961 resultados para Rating soberano
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Supervisor ratings are useful criteria for the validation of selection instruments but maybe limited because of the presence of rating errors, such as halo. This study set out to show that supervisor ratings which are high in halo remain successful criteria in selection. Following a thorough job analysis, a customer service questionnaire was designed to assess the potential of retail sales staff on three orthogonal subscales labelled Dealing with people, Emotions and energy, and Solitary style. These subscales were uncorrelated with supervisor ratings made about 8 weeks later. However, the supervisor ratings were correlated with an overall scale derived from the three scales of the customer service questionnaire. These results support the view that supervisor ratings generally consist of global impressions and suggest that these global impressions are useful measures of overall performances. This field study confirms laboratory results that halo does not necessarily reduce rating accuracy.
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This article describes a new test method for the assessment of the severity of environmental stress cracking of biomedical polyurethanes in a manner that minimizes the degree of subjectivity involved. The effect of applied strain and acetone pre-treatment on degradation of Pellethane 2363 80A and Pellethane 2363 55D polyurethanes under in vitro and in vivo conditions is studied. The results are presented using a magnification-weighted image rating system that allows the semi-quantitative rating of degradation based on distribution and severity of surface damage. Devices for applying controlled strain to both flat sheet and tubing samples are described. The new rating system consistently discriminated between. the effects of acetone pre-treatments, strain and exposure times in both in vitro and in vivo experiments. As expected, P80A underwent considerable stress cracking compared with P55D. P80A produced similar stress crack ratings in both in vivo and in vitro experiments, however P55D performed worse under in vitro conditions compared with in vivo. This result indicated that care must be taken when interpreting in vitro results in the absence of in vivo data. (C) 2001 Elsevier Science Ltd. All rights reserved.
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This study describes the rehabilitation length of stay (LOS), discharge destination and discharge functional status of 149 patients admitted with traumatic brain injury (TBI) to an Australian hospital over a 5-year period. Hospital charts of patients admitted between 1993-1998 were reviewed. Average LOS over the 5-year time period was 61.8 days and only decreased nominally over this time. Longer LOS was predicted by lower admission motor FIM scores and presence of comorbidities. Mean admission and discharge motor FIM scores were 58 and 79, which represented a gain of 21 points. Higher discharge motor FIM scores were predicted by higher admission motor FIM scores and younger age. FIM gain was predicted by cognitive status and age. Most patients, 88%, were discharged back to the community, with 30% changing their living setting or situation. Changing living status was predicted by living alone and having poorer functional status on admission.
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Background Diagnosis of the HIV-associated lipodystrophy syndrome is based on clinical assessment, in lack of a consensus about case definition and reference methods. Three bedside methods were compared in their diagnostic value for lipodystrophy. Patients and Methods. Consecutive HIV-infected outpatients (n = 278) were investigated, 128 of which also had data from 1997 available. Segmental bioelectrical impedance analysis (BIA) and waist, hip and thigh circumferences were performed. Changes in seven body regions were rated by physicians and patients using linear analogue scale assessment (LASA). Diagnostic cut-off values were searched by receiver operator characteristics. Results. Lipodystrophy was diagnosed in 85 patients (31%). BIA demonstrated higher fat-free mass in patients with lipodystrophy but not after controlling for body mass index and sex. Segmental BIA was not superior to whole body BIA in detecting lipodystrophy. Fat-free mass increased from 1997 to 1999 independent from lipodystrophy. Waist-hip and waist-thigh ratios were higher in patients with lipodystrophy. BIA, anthropometry and LASA did not provide sufficient diagnostic cut-off values for lipodystrophy. Agreement between methods, and between patient and physician rating, was poor. Conclusion: These methods do not fulfil the urgent need for quantitative diagnostic tools for lipodystrophy. BIA estimates of fat free mass may be biased by lipodystrophy, indicating a need for re-calibration in HIV infected populations. (C) 2001 Harcourt Publishers Ltd.
