999 resultados para 7140-248


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Tutkimuksessa haetaan vastausta kysymykseen: millaista tietoa ammattikorkeakoulun taloushallinnon laskentajärjestelmistä pitäisi saada, jotta se vastaisi tiedon tarvitsijoiden tarpeisiin, sekä ammattikorkeakoulun sisällä että organisaation sidosryhmiin nähden, mahdollisimman tarkoituksenmukaisesti ja tehokkaasti? Tavoitteina on selvittää taloushallinnon laskentajärjestelmien kehitystarpeet maksullisen palvelutoiminnan osalta ja vertailla kolmen eri ammattikorkeakoulun välillä taloushallinnon laskentajärjestelmistä saatavaa tietoa tuoden esille parhaat käytännöt ja tiedon-tuottamistavat. Tutkimus on rajattu koskemaan maksullista palvelutoimintaa ja tutkittavaa ilmiötä käsitellään ammattikorkeakoulun sisällä. Näkökulmina ovat johtajan ja päätöksentekijän, kehittäjän ja taloushallinto-osaston näkökulmat. Tutkimus on teemahaastatteluin toteutettava kvalita-tiivinen case-tutkimus, jonka lopputulemana syntyy 'Taloushallinnon raportoinnin johdonmukainen ja aktiivinen kehittäminen' -toimintamalli. Tutkimuksen teoria perustuu pääosin laskentatoimesta (strateginen, johdon ja rahoituksen laskentatoimi sekä laskentatoimi yrityksen informaatiojärjestelmänä), taloushallinnosta (mm.talousjohtaminen, taloushallinnon muuttuva rooli) sekä benchmarkingista kirjoitetulle kirjallisuudelle. Näistä muodostuu tutkimuksen teoreettinen viitekehys jaedelleen teemahaastattelu-lomake, joka toimii empiirisen osion tiedon hankinnan pohjana.

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De nombreuses recommandations de pratique clinique (RPC) ont été publiées, en réponse au développement du concept de la médecine fondée sur les preuves et comme solution à la difficulté de synthétiser et trier l'abondante littérature médicale. Pour faire un choix parmi le foisonnement de nouvelles RPC, il est primordial d'évaluer leur qualité. Récemment, le premier instrument d'évaluation standardisée de la qualité des RPC, appelé " AGREE " pour appraisal of guidelines for research and evaluation, a été validé. Nous avons comparé - avec l'aide de la grille " AGREE " - les six principales RPC publiées depuis une dizaine d'années sur le traitement de la schizophrénie : (1) les Recommandations de l'Agence nationale pour le développement de l'évaluation médicale (ANDEM) ; (2) The American Psychiatric Association (APA) practice guideline for the treatment of patients with schizophrenia ; (3) The quick reference guide of APA practice guideline for the treatment of patients with schizophrenia [APA - guide rapide de référence] ; (4) The schizophrenia patient outcomes research team (PORT) treatment recommandations ; (5) The Texas medication algorithm project " T-MAP " ; (6) The expert consensus guideline for the treatment of schizophrenia. Les résultats de notre étude ont ensuite été comparés avec ceux d'une étude similaire publiée en 2005 par Gæbel et al. portant sur 24 RPC abordant le traitement de la schizophrénie, réalisée également avec l'aide de la grille " AGREE " et deux évaluateurs [Br J Psychiatry 187 (2005) 248-255]. De manière générale, les scores des deux études ne sont pas trop éloignés et les deux évaluations globales des RPC convergent : chacune des six RPC est perfectible et présente différemment des points faibles et des points forts. La rigueur d'élaboration des six RPC est dans l'ensemble très moyenne, la prise en compte de l'opinion des utilisateurs potentiels est lacunaire et un effort sur la présentation des recommandations faciliterait leur utilisation clinique. L'applicabilité des recommandations est également peu considérée par les auteurs. Globalement, deux RPC se distinguent et peuvent être fortement recommandées selon les critères de la grille " AGREE " : " l'APA - guide rapide de référence " et le " T-MAP ".

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Aging is a fascinating, albeit controversial, chapter in biology. Few other subjects have elicited more than a century of ever-increasing scientific interest. In this review, we discuss studies on aging in social insects, a group of species that includes ants and termites, as well as certain bee and wasp species. One striking feature of social insects is the lifespan of queens (reproductive females), which can reach nearly 30 years in some ant species. This is over 100 times the average lifespan of solitary insects. Moreover, there is a tremendous variation in lifespan among castes, with queens living up to 500 times longer than males and 10 times longer than workers (non-reproductive individuals). This lifespan polymorphism has allowed researchers to test the evolutionary theory of aging and Y more recently Y to investigate the proximate causes of aging. The originality of these studies lies in their use of naturally evolved systems to address questions related to aging and lifespan determination that cannot be answered using the conventional model organisms.

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El contingut d’aquest projecte és bàsicament tots els processos a tenir en compte desde el punt de partida d’una idea o necessitat fins a poder introduir aquesta en el mercat internacional com a producte. S’estudien els antecedents o productes que competiran amb la teva idea, es fa un pla de marketing complert, es fan els prototips, es fa la protecció del producte i es comercialitza; tots aquests processos estan explicats al projecte.

