873 resultados para non-dialysis management
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O Programa de Desenvolvimento Sustentável Socioambiental e Cultural da Terra Indígena Apucaraninha foi criado como condicionalidade para que a comunidade pudesse receber parte dos recursos oriundos da compensação pela construção e operação da Usina Hidrelétrica de Apucaraninha, instalada dentro das terras indígenas. Teoricamente criado para ser um programa em que os índios participassem de forma ativa e igualitária na sua construção e implementação, já nasce contraditório frente à hegemonia da ideologia da sociedade envolvente imersa na ideologia do management. É assim que tenho como objetivo compreender como o management, enquanto ideologia que se materializa em discurso, atua sobre o Programa de Sustentabilidade Socioambiental e Cultural na Terra Indígena Apucaraninha, Paraná. Para isso, faço uma pesquisa qualitativa em que os discursos, coletados por meio de entrevistas semiestruturadas e grupo focal, aplicados aos indígenas e aos não-indígenas participantes do programa, foram interpretados sob a perspectiva dos elementos da Análise do Discurso na Linha Francesa. Como apoio, ainda analisei documentos do programa e os emitidos pelo Ministério Público Federal. Os principais resultados mostram que, como eu já desconfiava, o programa exclui a participação dos indígenas de fato, uma vez que eles são considerados pelos \"brancos\", de maneira estereotipada, como irracionais, indolentes e atrasados e, assim, incapazes de escolher o \"melhor caminho\" para a sustentabilidade do programa que, neste momento, passa se orientar por uma visão economicista e materialista, contrário a lógica dos índios Kaingang. Ao discurso do management, sustentado pelo discurso capitalista, que promete a felicidade, se junta o discurso do colonizador, que trabalha desclassificando o modo de vida dos indígenas, os colocando em uma situação de vulnerabilidade que pode, assim, promover o seu extermínio, mesmo que não seja físico
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Phosphorus pollution is a major concern in Illinois. Excessive amounts of phosphorus can be detrimental to water bodies. To help control phosphorus, the Illinois Pollution Control Board has proposed phosphorus limits on wastewater treatment facility discharges. If enacted, these limits will have negative impacts on the Springbrook Water Reclamation Center in Naperville, Illinois. To minimize these impacts, Naperville can utilize various non-point controls recommended in this paper to decrease the amount of phosphorus entering into the DuPage River and the Springbrook Water Reclamation Center. While these controls will not reduce levels low enough to totally satisfy limits on phosphorus discharges, they will significantly reduce the treatment costs Naperville will need to expend to meet them and be more environmentally effective.
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This capstone explores vegetation changes in the Okavango Delta area of Botswana. Spatial analyses were conducted using Moderate Resolution Imaging Spectroradiometer Normalized Difference Vegetation Index satellite imagery and Geographic Information System land management data to compare vegetation changes within managed areas to determine whether management practices have had beneficial or adverse impacts. Rainfall, logging, and livestock data were utilized to attempt to find a link to precipitation, logging, or overgrazing. After analysis the livestock data were the only one that showed a correlation to the vegetation changes observed. Of the vegetation cover types analyzed, forest showed the most change, a significant decrease. Little difference in vegetation changes was found in the managed areas, indicating that land management techniques are ineffective.
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The five installations operated by the Department of Defense (DoD) in the Front Range region of Colorado do not meet the DoD non-hazardous solid waste diversion goal of 40 percent, further impacting landfills and generating greenhouse gases. This applied capstone project identifies and evaluates best management practices of a Materials Recovery Facility (MRF), qualitatively and quantitatively, to increase solid waste diversion at a DoD MRF. An environmental benefits model quantified the externalities of increasing solid waste diversion at the installations. By implementing best management practices at a MRF, the DoD would divert an additional 1,400 tons of solid waste per year, resulting in the equivalent of 1,502,567 gallons of gasoline being saved, among many benefits presented in this capstone.