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Manual therapy, exercise and education target distinct aspects of chronic low back pain and probably have distinct effects, This study aimed to determine the efficacy of a combined physiotherapy treatment that comprised all of these strategies. By concealed randomisation, 57 chronic low back pain patients were allocated to either the four-week physiotherapy program or management as directed by their general practitioners, The dependent variables of interest were pain and disability. Assessors were blind to treatment group. Outcome data from 49 subjects (86%) showed a significant treatment effect. The physiotherapy program reduced pain and disability by a mean of 1.5/10 points on a numerical rating scale (95% CI 0.7 to 2.3) and 3.9 points on the 18-point Roland Morris Disability Questionnaire (95% CI 2 to 5.8), respectively. The number needed to treat in order to gain a clinically meaningful change was 3 (95% CI 3 to 8) for pain, and 2 (95% CI 2 to 5) for disability. A treatment effect was maintained at one-year follow-up. The findings support the efficacy of combined physiotherapy treatment in producing symptomatic and functional change in moderately disabled chronic low back pain patients.
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Background: A small number of patients develop acute severe dysphagia for which reoperation is necessary within 10 days of laparoscopic fundoplication. The aim of this study was to identify clinical variables that might predict the likelihood of this condition occurring, such that it could be avoided in the future. Methods: This was a prospective cohort study from three tertiary referral centres, using reoperation for acute dysphagia as the main outcome variable. Gastrointestinal symptom rating scale, and psychological well-being index questionnaires were undertaken before laparoscopic fundoplication, and dysphagia scores were determined before operation and 1 year later. Standard preoperative assessment included gastroscopy, oesophageal manometry and pH studies. Results: Twelve (1.9 per cent) of the 617 patients suffered acute dysphagia, which was predicted by older age and female sex, and resulted in a longer duration of hospital stay. This condition was not predicted by any other demographic, clinical, investigative or operative variables. Conclusions: The study did not identify useful criteria by which severe acute dysphagia could be anticipated and thereby avoided following laparoscopic fundoplication.
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We compared the quality of realtime fetal ultrasound images transmitted using ISDN and IP networks. Four experienced obstetric ultrasound specialists viewed standard recordings in a randomized trial and rated the appearance of 30 fetal anatomical landmarks, each on a seven-point scale. A total of 12 evaluations were performed for various combinations of bandwidths (128, 384 or 768 kbit/s) and networks (ISDN or IF). The intraobserver coefficient of variation was 2.9%, 5.0%, 12.7% and 14.7% for the four observers. The mean overall ratings by each of the four observers were 4.6, 4.8, 5.0 and 5.3, respectively (a rating of 4 indicated satisfactory visualization and 7 indicated as good as the original recording). Analysis of variance showed that there were no significant interobserver variations nor significant differences in the mean scores for the different types of videoconferencing machines used. The most significant variable affecting the mean score was the bandwidth used. For ISDN, the mean score was 3.7 at 128 kbit/s, which was significantly worse than the mean score of 4.9 at 384 kbit/s, which was in turn significantly worse than the mean score of 5.9 at 768 kbit/s. The mean score for transmission using IP was about 0.5 points lower than that using ISDN across all the different bandwidths, but the differences were not significant. It appears that IP transmission in a private (non-shared) network is an acceptable alternative to ISDN for fetal tele-ultrasound and one deserving further study.