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El sorgiment de l'estat de benestar al segle passat ha sofert diverses variacions i ha estat subjecte a distintes conceptualitzacions teòriques en vinculació a formes històricament anteriors de control de la pobresa vs. treball assalariat. Aquest i d'altres temes sobre la crisi actual de l'estat de benestar són objecte d'anàlisi en aquest article.

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Background: Macular edema resulting from central retinal vein occlusion is effectively treated with anti-vascular endothelial growth factor injections. However, some patients need monthly retreatment and still show frequent recurrences. The purpose of this study was to evaluate the visual and anatomic outcomes of refractory macular edema resulting from ischemic central retinal vein occlusion in patients switched from ranibizumab to aflibercept intravitreal injections. Patients and Methods: We describe a retrospective series of patients followed in the Medical Retina Unit of the Jules Gonin Eye Hospital for macular edema due to ischemic central retinal vein occlusion, refractory to monthly retreatment with ranibizumab, and changed to aflibercept. Refractory macular edema was defined as persistence of any fluid at each visit one month after last injection during at least 6 months. All patients had to have undergone pan-retinal laser scan. Results: Six patients were identified, one of whom had a very short-term follow-up (excluded from statistics). Mean age was 57 ± 12 years. The mean changes in visual acuity and central macular thickness from baseline to switch were + 20.6 ± 20.3 ETDRS letters and - 316.4 ± 276.6 µm, respectively. The additional changes from before to after the switch were + 9.2 ± 9.5 ETDRS letters and - 248.0 ± 248.7 µm, respectively. The injection intervals could often be lengthened after the switch. Conclusions: Intravitreal aflibercept seems to be a promising alternative treatment for macular edema refractory to ranibizumab in ischemic central retinal vein occlusion.

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O controle do ácaro Brevipalpus phoenicis (Geijskes, 1939), transmissor do vírus da leprose, deve ser realizado quando sua população atinge o nível de ação, obtido pelo monitoramento de sua população, por meio de amostragens. Objetivou-se determinar o tamanho da amostra aceitável para estimar a população do ácaro, para posterior tomada de decisão. O experimento foi realizado na Fazenda Cambuhy, Matão - SP, no ano agrícola 2003-2004. Escolheu-se ao acaso um talhão da variedade Valência, com oito anos de idade, plantada no espaçamento 7x3,5m, com 2.480 plantas. Nesse talhão, foram inspecionados 1; 2; 3; 5; 10 e 100% das plantas, o que corresponde a 25; 50; 74; 124; 248 e 2.480 plantas, respectivamente, em caminhamento no sentido das linhas de plantio. Foram amostrados 3 frutos ou, na ausência destes, eram analisados ramos. De acordo com os resultados obtidos, observa-se que a porcentagem de erro na estimativa da média para a porcentagem de frutos com presença de ácaros, quando se amostra apenas 1% das plantas (25 plantas), é de 50%, ou seja, para uma infestação de 10%, a variação da porcentagem de frutos infestados estaria entre 5 e 15%, levando o produtor a subestimar ou a superestimar o nível de infestação, aumentando os gastos com pulverizações desnecessárias ou um controle ineficiente do ácaro. Para que o erro na amostragem fique dentro da situação aceitável, de 20 a 30% (em média 25%) de erro, deveriam ser amostradas 105 plantas. Na porcentagem de frutos com mais de 10 ácaros, verifica-se que, para a situação aceitável (20 a 30%), devem ser inspecionadas 540 plantas.

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BACKGROUND: Pneumonia is the biggest cause of deaths in young children in developing countries, but early diagnosis and intervention can effectively reduce mortality. We aimed to assess the diagnostic value of clinical signs and symptoms to identify radiological pneumonia in children younger than 5 years and to review the accuracy of WHO criteria for diagnosis of clinical pneumonia. METHODS: We searched Medline (PubMed), Embase (Ovid), the Cochrane Database of Systematic Reviews, and reference lists of relevant studies, without date restrictions, to identify articles assessing clinical predictors of radiological pneumonia in children. Selection was based on: design (diagnostic accuracy studies), target disease (pneumonia), participants (children aged <5 years), setting (ambulatory or hospital care), index test (clinical features), and reference standard (chest radiography). Quality assessment was based on the 2011 Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) criteria. For each index test, we calculated sensitivity and specificity and, when the tests were assessed in four or more studies, calculated pooled estimates with use of bivariate model and hierarchical summary receiver operation characteristics plots for meta-analysis. FINDINGS: We included 18 articles in our analysis. WHO-approved signs age-related fast breathing (six studies; pooled sensitivity 0·62, 95% CI 0·26-0·89; specificity 0·59, 0·29-0·84) and lower chest wall indrawing (four studies; 0·48, 0·16-0·82; 0·72, 0·47-0·89) showed poor diagnostic performance in the meta-analysis. Features with the highest pooled positive likelihood ratios were respiratory rate higher than 50 breaths per min (1·90, 1·45-2·48), grunting (1·78, 1·10-2·88), chest indrawing (1·76, 0·86-3·58), and nasal flaring (1·75, 1·20-2·56). Features with the lowest pooled negative likelihood ratio were cough (0·30, 0·09-0·96), history of fever (0·53, 0·41-0·69), and respiratory rate higher than 40 breaths per min (0·43, 0·23-0·83). INTERPRETATION: Not one clinical feature was sufficient to diagnose pneumonia definitively. Combination of clinical features in a decision tree might improve diagnostic performance, but the addition of new point-of-care tests for diagnosis of bacterial pneumonia would help to attain an acceptable level of accuracy. FUNDING: Swiss National Science Foundation.

