USO DO BRINQUEDO NO ATENDIMENTO FISIOTERAPÊUTICO DE CRIANÇAS COM PARALISIA CEREBRAL

A paralisia cerebral, doença não progressiva, compromete movimentos e postura. A fisioterapia atual volta-se para um tratamento holístico. Brincar proporciona desenvolvimento neuropsicomotor. O presente estudo tem como objetivos investigar a opinião de fisioterapeutas que atuam em neuropediatria sobre a utilização do brinquedo em sua prática clínica e verificar sua possível utilização em intervenções junto a crianças com paralisia cerebral. Utiliza-se inicialmente de questionário de opinião junto a 50 fisioterapeutas das diversas clínicas da Associação de Apoio a Criança com Deficiência, AACD - SP, verificando a utilização de brinquedos face aos diversos objetivos fisioterapeuticos; a seguir, realiza observação de 60 atendimentos, em fisioterapia aquática e de solo, de crianças com paralisia cerebral, identificando a utilização de cada categoria de brinquedo relativo ao objetivo terapêutico. Os dados obtidos no questionário revelaram em ordem decrescente utilização de: brinquedos sensório-motores 57,4%, para ganho de equilíbrio (E); 22,2% para coordenação motora (CM); 18,5% para aquisições posturais (AP) e 2% para relaxamento muscular (RM). Em relação aos jogos de faz-de-conta: 37% (E); 39% (AP) e 24% (CM).Para os jogos de regras: 54% (E); 35% (CM); 11% (AP). Com os jogos de montagem: 52% (CM); 24% (E); 24% (AP). Os dados da observação revelaram que os principais objetivos terapêuticos visados com utilização de brinquedos foram: alongamento, primeiro 10 ; fortalecimento muscular, equilíbrio e treino de marcha de 10 a 40 . Quanto à modalidade de brinquedo observada houve predomínio do faz de conta no início e no fim da sessão e das demais categorias no meio, de forma intercalada. Os dados da observação coincidiram com os do questionário revelando utilização sistemática de brinquedos com objetivos fisioterapeuticos.(AU)

Lay perceptions of type 2 diabetes in Scotland:bringing health services back in

The growing prevalence of type 2 diabetes is placing Scottish health services under considerable strain. Consequently, diabetes services are undergoing a major process of reorganisation, including the devolvement of routine diabetes care/diabetic review from secondary to primary healthcare settings. This qualitative study was devised to explore newly diagnosed type 2 diabetes patients' perceptions of their disease and the health services they receive at a time when this restructuring of services is taking place. The sample comprised 40 patients resident in Lothian, Scotland, who had diverse experiences of services, some receiving GP-based care only, others having varying contact with hospital diabetes clinics. In-depth interviews were undertaken with patients, three times at six monthly intervals over 1 year, enabling their experiences to be tracked at critical junctures during the post-diagnostic period. Disease perceptions and health service delivery were found to be mutually informing and effecting. Not only did (different types of) health service delivery influence the ways in which patients thought about and self-managed their disease, over time patients' disease perceptions also informed their expectations of, and preferences for, diabetes services. We thus argue that there is a need for a reconceptualisation within the medical social sciences to take into account the context of healthcare and the economic/policy factors that inform health service delivery when looking at patients' disease perceptions. We also discuss the logistical and ethical challenges of drawing upon patients' perspectives, preferences and views in the design and delivery of future health services. © 2004 Elsevier Ltd. All rights reserved.

About Electronic Assessment, Accreditation and Management of the Quality of Teaching in Higher Education

The article examines the main approaches to external evaluation and accreditation in higher education. It also presents COMPASS-OK: a social network for electronic evaluation and management of the quality of education, which utilizes mechanisms for management of documentation flows and supports tools for modeling of evaluation methods and procedures.

CVaR minimization by the SRA algorithm

Using the risk measure CV aR in �nancial analysis has become more and more popular recently. In this paper we apply CV aR for portfolio optimization. The problem is formulated as a two-stage stochastic programming model, and the SRA algorithm, a recently developed heuristic algorithm, is applied for minimizing CV aR.

Viable solutions to nonautonomous inclusions without convexity

The existence of viable solutions is proven for nonautonomous upper semicontinuous differential inclusions whose right-hand side is contained in the Clarke subdifferential of a locally Lipschitz continuous function.

The efficiency of remanufacturing in a dynamic input–output model

For industrialised economy of ourdays, remanufacturing represents perhaps the largest unexploited resource and opportunity for realising a greater growth of the economy in an environmental-conscious manner. The aim of this paper is to investigate of the impact of remanufacturing in the economy from an economic-efficiency point of view. In static context this phenomenon was analysed in the literature. We use the multi-sector input–output framework in a dynamic context to study intra-period relationships of the sectors of economy. We extend the classical dynamic input–output model taking into consideration the activity of remanufacturing .We try to answer the question, whether the remanufacturing/reuse increases the growth possibility of an economy. We expose a sufficient condition concerning the effectivity of an economy with remanufacturing. By this evaluation we analyse a possible sustainable development of the economy on the basis of the product recovery management of industries.

Generalized correlated equilibrium for two-person games in extensive form with perfect information

A correlation scheme (leading to a special equilibrium called “soft” correlated equilibrium) is applied for two-person finite games in extensive form with perfect information. Randomization by an umpire takes place over the leaves of the game tree. At every decision point players have the choice either to follow the recommendation of the umpire blindly or freely choose any other action except the one suggested. This scheme can lead to Pareto-improved outcomes of other correlated equilibria. Computational issues of maximizing a linear function over the set of soft correlated equilibria are considered and a linear-time algorithm in terms of the number of edges in the game tree is given for a special procedure called “subgame perfect optimization”.