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Aims: To characterise chronic lateral epicondylalgia using the McGill Pain Questionnaire, Visual Analog Scales for pain and function, and Quantitative Sensory Tests; and to examine the relationship between these tests in a population with chronic lateral epicondylalgia. Method: Fifty-six patients (29 female, 27 male) diagnosed with unilateral lateral epicondylalgia of 18.7 months (mean) duration (range 1-300), with a mean age of 50.7 years (range 27-73) participated in this study. Each participant underwent assessment with the McGill Pain Questionnaire (MPQ), Visual Analog Scales (VAS) for pain and function. and Quantitative Sensory Tests (QST) including thermal and pressure pain thresholds, pain free grip strength, and neuromeningeal tissue testing via the upper limb tension test 2b (ULTT 2b). Results: Moderate correlation (r = .338-.514, p = .000-.013) was found between all indices of the MPQ and VAS for pain experienced in the previous 24 hours and week. Thermal pain threshold was found to be significantly higher in males. A significant poor to moderate correlation was found between the Pain Rating Index (PRI) in the sensory category of the MPQ and ULTT2b scores (r = .353, p = .038). There was no other significant correlation between MPQ and QST data. Pain free grip strength was poorly yet significantly correlated with duration of pathology (r = 318, p = .038). Conclusion: The findings of this study are in agreement with others (Melzack and Katz, 1994) regarding the multidimensional nature of pain, in a condition conventionally conceived as a musculoskeletal pain state. The findings also suggest that utilisation of only one pain measurement tool is unlikely to provide a thorough clinical picture of pain experienced with chronic lateral epicondylalgia.
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The most widely used method for predicting the onset of continuous caving is Laubscher's caving chart. A detailed examination of this method was undertaken which concluded that it had limitations which may impact on results, particularly when dealing with stronger rock masses that are outside current experience. These limitations relate to inadequate guidelines for adjustment factors to rock mass rating (RMR), concerns about the position on the chart of critical case history data, undocumented changes to the method and an inadequate number of data points to be confident of stability boundaries. A review was undertaken on the application and reliability of a numerical method of assessing cavability. The review highlighted a number of issues, which at this stage, make numerical continuum methods problematic for predicting cavability. This is in particular reference to sensitivity to input parameters that are difficult to determine accurately and mesh dependency. An extended version of the Mathews method for open stope design was developed as an alternative method of predicting the onset of continuous caving. A number of caving case histories were collected and analyzed and a caving boundary delineated statistically on the Mathews stability graph. The definition of the caving boundary was aided by the existence of a large and wide-ranging stability database from non-caving mines. A caving rate model was extrapolated from the extended Mathews stability graph but could only be partially validated due to a lack of reliable data.
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Objective: To examine the association between gain in motor and cognitive functional status with patient satisfaction 3-6 mo after rehabilitation discharge. Design: Patient satisfaction and changes in functional status were examined in 18,375 patients with stroke who received inpatient medical rehabilitation. Information was obtained from 144 hospitals and rehabilitation facilities contributing records to the Uniform Data System for Medical Rehabilitation and the National Follow-up Services. Results: Data analysis revealed significant (P < 0.05) differences in satisfaction responses based on whether information was collected from patient self-report or from a family member proxy, and the two subsets were analyzed separately. Logistic regression revealed the following significant predictors of satisfaction for data collected from stroke patients: cognitive and motor gain, rehospitalization, who the patient was living with at follow-up, age, and follow-up therapy. In the patient-reported data subset, compared with patients who showed improved cognitive or motor functional status, those with no change, respectively, had a 31% and 33% reduced risk of dissatisfaction. In addition, rehospitalized patients had a higher risk of dissatisfaction. For the proxy reported data subset, significant influences on satisfaction were health maintenance, rehospitalization, stroke type, ethnicity, cognitive FIM(TM) gain, length of stay, and follow-up therapy. Conclusions: Ratings of satisfaction with rehabilitation services were affected by change in functional status and whether the information was collected from patient rating or proxy response.
