducted in high- and low-income divisions of the city, a detailed empirical evaluation of the storage and use of water, the strategies used by households to manage water and overall satisfaction with water supply issues is provided in this paper, looking specifically at issues of social equity. The analysis demonstrates the social and economic costs of water rationing and consequent management to be high, as well as emphasizing that issues of water quality are of central importance to all consumers regardless of their socio-economic status within the city.

The assessment of benchmarks executed on bare-metal and using para-virtualization

A full assessment of para-­virtualization is important, because without knowledge about the various overheads, users can not understand whether using virtualization is a good idea or not. In this paper we are very interested in assessing the overheads of running various benchmarks on bare-­‐metal, as well as on para-­‐virtualization. The idea is to see what the overheads of para-­‐ virtualization are, as well as looking at the overheads of turning on monitoring and logging. The knowledge from assessing various benchmarks on these different systems will help a range of users understand the use of virtualization systems. In this paper we assess the overheads of using Xen, VMware, KVM and Citrix, see Table 1. These different virtualization systems are used extensively by cloud-­‐users. We are using various Netlib1 benchmarks, which have been developed by the University of Tennessee at Knoxville (UTK), and Oak Ridge National Laboratory (ORNL). In order to assess these virtualization systems, we run the benchmarks on bare-­‐metal, then on the para-­‐virtualization, and finally we turn on monitoring and logging. The later is important as users are interested in Service Level Agreements (SLAs) used by the Cloud providers, and the use of logging is a means of assessing the services bought and used from commercial providers. In this paper we assess the virtualization systems on three different systems. We use the Thamesblue supercomputer, the Hactar cluster and IBM JS20 blade server (see Table 2), which are all servers available at the University of Reading. A functional virtualization system is multi-­‐layered and is driven by the privileged components. Virtualization systems can host multiple guest operating systems, which run on its own domain, and the system schedules virtual CPUs and memory within each Virtual Machines (VM) to make the best use of the available resources. The guest-­‐operating system schedules each application accordingly. You can deploy virtualization as full virtualization or para-­‐virtualization. Full virtualization provides a total abstraction of the underlying physical system and creates a new virtual system, where the guest operating systems can run. No modifications are needed in the guest OS or application, e.g. the guest OS or application is not aware of the virtualized environment and runs normally. Para-­‐virualization requires user modification of the guest operating systems, which runs on the virtual machines, e.g. these guest operating systems are aware that they are running on a virtual machine, and provide near-­‐native performance. You can deploy both para-­‐virtualization and full virtualization across various virtualized systems. Para-­‐virtualization is an OS-­‐assisted virtualization; where some modifications are made in the guest operating system to enable better performance. In this kind of virtualization, the guest operating system is aware of the fact that it is running on the virtualized hardware and not on the bare hardware. In para-­‐virtualization, the device drivers in the guest operating system coordinate the device drivers of host operating system and reduce the performance overheads. The use of para-­‐virtualization [0] is intended to avoid the bottleneck associated with slow hardware interrupts that exist when full virtualization is employed. It has revealed [0] that para-­‐ virtualization does not impose significant performance overhead in high performance computing, and this in turn this has implications for the use of cloud computing for hosting HPC applications. The “apparent” improvement in virtualization has led us to formulate the hypothesis that certain classes of HPC applications should be able to execute in a cloud environment, with minimal performance degradation. In order to support this hypothesis, first it is necessary to define exactly what is meant by a “class” of application, and secondly it will be necessary to observe application performance, both within a virtual machine and when executing on bare hardware. A further potential complication is associated with the need for Cloud service providers to support Service Level Agreements (SLA), so that system utilisation can be audited.

Customer satisfaction and organisational justice

Applies organisational justice theory to facilities management with the aim of increasing customer satisfaction with the service received. Provides an overview of organisational justice theory, and reviews the numerous different forms that this may take. Although there is strong theoretical support for participative decision making, in practice it often leads to conflict and delays. Two-way communication appears to represent the most effective form. The conclusions are based upon theoretical support as well as semi-structured interviews and observations in an organisational setting. The conclusions drawn do not have the benefits of more objective quantitative research methods. Contributes to practical understanding of how to maintain customer satisfaction in the facilities management industry and the theoretical reasons why the proposed methods will be effective. Argues that the impact of organisational justice on employee satisfaction can be applied to customer satisfaction with specific reference to facilities management.

Application of constrained predictive control on a 3D crane system

This paper describes the SIMULINK implementation of a constrained predictive control algorithm based on quadratic programming and linear state space models, and its application to a laboratory-scale 3D crane system. The algorithm is compatible with Real Time. Windows Target and, in the case of the crane system, it can be executed with a sampling period of 0.01 s and a prediction horizon of up to 300 samples, using a linear state space model with 3 inputs, 5 outputs and 13 states.

