1000 resultados para future doctor
Resumo:
Sepsis is a common and lethal syndrome: although outcomes have improved, mortality remains high. No specific anti-sepsis treatments exist; as such, management of patients relies mainly on early recognition allowing correct therapeutic measures to be started rapidly, including administration of appropriate antibiotics, source control measures when necessary, and resuscitation with intravenous fluids and vasoactive drugs when needed. Although substantial developments have been made in the understanding of the basic pathogenesis of sepsis and the complex interplay of host, pathogen, and environment that affect the incidence and course of the disease, sepsis has stubbornly resisted all efforts to successfully develop and then deploy new and improved treatments. Existing models of clinical research seem increasingly unlikely to produce new therapies that will result in a step change in clinical outcomes. In this Commission, we set out our understanding of the clinical epidemiology and management of sepsis and then ask how the present approaches might be challenged to develop a new roadmap for future research.
Resumo:
En el presente estudio hacemos una revisión del estado de conservación y las tendencias poblacionales de la codorniz común (Coturnix coturnix) desde 1900 hasta nuestros días. Algunos de los datos de los que disponemos son contradictorios con respecto al estado de la especie, que presenta ciertas características que dificultan el poder proporcionar estimas poblacionales fiables. Datos recientes sugieren claramente, tanto a escala local como a escala transnacional, que las poblaciones atlánticas de codorniz común han permanecido estables en las dos últimas décadas y que la práctica de liberar codornices criadas en granjas (híbridas con la codorniz japonesa, Coturnix japonica) con finalidades cinegéticas, no afectan significativamente a nuestras estimas. Por otra parte, los complejos patrones de desplazamiento de esta especie requieren especial atención. En este sentido, el análisis de recuperaciones de anillas puede aportar información relevante, especialmente de los movimientos nomádicos de codornices a la búsqueda de hábitats adecuados, tras la destrucción de los cultivos invernales de cereales debido a la siega. Así, al desarrollar un modelo de distribución de cría para esta especie, se debe incorporar continuamente información actualizada de los cambios estacionales de hábitat y clima, con el fin de obtener unas predicciones óptimas. En este sentido, por ejemplo, la inclusión de datos quincenales de índices de vegetación en los modelos de distribución ha dado muy buenos resultados. La obtención de predicciones fiables de los cambios de la distribución de la especie y de sus desplazamientos durante la estación de cría puede ser muy útil para un mejor conocimiento del estado de conservación y las tendencias poblacionales de la especie, así como para el diseño de futuras medidas de gestión.
Resumo:
Purpose: The purpose of this paper is to analyse the impact of business exits on future dimensions of entrepreneurial activity at the macroeconomic level. Design/methodology/approach: This research uses the Global Entrepreneurship Monitor (GEM) data for 41 countries and the Generalized Method of Moments (GMM) to carry out the analysis. The paper differentiates the effect of the two components of total entrepreneurial activity, and the two motivations for it – opportunity and necessity entrepreneurship. Findings: The results presented here show a positive and significant effect of the coefficient associated with exits in all models. This means that the levels of entrepreneurial activity exceed business exits. The robustness of the models are tested, including other variables such as the fear of failure, the Gross Domestic Product, role models, entrepreneurial skills and the unemployment variables. The main hypothesis which stated that at national level business exits imply greater rates of opportunity-driven entrepreneurship is corroborated. Originality/value: One would expect that unemployment rates would imply higher levels of necessity entrepreneurship. However, results show that unemployment rates do in fact favour opportunity entrepreneurship levels. This could be due to those government policies that are aimed at promoting entrepreneurship through the capitalization of unemployment to be totally invested in a new start-up. To the best of our knowledge, this is the first panel data study to link previous exit rates to future dimensions of entrepreneurial activity. Keywords: Entrepreneurship, business exits, social values, industrial organization Paper type: Research paper
Resumo:
Parlar de la relació de Salvador Espriu amb la Universitat de Barcelona és donar a aquesta institució l"autèntic paper d"Alma Mater, de mare nutrícia, que tantes vegades se li atribueix i que en tan poques s"acompleix. Lluny del senil desencís que traspua la seva carta d"acceptació del doctorat honoris causa que li va ser concedit l"any 1980, d"altra banda lúcid testimoni i testament de la seva experiència acadèmica estroncada, hem de baixar als seus anys juvenils, universitaris, per retrobar un Salvador Espriu optimista, alegre, vital, enginyós i punyent, ple d"il·lusions.
