714 resultados para barriers to change


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O solo desempenha importante papel no ciclo do C, porém a substituição da floresta tropical por áreas cultivadas altera a dinâmica e o estoque desse elemento. Em uma frente pioneira de colonização no município de Itupiranga (PA), na Amazônia Oriental, foi desenvolvido este estudo com o objetivo de avaliar as consequências da substituição de floresta nativa por pastagens de Brachiaria brizantha no conteúdo de C de um Latossolo Amarelo distrófico. As amostras de solo foram coletadas em área de floresta nativa (FN), floresta secundária de 8–10 anos (FS), pastagens de 1–2 anos (P1-2), de 5–7 anos (P5–7) e de 10–12 anos (P10–12), nas camadas de 0–2, 2–5 e 5–10 cm, para avaliar os teores e o estoque de C e realizar um fracionamento granulométrico da matéria orgânica. Após o desmatamento, a densidade do solo aumentou até a profundidade de 5 cm, sendo esse aumento maior nas pastagens mais antigas. As maiores mudanças no conteúdo de C ocorreram na camada superior do solo, havendo aumento nesse conteúdo com o tempo de implantação das pastagens. Nas camadas de 2–5 e 5–10 cm, o conteúdo de C se mostrou estável entre os tipos de cobertura vegetal avaliados. As maiores concentrações de C foram encontradas na fração silte, mas os maiores conteúdos de C ocorreram na fração argila, independentemente do tipo de cobertura vegetal. Um aumento da quantidade de C associado à fração areia, na forma de resíduos orgânicos pouco decompostos, foi observado nas pastagens, confirmando a maior sensibilidade dessa fração às mudanças de uso do solo.

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In this action research study of my two high school geometry classrooms, I investigated the use of homework. By changing the focus on homework away from the answers to the process involved in getting the answers, I found that students felt more confident, utilized their class time better, and placed more effort on complex problems. Their questions also became more specific and more effective for finding gaps in their understanding. As a result of this research, I plan to change my strategy in the practice of homework. I will give students the answers on multi-step problems to allow them the opportunity to utilize problem solving and critical thinking skills to gain practice in autonomous learning.

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Objective: To determine current food handling practices, knowledge and beliefs of primary food handlers with children 10 years old and the relationship between these components. Design: Surveys were developed based on FightBac!™ concepts and the Health Belief Model (HBM) construct. Participants: The majority of participants (n= 503) were females (67%), Caucasians (80%), aged between 30 to 49 years old (83%), had one or two children (83%), prepared meals all or most of the time (76%) and consumed meals away from home three times or less per week (66%). Analysis: Descriptive statistics and inferential statistics using Spearman’s rank correlation coefficient (rho) (p<0.05 and one-tail) and Chi-square were used to examine frequency and correlations. Results: Few participants reached the food safety objectives of Healthy People 2010 for safe food handling practices (79%). Mixed results were reported for perceived susceptibility. Only half of the participants (53-54%) reported high perceived severity for their children if they contracted food borne illness. Most participants were confident of their food handling practices for their children (91%) and would change their food handling practices if they or their family members previously experienced food poisoning (79%). Participants’ reasons for high self-efficacy were learning from their family and independently acquiring knowledge and skills from the media, internet or job. The three main barriers to safe food handling were insufficient time, lots of distractions and lack of control of the food handling practices of other people in the household. Participants preferred to use food safety information that is easy to understand, has scientific facts, causes feelings of health-threat and has lots of pictures or visuals. Participants demonstrate high levels of knowledge in certain areas of the FightBac!TM concepts but lacked knowledge in other areas. Knowledge and cues to action were most supportive of the HBM construct, while perceived susceptibility was least supportive of the HBM construct. Conclusion: Most participants demonstrate many areas to improve in their food handling practices, knowledge and beliefs. Adviser: Julie A. Albrecht

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This paper describes a program, conducted over a 5-year period, that effectively reduced heavy drinking and alcohol-related harms among university students. The program was organized around strategies to change the environment in which binge drinking occurred and involved input and cooperation from officials and students of the university, representatives from the city and the neighborhood near the university, law enforcement, as well as public health and medical officials. In 1997, 62.5% of the university’s approximately 16,000 undergraduate student population reported binge drinking. This rate had dropped to 47% in 2003. Similar reductions were found in both self-reported primary and secondary harms related to alcohol consumption.