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The Marshall Islands, a small island developing nation, has a significant solid waste problem. The atoll environment of the Majuro, the capital of the Marshall Islands, is one of scarce land and overpopulation. Increasing Western influences has been a major factor in this solid waste problem. This problem has created health issues and is an impediment to the development of a tourism industry, which is essential to the development of economic opportunities. Responsibility for solid waste management in Majuro is divided between several governmental and non-governmental agencies. This system is dysfunctional as there is little or no cooperation between the agencies. Although many consultants have developed recommendations, no action has been taken. Developing an action plan to consolidate solid waste management under one authority is important to solving of this solid waste problem. This project proposes legislation creating a solid waste management authority that will have the power to regulate all aspects of solid waste and help implement education and awareness to the people of the Marshall Islands.
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The construction industry has long been considered as highly fragmented and non-collaborative industry. This fragmentation sprouted from complex and unstructured traditional coordination processes and information exchanges amongst all parties involved in a construction project. This nature coupled with risk and uncertainty has pushed clients and their supply chain to search for new ways of improving their business process to deliver better quality and high performing product. This research will closely investigate the need to implement a Digital Nervous System (DNS), analogous to a biological nervous system, on the flow and management of digital information across the project lifecycle. This will be through direct examination of the key processes and information produced in a construction project and how a DNS can provide a well-integrated flow of digital information throughout the project lifecycle. This research will also investigate how a DNS can create a tight digital feedback loop that enables the organisation to sense, react and adapt to changing project conditions. A Digital Nervous System is a digital infrastructure that provides a well-integrated flow of digital information to the right part of the organisation at the right time. It provides the organisation with the relevant and up-to-date information it needs, for critical project issues, to aid in near real-time decision-making. Previous literature review and survey questionnaires were used in this research to collect and analyse data about information management problems of the industry – e.g. disruption and discontinuity of digital information flow due to interoperability issues, disintegration/fragmentation of the adopted digital solutions and paper-based transactions. Results analysis revealed efficient and effective information management requires the creation and implementation of a DNS.
Clinical practice guidelines for management of parkinson’s disease : a systematic critical appraisal
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Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2014
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Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2014
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Problématique : L'allergie au lait de vache (ALV) est reconnue comme une condition transitoire qui disparaît chez la majorité des enfants avant l’âge de 3-5 ans, mais des données récentes révèlent une persistance de l’ALV. Les enfants souffrant d’une ALV sont à risque d’apports insuffisants en calcium et en vitamine D, deux nutriments impliqués dans la santé osseuse. Une première étude transversale portant sur la santé osseuse d’enfants prépubères ALV a observé que la densité osseuse (DMO) lombaire était significativement inférieure à celle d’enfants sans allergie au lait de vache (SALV). Objectifs : Sur la base de ces résultats, nous désirons documenter l’évolution longitudinale de la santé osseuse, du statut en vitamine D, des apports en calcium et en vitamine D et de l’adhérence à la supplémentation des enfants ALV (n=36) et de comparer ces données aux enfants SALV (n=19). Résultats : Le gain annualisé de la DMO lombaire est similaire entre les enfants ALV et SALV. Bien qu’il n’y ait pas de différence significative entre les deux groupes, la DMO lombaire des enfants ALV demeure cependant inférieure à celle des témoins. Qui plus est, le score-Z de la DMO du corps entier tend à être inférieur chez les enfants-cas comparé aux témoins. Au suivi, la concentration de 25OHD et le taux d’insuffisance en vitamine D sont similaires entre les deux groupes tout comme les apports en calcium et en vitamine D. Davantage d’enfants ALV prennent un supplément de calcium au suivi comparativement au temps initial (42% vs. 49%, p<0,05), mais le taux d’adhérence à la supplémentation a diminué à 4 jours/semaine. Conclusion : Une évaluation plus précoce ainsi qu’une prise en charge de la santé osseuse des enfants ALV pourraient être indiquées afin de modifier l’évolution naturelle de leur santé osseuse. Les résultats justifient aussi le suivi étroit des apports en calcium et vitamine D par une nutritionniste et la nécessité d'intégrer la supplémentation dans le plan de traitement de ces enfants et d’assurer une surveillance de l’adhérence à la supplémentation.