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Introdução: A relação entre eventos de vida e o surgimento e progressão do câncer de mama tem sido investigada por alguns estudos. Objetivo: Identificar os eventos de vida ocorridos em mulheres com diagnóstico de câncer de mama, examinar o tempo transcorrido entre o evento e o diagnóstico, examinar a associação entre a sobrecarga ocasionada pelo evento no momento da ocorrência e após o diagnóstico e examinar a associação entre metástase e eventos de vida pós diagnóstico de câncer de mama. Metodologia: Estudo transversal realizado no Hospital Santa Rita de Cássia, Vitória – ES. Compõe-se a amostra por 300 mulheres. Coletaram-se os dados no período de setembro a dezembro de 2014. Utilizou-se o instrumento Life Events Units – LEU/VAS que se baseia na Escala de Avaliação de Reajustamento Social de Holmes e Rahe, que no Brasil foi adaptada por Vasconcellos. Utilizou-se o Pacote Estatístico para Ciências Sociais (SPSS), versão 20.0, para calcular a frequência, média, mediana, desvio padrão e aplicar os testes não paramétrico de Wilcoxon e qui-quadrado. Resultados: A média de idade foi de 53 anos. Predominou-se mulheres de raça/cor não branca (65%), com menos de 8 anos de estudo (64%) e casadas (54%). Identificou-se que a maioria da amostra relatou pelo menos um evento de vida (99,3%). O principal evento de vida relatado foi morte de alguém na família. As medianas do tempo transcorrido entre os eventos de vida mais relatados e o diagnóstico de câncer de mama variaram de 5 a 15 anos. Observou-se diferença significante (p< 0,05) entre a sobrecarga ocasionada pelos eventos de vida nos dois momentos examinados. Em relação à metástase, 31,7% das que tiveram recidivas relataram um ou mais eventos de vida (p= 0,001). Quando considerado o tempo transcorrido entre o diagnóstico e o surgimento da metástase nas 46 mulheres, observou-se uma mediana de 18,0 meses. Conclusão: Os resultados deste estudo são potencialmente importantes, pois dão suporte a uma possível interação entre eventos de vida pós diagnóstico de câncer de mama e metástase. Estudos futuros são necessários para melhor compreensão desta relação.
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O objetivo do artigo é examinar por que não existe paradoxo entre o desenvolvimento de estruturas de governança multinível no âmbito do processo de integração europeu e a permanência do Estado soberano como fonte de representação e lealdade. Concebendo que a cessão de independência constitucional, a modificação da igualdade soberana e o comprometimento da autonomia econômica não se processaram de forma homogênea, pretende-se explicar as diferenças entre tais processos de partilha da soberania dos países membros da União Européia.
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A divisão entre as funções de legislar, de executar e de se manifestar, julgando os conflitos, bem como entre as atividades necessárias à gestão do Estado em um ambiente de res publica, difundida como divisão de poderes, com atribuições precípuas, porém não exclusivas a cada um, é lição antiga deixada por Montesquieu para evitar a tirania do soberano estatal. No caso brasileiro, apesar de a Constituição Federal de 1988 ser considerada a Constituição Cidadã, ela apresenta vícios de origem, sendo o de maior repercussão o fato de ter adotado o sistema presidencialista de governo, mas atribuindo ao Congresso competências próprias aos sistemas parlamentaristas. Tal desenho, por si eivado de contradições, aliado à tradição e ao peso do direito civil vis-à-vis ao dos usos e costumes, e em que pese ser um Estado federado, faz com que haja um excesso de competências a cargo da União. Diante desses vícios e contradições, este artigo mostra, a partir de pesquisa bibliográfica e dados secundários, como a interdependência entre os três poderes acabou se tornando um processo descontrolado de usurpação das atribuições e competências uns dos outros. Assim, é feito um pano de fundo estabelecendo os principais aspectos das postulações de Montesquieu e como tais aspectos estão presentes no sistema de governo do modelo tripartite, o presidencialismo, com destaque para as peculiaridades do contexto brasileiro, enfatizando importantes questões institucionais do sistema político nacional: multipartidarismo em um sistema federal bicameral; o elevado número de partidos; a dificuldade de, como resultado direto da consulta popular, um partido obter a maioria nos respectivos parlamentos; alianças parlamentares funcionais-fisiológicas; e o caráter nacional dos partidos. Posteriormente, são discutidos exemplos de como o Executivo usurpa o poder de legislar via medidas provisórias que acabam interferindo na agenda do Legislativo, em que pese a exigência constitucional de utilização deste instrumento somente em casos de urgência e relevância; de como o Judiciário também acaba legislando em razão da omissão do Parlamento em questões importantes; e de como o Judiciário não só força o Executivo a estabelecer e a implementar estratégias de ação, como assume ações que são de sua competência original. O quadro, como se percebe, é complexo; neste ambiente, as interferências de um poder nos domínios do outro são antes consequência do que fato originário. Isso impacta sobremaneira a formulação e implementação de políticas públicas, veja a ampla divulgação do que ocorre nas áreas da saúde e execução das penas privativas de liberdade em presídios. O modelo tripartite propaga o equilíbrio dos poderes, sem concentração nem separação absoluta entre eles, o que atualmente não vem ocorrendo no país.
