Fatores Influentes nos Programas Terapêuticos em Doença Mental

O presente estudo partiu de reflexões acerca dos movimentos da reforma assistencial psiquiátrica e o processo de desinstitucionalização. Apresenta-se a evolução dos espaços de loucura e da Saúde Mental até aos conceitos de comunidade terapêutica, reabilitação psicossocial e suporte social. A Saúde mental não pode ser considerada de forma restrita ao indivíduo pois reflete uma experiência grupal. Objetivo: Identificar variáveis capazes de influenciar o decurso de um processo terapêutico, em regime de comunidade terapêutica na área da Saúde Mental. Método: estudo de natureza mista, de carácter exploratório, contou com a informação relativa a 112 pacientes que estão ou estiveram incluídos no programa terapêutico de uma instituição vocacionada para intervenção em sujeitos com patologia mental severa. Foi utilizada uma grelha por nós construída de forma a obter dados relativos às variáveis idade, diagnóstico, nível de retração social, especificidades da estrutura familiar, suporte disponibilizado, grau de motivação e tipo de alta. Resultados: Os dados revelam a importância do tipo de diagnóstico, especificidades da estrutura familiar e grau de motivação para o processo terapêutico. Por meio destas variáveis podemos indiciar o sucesso ou insucesso terapêutico de um doente mental com uma probabilidade de 71,4%. Os dados sublinham ainda a importância da interação social e comportamentos da família para a motivação do doente para o tratamento. / This study was based on reflections about the movements of the psychiatric care reform and the process of deinstitutionalization. It presents the evolution of the spaces of madness and mental health to the concepts of therapeutic community, psychosocial rehabilitation and social support. The mental health can not be considered narrowly as the individual reflects a group experience. Objective: To identify variables that influence the course of a therapeutic process, on a therapeutic community in the area of Mental Health. Method: study of a mixed nature, exploratory, had information on 112 patients who are or have been included in the therapeutic program of an institution devoted to intervention in subjects with severe mental illness. We used a grid constructed by us to obtain data on age, diagnosis, level of social withdrawal, specific family structure, support available, motivation level and type of discharge. Results: The data reveal the importance of the type of diagnosis, the specific family structure and degree of motivation for the therapeutic process. By means of these variables can indicate the success or treatment failure of a mental patient with a probability of 71.4%. The data underline the importance of social interaction and behavior of the family to the patient's motivation for treatment.

Studia europejskie jako element internacjonalizacji szkolnictwa wyzszego w Unii Europejskiej

The aim of this article is to investigate how the European university education sector is being internationalized. The authors test „European Studies” programs, assuming that due to their peculiar character they are the forerunners of change, which results, among other things, from Europeanization processes. The field of „Teaching Europe” is mapped in the European Union and then a more detailed analysis is conducted in Poland and Germany. These allow the authors to formulate three models describing how universities in Europe are answering the challenges created by the integration process. The Polish and German cases further illustrate the dynamics of „European Studies” development, as well as differences in general aims, disciplinary construction as well as level of internationalization. Various geographical patterns of enhanced collaboration are revealed by the research when checking Double Degree programs.

Drivers of revenues and expenses in higher-education non-profit institutions

Double Degree

A holistic attempt to predicating excess aftermarket returns of IPOs over a 90-day period post IPO

Double Degree

Using text-mining-assisted analysis to examine the applicability of unstructured data in the context of customer complaint management

Double Degree

Use of Hyaluronidase to Prevent Perineal Trauma During Spontaneous Births: A Randomized, Placebo-Controlled, Double-blind, Clinical Trial

Introduction: The purpose of this study was to compare the frequency and severity of perineal trauma during spontaneous birth with or without perineal injections of hyaluronidase (HAase). Methods: A randomized, placebo-controlled, double-blind clinical trial was conducted in a midwife-led, in-hospital birth center in Sao Paulo, Brazil. Primiparous women (N = 160) were randomly assigned to an experimental (n = 80) or control (n = 80) group. During the second stage of labor, women in the experimental group received an injection of 20.000 turbidity-reducing units of HAase in the posterior region of the perineum, and those in the control group received a placebo injection. The assessment of perineal outcome was performed by 2 independent nurse-midwives. A 1-tailed Fisher exact test was performed, and a P value < .025 was considered statistically significant. Results: Perineal integrity occurred in 34.2% of the experimental group and in 32.5% of the control group, which was not a statistically significant difference (P = .477). First-degree laceration was the most common trauma in the posterior region of the perineum in women in both groups (experimental = 56%, control = 42.6%). Severe perineal trauma occurred in 28.9% of the experimental group and 38.8% of the control group, which also was not a statistically significant difference (P =. 131). The depth of second-degree perineal lacerations in the experimental and control groups, measured by the Peri-Rule, was 1.9 cm and 2.3 cm, respectively. An episiotomy was performed in 11 women (experimental group = 3, control group = 8), and 4 (all in control group) had third-degree lacerations. Discussion: The use of injectable HAase did not increase the proportion of intact perineum and did not reduce the proportion of severe perineal trauma in our sample. J Midwifery Womens Health 2011; 56: 436-445 (C) 2011 by the American College of Nurse-Midwives.