On the implementation of the L-Nash bargaining solution in two-person bargaining games

The “Nash program” initiated by Nash (Econometrica 21:128–140, 1953) is a research agenda aiming at representing every axiomatically determined cooperative solution to a game as a Nash outcome of a reasonable noncooperative bargaining game. The L-Nash solution first defined by Forgó (Interactive Decisions. Lecture Notes in Economics and Mathematical Systems, vol 229. Springer, Berlin, pp 1–15, 1983) is obtained as the limiting point of the Nash bargaining solution when the disagreement point goes to negative infinity in a fixed direction. In Forgó and Szidarovszky (Eur J Oper Res 147:108–116, 2003), the L-Nash solution was related to the solution of multiciteria decision making and two different axiomatizations of the L-Nash solution were also given in this context. In this paper, finite bounds are established for the penalty of disagreement in certain special two-person bargaining problems, making it possible to apply all the implementation models designed for Nash bargaining problems with a finite disagreement point to obtain the L-Nash solution as well. For another set of problems where this method does not work, a version of Rubinstein’s alternative offer game (Econometrica 50:97–109, 1982) is shown to asymptotically implement the L-Nash solution. If penalty is internalized as a decision variable of one of the players, then a modification of Howard’s game (J Econ Theory 56:142–159, 1992) also implements the L-Nash solution.

Pairwise comparison matrices and the error-free property of the decision maker

Pairwise comparison is a popular assessment method either for deriving criteria-weights or for evaluating alternatives according to a given criterion. In real-world applications consistency of the comparisons rarely happens: intransitivity can occur. The aim of the paper is to discuss the relationship between the consistency of the decision maker—described with the error-free property—and the consistency of the pairwise comparison matrix (PCM). The concept of error-free matrix is used to demonstrate that consistency of the PCM is not a sufficient condition of the error-free property of the decision maker. Informed and uninformed decision makers are defined. In the first stage of an assessment method a consistent or near-consistent matrix should be achieved: detecting, measuring and improving consistency are part of any procedure with both types of decision makers. In the second stage additional information are needed to reveal the decision maker’s real preferences. Interactive questioning procedures are recommended to reach that goal.

A Dynamic Input-Output Model with Renewable Resources

The paper studies a generalisation of the dynamic Leontief input-output model. The standard dynamic Leontief model will be extended with the balance equation of renewable resources. The renewable stocks will increase regenerating and decrease exploiting primary natural resources. In this study the controllability of this extended model is examined by taking the consumption as the control parameter. Assuming balanced growth for both consumption and production, we investigate the exhaustion of renewable resources in dependence on the balanced growth rate and on the rate of natural regeneration. In doing so, classic results from control theory and on eigenvalue problems in linear algebra are applied.

A simplified implementation of the least squares solution for pairwise comparisons matrices

This is a follow up to "Solution of the least squares method problem of pairwise comparisons matrix" by Bozóki published by this journal in 2008. Familiarity with this paper is essential and assumed. For lower inconsistency and decreased accuracy, our proposed solutions run in seconds instead of days. As such, they may be useful for researchers willing to use the least squares method (LSM) instead of the geometric means (GM) method.

A method for solving LSM problems of small size in the AHP

The Analytic Hierarchy Process (AHP) is one of the most popular methods used in Multi-Attribute Decision Making. It provides with ratio-scale measurements of the prioirities of elements on the various leveles of a hierarchy. These priorities are obtained through the pairwise comparisons of elements on one level with reference to each element on the immediate higher level. The Eigenvector Method (EM) and some distance minimizing methods such as the Least Squares Method (LSM), Logarithmic Least Squares Method (LLSM), Weighted Least Squares Method (WLSM) and Chi Squares Method (X2M) are of the tools for computing the priorities of the alternatives. This paper studies a method for generating all the solutions of the LSM problems for 3 × 3 matrices. We observe non-uniqueness and rank reversals by presenting numerical results.

Solving the Least Squares Method problem in the AHP for 3 X 3 and 4 X 4 matrices

The Analytic Hierarchy Process (AHP) is one of the most popular methods used in Multi-Attribute Decision Making. The Eigenvector Method (EM) and some distance minimizing methods such as the Least Squares Method (LSM) are of the possible tools for computing the priorities of the alternatives. A method for generating all the solutions of the LSM problem for 3 × 3 and 4 × 4 matrices is discussed in the paper. Our algorithms are based on the theory of resultants.

Solution of the Least Squares Method problem of pairwise comparison matrices

The aim of the paper is to present a new global optimization method for determining all the optima of the Least Squares Method (LSM) problem of pairwise comparison matrices. Such matrices are used, e.g., in the Analytic Hierarchy Process (AHP). Unlike some other distance minimizing methods, LSM is usually hard to solve because of the corresponding nonlinear and non-convex objective function. It is found that the optimization problem can be reduced to solve a system of polynomial equations. Homotopy method is applied which is an efficient technique for solving nonlinear systems. The paper ends by two numerical example having multiple global and local minima.

On pairwise comparison matrices that can be made consistent by the modification of a few elements

Pairwise comparison matrices are often used in Multi-attribute Decision Making forweighting the attributes or for the evaluation of the alternatives with respect to a criteria. Matrices provided by the decision makers are rarely consistent and it is important to index the degree of inconsistency. In the paper, the minimal number of matrix elements by the modification of which the pairwise comparison matrix can be made consistent is examined. From practical point of view, the modification of 1, 2, or, for larger matrices, 3 elements seems to be relevant. These cases are characterized by using the graph representation of the matrices. Empirical examples illustrate that pairwise comparison matrices that can be made consistent by the modification of a few elements are present in the applications.