Efectos de un programa de rehabilitación pulmonar en un epoc severo

Se describe el caso de un varón de 59 años,con diagnóstico de enfermedad pulmonar obstructiva crónica (EPOC) severa, producto del consumo de cigarrillo. En la evaluación, presenta deficiencias en la capacidad aeróbica, en el desempeño muscular, en la ventilación e intercambio gaseoso, con alteración de sus volúmenes pulmonares, las cuales le ocasionaron limitación funcional y restricción en la realización de las actividades de la vida diaria. Se inició un plan de cuidado y acondicionamiento físico, consistente en incrementar la fuerza y resistencia de miembros inferiores y superiores, entrenamiento de músculos respiratorios y un plan de educación individual y grupal acerca del conocimiento y manejo de la enfermedad, además se le brindó soporte psicoterapéutico. Los resultados del programa mostraron efectos positivos en su condición de salud, en general, y en la disminución de su limitación funcional.

La satisfacción del cliente bancario en Canadá: Diferencias entre canadienses e inmigrantes de la América Latina – Revisión y traducción

The measure of customer satisfaction level is one of the most important topics at present time in marketing science. In addition, its measure in the bank field takes force in view of the high level of competition inside it, even more so if the study counts “immigrants” as a variable in analysis, a much important variable in the demographic situation of Canada. Oliver (1980) proposes the model of “disconfirmation” to measure customer satisfaction level; this model confirms that the difference between customer perceived performance and customer expectations gives as result his satisfaction level (additional model). Presently multiple scales exist to evaluate and to quantify this satisfaction level, Parasuraman (1987) is the creator of the servqual scale, while Avkiran (1999) developed the bankserv scale in order to evaluate customer expectations and customer satisfaction level specifically inside the bank field; this scale was divided in four factors via factorial analysis. Literature suggests the presence of a relation between individual expectations and/or satisfaction level, and the individual tolerance level towards non-constructed situations (Newman, 2001). Hofstede (1980) developed five cultural dimensions worldwide; among these is the Uncertainty Avoidance Index (uai) that fits to the dimension directly related to customer expectations and customer satisfaction levels, since it measures the tolerance levels towards non-structured ituations. For this research I focused on the satisfaction model analysis proposed by Oliver (1980) based on Avkiran´s scale (1999), having the Latin American or Canadian origin as variables. The concept of Hofstede’s cultural differences leads me to propose two samples: 50 Canadian French speakers and 50 Latin American individuals (Canadian residents). Results demonstrate that in the Latin American group the expectations are in average higher that in the Canadian group, considering all four factors (Avkiran). Perceived performance and satisfaction level are higher in the Latin American group that in the Canadian group for “personal branch conduct” and “access to personalized services” factors, nevertheless, no statistically significant difference has been proved for “credibility” and “communication” factors. The expectations variable presents a mediating effect over the relation between variables uai (Latin American or Canadian origin) and satisfaction level. This effect is partial for “personal branch conduct” and perfect for “access to personalized services”.

Efectos de la reforma política del 2003 en la reorganización del Partido Liberal 2002-2010

Este trabajo busca analizar los efectos e implicaciones que tuvo la reforma política de 2003 sobre el Partido Liberal Colombiano (PLC), y cómo los cambios institucionales configuraron un marco para la reorganización de la colectividad liberal hasta 2010. En la primera parte del trabajo se expone el desarrollo del sistema de partidos en Colombia y la estructura de incentivos existente en el marco institucional antes y después de la reforma. Para dar cuenta de los cambios en el PLC, se hace una revisión de los principales debates que se dieron dentro de la bancada liberal en el Congreso con respecto a la reforma y sus posteriores modificaciones. Finalmente, se presenta la relación del alcance de la reforma sobre el PLC que a la luz de la teoría neo-institucionalista, explica el comportamiento del Partido como organización, así como la de sus miembros.

Empowerment: model i instrument de mesura basat en les variables primàries o efectives PIEQ (Primary Items Empowerment Questionnaire)

In this thesis a review of the state of the art on empowerment is found. A proposal is put forward for a model of the effective variables of empowerment, a new theoretical model that provides a distinct classification of individual variables. The model consists of four metavariables called reciprocal, unidirectional, shared and reflexive. Finally, a measurement tool for measuring and representing these variables graphically is described, including its process of elaboration through a preliminary pilot study that served to refine and improve the questionnaire. Both the model and the instrument proposed aim to determine the state of the primary variables involved in determining the predisposition and potential of a working group towards empowerment. With the measurement tool both organisational, departmental, working group and/or individual data can be obtained. This instrument can help companies and organisations to discover the limitations existing within a working group and act in consequence.

