862 resultados para Mäkelä, Klaus: Alcoholics Anonymous as a mutual-help movement


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Medical errors and close calls are pervasive in health care. It is hypothesized that the causes of close calls are the same as for medical errors; therefore learning about close calls can help prevent errors and increase patient safety. Yet despite efforts to encourage close call reporting, close calls as well as medical errors are under-reported in health care. The purpose of this dissertation was to implement and evaluate a web-based anonymous close call reporting system in three units at an urban hospital. ^ The study participants were physicians, nurses and medical technicians (N = 187) who care for patients in the Medical Intermediate Care Unit, the Surgical Intermediate Care Unit, and the Coronary Catheterization Laboratory in the hospital. We provided educational information to the participants on how to use the system and e-mailed and delivered paper reminders to report to the participants throughout the 19-month project. We surveyed the participants at the beginning and at the end of the study to assess their attitudes and beliefs regarding incident reporting. We found that the majority of the health care providers in our study are supportive of incident reporting in general but in practice very few had actually reported an error or a close call, semi-structured interview 20 weeks after we made the close call reporting system available. The purpose of the interviews was to further assess the participants' attitudes regarding incident reporting and the reporting system. Our findings suggest that the health care providers are supportive of medical error reporting in general, but are not convinced of the benefit of reporting close calls. Barriers to close call reporting cited include lack of time, heavy workloads, preferring to take care of close calls "on the spot", and not seeing the benefits of close call reporting. Consequently only two = close calls were reported via the system by two separate caregivers during the project. ^ The findings suggest that future efforts to increase close call reporting must address barriers to reporting, especially the belief among care givers that it is not worth taking time from their already busy schedules to report close calls. ^

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Fil: Zavala, Armando.

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We conducted an integrated paleomagnetic and rock magnetic study on cores recovered from Ocean Drilling Program Sites 1276 and 1277 of the Newfoundland Basin. Stable components of magnetization are determined from Cretaceous-aged sedimentary and basement cores after detailed thermal and alternating-field demagnetization. Results from a series of rock magnetic measurements corroborate the demagnetization behavior and show that titanomagnetites are the main magnetic carrier. In view of the normal polarity of magnetization and radiometric dates for the sills at Site 1276 (~98 and ~105 Ma, both within the Cretaceous Normal Superchron) and for a gabbro intrusion in peridotite at Site 1277 (~126 Ma, Chron M1), our results suggest that the primary magnetization of the Cretaceous rocks is likely retained in these rocks. The overall magnetic inclination of lithologic Unit 2 in Hole 1277A between 143 and 180 meters below seafloor is 38°, implying significant (~35° counterclockwise, viewed to the north) rotation of the basement around a horizontal axis parallel to the rift axis (010°). The paleomagnetic rotational estimates should help refine models for the tectonic evolution of the basement. The mean inclinations for Sites 1276 and 1277 rocks imply paleolatitudes of 30.3° ± 5.1° and 22.9° ± 12.0°, respectively, with the latter presumably influenced by tectonic rotation. These values are consistent with those inferred from the mid-Cretaceous reference poles for North America, suggesting that the inclination determinations are reliable and consistent with a drill site on a location in the North America plate since at least the mid-Cretaceous. The combined paleolatitude results from Leg 210 sites indicate that the Newfoundland Basin was some 1800 km south of its current position in the mid-Cretaceous. Assuming a constant rate of motion, the paleolatitude data would suggest a rate of 12.1 mm/yr for the interval from ~130 Ma (Site 1276 age) to present, and 19.6 mm/yr for the interval from 126 Ma (Site 1277 age) to recent. The paleolatitude and rotational data from this study are consistent with the possibility that Site 1276 may have passed over the Canary and Madeira hotspots that formed the Newfoundland Seamounts in the mid-Cretaceous.

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This work provides the development of an antenna for satellite communications onboard systems based on the recommendations ITU-R S.580-6 [1] and ITU-R S.465-5 [2]. The antenna consists of printed elements grouped in an array, working in a frequency band from 7.25 up to 8.4 GHz (15% of bandwidth). In this working band, transmission and reception are included simultaneously. The antenna reaches a gain about 31 dBi, has a radiation pattern with a beam width smaller than 10oand dual circular polarization. It has the capability to steer in elevation through a Butler matrix to 45

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From its creation, Spanish Young Generation in Nuclear (Jóvenes Nucleares, JJNN), a non-profit organization that depends on the Spanish Nuclear Society (SNE), has as an important scope to help transferring the knowledge between those generations in the way that it can be possible.

