946 resultados para 730109 Surgical methods and procedures


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The increase in the elderly population is a worldwide phenomenon and has different consequences not only in terms of health, but also in terms of economy. One of those consequences is the institutionalization. The understanding of this process, as well as of the reality of the institutionalized elderly is essential to develop policies of care. Goals: a) present the epidemiological profile of institutionalized elderly who live in institutions in the countryside of São PauloState and describe the development of an extension project implemented in two elderly-care institutions (IRLPI’s). Methods and procedures: data were collected in three forms, from which it was possible to verify: a) institutional data; b) social data and c) data about general and mental health. The data related to health were collected from the medication of continuous use. All data were launched into the database (Access) and subjected to the descriptive statistical analysis. Data related to mental health were confirmed from the application of clinical trials (Geriatric Depression Scale – GDS and Mini Mental State Examination: MMSE).

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Pós-graduação em Educação - FFC

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Seit Jahren werden Diskussionen über Erfolgskontrolle in der kommunalen Wirtschaftsförderung geführt. Im Vordergrund steht dabei die Suche nach Indikatoren und Verfahren, die es den kommunalen Wirtschaftsförderungen ermöglichen sollen, Erfolge zu messen. rnDa die Wirtschaftsförderung zu den freiwilligen Leistungen einer Gemeinde zählt, erhöht sich der Druck der Rechtfertigung gegenüber der Öffentlichkeit oder der Politik, das gilt insbesondere in Zeiten knapper öffentlicher Haushalte. Firmenansiedlungen, eine positive wirtschaftliche Entwicklung oder eine geringe Arbeitslosenquote sind sowohl im öffentlichen Bewusstsein als auch in der Politik wesentliche Kriterien einer erfolgreichen Wirtschaftsförderung. Sich ständig ändernde Rahmenbedingungen im wirtschaftsstrukturellen Gefüge haben dazu geführt, dass diese klassischen Nachweise von Erfolg immer seltener als solche präsentiert werden können. Erfolge sollten dennoch gemessen werden, um Maßnahmen und Instrumente einer kommunalen Wirtschaftsförderung zu überprüfen und gegebenenfalls an die geänderten Bedingungen anzupassen. rnEs ist schon mehr als 30 Jahre her, als in den 1970er Jahren die Suche nach Methoden und Verfahren der Erfolgskontrolle in der öffentlichen Verwaltung begann. Erfolge von kommunaler Wirtschaftsförderung können nicht einfach und ausschließlich an den markantesten wirtschaftlichen Ziffern der Kommune gemessen werden, z. B. der Zahl der sozialversicherungspflichtigen Arbeitsplätze. Seit Jahren wird um einen Lösungsweg bei der Durchführung von Erfolgskontrolle in der kommunalen Wirtschaftsförderung gerungen, abschließend wurde jedoch noch kein vollends befriedigend praktikabler Weg gefunden. Zu hinterfragen ist vor dem Hintergrund, inwiefern die vier Elemente einer Erfolgskontrolle, nämlich die Zielerreichungs-, Vollzugs-, Bedingungs- und Wirkungskontrolle, tatsächlich und hinreichend zum Einsatz kommen können.rnDie vorliegenden empirischen Untersuchungen beleuchten nun das Thema aus Sicht der kommunalen Wirtschaftsförderer und liefern Ergebnisse, die zu einem veränderten Bewusstsein gegenüber der Durchführung von Erfolgskontrolle in der kommunalen Wirtschaftsförderung führen müssten. Unabhängig von der Organisationsform und der Größe einer kommunalen Wirtschaftsförderung lässt sich empirisch nachweisen, dass der Anspruch, den der Begriff der Erfolgskontrolle in seiner gängigen Beschreibung erhebt, nicht hinreichend von einer kommunalen Wirtschaftsförderung erfüllt werden kann. rnMit Hilfe des neu entwickelten Prozesses einer modifizierten Erfolgskontrolle wird in vorliegender Arbeit ein idealtypischer Ablauf für eine kommunale Wirtschaftsförderung dargestellt. Der neue Ansatz einer modifizierten Erfolgskontrolle ist eine konsequente Reduzierung der Anforderungen auf das Praktikable und führt dazu, dass Erfolge der kommunalen Wirtschaftsförderung dargestellt werden können, ohne dass das Verfahren mehr Fragen offen lässt, als es beantwortet. Durch die modifizierte Erfolgskontrolle können die spezifischen Erfolge einer kommunalen Wirtschaftsförderung dargestellt und dokumentiert werden. rnEine modifizierte Erfolgskontrolle kann zweierlei: Sie ist eine Hilfestellung für die politisch Verantwortlichen bei der Erkenntnis, dass eine Notwendigkeit nach konkreten und der Ist-Situation sowie den Randbedingungen angepassten Zielformulierungen besteht. Sie bietet aber auch eine Möglichkeit, dass die kommunalen Wirtschaftsförderungseinrichtungen dem in der öffentlichen Diskussion formulierten Anspruch nach Erfolgskontrolle mit einem hohen Grad an Praktikabilität gerecht werden können. rnBevor also viele kommunale Wirtschaftsförderungen durch die fragwürdige Forderung an eine Erfolgskontrolle aufgrund der zu hohen Anforderungen an Methodik, Zeit und Personal aufgeben, sollte ihnen die Konzentration auf das Praktikable wieder Anreiz sein, eine modifizierte Erfolgskontrolle nach dem neuen Prozessschema in Angriff zu nehmen. rnrn