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Foods rich in adenine and hypoxanthine may contribute to the increase of uricemia. Hyperuricemia is associated with other pathological conditions pertaining to metabolic syndrome. Objective: the assessement of the impact of fiber rich diet on uricemia in patients with metabolic syndrome. Methods: the study involved 46 male patients with metabolic syndrome who claimed to have reduced mobility in fingers, hypertension, obesity, hyperglycemia and hyperuricemia. A validated questionnaire about dietary habits was applied at the beginning of the study and after 6 weeks of fiber-rich diet by eliminating from patients diet preparations of animal food and increased intake of vegetable foods. Blood presure, body mass index, blood glucose and uric acids were measured at the beginning of the study and after 6 weeks of fiber rich diet by daily consumption of 2 servings of added grains - 60g totally and vegetables 200g, fruits 300g respectively. Results: The study shows that at baseline all patients had an inadequate dietary intake of dietary fiber, 28.5 ± 2.2 g/day instead of 38 g per day.The increase in fiber intake of 10 ± 5 g/day was associated with a decrease of serum uric acid by 69.87% from 8.3 0.6 mg/dL to 5.8 0.5 mg/dL, p = 0.008, non-significant decrease of BMI (from 26.8 4.5 to 26.4 4.6 kg/m2, p<0.01), significant decrease of glycemia (from 130 0.8 to 105 4.2mg/dL, p <0.001) and significant decrease in blood pressure (from 150 10.6 to 130 8.4 mmHg, p <0.001). Conclusion: The fiber rich diet decreased blood uric acid, blood glucose levels an arterial pressure in patients with metabolic syndrome.
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Principals who delegate tasks to agents face the perennial challenge of overcoming agency problems. We investigate whether feelings of ownership among senior managers in the absence of formal ownership can align agents' interests with those of principals, thus turning agents into psychological principals. Using a moderated mediation model, we find that psychological ownership is positively related to company performance through the mediating effect of individual-level entrepreneurial behaviour. We also find that the effect of psychological ownership on individual-level entrepreneurial behaviour and, ultimately, company performance is weaker for high levels of monitoring compared to low levels. These findings offer important contributions to agency, psychological ownership, and entrepreneurship literatures.
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Due to numerous characteristics often attributed to family firms, they constitute a unique context for non-family employees’ justice perceptions. These are linked to non-family employees’ pro-organizational attitudes and behaviors, which are essential for family firms’ success. Even though scholarly interest in non-family employees’ justice perceptions has increased, more research is still needed, also because the mechanism connecting justice perceptions and favorable outcomes is not fully understood yet. We address this gap by explicitly investigating non-family employees’ justice perceptions and by introducing psychological ownership as a mediator in the relationships between justice perceptions (distributive and procedural) and common work attitudes (affective commitment and job satisfaction). Our analysis of a sample of 310 non-family employees from Germany and German-speaking Switzerland reveals that psychological ownership mediates the relationships between distributive justice and affective commitment as well as job satisfaction. This represents valuable contributions to family business research, organizational justice and psychological ownership literature, and to practice.
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A main challenge that family businesses face is fostering non-family employees' val-ue-creating attitudes, such as affective commitment and job satisfaction. While justice perceptions have been identified as being critical in the creation of these outcomes, the process how they actually evolve is less clear, especially in family firms. We address this gap by introducing psychological ownership as a mediator in the relationships between justice perceptions (distributive and procedural) and common work attitudes (affective commitment and job satisfaction). Our analysis of a sample of 310 non-family employees from family firms in German-speaking Switzerland and Germany reveals that psychological ownership mediates the relationships between distributive justice and affective commitment as well as job satisfaction. This leads to valuable contributions to family business research, organizational justice and psychological ownership literatures, and to practice.
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One in five strokes affects the posterior circulation. Diagnosing posterior circulation stroke can be challenging, as the vascular anatomy can be variable, and because presenting symptoms are often non-specific and fluctuating. Nevertheless, making the correct diagnosis is important, as these strokes have a high chance of recurrence, can be life threatening, and can lead to equally life-threatening complications. Investigation and management largely follow those for stroke in general, although some specific differences exist. These include the preferred use of MRI for diagnosing posterior fossa lesions, the management of basilar artery thrombosis, which may have a longer time window for recanalisation therapy, and the use of endovascular therapies for secondary prevention, which, so far, have not shown any benefit in the treatment of vertebral or basilar artery stenosis. In this review, we summarise the anatomy, aetiology and presentation of posterior circulation stroke, and discuss current approaches to management.