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Automatic analysis of minimally invasive surgical (MIS) video has the potential to drive new solutions that alleviate existing needs for safer surgeries: reproducible training programs, objective and transparent assessment systems and navigation tools to assist surgeons and improve patient safety. As an unobtrusive, always available source of information in the operating room (OR), this research proposes the use of surgical video for extracting useful information during surgical operations. Methodology proposed includes tools' tracking algorithm and 3D reconstruction of the surgical field. The motivation for these solutions is the augmentation of the laparoscopic view in order to provide orientation aids, optimal surgical path visualization, or preoperative virtual models overlay

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We propose an analysis for detecting procedures and goals that are deterministic (i.e., that produce at most one solution at most once),or predicates whose clause tests are mutually exclusive (which implies that at most one of their clauses will succeed) even if they are not deterministic. The analysis takes advantage of the pruning operator in order to improve the detection of mutual exclusion and determinacy. It also supports arithmetic equations and disequations, as well as equations and disequations on terms,for which we give a complete satisfiability testing algorithm, w.r.t. available type information. Information about determinacy can be used for program debugging and optimization, resource consumption and granularity control, abstraction carrying code, etc. We have implemented the analysis and integrated it in the CiaoPP system, which also infers automatically the mode and type information that our analysis takes as input. Experiments performed on this implementation show that the analysis is fairly accurate and efficient.

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There are large numbers of business communities in India which neither had any formal education nor they took any professional training but still they contribute in successful business formation. Their presence can be felt in all areas of business. Still there is a big professional gap between the educational institutes, specially the B-Schools and this independent business community. With the help of this paper an effort is made to develop a Two-Way learning relationship for the mutual benefit of both entities. It will also highlight the role of an educational institute beyond academics for the well being of society. This may lead to derive and develop the exchange of innovative business ideas and framing the suitable policies for long term sustainability in today´s competitive arena. The study conducted by researcher with a sample size of 100 which includes a mix of well known academic professionals, MBA students and non academic business professionals has revealed that there is a need of an exchange program for the mutual benefits. There exists a big professional gap in this area which can be filled with the active and effective initiative by management institutes. An effort is made in this paper to highlight this gap and to suggest some framework to bridge the gap

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We propose an analysis for detecting procedures and goals that are deterministic (i.e., that produce at most one solution at most once), or predicates whose clause tests are mutually exclusive (which implies that at most one of their clauses will succeed) even if they are not deterministic. The analysis takes advantage of the pruning operator in order to improve the detection of mutual exclusion and determinacy. It also supports arithmetic equations and disequations, as well as equations and disequations on terms, for which we give a complete satisfiability testing algorithm, w.r.t. available type information. We have implemented the analysis and integrated it in the CiaoPP system, which also infers automatically the mode and type information that our analysis takes as input. Experiments performed on this implementation show that the analysis is fairly accurate and efficient.

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We present two approaches to cluster dialogue-based information obtained by the speech understanding module and the dialogue manager of a spoken dialogue system. The purpose is to estimate a language model related to each cluster, and use them to dynamically modify the model of the speech recognizer at each dialogue turn. In the first approach we build the cluster tree using local decisions based on a Maximum Normalized Mutual Information criterion. In the second one we take global decisions, based on the optimization of the global perplexity of the combination of the cluster-related LMs. Our experiments show a relative reduction of the word error rate of 15.17%, which helps to improve the performance of the understanding and the dialogue manager modules.

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In this letter, a dual circular polarized steering antenna for satellite communications in X-band is presented. This antenna consists of printed elements grouped in an array, able to work from 7.25 up to 8.4 GHz in both polarizations: left-handed circular polarization (LHCP) and right-handed circular polarization (RHCP). The module antenna is compact, with narrow beamwidth, and reaches a gain of 16 dBi. It has the capability to steer in elevation to and electronically with a Butler matrix. In order to reduce the mutual coupling between adjacent patches, electromagnetic band-gap (EBG) structures are introduced. These EBGs combine double-layer and edge location via in order to reduce the size, without changing the low-permittivity substrate, and therefore maintaining the high radiation efficiency of the antenna.