Effectiveness of local anaesthetics with and without vasoconstrictors for perineal repair during spontaneous delivery: Double-blind randomised controlled trial

Objective: to investigate the use of local anaesthetics, in the presence or absence of vasoconstrictors, for perineal repair during spontaneous delivery. Design: double-blind, randomised-controlled trial. Setting: a birth centre, in the city of Sao Paulo, Brazil. Participants: from June to December 2004, a total of 96 women were allocated into three groups (first-degree perineal lacerations, second-degree perineal lacerations or episiotomy), and treated with local anaesthesia (1% lidocaine or 1% lidocaine with epinephrine) (n = 16 per treatment per group). Interventions: an initial local infiltration of the anaesthetic solution was given so that episiotomy could be carried out (5 ml) and to suture spontaneous lacerations (1 ml), followed by repeated doses (1 ml) until pain was completely inhibited. Measurements and findings: the main outcome measurement was the volume of anaesthetic used during episiotomy and perineal suture. Our data suggest that the concomitant use of the vasoconstrictor resulted in a significantly lower average volume used in the treatment of first-degree (1 ml, 95% confidence interval (0) 0.4-1.6) and second-degree (3.7 ml, 95% CI 1.6-5.8) lacerations (p = 0.002 and 0.001, respectively). A 0.3 ml (95% CI 1.5-2.1) average decrease in anaesthetic volume was observed with episiotomy (p = 0.724). The maximum volume of anaesthetic used with and without vasoconstrictor was 1-2 ml in 95% and 3-4 ml in 50% of first-degree lacerations, respectively, and 1-6 ml in 88% and 7-15 ml in 81% of second-degree lacerations, respectively. For episiotomy, the maximum dose was 15 ml, regardless of anaesthetic solution used. Key conclusions: our data confirm the hypothesis that the use of anaesthetics in conjunction with vasoconstrictors is more effective than anaesthetics alone in the repair of perineal lacerations, but not for episiotomy. (C) 2007 Elsevier Ltd. All rights reserved.

Proactive motivation and engagement in career behaviors: Investigating direct, mediated, and moderated effects

Proactive career behaviors become increasingly important in today's career environment, but little is known about how and when motivational patterns affect individual differences. In a six-month longitudinal study among German university students (Study 1; N = 289) it was demonstrated that motivation in terms of "can do" (self-efficacy and context beliefs), "reason to" (autonomous career goals), and "energized to" (positive affect) significantly predicted career behaviors. Contrary to expectation, negative context beliefs had a positive effect when combined with other motivational states. Study 2 replicated and extended those results by investigating whether "can do" motivation mediates the effect of proactive personality and whether those effects are conditional upon the degree of career choice decidedness. We tested a moderated multiple mediation model with a unique sample of 134 German students, assessed three times, each interval being 6 weeks apart. The results showed that effects of proactivity were partially carried through higher self-efficacy beliefs but not context beliefs. Supporting a moderation model, indirect effects through self-efficacy beliefs were not present for students with very low decidedness.

Putting Public Service Motivation into Context. A Balance Between Universalism and Particularism

Research on Public Service Motivation (PSM) has increased enormously in the last 20 years. Besides the analysis of the antecedents of PSM and its impact on organizations and individuals, many open questions about the nature of PSM itself still remain. This article argues that the theoretical construct of PSM should be contextualized by integrating the political and administrative contexts of public servants when investigating their specific attitudes towards working in a public environment. It also challenges the efficacy of the classic four-dimensional structure of PSM when it is applied to a specific context. The findings of a confirmatory factor analysis from a dataset of 3754 employees of 279 Swiss municipalities support the appropriateness of contextualizing parts of the PSM construct. They also support the addition of an extra dimension called, according to previous research, Swiss democratic governance. With regard to our results, there is a need for further PSM research to set a definite measure of PSM, particularly in regard to the international diffusion of empirical research on PSM.Points for practitionersThis study shows that public service motivation is a relevant construct for practitioners and may be used to better assess whether public agents are motivated by values or not. Nevertheless, it stresses also that the measurement of PSM must be adapted to the institutional context as well. Public managers interested in understanding better the degree to which their employees are motivated by public values must be aware that the measurement of this PSM construct has to be contextualized. In other words, PSM is also a function of the institutional environment in which organizations operate.