Les aules d'acollida d'educació primària a Catalunya: descripció i avaluació dels resultats

Les aules d'acollida tenen com a objectiu principal donar suport lingüístic a l'alumnat estranger perquè aquest desenvolupi coneixement de la llengua de l'escola.La tesi presenta els resultats de l'avaluació de les aules d'acollida de primària de tot Catalunya durant el curs 2006-2007. En l'avaluació es van emprar tres instruments: una prova de coneixement de català nivell A2, un qüestionari d'adaptació escolar i un qüestionari individual que recollia variables com el temps d'estada a Catalunya, el nombre d'hores setmanals a l'aula d'acollida, la llengua inicial o l'escolarització prèvia de l'alumnat. Totes les dades van ser introduïdes en el programa SPSS versió 15 i es van aplicar diferents tècniques estadístiques.Els resultats mostren que la variable que descriu millor les diferències de coneixement de català de l'alumnat estranger de les aules d'acollida és la seva adaptació escolar. Aquesta variable es mostra tan potent en la descripció dels resultats que mitiga els efectes reals d'altres variables com el temps d'estada a Catalunya, el nombre d'hores setmanals a l'aula d'acollida o la llengua inicial de l'alumnat.

Inovação pedagógica : a música no ensino de frações

Apesar da modernização dos meios tecnológicos e processos de aprendizagem, a Matemática na escola pública brasileira permanece difícil de ensinar e aprender, falta inovação metodológica que promova condições necessárias na apropriação dos saberes pelo aluno. Essa pesquisa sobre a Formação continuada de professores de Matemática do Ensino Fundamental Ciclo I e inovação da prática pedagógica: a música no ensino de frações propõe o uso da música como recurso didático metodológico inovador para o ensino de frações, com o objetivo de substituir aulas expositivas e exercícios mecânicos por vivências prazerosas, significativas e formadoras de um sujeito crítico participativo. Apresenta os mecanismos de avaliação da política educacional brasileira bem como o Ensino Fundamental de nove anos. Destaca a inovação metodológica como necessidade na formação continuada para o professor polivalente não especialista em matemática. Desenvolve a pesquisa qualitativa, estudo de caso, e considera o processo histórico da sociedade e do sujeito, para compreender o papel da escola, do professor e as especificidades do processo ensino e aprendizagem. O resultados dessa pesquisa mostram a necessidade de revisão, pelas instituições de ensino superior, na formação de profissionais de postura interrogativa de sua própria ação docente, capazes de reproduzir tal atitude no aluno. Este estudo contribui para a aprendizagem de frações, evitando-se aulas expositivas, exercícios mecânicos, por meio de uma proposta de formação continuada, utilizando música como instrumento para o ensino de frações, desenvolvida pela pesquisadora durante o processo da pesquisa ação, além de promover o debate nas unidades escolares envolvidas nas inovações de seus Projetos Pedagógicos.

A influência da publicidade na obesidade infantil

A obesidade infantil apresenta-se como uma epidemia que afeta milhares de crianças em todo o Mundo, e a publicidade tem sido apontada por inúmeros autores como sendo a principal causa por este problema global. Ao longo deste estudo, tivemos como objetivo analisar se existe algum efeito da publicidade na obesidade infantil, tendo em conta o estímulo ao consumo de grande variedade de alimentos com alta intensidade calórica, por via das estratégias de marketing. Para enquadrar este estudo, procuramos identificar o papel da publicidade na vida das crianças, nas atividades desenvolvidas nos tempos livres, a influência do estilo de vida nas atividades físicas, e por fim tentar perceber o papel que a publicidade, os tempos livres e o estilo de vida têm na obesidade infantil. A investigação apresenta-se como um estudo de caso exploratório qualitativo, onde foram utilizadas entrevistas estruturadas e não estruturadas individuais, bem como de grupo utilizando a técnica de Focus Grupo num infantário privado no concelho de Cascais. A amostra analisada contou com 12 crianças com idades compreendidas entre os 2 anos e os 5 anos, 10 encarregados de educação, entre eles 3 homens e 7 mulheres com idades compreendidas entre os 27 anos e os 45 anos. Foram incluídas ainda na amostra uma educadora de infância e a directora do infantário, o que permitiu estabelecer uma relação entre as diversas variáveis em estudo. Desta forma, foi possível chegar a resultados que nos indicaram em primeiro lugar, que as crianças nesta faixa etária estão expostas a um número muito elevado de mensagens publicitárias, e que a publicidade já faz parte integrante da sua vida. Percebemos ainda que alguns pais tentam controlar o número de horas de exposição à publicidade, na televisão, bem como os canais visualizados pelos filhos. No entanto não o conseguem, por eles estarem em contato com a publicidade através dos mais variados meios. Verificou-se deste modo que as crianças já conhecem muitas marcas, embalagens e as respectivas mascotes e que por isso solicitam a sua compra. A embalagem reforçou neste estudo a sua importância, uma vez que se apresenta em alguns casos como a grande atração no ponto de venda independentemente do tipo de produto. Relativamente aos tempos livres, existe um padrão de comportamentos onde as crianças praticam mais actividades no verão e aos fins-de-semana devido à disponibilidade dos pais, sendo que no restante período o sedentarismo é muito grande e que a exposição à televisão é muito acentuada. Os factores económicos, sociais e tecnológicos apresentam-se como os principais influenciadores relativamente ao estilo de vida. Como conclusão, consideramos que a obesidade nas crianças é multifacetada e que a publicidade não é o seu principal influenciador, é apenas mais um factor que poderá agravar a situação de muitas crianças quando não têm o devido acompanhamento familiar.

