909 resultados para Database management -- Computer programs
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Environmental management is a complex task. The amount and heterogeneity of the data needed for an environmental decision making tool is overwhelming without adequate database systems and innovative methodologies. As far as data management, data interaction and data processing is concerned we here propose the use of a Geographical Information System (GIS) whilst for the decision making we suggest a Multi-Agent System (MAS) architecture. With the adoption of a GIS we hope to provide a complementary coexistence between heterogeneous data sets, a correct data structure, a good storage capacity and a friendly user’s interface. By choosing a distributed architecture such as a Multi-Agent System, where each agent is a semi-autonomous Expert System with the necessary skills to cooperate with the others in order to solve a given task, we hope to ensure a dynamic problem decomposition and to achieve a better performance compared with standard monolithical architectures. Finally, and in view of the partial, imprecise, and ever changing character of information available for decision making, Belief Revision capabilities are added to the system. Our aim is to present and discuss an intelligent environmental management system capable of suggesting the more appropriate land-use actions based on the existing spatial and non-spatial constraints.
Consumption Management of Air Conditioning Devices for the Participation in Demand Response Programs
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Demand Response has been taking over the years an extreme importance. There’s a lot of demand response programs, one of them proposed in this paper, using air conditioners that could increase the power quality and decrease the spent money in many ways like: infrastructures and customers energy bill reduction. This paper proposes a method and a study on how air conditioners could integrate demand response programs. The proposed method has been modelled as an energy resources management optimization problem. This paper presents two case studies, the first one with all costumers participating and second one with some of costumers. The results obtained for both case studies have been analyzed.
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To assure enduring success, firms need to generate economic value with respect for the environment and social value. They also need to be aware of the needs and expectations of relevant stakeholders and incorporate them in their business strategies and programs. These challenges imply that engineers should take into consideration societal, health and safety,environmental and commercial issues in their professional activity. This investigation accesses the influence of firms’ environmental management programs and community involvement programs on their own employees and in the community, with a focus on small and medium companies. Based on a quantitative research, the findings suggest that firms that invest both in environmental management programs and in community involvement programs have a higher involvement of their own employees with the community, while at the same time receiving more feedback (positive, but also negative) from the community, stressing the need to pay special attention to their communication policies.
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BACKGROUND To compare outcomes for patients with recurrent or persistent papillary thyroid cancer (PTC) who had metastatic tumors that were fluorodeoxyglucose-positron emission tomography (FDG-PET) positive or negative, and to determine whether the FDG-PET scan findings changed the outcome of medical and surgical management. METHODS From a prospective thyroid cancer database, we retrospectively identified patients with recurrent or persistent PTC and reviewed data on demographics, initial stage, location and extent of persistent or recurrent disease, clinical management, disease-free survival and outcome. We further identified subsets of patients who had an FDG-PET scan or an FDG-PET/CT scan and whole-body radioactive iodine scans and categorized them by whether they had one or more FDG-PET-avid (PET-positive) lesions or PET-negative lesions. The medical and surgical treatments and outcome of these patients were compared. RESULTS Between 1984 and 2008, 41 of 141 patients who had recurrent or persistent PTC underwent FDG-PET (n = 11) or FDG-PET/CT scans (n = 30); 22 patients (54%) had one or more PET-positive lesion(s), 17 (41%) had PET-negative lesions, and two had indeterminate lesions. Most PET-positive lesions were located in the neck (55%). Patients who had a PET-positive lesion had a significantly higher TNM stage (P = 0.01), higher age (P = 0.03), and higher thyroglobulin (P = 0.024). Only patients who had PET-positive lesions died (5/22 vs. 0/17 for PET-negative lesions; P = 0.04). In two of the seven patients who underwent surgical resection of their PET-positive lesions, loco-regional control was obtained without evidence of residual disease. CONCLUSION Patients with recurrent or persistent PTC and FDG-PET-positive lesions have a worse prognosis. In some patients loco-regional control can be obtained without evidence of residual disease by reoperation if the lesion is localized in the neck or mediastinum.