A robust hybrid feedback active noise cancellation headset

This paper investigates the robustness of a hybrid analog/digital feedback active noise cancellation (ANC) headset system. The digital ANC systems with the filtered-x least-mean-square (FXLMS) algorithm require accurate estimation of the secondary path for the stability and convergence of the algorithm. This demands a great challenge for the ANC headset design because the secondary path may fluctuate dramatically such as when the user adjusts the position of the ear-cup. In this paper, we analytically show that adding an analog feedback loop into the digital ANC systems can effectively reduce the plant fluctuation, thus achieving a more robust system. The method for designing the analog controller is highlighted. A practical hybrid analog/digital feedback ANC headset has been built and used to conduct experiments, and the experimental results show that the hybrid headset system is more robust under large plant fluctuation, and has achieved satisfactory noise cancellation for both narrowband and broadband noises.

Robots with a gentle touch: advances in assistive robotics and prosthetics

As healthcare costs rise and an aging population makes an increased demand on services, so new techniques must be introduced to promote an individuals independence and provide these services. Robots can now be designed so they can alter their dynamic properties changing from stiff to flaccid, or from giving no resistance to movement, to damping any large and sudden movements. This has some strong implications in health care in particular for rehabilitation where a robot must work in conjunction with an individual, and might guiding or assist a persons arm movements, or might be commanded to perform some set of autonomous actions. This paper presents the state-of-the-art of rehabilitation robots with examples from prosthetics, aids for daily living and physiotherapy. In all these situations there is the potential for the interaction to be non-passive with a resulting potential for the human/machine/environment combination to become unstable. To understand this instability we must develop better models of the human motor system and fit these models with realistic parameters. This paper concludes with a discussion of this problem and overviews some human models that can be used to facilitate the design of the human/machine interfaces.

Post-occupancy evaluation studies in recently refurbished office building: energy performance and employees' satisfaction

Existing buildings contribute greatly to global energy use and greenhouse gas emissions. In the UK, about 18% of carbon emissions are generated by non-domestic buildings; sustainable building refurbishment can play an important role in reducing carbon emissions. This paper looks at the performance of a recently refurbished 5-storey office building in London, in terms of energy consumption as well as occupants’ satisfaction. Pre- and post-occupancy evaluation studies were conducted using online questionnaire surveys and energy consumption evaluation. Results from pre-occupancy and post-occupancy evaluation studies showed that employees, in general, were more satisfied with their work environment at the refurbished building than with that of their previous office. Employees’ self-reported productivity improved after the move to Elms House. These surveys showed a positive relationship between employees’ satisfaction with their work environment and their self-reported productivity, well-being and enjoyment at work. The factor that contributed to increasing employee satisfaction the most was: better use of interior space. Although the refurbishment was a success in terms of reducing energy consumption per m2, the performance gap was almost 3 times greater than that estimated. Unregulated loads, problems with building control, ineffective use of space and occupants’ behaviour are argued to be reasons for this gap.

Tracing troposphere-to-stratosphere transport above a mid-latitude deep convective system

Within the project SPURT (trace gas measurements in the tropopause region) a variety of trace gases have been measured in situ in order to investigate the role of dynamical and chemical processes in the extra-tropical tropopause region. In this paper we report on a flight on 10 November 2001 leading from Hohn, Germany (52�N) to Faro, Portugal (37�N) through a strongly developed deep stratospheric intrusion. This streamer was associated with a large convective system over the western Mediterranean with potentially significant troposphere-to-stratosphere transport. Along major parts of the flight we measured unexpectedly high NOy mixing ratios. Also H2O mixing ratios were significantly higher than stratospheric background levels confirming the extraordinary chemical signature of the probed air masses in the interior of the streamer. Backward trajectories encompassing the streamer enable to analyze the origin and physical characteristics of the air masses and to trace troposphere-to-stratosphere transport. Near the western flank of the streamer features caused by long range transport, such as tropospheric filaments characterized by sudden drops in the O3 and NOy mixing ratios and enhanced CO and H2O can be reconstructed in great detail using the reverse domain filling technique. These filaments indicate a high potential for subsequent mixing with the stratospheric air. At the south-western edge of the streamer a strong gradient in the NOy and the O3 mixing ratios coincides very well with a sharp gradient in potential vorticity in the ECMWF fields. In contrast, in the interior of the streamer the observed highly elevated NOy and H2O mixing ratios up to a potential temperature level of 365K and potential vorticity values of maximum 10 PVU cannot be explained in terms of resolved troposphere-to-stratosphere transport along the backward trajectories. Also mesoscale simulations with a High Resolution Model reveal no direct evidence for convective H2O injection up to this level. Elevated H2O mixing ratios in the ECMWF and HRM are seen only up to about tropopause height at 340 hPa and 270 hPa, respectively, well below flight altitude of about 200 hPa. However, forward tracing of the convective influence as identified by satellite brightness temperature measurements and counts of lightning strokes shows that during this part of the flight the aircraft was closely following the border of an air mass which was heavily impacted by convective activity over Spain and Algeria. This is evidence that deep convection at mid-latitudes may have a large impact on the tracer distribution of the lowermost stratosphere reaching well above the thunderstorms anvils as claimed by recent studies using cloud-resolving models.