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Järvimaisema Aulangolta. Vastarannalla puiden keskellä Karlbergin kartano ja linnanrauniot.

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BACKGROUND: Visceral obesity (VO) increases technical difficulty in laparoscopic surgery. The body mass index (BMI) does not always correlate to intra-abdominal fat distribution. Our hypothesis was that simple anthropometric measures that reflect VO, could predict technical difficulty in laparoscopic colorectal surgery, as reflected by the operative time, more accurately than the BMI. METHODS: Charts of all consecutive patients who underwent laparoscopic left colon resection in our institution between 2007 and 2010 were reviewed retrospectively. On a preoperative CT scan, anthropometric measures were taken on an axial plane at the L4-L5 level. Demographic, operative and anthropometric CT measures were correlated with the operative time. Logistic regression analysis was performed to assess the value of anthropometric CT measures or BMI to predict the duration of the colectomy. RESULTS: 121 patients with elective left colon resection for benign (56%) or malignant disease (44%) were included. There were 74 sigmoid resections (61%), 21 left hemicolectomies (17%) and 26 low anterior resections (22%). A longer sagittal abdominal diameter (≥24.8 cm) was significantly associated with longer corrected operative time (248 vs. 228 min, p = 0.043). In multivariate analysis, greater sagittal abdominal diameter, sagittal internal diameter and abdominal perimeter were significantly associated with longer operative time. No significant association was found for the BMI neither in univariate nor in multivariate analysis. CONCLUSIONS: This study suggests that simple linear measures taken on a CT scan, such as sagittal abdominal diameter, sagittal internal diameter and abdominal perimeter, may predict longer operative time in laparoscopic left colonic resections more accurately than BMI.

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Estudi d’un capbreu del terme de Conesa del segle xviii dipositat en el fons notarial de Valls, des del punt de vista de l’onomàstica, els terratinents i el noms de les partides de terra que s ́hi conreaven. El treball detalla la presència dels cognoms anotats des del segle XVII fins al XIX i si els noms dels topònims relacionats en aquest document són vius actualment.

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O objetivo do trabalho foi avaliar a resposta de três cultivares de pessegueiro quanto à brotação de gemas, em ramos com ou sem desponte, quando submetidas a diferentes períodos de exposição ao frio. Ramos de ano das cultivares Coral, Eragil e Rubidoux foram submetidas ao frio complementar (0; 312; 624 e 1.248 unidades de frio). Posteriormente, metade dos ramos foram mantidos inteiros e nos demais efetuou-se o desponte, com a retirada da gema apical. Os ramos foram mantidos em câmara de crescimento a 25ºC, sendo avaliado o percentual de brotação de gemas vegetativas e floríferas aos 15 e 30 dias após início da exposição a 25ºC. O desponte incrementou a brotação de gemas vegetativas em todas as cultivares avaliadas. O efeito do desponte sobre a brotação das gemas vegetativas foi variável conforme as unidades de frio aos quais os ramos foram expostos, sendo evidenciado maior efeito do desponte nos tratamentos com maior exposição ao frio.

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La calidad educativa de los centros de hoy depende del nivel de competencias adquirido por sus educadores (Perrenoud, 2002). En este sentido, debemos apostar por un equipo humano formado por sujetos que sepan superarse permanentemente, aptos para ejercer tareas dinámicas y cambiantes y que compartan alternativas para crecer en todos los sentidos. Más todavía, debemos apostar por profesionales capaces de identificar y dominar los procesos que se deben realizar actuando con decisión y responsabilidad. La adquisición de competencias comporta aptitud y actitud para utilizar conocimientos, más concretamente, habilidades y valores, de manera interdisciplinaria, transversal e interactiva en contextos y situaciones que requieren la intervención de contenidos vinculados a las diferentes áreas del currículum (Lleixà, 2007), sin exclusividad, en este caso, del área de Educación Física. Presentamos una propuesta metodológica, el «Paradigma Estratégico para el desarrollo de habilidades competenciales», cuya ejecución implica comprensión, reflexión y discernimiento, teniendo en cuenta la dimensión social de cada situación. El estudio se ha llevado a cabo en la Universidad de Lleida con 40 alumnos de tercer curso de la asignatura «Educación Física y su didáctica». Se pretende valorar el impacto que provoca la implementación del programa «Paradigma estratégico para la adquisición de habilidades competenciales» sobre sus propias percepciones competenciales intrapersonales, antes y después de la aplicación de dicho programa.