848 resultados para Juan, Jorge, 1713-1773-Llibres per a infants


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Mode of access: Internet.

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On double leaves, oriental style, in case.

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Ju "Qianlong 18 nian [1753] xiu ben" zeng xiu.

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Blockprint.

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Kuang 17 x 12.3 cm., 9 hang 22 zi, dan hei yu wei, zuo you shuang bian, ban xin zhong juan juan ci ji ye ci.

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Este libro es producto de una iniciativa de la Comisión Económica para América Latina y el Caribe (CEPAL) y la Organización Internacional del Trabajo (OIT), destinada a contribuir al fortalecimiento del marco analítico y el debate en torno al diseño de una estrategia de desarrollo inclusivo en el Perú, así como a apoyar la formulación de políticas que impulsen la convergencia productiva, el crecimiento económico para la igualdad y la justicia social. Se trata de adoptar una estrategia renovada, con un crecimiento económico basado en una menor heterogeneidad estructural y más desarrollo productivo, cuyo dinamismo tenga efectos positivos sobre el empleo, la distribución del ingreso y la inclusión social. En la formulación de políticas consecuentes con este enfoque del desarrollo se requiere conjugar dos líneas de actuación fundamentales. Por una parte, se precisa un cambio estructural en el sistema productivo, que mejore la productividad y genere pleno empleo. Por otra, es necesario emprender iniciativas destinadas a lograr un acceso igualitario a los resultados del progreso alcanzado, que contribuyan a crear el escenario propicio para la continua mejora de las condiciones laborales, tanto salariales como no salariales, es decir, para la creación de trabajo decente.

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Cambiando drásticamente de tendencia, se ha observado un proceso de formalización laboral en el Perú, en un contexto de crecimiento económico, durante el cual también se impulsó una reforma laboral que creó un régimen especial para micro y pequeñas empresas —lo que redujo los costos laborales— y se introdujeron mejoras en la inspección del trabajo. Mediante un panel de regiones subnacionales se analiza el papel cumplido por estos factores en el proceso de formalización. En primer lugar, se confirma que la composición del crecimiento importa para la formalización. Al analizar de manera conjunta los factores económicos (crecimiento y crecimiento sectorial) y los cambios institucionales recientes, se encuentra que —en el período analizado— dichos factores explican la mayor parte del proceso de formalización y que el crecimiento de los sectores intensivos en empleo agrega poder explicativo, mientras que los cambios institucionales no incidieron significativamente a pesar de su magnitud.

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Thesis (Master's)--University of Washington, 2016-06

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Thesis (Master's)--University of Washington, 2016-06

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Thesis (Master's)--University of Washington, 2016-06

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Thesis (Master's)--University of Washington, 2016-06

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Thesis (Master's)--University of Washington, 2016-06

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Thesis (Ph.D.)--University of Washington, 2016-06

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Background: Screening for congenital heart defects (CHDs) relies on antenatal ultrasound and postnatal clinical examination; however, life-threatening defects often go undetected. Objective: To determine the accuracy, acceptability and cost-effectiveness of pulse oximetry as a screening test for CHDs in newborn infants. Design: A test accuracy study determined the accuracy of pulse oximetry. Acceptability of testing to parents was evaluated through a questionnaire, and to staff through focus groups. A decision-analytic model was constructed to assess cost-effectiveness. Setting: Six UK maternity units. Participants: These were 20,055 asymptomatic newborns at = 35 weeks’ gestation, their mothers and health-care staff. Interventions: Pulse oximetry was performed prior to discharge from hospital and the results of this index test were compared with a composite reference standard (echocardiography, clinical follow-up and follow-up through interrogation of clinical databases). Main outcome measures: Detection of major CHDs – defined as causing death or requiring invasive intervention up to 12 months of age (subdivided into critical CHDs causing death or intervention before 28 days, and serious CHDs causing death or intervention between 1 and 12 months of age); acceptability of testing to parents and staff; and the cost-effectiveness in terms of cost per timely diagnosis. Results: Fifty-three of the 20,055 babies screened had a major CHD (24 critical and 29 serious), a prevalence of 2.6 per 1000 live births. Pulse oximetry had a sensitivity of 75.0% [95% confidence interval (CI) 53.3% to 90.2%] for critical cases and 49.1% (95% CI 35.1% to 63.2%) for all major CHDs. When 23 cases were excluded, in which a CHD was already suspected following antenatal ultrasound, pulse oximetry had a sensitivity of 58.3% (95% CI 27.7% to 84.8%) for critical cases (12 babies) and 28.6% (95% CI 14.6% to 46.3%) for all major CHDs (35 babies). False-positive (FP) results occurred in 1 in 119 babies (0.84%) without major CHDs (specificity 99.2%, 95% CI 99.0% to 99.3%). However, of the 169 FPs, there were six cases of significant but not major CHDs and 40 cases of respiratory or infective illness requiring medical intervention. The prevalence of major CHDs in babies with normal pulse oximetry was 1.4 (95% CI 0.9 to 2.0) per 1000 live births, as 27 babies with major CHDs (6 critical and 21 serious) were missed. Parent and staff participants were predominantly satisfied with screening, perceiving it as an important test to detect ill babies. There was no evidence that mothers given FP results were more anxious after participating than those given true-negative results, although they were less satisfied with the test. White British/Irish mothers were more likely to participate in the study, and were less anxious and more satisfied than those of other ethnicities. The incremental cost-effectiveness ratio of pulse oximetry plus clinical examination compared with examination alone is approximately £24,900 per timely diagnosis in a population in which antenatal screening for CHDs already exists. Conclusions: Pulse oximetry is a simple, safe, feasible test that is acceptable to parents and staff and adds value to existing screening. It is likely to identify cases of critical CHDs that would otherwise go undetected. It is also likely to be cost-effective given current acceptable thresholds. The detection of other pathologies, such as significant CHDs and respiratory and infective illnesses, is an additional advantage. Other pulse oximetry techniques, such as perfusion index, may enhance detection of aortic obstructive lesions.