Resumo:
In 2007 (the last agricultural census), Chile had 308, 445 ha of fruit orchards: an increase of almost 32% from the previous census (1997). The most important species were table grapes (20%), avocados (13%) and apples (12%). Some 22% of the fruit crops growing area corresponded to juvenile orchards; within the species with higher proportion of juvenile orchards were prunes (42%) and blueberries (56%). Most orchards are located between latitude 27º18` S (Copiapó) and 40º36´S (Puerto Varas). The industry is driven by the export component which accounts for more than 50% of the fruits produced. In the crop season 2009-2010, approximately 254 million boxes (around 2.5 million tons) were exported, representing over US$ 3.5 million. Processed and fresh fruits represented 8.2 and 26.7% of the total forest and agricultural Chilean exports in 2008, respectively. The main markets for this fruits were USA/Canada (42%) and Europe (32%). The fruit grower receives, on average, 12-16% of the total price of the fruit in its final destination. Each year the fruit industry employs 450.000 people directly, of which 1/3 are permanent. Even though the fruit industry employs the highest proportion of the agricultural labor and the growing area has increased in the last 20 years, the proportion of agricultural employment has decreased from 19.5% in 1989 to 10.8% in 2008. It might also be noted that Chile invests only 0.7% of the GDP in research. In the last 40 years, the fruit industry has been a motor for the Chilean economic development, but the lower rates of currency exchange, the rising costs of energy (oil, electricity), and the increasing scarcity of hand labor have drastically reduced the profitability and are putting at risk the viability of a large proportion of the fruit orchards in Chile. It is estimated that this season around 65% of the orchards will have a negative economic balance in their operations. Higher investment in research, improvements in fruit quality and various orchard management practices, as well as higher financial support from the Government are needed for the long term viability of the fruit industry in Chile.
Resumo:
Erilaisten IP-pohjaisten palvelujen käyttö lisääntyy jatkuvasti samalla, kun käyttäjistä tulee yhä liikkuvaisempia. Tästä syystä IP- protokolla tulee väistämättä myös mobiiliverkkoihin. Tässä diplomityössä tutkitaan mobiliteetin IP multcastingiin tuomia ongelmia ja simuloidaan niitä Network Simulatoria käyttäen. Pääpaino on ongelmalla, joka aiheutuu multicast- ryhmänmuodostusviiveestä. Tätä ongelmaa simuloidaan, jotta viiveen, mobiilikäyttäjien palveluunsaapumistaajuuden ja Scalable Reliable Multicast (SRM) protokollan ajastinarvojen asetusten vaikutus repair request- pakettien määrään ja sitä kautta suoritettavien uudelleenlähetysten määrään selviäisi. Eri parametrien vaikutuksen tutkimiseksi esitetään simulaatiotuloksia varioiduilla parametreillä käyttäen CDF- käyriä. Tulosten perusteella merkittävin tekijä uudelleenlähetyspyyntöjen kannalta on protokollan ajastimien arvot ja haluttu palvelun taso, viiveen merkityksen jäädessä vähäiseksi. Työn lopuksi tutkitaan SRM- protokollan soveltuvuutta mobiiliverkkoihin ja pohditaan vaihtoehtoja toiminnan parantamiseksi.
Resumo:
The Rare Cancer Network (RCN) was formed in the early 1990's to create a global network that could pool knowledge and resources in the studies of rare malignancies whose infrequency prevented both their study with prospective clinical trials. To date, the RCN has initiated 74 studies resulting in 46 peer reviewed publications. The First International Symposium of the Rare Cancer Network took place in Nice in March of 2014. Status updates and proposals for new studies were heard for fifteen topics. Ongoing studies continue for cardiac sarcomas, thyroid cancers, glomus tumors, and adult medulloblastomas. New proposals were presented at the symposium for primary hepatic lymphoma, solitary fibrous tumors, Rosai-Dorfman disease, tumors of the ampulla of Vater, salivary gland tumors, anorectal melanoma, midline nuclear protein in testes carcinoma, pulmonary lymphoepithelioma-like carcinoma, adenoid cystic carcinoma of the trachea, osteosarcomas of the mandible, and extra-cranial hemangiopericytoma. This manuscript presents the abstracts of those proposals and updates on ongoing studies, as well a brief summary of the vision and future of the RCN.