Why Mathematics is essential in Biomedical Sciences degree?

Improvement of mathematical education and motivation of students in the mathematics" area is needed. What can be done? We introduce some ideas to generate the student"s interest for mathematics, because they often present difficulties in appreciating the relevance of mathematics and its role in the health sciences. We consider that a cornerstone in the strategy to attract the students" interest is linking the mathematics with real biomedical situations. We proceed in the following manner: We first present a real biomedical situation to produce interest and to generate curiosity. Second, we ask thought-provoking questions to students as: Which is the biomedical problem presented? Which is my knowledge on this situation? What could I do to solve this biomedical situation? Do I need some new mathematical concepts and procedures? Thereupon, the teacher explains the mathematical concepts necessary to solve the case presented, providing definitions, properties and tools for graphical display and/or mathematical calculations. In this learning methodology, ICTs were cornerstones for reaching the proposed competences. Furthermore, ICTs can also be used in the evaluative task in its two possible aspects: formative and for obtaining a qualification. Comments from students about this new mathematics teaching method indicate that the use of real biomedical case studies kept the lessons in mathematics interesting.

Content and Language Integration as a part of a degree reform at Tampere University of Technology

Tampere University of Technology is undergoing a degree reform that started in 2013. One of the major changes in the reform was the integration of compulsory Finnish, Swedish and English language courses to substance courses at the bachelor level. The integration of content and language courses aims at higher quality language learning, more fluency in studies, and increased motivation toward language studies. In addition, integration is an opportunity to optimize the use of resources and to offer courses that are more tailored to the students' field of study and to the skills needed in working life. The reform also aims to increase and develop co-operation between different departments at the university and to develop scientific follow up. This paper gives an overview of the integration process conducted at TUT and gives examples of adjunct CLIL implementations in three different languages.

Lightweight, liquid-cooled, direct-drive generator for highpower wind turbines: motivation, concept, and performance