Sequentially testing for a gene-drug interaction in a genomewide analysis

Assaying a large number of genetic markers from patients in clinical trials is now possible in order to tailor drugs with respect to efficacy. The statistical methodology for analysing such massive data sets is challenging. The most popular type of statistical analysis is to use a univariate test for each genetic marker, once all the data from a clinical study have been collected. This paper presents a sequential method for conducting an omnibus test for detecting gene-drug interactions across the genome, thus allowing informed decisions at the earliest opportunity and overcoming the multiple testing problems from conducting many univariate tests. We first propose an omnibus test for a fixed sample size. This test is based on combining F-statistics that test for an interaction between treatment and the individual single nucleotide polymorphism (SNP). As SNPs tend to be correlated, we use permutations to calculate a global p-value. We extend our omnibus test to the sequential case. In order to control the type I error rate, we propose a sequential method that uses permutations to obtain the stopping boundaries. The results of a simulation study show that the sequential permutation method is more powerful than alternative sequential methods that control the type I error rate, such as the inverse-normal method. The proposed method is flexible as we do not need to assume a mode of inheritance and can also adjust for confounding factors. An application to real clinical data illustrates that the method is computationally feasible for a large number of SNPs. Copyright (c) 2007 John Wiley & Sons, Ltd.

Tales of the expected: investigating the rhetorical strategies of innovation champions

Innovation continues to be high on the agenda in construction. It is widely considered to be an essential prerequisite of improved performance both for the sector at large and for individual firms. Success stories dominate the parts of the academic literature that rely heavily on the recollections of key individuals. A complementary interpretation focuses on the way innovation champions in hindsight interpret, justify and legitimize the diffusion of innovations. Emphasis is put on the temporal dimension of interpretation and how this links to rhetorical strategies and impression management tactics. Rhetorical theories are drawn upon to analyse the accounts given by innovation champions in seven facilities management organizations. In particular, the three persuasive appeals in classic rhetoric are used to highlight the rhetorical justifications mobilized in the descriptions of what took place. The findings demonstrate the usefulness of rhetorical theories in complementing studies of innovation.

Molecular mechanisms by which dietary isoflavones potentially prevent atherosclerosis

Dietary isoflavones are currently receiving much attention because of their potential role in preventing coronary artery disease and other chronic diseases. Accumulating evidence from cell culture and laboratory animal experiments indicates that isoflavones have the potential to prevent or delay atherogenesis. Suggested mechanisms of action include: a reduction in low-density lipoprotein (LDL) cholesterol and a potential reduction in the susceptibility of the LDL particle to oxidation; (2) an improvement in vascular reactivity; (3) an inhibition of pro-inflammatory cytokines, cell adhesion proteins and nitric oxide (NO) production; and (4) an inhibition of platelet aggregation. These mechanisms are consistent with the epidemiological evidence that a high consumption of isoflavone-rich soy products is associated with a reduced incidence of coronary artery disease. Biological effects of isoflavones are dependent on many factors, including dose consumed, duration of use, protein-binding affinity, and an individual's metabolism or intrinsic oestrogenic state. Further clinical studies are necessary to determine the potential health effects of isoflavones in specific population groups as we currently know little about age-related differences in exposure to these compounds and there are few guidelines on optimal dose for cardiovascular health benefits.