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Resumo Este artigo visa discutir a relação entre o segundo imperador do Brasil, Pedro d'Alcântara, e seu último mestre de línguas semíticas e orientais, o alemão Christian Friedrich Seybold (1859-1921). Uma leitura preliminar dos diários do monarca nos chamou a atenção para a enorme quantidade de menções e referências àquele orientalista alemão, o que revela, de certa forma, a importância que o professor ocupava na vida de d. Pedro II. No entanto, ao passo que Seybold está presente em numerosas páginas dos diários, nos causa certa estranheza que tal fato tenha merecido pouca ou nenhuma consideração por parte dos biógrafos do imperador, já que o contato frequente entre eles durante cinco anos se resume a algumas poucas linhas e alusões esparsas. Partindo de uma releitura crítica do material disponível na historiografia brasileira sobre Seybold, pretendemos aportar novos dados para o estudo bio-bibliográfico daquele que foi uma figura atuante na vida intelectual de d. Pedro II, presente até os últimos dias de vida do soberano.
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Previous studies (1982,1987) have emphasized the superiority of sylvatic vector species over domestic species as xenodiagnostic agents in testing hosts with acute or chronic infections by T. cruzi "Y" stock. The present study, which is unique in that it contains data on both infectivity rates produced by the same stock in 11 different vector species and also the reaction of the same vector species to seven different parasite stocks, establishes the general validity of linking efficiency of xenodiagnosis to the biotope of its agent. For example, infectivity rates produced by "São Felipe" stock varied from 82.5% to 98.3% in sylvatic vectors but decreased to 42.5% to 71.3% in domestic species. "Colombiana" stock produced in the same sylvatic vectors infectivity rates ranging from 12.5% to 45%. These shrank to 5%-22.5% in domestic bugs. The functional role of the biotope in the vector-parasite interaction has not been eluddated. But since this phenomenon has been observed to be stable and easy to reproduce, it leads us to believe that the results obtained are valid. Data presented also provide increasing evidence that the infectivity rates exhibited by bugs from xenodiagnosis in chronic hosts, are parasite stock specific. For example, infectivity rates produced by "Berenice", "Y", "FL" and "CL" varied in R. neglectus from 26.3% to 75%; in P. megistus from 56.3% to 83.8%; in T. sordida from 28.8% to 58.8% in T. pseudomaculata from 41.3% to 66.3% and in T. rubrovaria from 48.8% to 85%. Data from xenodiagnosis in the same hosts, carrying acute infections by the same parasite stocks, gave the five sylvatic vectors a positive rating of approximately 100%, thus suggesting that the heavy loads of parasites circulating in the acute hosts obscured the characteristic interspecific differences for the parasite stock. Nonetheless these latter were revealed in the same hosts with chronic infections stimulated by very low numbers of the same parasite stocks. Certain observations here described lead us to speculate as to the possibility of further results from other parasite stocks, allowing the association of the infectivity rates produced in bugs by different parasite stocks with the isoenzymic patterns revealed by these stocks.