Thesis: A liquid-cooled, direct-drive, permanent-magnet, synchronous generator with helical, double-layer, non-overlapping windings formed from a copper conductor with a coaxial internal coolant conduit offers an excellent combination of attributes to reliably provide economic wind power for the coming generation of wind turbines with power ratings between 5 and 20MW. A generator based on the liquid-cooled architecture proposed here will be reliable and cost effective. Its smaller size and mass will reduce build, transport, and installation costs. Summary: Converting wind energy into electricity and transmitting it to an electrical power grid to supply consumers is a relatively new and rapidly developing method of electricity generation. In the most recent decade, the increase in wind energy’s share of overall energy production has been remarkable. Thousands of land-based and offshore wind turbines have been commissioned around the globe, and thousands more are being planned. The technologies have evolved rapidly and are continuing to evolve, and wind turbine sizes and power ratings are continually increasing. Many of the newer wind turbine designs feature drivetrains based on Direct-Drive, Permanent-Magnet, Synchronous Generators (DD-PMSGs). Being low-speed high-torque machines, the diameters of air-cooled DD-PMSGs become very large to generate higher levels of power. The largest direct-drive wind turbine generator in operation today, rated just below 8MW, is 12m in diameter and approximately 220 tonne. To generate higher powers, traditional DD-PMSGs would need to become extraordinarily large. A 15MW air-cooled direct-drive generator would be of colossal size and tremendous mass and no longer economically viable. One alternative to increasing diameter is instead to increase torque density. In a permanent magnet machine, this is best done by increasing the linear current density of the stator windings. However, greater linear current density results in more Joule heating, and the additional heat cannot be removed practically using a traditional air-cooling approach. Direct liquid cooling is more effective, and when applied directly to the stator windings, higher linear current densities can be sustained leading to substantial increases in torque density. The higher torque density, in turn, makes possible significant reductions in DD-PMSG size. Over the past five years, a multidisciplinary team of researchers has applied a holistic approach to explore the application of liquid cooling to permanent-magnet wind turbine generator design. The approach has considered wind energy markets and the economics of wind power, system reliability, electromagnetic behaviors and design, thermal design and performance, mechanical architecture and behaviors, and the performance modeling of installed wind turbines. This dissertation is based on seven publications that chronicle the work. The primary outcomes are the proposal of a novel generator architecture, a multidisciplinary set of analyses to predict the behaviors, and experimentation to demonstrate some of the key principles and validate the analyses. The proposed generator concept is a direct-drive, surface-magnet, synchronous generator with fractional-slot, duplex-helical, double-layer, non-overlapping windings formed from a copper conductor with a coaxial internal coolant conduit to accommodate liquid coolant flow. The novel liquid-cooling architecture is referred to as LC DD-PMSG. The first of the seven publications summarized in this dissertation discusses the technological and economic benefits and limitations of DD-PMSGs as applied to wind energy. The second publication addresses the long-term reliability of the proposed LC DD-PMSG design. Publication 3 examines the machine’s electromagnetic design, and Publication 4 introduces an optimization tool developed to quickly define basic machine parameters. The static and harmonic behaviors of the stator and rotor wheel structures are the subject of Publication 5. And finally, Publications 6 and 7 examine steady-state and transient thermal behaviors. There have been a number of ancillary concrete outcomes associated with the work including the following. X Intellectual Property (IP) for direct liquid cooling of stator windings via an embedded coaxial coolant conduit, IP for a lightweight wheel structure for lowspeed, high-torque electrical machinery, and IP for numerous other details of the LC DD-PMSG design X Analytical demonstrations of the equivalent reliability of the LC DD-PMSG; validated electromagnetic, thermal, structural, and dynamic prediction models; and an analytical demonstration of the superior partial load efficiency and annual energy output of an LC DD-PMSG design X A set of LC DD-PMSG design guidelines and an analytical tool to establish optimal geometries quickly and early on X Proposed 8 MW LC DD-PMSG concepts for both inner and outer rotor configurations Furthermore, three technologies introduced could be relevant across a broader spectrum of applications. 1) The cost optimization methodology developed as part of this work could be further improved to produce a simple tool to establish base geometries for various electromagnetic machine types. 2) The layered sheet-steel element construction technology used for the LC DD-PMSG stator and rotor wheel structures has potential for a wide range of applications. And finally, 3) the direct liquid-cooling technology could be beneficial in higher speed electromotive applications such as vehicular electric drives.

Relating leadership, thinking styles, self-concept, motivation and stress management in education

Seventy-five principals and vice-.wincipals from public elementary and secondary schools in Hamilton, Ontario, Canada participated in this study. Participants provided ,information concerning their thinking styles, motivations, and the physical effects of stress. This information was examined to find out how satisfaction-oriented, and how security-oriented the thinking styles of the participants were. Second, the data were analysed to see how the thinking style orientations related to life style habits and the effects of stress. The satisfaction-oriented thinking styles scored higher than all of the security-oriented thinking styles by a wide margin with a small preference for the satisfaction-people-oriented styles labelled humanistic-helpful, and affiliative as opposed to the satisfaction-task-oriented styles labeled achievement, and self-actualizing. Although all eight of the security-oriented thinking styles scored well below all of the satisfaction-oriented thinking styles on the Life Styles Inventory, the perfectionistic style scored higher than all of the security-oriented styles by an impressive margin. The next highest scores were recorded by a cluster of three passive-defensive people-oriented thinking styles labeled approval, conventional, and dependent. The competitive style scored lower, and the styles labeled avoidance, oppositional, and power scored the lowest of all the defensive-security-oriented styles. These findings suggest that principals and vice-principals see themselves as relaxed, flexible, and satisfied with their ability to adapt to the stress levels they experience in their lives; however, there was some support for medical research findings that suggest that specific security-oriented thinking styles are associated with emotional stresses that contribute to the development of specific lifestyle habits, physical symptoms, and illnesses. Although the number of females in this study provides very limited generalizability, the findings of this study suggest that high achieving females tend to develop satisfaction-growth styles to a higher level than males, and they tend to use security-oriented styles to a lesser degree than males.

L'émergence d'un double régime de subventions dans le système GATT/OMC : analyse du clivage entre subventions agricoles et non agricoles

"Mémoire présenté à la Faculté des études supérieures en vue de l'obtention du grade de maîtrise en droit (LL.M) option recherche"