Dynamic data reconciliation for sequential modular simulators: application to a mixing process

This paper describes a method for dynamic data reconciliation of nonlinear systems that are simulated using the sequential modular approach, and where individual modules are represented by a class of differential algebraic equations. The estimation technique consists of a bank of extended Kalman filters that are integrated with the modules. The paper reports a study based on experimental data obtained from a pilot scale mixing process.

Stratospheric temperature trends: our evolving understanding

We review the scientific literature since the 1960s to examine the evolution of modeling tools and observations that have advanced understanding of global stratospheric temperature changes. Observations show overall cooling of the stratosphere during the period for which they are available (since the late 1950s and late 1970s from radiosondes and satellites, respectively), interrupted by episodes of warming associated with volcanic eruptions, and superimposed on variations associated with the solar cycle. There has been little global mean temperature change since about 1995. The temporal and vertical structure of these variations are reasonably well explained bymodels that include changes in greenhouse gases, ozone, volcanic aerosols, and solar output, although there are significant uncertainties in the temperature observations and regarding the nature and influence of past changes in stratospheric water vapor. As a companion to a recent WIREs review of tropospheric temperature trends, this article identifies areas of commonality and contrast between the tropospheric and stratospheric trend literature. For example, the increased attention over time to radiosonde and satellite data quality has contributed to better characterization of uncertainty in observed trends both in the troposphere and in the lower stratosphere, and has highlighted the relative deficiency of attention to observations in the middle and upper stratosphere. In contrast to the relatively unchanging expectations of surface and tropospheric warming primarily induced by greenhouse gas increases, stratospheric temperature change expectations have arisen from experiments with a wider variety of model types, showingmore complex trend patterns associated with a greater diversity of forcing agents.

Cooperative task support for the control room

The National Grid Company plc. owns and operates the electricity transmission network in England and Wales, the day to day running of the network being carried out by teams of engineers within the national control room. The task of monitoring and operating the transmission network involves the transfer of large amounts of data and a high degree of cooperation between these engineers. The purpose of the research detailed in this paper is to investigate the use of interfacing techniques within the control room scenario, in particular, the development of an agent based architecture for the support of cooperative tasks. The proposed architecture revolves around the use of interface and user supervisor agents. Primarily, these agents are responsible for the flow of information to and from individual users and user groups. The agents are also responsible for tackling the synchronisation and control issues arising during the completion of cooperative tasks. In this paper a novel approach to human computer interaction (HCI) for power systems incorporating an embedded agent infrastructure is presented. The agent architectures used to form the base of the cooperative task support system are discussed, as is the nature of the support system and tasks it is intended to support.

The effects of landscape modifications on the long-term persistence of animal populations

Background: The effects of landscape modifications on the long-term persistence of wild animal populations is of crucial importance to wildlife managers and conservation biologists, but obtaining experimental evidence using real landscapes is usually impossible. To circumvent this problem we used individual-based models (IBMs) of interacting animals in experimental modifications of a real Danish landscape. The models incorporate as much as possible of the behaviour and ecology of four species with contrasting life-history characteristics: skylark (Alauda arvensis), vole (Microtus agrestis), a ground beetle (Bembidion lampros) and a linyphiid spider (Erigone atra). This allows us to quantify the population implications of experimental modifications of landscape configuration and composition. Methodology/Principal Findings: Starting with a real agricultural landscape, we progressively reduced landscape complexity by (i) homogenizing habitat patch shapes, (ii) randomizing the locations of the patches, and (iii) randomizing the size of the patches. The first two steps increased landscape fragmentation. We assessed the effects of these manipulations on the long-term persistence of animal populations by measuring equilibrium population sizes and time to recovery after disturbance. Patch rearrangement and the presence of corridors had a large effect on the population dynamics of species whose local success depends on the surrounding terrain. Landscape modifications that reduced population sizes increased recovery times in the short-dispersing species, making small populations vulnerable to increasing disturbance. The species that were most strongly affected by large disturbances fluctuated little in population sizes in years when no perturbations took place. Significance: Traditional approaches to the management and conservation of populations use either classical methods of population analysis, which fail to adequately account for the spatial configurations of landscapes, or landscape ecology, which accounts for landscape structure but has difficulty predicting the dynamics of populations living in them. Here we show how realistic and replicable individual-based models can bridge the gap between non-spatial population theory and non-dynamic landscape ecology. A major strength of the approach is its ability to identify population vulnerabilities not detected by standard population viability analyses.