Resumo:
Alcohol use is common among United States and Swedish high school students and is related to negative consequences. Whereas drinking intentions are associated with future drinking behaviors, the use of protective behavioral strategies (PBS) is associated with decreased alcohol-related harm among young adults. The interactive effect of PBS and drinking intentions in predicting alcohol outcomes has not been examined. Further, because most PBS studies have been conducted among U.S. college students, PBS research among other populations is needed. The aims of this study were to evaluate longitudinally (a) the relationships between drinking intentions, PBS and alcohol outcomes, and (b) the moderating roles of drinking intentions and country in these relationships among United States and Swedish high school drinkers. Data were collected at baseline, 6- and 12-month follow-ups on 901 Swedish and 288 U.S. high school drinkers. Drinking intentions were associated with more alcohol use and consequences, and use of certain PBS was related to fewer alcohol-related consequences over time. Additionally, the negative prospective relationship between use of PBS and alcohol use, but not alcohol-related consequences, was moderated by intentions, such that the relationship was stronger among participants endorsing high drinking intentions. Country did not moderate these relationships. These results provide initial support for the generalizability of PBS college research to United States and Swedish high school students and suggest that interventions targeting the use of PBS may be most effective among high school drinkers endorsing high drinking intentions. (PsycINFO Database Record
Resumo:
Chile has become a major actor in the blueberry industry as the most important supplier of off-season fresh fruit for the northern hemisphere. Blueberry exports passed from US$ 30 million (around 4,000 tons) in 2000 to US$ 380 million (94,000 tons) in 2011. The characteristics of the major blueberry growing regions (North, Central, South-central and South) are presented in terms of acreage, varieties, management practices, extension of the harvest season, and soil and climatic conditions. Most fruit is from highbush varieties, picked by hand and exported fresh by boat to United States. Largest proportion of fruit is exported from mid December to late January, which coincides with lowest prices. The south-central region (latitudes 34º50' to 38º15' S) was in 2007 the most important one with 5,075 ha (51.1% of area planted). Among the challenges for the Chilean blueberry industry in the near future are: 1. Lower profitability due to lower rates of currency exchange and higher costs, 2 - Greater scarcity and higher cost of labor, 3.- Need for higher productivity and sustainable production practices, 4- Fruit of high and consistent quality, and 5.- Greater investment in research. As a case study the article presents three approaches that can help identify areas with low availability of labor and improve its efficiency. The article shows the use of geomatic tools to establish labor availability, application of growth regulators to reduce crop load, increase fruit size and improve harvest efficiency, and the use of shakers to harvest fresh fruit for long distance markets. More research is needed to improve yields, reduce costs and give greater economical and ecological sustainability to the Chilean blueberry industry.
Resumo:
Työn päätavoitteena oli tutkia mobiilipalveluita ja langattomia sovelluksia Suomen terveydenhuollon sektorilla. Tutkimus havainnollistaa avain-alueita, missä mobiilipalvelut ja langattomat sovellukset voivat antaa lisäarvoa perinteiseen lääketieteen harjoittamiseen, ja selvittää, mitkä ovat tähän kehitykseen liittyvät suurimmat ongelmat ja uhkat sekä tutkimustuloksiin pohjautuvat mahdolliset palvelut ja sovellukset 5-10 vuoden kuluttua. Tutkimus oli luonteeltaan kvalitatiivinen ja tutkimuksen toteuttamiseen valittiin tulevaisuudentutkimus ja erityisesti yksi sen menetelmistä, delfoi-menetelmä. Tutkimuksen aineisto kerättiin kahdelta puolistrukturoidulta haastattelukierrokselta. Työn empiirinen osuus keskittyi kuvailemaan Suomen terveydenhuollon sektoria, siinä meneillään olevia projekteja sekä teknisiä esteitä. Lisäksi pyrittiin vastaamaan tutkimuksen pääkysymykseen. Tutkimustulokset osoittivat, että tärkeät alueet, joihin langaton kommunikaatio tulisi vaikuttamaan merkittävästi, ovat ensiaputoiminta, kroonisten potilaiden etämonitorointi, välineiden kehittäminen langattomaan kommunikaatioon kotihoidon parantamiseksi ja uusien toimintamallien luomiseksi sekä lääketieteellinen yhteistyö jakamalla terveydenhuoltoon liittyvät informaation lähteet. Työn tulosten perusteellavoitiin antaa myös muutamia toimenpide-ehdotuksia jatkotutkimuksia varten.