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BACKGROUND: In Switzerland, intravenous drug use (IDU) accounts for 80% of newly acquired hepatitis C virus (HCV) infections. Early HCV treatment has the potential to interrupt the transmission chain and reduce morbidity/mortality due to decompensated liver cirrhosis and hepatocellular carcinoma. Nevertheless, patients in drug substitution programs are often insufficiently screened and treated. OBJECTIVE/METHODS: With the aim to improve HCV management in IDUs, we conducted a cross sectional chart review in three opioid substitution programs in St. Gallen (125 methadone and 71 heroin recipients). Results were compared with another heroin substitution program in Bern (202 patients) and SCCS/SHCS data. RESULTS: Among the methadone/heroin recipients in St. Gallen, diagnostic workup of HCV was better than expected: HCV/HIV-status was unknown in only 1% (2/196), HCV RNA was not performed in 9% (13/146) of anti-HCV-positives and the genotype missing in 15% (12/78) of HCV RNA-positives. In those without spontaneous clearance (two thirds), HCV treatment uptake was 23% (21/91) (HIV-: 29% (20/68), HIV+: 4% (1/23)), which was lower than in methadone/heroin recipients and particularly non-IDUs within the SCCS/SHCS, but higher than in the, mainly psychiatrically focussed, heroin substitution program in Bern (8%). Sustained virological response (SVR) rates were comparable in all settings (overall: 50%, genotype 1: 35-40%, genotype 3: two thirds). In St. Gallen, the median delay from the estimated date of infection (IDU start) to first diagnosis was 10 years and to treatment was another 7.5 years. CONCLUSIONS: Future efforts need to focus on earlier HCV diagnosis and improvement of treatment uptake among patients in drug substitution programs, particularly if patients are HIV-co-infected. New potent drugs might facilitate the decision to initiate treatment.
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BACKGROUND: Disease-management programs may enhance the quality of care provided to patients with chronic diseases, such as chronic obstructive pulmonary disease (COPD). The aim of this systematic review was to assess the effectiveness of COPD disease-management programs. METHODS: We conducted a computerized search of MEDLINE, EMBASE, CINAHL, PsychINFO, and the Cochrane Library (CENTRAL) for studies evaluating interventions meeting our operational definition of disease management: patient education, 2 or more different intervention components, 2 or more health care professionals actively involved in patients' care, and intervention lasting 12 months or more. Programs conducted in hospital only and those targeting patients receiving palliative care were excluded. Two reviewers evaluated 12,749 titles and fully reviewed 139 articles; among these, data from 13 studies were included and extracted. Clinical outcomes considered were all-cause mortality, lung function, exercise capacity (walking distance), health-related quality of life, symptoms, COPD exacerbations, and health care use. A meta-analysis of exercise capacity and all-cause mortality was performed using random-effects models. RESULTS: The studies included were 9 randomized controlled trials, 1 controlled trial, and 3 uncontrolled before-after trials. Results indicate that the disease-management programs studied significantly improved exercise capacity (32.2 m, 95% confidence interval [CI], 4.1-60.3), decreased risk of hospitalization, and moderately improved health-related quality of life. All-cause mortality did not differ between groups (pooled odds ratio 0.84, 95% CI, 0.54-1.40). CONCLUSION: COPD disease-management programs modestly improved exercise capacity, health-related quality of life, and hospital admissions, but not all-cause mortality. Future studies should explore the specific elements or characteristics of these programs that bring the greatest benefit.
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Performance & Development Solutions (PDS) publishes a variety of newsletters that include some great information about our programs and services. Some of the topics you may find include: Upcoming Seminars Current events or news related to training Recognition of achievements How-to section
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Performance & Development Solutions (PDS) publishes a variety of newsletters that include some great information about our programs and services. Some of the topics you may find include: Upcoming Seminars Current events or news related to training Recognition of achievements How-to section
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Performance & Development Solutions (PDS) publishes a variety of newsletters that include some great information about our programs and services. Some of the topics you may find include: Upcoming Seminars Current events or news related to training Recognition of achievements How-to section
Resumo:
Performance & Development Solutions (PDS) publishes a variety of newsletters that include some great information about our programs and services. Some of the topics you may find include: Upcoming Seminars Current events or news related to training Recognition of achievements How-to section
Resumo:
Performance & Development Solutions (PDS) publishes a variety of newsletters that include some great information about our programs and services. Some of the topics you may find include: Upcoming Seminars Current events or news related to training Recognition of achievements How-to section
Resumo:
Performance & Development Solutions (PDS) publishes a variety of newsletters that include some great information about our programs and services. Some of the topics you may find include: Upcoming Seminars Current events or news related to training Recognition of achievements How-to section
Resumo:
Performance & Development Solutions (PDS) publishes a variety of newsletters that include some great information about our programs and services. Some of the topics you may find include: Upcoming Seminars Current events or news related to training Recognition of achievements How-to section
Resumo:
Performance & Development Solutions (PDS) publishes a variety of newsletters that include some great information about our programs and services. Some of the topics you may find include: Upcoming Seminars Current events or news related to training Recognition of achievements How-to section