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Introduction C-reactive protein (CRP) levels rise during inflammatory processes and have been ordered for rheumatic disease follow-up since the 1950s. The number of tests ordered in the emergency setting has increased, but without evident improvement in medical care quality. Objective To determine the pattern of CRP determinations in the emergency department (ED) of a university hospital in Sao Paulo, Brazil, and to evaluate the effect of an intervention with staff and students about the best use of the test in the ED. Methods Data regarding CRP testing requests, related diagnoses and the number of monthly consultations in the hospital ED were analysed before and after the intervention. Because of an increase in CRP measurement requests from 2007 to 2009, the author started discussing the role of CRP determinations in the medical decision-making process in early 2010. Staff and faculty members openly discussed the pattern of requests in the hospital and related current medical literature. During 2010, the medical staff worked as multipliers to change the behaviour of new students and residents. The results of the first 4 months after the intervention were presented at another general meeting in July 2010. Results From 2007 to 2009, there were 11 786 CRP measurement requests with a clear exponential trend. After the intervention, during the calendar year 2010, there was a 48% reduction in adjusted annual CRP requests. Pneumonia, fever and urinary tract infections were the most common reasons for CRP requests. Discussion Inexpensive, well-directed, interactive educational interventions may affect professional behaviour and curb rates of laboratory tests.

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This study aimed to compare clinical characteristics, evolution and severity of adult patients admitted to public and private Intensive Care Units. It is a retrospective, longitudinal and quantitative analysis of 600 patients admitted to four Intensive Care Units of Sao Paulo, Brazil. Differences were found between patients admitted in private and public hospitals regarding the following variables: age, origin, length of stay and mortality in the critical unit, cardiologic, hematologic, neurologic and renal failures and some comorbidities. The results reveal the importance of analyzing in detail clinical characteristics and healthcare of patients admitted in public institutions, because of the high mortality found. The Intensive Care Nurse can contribute to change this scenario, because she/he plays a leading role in planning and providing resources for intensive care.

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This article presents methodological contributions and a conceptual innovation for thinking about the production of health care, stemming from a study on access and barriers in mental health carried out in the municipality of Campinas (Sao Paulo, Brazil). The study used a cartographic approach and, after an initial identification of the most complex cases (on the part of the teams of workers), adopted the users as guides to explore the different levels of production of their lives and to evaluate the possibility of forming a network of existential connections that produce life as a fundamental analyzer of access or barriers to care.

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Interoperability is a crucial issue for electronic government due to the need of agencies' information systems to be totally integrated and able to exchange data in a seamless way. A way to achieve it is by establishing a government interoperability framework (GIF). However, this is a difficult task to be carried out due not only to technological issues but also to other aspects. This research is expected to contribute to the identification of the barriers to the adoption of interoperability standards for electronic government. The article presents the preliminary findings from a case study of the Brazilian Government framework (e-PING), based on the analyses of documents and face-to-face interviews. It points out some aspects that may influence the establishment of these standards, becoming barriers to their adoption.

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The current research compared resting heart rate variability (VFC) before and after 10 weeks of strength training in groups that used and did not use a vibration platform. Seventeen healthy men were divided into conventional strength training (TF) or strength training using a vibration platform with a frequency of 30 Hz (TF+V30) training groups. One repetition maximum load (1-RM) on half squat exercise and VFC measurements were determined pre- and post-training program. Both groups had improved 1-RM load after the program (15.1% in TF group and 16.4% in TF+V30 group), although this increase was changed in the same extent for the two groups and there was no difference in 1-RM load between groups pre- and post-training program. No significant difference was observed in resting VFC measurements between groups pre and post-training program, however the magnitude of the effect size was moderated (ES = 0.50-0.80) for some variables (R-R interval, standard deviation of all R-R interval - SDNN, RMSSD, log-transformed of low frequency - InLF, and log-transformed of high frequency - InHF) in TF+V30 group. It was concluded that 10 weeks of strength training program with or without the vibration platform provided similar increase in 1-RM load in both groups, and although some evidences in this study indicate that vibration can increase vagal activity analyzed by ES, in neither groups the strength training was able to change VFC significantly.

