990 resultados para Case-fatality
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In the context of previous publications, we propose a new lightweight UM process, intended to work as a tourism recommender system in a commercial environment. The new process tackles issues like cold start, gray sheep and over specialization through a rich user model and the application of a gradual forgetting function to the collected user action history. Also, significant performance improvements were achieved regarding the previously proposed UM process.
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A novel agent-based approach to Meta-Heuristics self-configuration is proposed in this work. Meta-heuristics are examples of algorithms where parameters need to be set up as efficient as possible in order to unsure its performance. This paper presents a learning module for self-parameterization of Meta-heuristics (MHs) in a Multi-Agent System (MAS) for resolution of scheduling problems. The learning is based on Case-based Reasoning (CBR) and two different integration approaches are proposed. A computational study is made for comparing the two CBR integration perspectives. In the end, some conclusions are reached and future work outlined.
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In this paper we present a Self-Optimizing module, inspired on Autonomic Computing, acquiring a scheduling system with the ability to automatically select a Meta-heuristic to use in the optimization process, so as its parameterization. Case-based Reasoning was used so the system may be able of learning from the acquired experience, in the resolution of similar problems. From the obtained results we conclude about the benefit of its use.
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The central place hospitals occupy in health systems transforms them into prime target of healthcare reforms. This study aims to identify current trends in organizational structure change in public hospitals and explore the role of accounting in attempts to develop controls over professionals within public hospitals. The analytical framework we proposed crosses the concept of “new professionalism” (Evetts, 2010), with the concept of “accounting logic” for controlling professionals (Broadbent and Laughlin, 1995). Looking for a more holistic overview, we developed a qualitative and exploratory study. The data were collected trough semi-structured interviews with doctors of a clinical hospital unit. Content analysis suggests that, although we cannot say that there is a complete and generalized integration of accounting information in the clinical decisions, important improvement has been made in that area. Despite the extensive literature developed on this topic, there is any empirical studies of authors are aware that allow us to realize how real doctors in reals day-to-day work integrated these trends of change in theirs clinical decisions.
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OBJECTIVE: To identify risk factors associated with infant mortality and, more specifically, with neonatal mortality. METHODS: A case-control study was carried out in the municipality of Caxias do Sul, Southern Brazil. Characteristics of prenatal care and causes of mortality were assessed for all live births in the 2001-2002 period with a completed live-birth certificate and whose mothers lived in the municipality. Cases were defined as all deaths within the first year of life. As controls, there were selected the two children born immediately after each case in the same hospital, who were of the same sex, and did not die within their first year of life. Multivariate analysis was performed using conditional logistic regression. RESULTS: There was a reduction in infant mortality, the greatest reduction was observed in the post-neonatal period. The variables gestational age (<36 weeks), birth weight (<2,500 g), and 5-minute Apgar (<6) remained in the final model of the multivariate analysis, after adjustment. CONCLUSIONS: Perinatal conditions comprise almost the totality of neonatal deaths, and the majority of deaths occur at delivery. The challenge for reducing infant mortality rate in the city is to reduce the mortality by perinatal conditions in the neonatal period.
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In the present study we focus on the interaction between the acquisition of new words and text organisation. In the acquisition of new words we emphasise the acquisition of paradigmatic relations such as hyponymy, meronymy and semantic sets. We work with a group of girls attending a private school for adolescents in serious difficulties. The subjects are from disadvantaged families. Their writing skills were very poor. When asked to describe a garden, they write a short text of a single paragraph, the lexical items were generic, there were no adjectives, and all of them use mainly existential verbs. The intervention plan assumed that subjects must to be exposed to new words, working out its meaning. In presence of referents subjects were taught new words making explicit the intended relation of the new term to a term already known. In the classroom subjects were asked to write all the words they knew drawing the relationships among them. They talk about the words specifying the relation making explicit pragmatic directions like is a kind of, is a part of or are all x. After that subjects were exposed to the task of choosing perspective. The work presented in this paper accounts for significant differences in the text of the subjects before and after the intervention. While working new words subjects were organising their lexicon and learning to present a whole entity in perspective.
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OBJECTIVE: To assess the performance of the rubella suspect case definition among patients with rash diseases seen at primary care units. METHODS: From January 1994 to December 2002, patients with acute rash, with or without fever, were seen at two large primary health care units and at a public general hospital in the municipality of Niterói, metropolitan area of Rio de Janeiro, Brazil. Data from clinical and serologic assessment were used to estimate the positive predictive values of the definition of rubella suspect case from the Brazilian Ministry of Health and other combination of signs/symptoms taking serologic status as the reference. Serum samples were tested for anti-rubella virus IgM using commercially available enzyme immunoassays. Positive predictive values and respective 95% confidence intervals were calculated. RESULTS: A total of 1,186 patients with an illness characterized by variable combinations of rash with fever, arthropathy and lymphadenopathy were studied. Patients with rash, regardless of other signs and symptoms, had 8.8% likelihood of being IgM-positive for rubella. The Brazilian suspect case definition (fever and lymphadenopathy in addition to rash) had low predictive value (13.5%). This case definition would correctly identify 42.3% of the IgM-positive cases, and misclassify 26.1% of the IgM-negative cases. CONCLUSIONS: These results support the recommendation to investigate and collect clinical specimens for laboratory diagnosis of all cases of rash, for surveillance purposes. Although this strategy may increase costs, the benefits of interrupting the circulation of rubella virus and preventing the occurrence of congenital rubella syndrome should pay off.