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BACKGROUND Several factors facilitate or hinder efficacy research in occupational therapy. Strategies are needed, therefore, to support the successful implementation of trials. AIM To assess the feasibility of conducting a randomised controlled trial (RCT). The main feasibility objectives of this study were to assess the process, resources, management, and scientific basis of a trial RCT. MATERIAL AND METHODS A total of 10 occupational therapists, between the ages of 30 and 55 (M 43.4; SD 8.3) with seven to 26 years' (M 14.3; SD 6.1) experience, participated in this study. Qualitative data collected included minutes of meetings, reports, and field notes. The data were analysed based on the principles of content analysis, using feasibility objectives as the main categories. RESULTS Data analysis revealed strengths in relation to retention and inclusion criteria of participants, the study protocol, study organisation, and the competence of researchers. Weaknesses were found related to recruitment, randomisation, data collection, time for training and communication, commitment, and design. CONCLUSION The findings indicated that there are several factors which had a considerable impact on the implementation of an RCT in practice. However, it was useful to assess methods and procedures of the trial RCT as a basis to refine research plans.

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The methodological approach a teacher uses in the competence teaching-learning process determines the way students learn. Knowledge can be acquired from a series of perspectives, mainly: “know-what” (concept), where facts and descriptions of (natural or social) phenomena are pursued; “know-how” (procedure), where methods and procedures for their application are described; and “know-why” (competence), where general principles and laws that explain both the facts and their applications are sought. As all the three cases are interconnected, the boundaries between them are not fully clear and their application uses shared elements. In any case, the depth of student’s acquired competences will be directly affected by the teaching-learning perspective, traditionally aiming to a “know-why” approach for full competence acquisition. In this work, we discuss a suitable teaching-learning methodology for evaluating whether a “know-how”, “know-what” or combined approach seems better for enhancing competence learning in students. We exemplify the method using a selection of formative activities from the Physical Chemistry area in the Grades of Chemistry and Chemical Engineering.

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The construction industry is characterised by fragmentation and suffers from lack of collaboration, often adopting adversarial working practices to achieve deliverables. For the UK Government and construction industry, BIM is a game changer aiming to rectify this fragmentation and promote collaboration. However it has become clear that there is an essential need to have better controls and definitions of both data deliverables and data classification. Traditional methods and techniques for collating and inputting data have shown to be time consuming and provide little to improve or add value to the overall task of improving deliverables. Hence arose the need in the industry to develop a Digital Plan of Work (DPoW) toolkit that would aid the decision making process, providing the required control over the project workflows and data deliverables, and enabling better collaboration through transparency of need and delivery. The specification for the existing Digital Plan of Work (DPoW) was to be, an industry standard method of describing geometric, requirements and data deliveries at key stages of the project cycle, with the addition of a structured and standardised information classification system. However surveys and interviews conducted within this research indicate that the current DPoW resembles a digitised version of the pre-existing plans of work and does not push towards the data enriched decision-making abilities that advancements in technology now offer. A Digital Framework is not simply the digitisation of current or historic standard methods and procedures, it is a new intelligent driven digital system that uses new tools, processes, procedures and work flows to eradicate waste and increase efficiency. In addition to reporting on conducted surveys above, this research paper will present a theoretical investigation into usage of Intelligent Decision Support Systems within a digital plan of work framework. Furthermore this paper will present findings on the suitability to utilise advancements in intelligent decision-making system frameworks and Artificial Intelligence for a UK BIM Framework. This should form the foundations of decision-making for projects implemented at BIM level 2. The gap identified in this paper is that the current digital toolkit does not incorporate the intelligent characteristics available in other industries through advancements in technology and collation of vast amounts of data that a digital plan of work framework could have access to and begin to develop, learn and adapt for decision-making through the live interaction of project stakeholders.

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Greek text of the work generally known as In Hippocratis De articulis; with reproduction of illuminated leaves illustrating surgical apparatus and procedures from manuscript Plut. LXXIV, 7, in the Laurentian Library, Florence.