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The mechanisms of tissue changes induced by occlusal trauma are in no way comparable to orthodontic movement. In both events the primary cause is of a physical nature, but the forces delivered to dental tissues exhibit completely different characteristics in terms of intensity, duration, direction, distribution, frequency and form of uptake by periodontal tissues. Consequently, the tissue effects induced by occlusal trauma are different from orthodontic movement. It can be argued that occlusal trauma generates a pathological tissue injury in an attempt to adapt to new excessive functional demands. Orthodontic movement, in turn,performs physiological periodontal bone remodeling to change the position of the teeth in a well-planned manner, eventually restoring normalcy.

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This doctoral dissertation is triggered by an emergent problem: how can firms reinvent themselves? Continuity- and change-oriented decisions fundamentally shape overtime the activities and potential revenues of organizations and other adaptive systems, but both types of actions draw upon limited resources and rely on different organizational routines and capabilities. Most organizations appear to have difficulties in making tradeoffs, so that it is easier to overinvest in one of them than to successfully achieve a mixture of both. Nevertheless, theory and empirical evidence suggest that too little of either may reduce performance, indicating a need to learn more about how organizations reconcile these tensions. In the first paper, I moved from the consideration that rapid changes in competitive environments increasingly require firms to be “ambidextrous” implementing organizational mechanisms and structures that allow continuity- and change-oriented activities to be engaged at the same time. More specifically, I show that continuity- and change-related decisions can’t be confined either inside or outside the firm, but span overtime across distinct decision domains located within and beyond the organizational boundaries. Reconciling static and dynamic perspectives of ambidexterity, I conceptualize a firm’s strategy as a bundle of decisions about product attributes and components of the production team, proposing a multidimensional and dynamic model of structural ambidexterity that explains why and how firms could manage conflicting pressures for continuity and change in the context of new products. In the second study I note how rigorous systematic evidence documenting the success of ambidextrous organizations is lacking, and there has been very little investigation of how firms deal with continuity and change in new products. How to manage the transition form a successful product to another? What to change and what to keep? Incumbents that deal with series of products over time need to update their offerings in order to have the most relevant attributes to prospect clients without disappoint the current customer base. They need to both match and anticipate consumers’ preferences, blending something old with something new to satisfy the current demand and enlarge the herd by appealing to newer audiences. This paper contributes to strategic renewal and ambidexterity-related research with the first empirically assessment of a positive consumer response to ambidexterity in new products. Also, this study provides a practical method to monitor overtime the degree to which a brand or a firm is continuity- or change- oriented and evaluate different strategy profiles across two decision domains that play a pivotal role in new products: product attributes and components of the production team.

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This text wants to explore the process of bone remodeling. The idea supported is that the signal, the cells acquire and which suggest them to change in their architectural conformation, is the potential difference on the free boundaries surfaces of collagen fibers. These ones represent the bone in the nanoscale. This work has as subject a multiscale model. Lots of studies have been made to try to discover the relationship between a macroscopic external bone load and the cellular scale. The tree first simulations have been a longitudinal, a flexion and a transversal compression force on a full longitudinal fiber 0-0 sample. The results showed first the great difference between a fully longitudinal stress and a flexion stress. Secondly a decrease in the potential difference has been observed in the transversal force configuration, suggesting that such a signal could be taken as the one, who leads the bone remodeling. To also exclude that the obtained results was not to attribute to a piezoelectric collagen effect and not to a mechanical load, different coupling analyses have been developed. Such analyses show this effect is really less important than the one the mechanical load is responsible of. At this point the work had to explore how bone remodeling could develop. The analyses involved different geometry and fibers percentage. Moreover at the beginning the model was to manually implement. The author, after an initial improvement of it, provided to implement a standalone version thanks to integration between Comsol Multiphysic, Matlab and Excel.