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We examine volunteer satisfaction with HRM practices, namely recruitment, training and reward in NPOs and attitudes regarding the appropriateness of these practices. The participants in this study are 76 volunteers affiliated with four different NPOs, who work in hospitals and have direct contact with patients and their families. Analysing aggregate results we show that volunteers are more satisfied with training, and consider the training strategies to be very appropriate. After identifying differences between organisations we discover that in some organisations volunteers are satisfied with rewards but they have negative attitudes regarding the appropriateness of the recognition strategies. We also identify the volunteers who are the most and the least satisfied.
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In the present paper we analyzed the behavior of firms in the construction and manufacturing sectors, located in the region of Vale do Sousa, in the north of Portugal. From the literature, even existing some disagreements, it is possible to conclude that planning is crucial for firms survival and growth. Cooperation is another aspect that the literature presents as an important factor for firms sustainability. It also plays a major role in competition, since firms are adopting coopetition strategies. By studying a sample of 251 firms, it was possible to realize, that the majority started their business without a formal planning, and they keep going without using it. In cooperation aspects, there is a lack of cooperation. It was possible to verify, that existing cooperation has some evidence but at a vertical level. These vertical relations were also identified in stakeholder’s involvement.
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Electric vehicles (EV) offer a great potential to address the integration of renewable energy sources (RES) in the power grid, and thus reduce the dependence on oil as well as the greenhouse gases (GHG) emissions. The high share of wind energy in the Portuguese energy mix expected for 2020 can led to eventual curtailment, especially during the winter when high levels of hydro generation occur. In this paper a methodology based on a unit commitment and economic dispatch is implemented, and a hydro-thermal dispatch is performed in order to evaluate the impact of the EVs integration into the grid. Results show that the considered 10 % penetration of EVs in the Portuguese fleet would increase load in 3 % and would not integrate a significant amount of wind energy because curtailment is already reduced in the absence of EVs. According to the results, the EV is charged mostly with thermal generation and the associated emissions are much higher than if they were calculated based on the generation mix.
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O estudo caso apresentado neste artigo aborda a colaboração entre profissionais de múltiplas áreas disciplinares. Este estudo descreve como foi realizada a parceria entre a equipa de enfermagem e a equipa de psicologia clinica nas visitas domiciliárias com familias em risco. Igualmente, discute as dificuldades enfrentadas quando os profissionais não partilhavam os mesmos modelos de praticas colaborativas.
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Tese de Doutoramento, Biologia (Taxonomia Zoológica), 11 de Outubro de 2013, Universidade dos Açores.
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We investigate the phase behaviour of 2D mixtures of bi-functional and three-functional patchy particles and 3D mixtures of bi-functional and tetra-functional patchy particles by means of Monte Carlo simulations and Wertheim theory. We start by computing the critical points of the pure systems and then we investigate how the critical parameters change upon lowering the temperature. We extend the successive umbrella sampling method to mixtures to make it possible to extract information about the phase behaviour of the system at a fixed temperature for the whole range of densities and compositions of interest. (C) 2013 AIP Publishing LLC.
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Formaldehyde (FA) ranks 25th in the overall U.S. chemical production, with more than 5 million tons produced each year. Given its economic importance and widespread use, many people are exposed to FA occupationally. Recently, based on the correlation with nasopharyngeal cancer in humans, the International Agency for Research on Cancer (IARC) confirmed the classification of FA as a Group I substance. Considering the epidemiological evidence of a potential association with leukemia, the IARC has concluded that FA can cause this lymphoproliferative disorder. Our group has developed a method to assess the exposure and genotoxicity effects of FA in two different occupational settings, namely FAbased resins production and pathology and anatomy laboratories. For exposure assessment we applied simultaneously two different techniques of air monitoring: NIOSH Method 2541 and Photo Ionization Detection Equipment with simultaneously video recording. Genotoxicity effects were measured by cytokinesis-blocked micronucleus assay in peripheral blood lymphocytes and by micronucleus test in exfoliated oral cavity epithelial cells, both considered target cells. The two exposure assessment techniques show that in the two occupational settings peak exposures are still occurring. There was a statistical significant increase in the micronucleus mean of epithelial cells and peripheral lymphocytes of exposed individuals compared with controls. In conclusion, the exposure and genotoxicity effects assessment methodologies developed by us allowed to determine that these two occupational settings promote exposure to high peak FA concentrations and an increase in the micronucleus mean of exposed workers. Moreover, the developed techniques showed promising results and could be used to confirm and extend the results obtained by the analytical techniques currently available.
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Although there is an abundance of literature concerning the ingestion of food contaminated with aflatoxin B1 (AFB1), only a small number of studies explore mycotoxin exposure in occupational settings. Taking this into consideration, our study was developed with the intention of elucidating whether there is occupational exposure to AFB1 in Portuguese poultry and swine production facilities. A specific biomarker was used to assess exposure to AFB1. A total of 45 workers (34 from poultry farms; 11 from swine production facilities) participated in this study, providing blood samples. Additionally, a control group (n=30) composed of subjects without any type of contact with agricultural activity was considered. All participants signed a consent form and were provided with the study protocol. Eighteen poultry workers (58.6%) and six workers from the swine production facilities (54.5%) showed detectable levels of AFB1. In the control group, the AFB1 values were all below 1 ng/ml. No significant differences in AFB1 levels in serum between workers from poultry and swine farms were found. Poultry workers, however, showed the highest serum levels and a significant statistical difference between this group and the control group was found. Results suggest that exposure to AFB1 by inhalation occurs in both occupational settings representing an additional risk that needs to be recognised, assessed and prevented.