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Primary objective: The study aimed to examine the changes in water distribution in the soft tissue during systemic steroid activity. Research design: A three-way cross-over, randomized, placebo-controlled, double-blind trial was used, including 4 weeks of fluticasone propionate pMDI 200 mug b.i.d. delivered via Babyhaler(R), budesonide pressurized metered dose inhaler (pMDI) 200 mug b.i.d. delivered via Nebuchamber(R) and placebo. Spacers were primed before use. In total, 40 children aged 1-3 years, with mild intermittent asthma were included. Twenty-five of the children completed all three treatments. At the end of each treatment period body impedance and skin ultrasonography were measured. Methods and procedures: We measured changes in water content of the soft tissues by two methods. Skin ultrasonography was used to detect small changes in dermal water content, and bioelectrical impedance was used to assess body water content and distribution. Main outcomes and results: We found an increase in skin density of the shin from fluticasone as measured by ultrasonography (p = 0.01). There was a tendency for a consistent elevation of impedance parameters from active treatments compared to placebo although overall this effect was not statistically significant (0.1< p <0.2). However, sub-analyses indicated a significant effect on whole-body and leg impedance from budesonide treatment (p <0.05). Conclusion: Decreased growth during inhaled steroid treatment seems to partly reflect generalized changes in body water.

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Primary objective : To establish a process whereby assessment of functional communication reflects the authentic communication of the target population. The major functional communication assessments available from the USA may not be as relevant to those who reside elsewhere, nor assessments developed primarily for persons who have had a stroke as relevant for traumatic brain injury rehabilitation. Research design : The investigation used the Nominal Group Technique to elicit free opinion and support individuals who have compromised communication ability. A survey mailed out sampled a larger number of stakeholders to test out differences among groups. Methods and procedures : Five stakeholder groups generated items and the survey determined relative 'importance'. The stakeholder groups in both studies comprised individuals with traumatic brain injury and their families, health professionals, third-party payers, employers, and Maori, the indigenous population of New Zealand. Main outcomes and results : There was no statistically significant difference found between groups for 19 of the 31 items. Only half of the items explicitly appear on a well-known USA functional communication assessment. Conclusions : The present study has implications for whether functional communication assessments are valid across cultures and the type of impairment.

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Primary objective: To describe a prospective memory rehabilitation programme based on a compensatory training approach and report the results of three case studies. Research design: Programme evaluation using pre-and post-intervention assessments and telephone follow-up. Methods and procedures: Three participants with traumatic brain injury completed 8 weeks of training with 1 - 2 hour individual sessions. Assessments were formal prospective memory assessment, self-report and measures of diary use. Experimental interventions: Intervention aimed to identify potential barriers, establish self-awareness of memory deficits, introduce a customized compensatory tool, a cueing system and organizational strategies. A significant other was involved in training to assist generalization. Main outcomes and results: All three participants improved on formal prospective memory assessment and demonstrated successful diary use after the programme. Self-report of prospective memory failure fluctuated and may reflect increased self-awareness. Conclusion: A compensatory approach may be useful in improving prospective memory performance following TBI.

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Primary objective: To investigate jaw movements in children following traumatic brain injury (TBI) during speech using electromagnetic articulography (EMA). Methods and procedures: Jaw movements of two non-dysarthric children ( aged 12.75 and 13.08 years) who had sustained a TBI were recorded using the AG-100 EMA system (Carstens Medizineletronik) during word-initial consonant productions. Mean quantitative kinematic parameters and coefficient of variation ( variability) values were calculated and individually compared to the mean values obtained by a group of six control children ( mean age 12.57 years, SD 1.52). Main outcomes and results: The two children with TBI exhibited word-initial consonant jaw movement durations that were comparable to the control children, with sub-clinical reductions in speed being offset by reduced distances. Differences were observed between the two children in jaw kinematic variability, with one child exhibiting increased variability, while the other child demonstrated reduced or comparable variability compared to the control group. Conclusions: Possible sub-clinical impairments of jaw movement for speech were exhibited by two children who had sustained a TBI, providing insight into the consequences of TBI on speech motor control development.

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Primary objective: To examine changes in the relationship between intonation, voice range and mood following music therapy programmes in people with traumatic brain injury. Research design: Data from four case studies were pooled and effect size, ANOVA and correlation calculations were performed to evaluate the effectiveness of treatment. Methods and procedures: Subjects sang three self-selected songs for 15 sessions. Speaking fundamental frequency, fundamental frequency variability, slope, voice range and mood were analysed pre- and post-session. Results: Immediate treatment effects were not found. Long-term improvements in affective intonation were found in three subjects, especially in fundamental frequency. Voice range improved over time and was positively correlated with the three intonation components. Mood scale data showed that immediate effects were in the negative direction whereas there weres increases in positive mood state in the longer-term. Conclusions: Findings suggest that, in the long-term, song singing can improve vocal range and mood and enhance the affective intonation styles of people with TBI.