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Der Globale Wandel ist im Begriff, den Tourismus zu verändern. Die Wechselwirkung von Tourismus und Klimawandel sind beidseitiger Art. Die vorliegende Arbeit zeigt Möglichkeiten der Adaption und einen wandelbaren Fremdenverkehr. Eine Übersicht der gängigen Tourismusmodelle stellt den Stand der Forschung dar. Der Fremdenverkehr ist durch drei Faktoren massiv geprägt: Die Nachfrage und Motivation, die Reisemittler und Veranstalter sowie das Destinationsangebot. Bei der Motivation wirken Motiv und Anreiz Motivationspsychologisch betrachtet auf die Reiseentscheidung deren Grundlage verarbeitete Informationen sind. Reisemittler und Veranstalter haben einen großen Einfluss auf Entscheidungsprozesse. Neue IuK Technologien haben deren Arbeit grundlegend verändert. Das Tourismusangebot wird stark durch die naturräumlichen Gegebenheiten sowie das politische System bestimmt. Überlebenswichtig für die Destination ist die evolutionstheoretisch etrachtete Fitnessmaximierung also Adaption und Wandel, um sich an geänderte Rahmenbedingungen anpassen zu können. Gerade im Bereich des Klimawandels müssen Maßnahmen ergriffen werden. Aber auch die Marktsättigung gerade in Verbindung mit der aktuellen Finanzkrise wirkt besonders schwer auf die Destination. Eine hohes Innovationsvermögen, Trendscanning und der Zusammenschluss in flexiblen Netzwerkclustern können einen Kundenmehrwert erzeugen. Die Fitnessmaximierung ist somit Überlebensziel der Destination und führt zur Kundenzufriedenheit die im Sättigungsmarkt alleinig Wachstum generieren kann.

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A model is developed to represent the activity of a farm using the method of linear programming. Two are the main components of the model, the balance of soil fertility and the livestock nutrition. According to the first, the farm is supposed to have a total requirement of nitrogen, which is to be accomplished either through internal sources (manure) or through external sources (fertilisers). The second component describes the animal husbandry as having a nutritional requirement which must be satisfied through the internal production of arable crops or the acquisition of feed from the market. The farmer is supposed to maximise total net income from the agricultural and the zoo-technical activities by choosing one rotation among those available for climate and acclivity. The perspective of the analysis is one of a short period: the structure of the farm is supposed to be fixed without possibility to change the allocation of permanent crops and the amount of animal husbandry. The model is integrated with an environmental module that describes the role of the farm within the carbon-nitrogen cycle. On the one hand the farm allows storing carbon through the photosynthesis of the plants and the accumulation of carbon in the soil; on the other some activities of the farm emit greenhouse gases into the atmosphere. The model is tested for some representative farms of the Emilia-Romagna region, showing to be capable to give different results for conventional and organic farming and providing first results concerning the different atmospheric impact. Relevant data about the representative farms and the feasible rotations are extracted from the FADN database, with an integration of the coefficients from the literature.

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Objective: Improved treatment has increased the survival of childhood cancer patients in recent decades, but follow-up care is recommended to detect and treat late effects. We investigated relationships between health beliefs and follow-up attendance in adult childhood cancer survivors. Methods: Childhood cancer survivors aged younger than 16 years when diagnosed between 1976 and 2003, who had survived for more than 5 years and were currently aged 201 years, received a postal questionnaire. We asked survivors whether they attended follow-up in the past year. Concepts from the Health Belief Model (perceived susceptibility and severity of future late effects, potential benefits and barriers to follow-up, general health value and cues to action) were assessed. Medical information was extracted from the Swiss Childhood Cancer Registry. Results: Of 1075 survivors (response rate 72.3%), 250 (23.3%) still attended regular followup care. In unadjusted analyses, all health belief concepts were significantly associated with follow-up (po0.05). Adjusting for other health beliefs, demographic, and medical variables, only barriers (OR50.59; 95%CI: 0.43–0.82) remained significant. Younger survivors, those with lower educational background, diagnosed at an older age, treated with chemotherapy, radiotherapy, or bone marrow transplantation and with a relapse were more likely to attend follow-up care. Conclusions: Our study showed that more survivors at high risk of cancer- and treatmentrelated late effects attend follow-up care in Switzerland. Patient-perceived barriers hinder attendance even after accounting for medical variables. Information about the potential effectiveness and value of follow-up needs to be available to increase the attendance among childhood cancer survivors.