986 resultados para Scenario
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OBJECTIVE: To study the prevalence of systemic hypertension and its control in the population of Catanduva, in the state of São Paulo, Brazil. METHODS: We carried out a randomized cross-sectional population-based study of the urban population of Catanduva with individuals above 18 years of age (688 individuals accounting for 0.9% of the referred population). We interviewed study participants to analyze the major qualitative and quantitative variables that could influence the hypertensive scenario and the risk for systemic hypertension. Blood pressure was measured through the indirect method according to the III Consenso Brasileiro de Hipertensão (III Brazilian Consensus on Hypertension), which established blood pressure levels > or = 140/90 mm Hg as hypertensive. RESULTS: The prevalence of systemic hypertension was higher in individuals with: (1) history of hypertension (p<0.0001); (2) diabetes mellitus (p=0.05); (3) body mass index (B. M. I) > or = 25 kg/m² (p<0.001); (4) low educational level (p<0.0001); (5) familial income ranging from 1 to 5 minimum wages (p<0.05); (6) unmarried status (divorced/separated and widow(er)s) (p<0.0001). Of the interviewed individuals, 27.6% (p=0.05) had blood pressure levels under control. CONCLUSION: Our study showed that the prevalence of systemic hypertension was 31.5%, and that 27.6% of the individuals interviewed had blood pressure levels under control at the time of the interview.
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Dissertação de mestrado em Bioengenharia
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Projeto de mestrado em Gestão de Unidades de Saúde
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Teses de Doutoramento em Ciências Empresariais.
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Dissertação de mestrado integrado em Engenharia de Telecomunicações e Informática
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Dissertação de Mestrado em Estratégia
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El nuevo escenario internacional produce lo que se ha dado en caracterizar como la globalización del derecho, especialmente en el ámbito de los derechos humanos. En este contexto se analiza la incidencia del Sistema Interamericano de protección de los Derechos Humanos con especial énfasis en el derecho de la información, desde la optica del derecho interno. Nos preguntamos acerca de cómo se presenta la tensión entre la lógica estatal con su rasgo de afirmación en la soberanía y monopolio en la creación de la jurisdicción doméstica, con la doctrina del derecho internacional de los derechos humanos, que consecuentemente conduce hacia una globalización jurídica de estos temas. Esto refleja un debilitamiento en el monopolio de creación y aplicación del derecho por parte de los Estados. A partir de este dato del escenario internacional buscamos determinar la incidencia de los informes de la Comisión Interamericana de Derechos Humanos y los pronunciamientos de la Corte Interamericana en materia de derecho de la información y su influencia en la jurisprudencia y creación de legislación en nuestro país. The new internacional scenario produces wtah has come to be characterized as the globalization of law, especially in the field of the human rights. In this context we analyze the impact of the Inter-American system of human Rights, whit particular emphasis on media law in domestic law
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The objective of this dissertation is to investigate the effect wind energy has on the Electricity Supply Industry in Ireland. Wind power generation is a source of renewable energy that is in abundant supply in Ireland and is fast becoming a resource that Ireland is depending on as a diverse and secure of supply of energy. However, wind is an intermittent resource and coupled with a variable demand, there are integration issues with balancing demand and supply effectively. To maintain a secure supply of electricity to customers, it is necessary that wind power has an operational reserve to ensure appropriate backup for situations where there is low wind but high demand. This dissertation examines the affect of this integration by comparing wind generation to that of conventional generation in the national grid. This is done to ascertain the cost benefits of wind power generation against a scenario with no wind generation. Then, the analysis examines to see if wind power can meet the pillars of sustainability. This entails looking at wind in a practical scenario to observe how it meets these pillars under the criteria of environmental responsibility, displacement of conventional fuel, cost competitiveness and security of supply.
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This research looked at the scientific evidence available on climate change and in particular, projections on sea level rise which ranged from 0.5m to 2m by the end of the century. These projections were then considered in an Irish context. A review of current policy in Ireland revealed that there was no dedicated Government policy on climate change or coastal zone management. In terms of spatial planning policy, it became apparent that there was little or no guidance on climate change either at a national, regional or local level. Therefore, to determine the likely impacts of sea level rise in Ireland based on current spatial planning practice and policy, a scenario-building exercise was carried out for two case study areas in Galway Bay. The two case study areas were: Oranmore, a densely populated town located to the east of Inner Galway Bay; and Tawin Island, a rural dispersed community, located to the south east of Inner Galway Bay. A ‘best’ and ‘worse’ case scenario was envisaged for both areas in terms of sea level rise. In the absence of specific climate change policies it was projected that in the ‘best’ case scenario of 0.5m sea level rise, Tawin Island would suffer serious and adverse impacts while Oranmore was likely to experience slight to moderate impacts. However, in the ‘worse’ case scenario of a 2m sea level rise, it was likely that Tawin Island would be abandoned while many houses, businesses and infrastructure built within the floodplain of Oranmore Bay would be inundated and permanently flooded. In this regard, it was the author’s opinion that a strategic and integrated climate change policy and adaptation plan is vital for the island of Ireland that recognises the importance of integrated land use and spatial planning in terms of mitigation and adaptation to climate change.
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Background: The TIMI Score for ST-segment elevation myocardial infarction (STEMI) was created and validated specifically for this clinical scenario, while the GRACE score is generic to any type of acute coronary syndrome. Objective: Between TIMI and GRACE scores, identify the one of better prognostic performance in patients with STEMI. Methods: We included 152 individuals consecutively admitted for STEMI. The TIMI and GRACE scores were tested for their discriminatory ability (C-statistics) and calibration (Hosmer-Lemeshow) in relation to hospital death. Results: The TIMI score showed equal distribution of patients in the ranges of low, intermediate and high risk (39 %, 27 % and 34 %, respectively), as opposed to the GRACE Score that showed predominant distribution at low risk (80 %, 13 % and 7%, respectively). Case-fatality was 11%. The C-statistics of the TIMI score was 0.87 (95%CI = 0.76 to 0.98), similar to GRACE (0.87, 95%CI = 0.75 to 0.99) - p = 0.71. The TIMI score showed satisfactory calibration represented by χ2 = 1.4 (p = 0.92), well above the calibration of the GRACE score, which showed χ2 = 14 (p = 0.08). This calibration is reflected in the expected incidence ranges for low, intermediate and high risk, according to the TIMI score (0 %, 4.9 % and 25 %, respectively), differently to GRACE (2.4%, 25% and 73%), which featured middle range incidence inappropriately. Conclusion: Although the scores show similar discriminatory capacity for hospital death, the TIMI score had better calibration than GRACE. These findings need to be validated populations of different risk profiles.
When is the Best Time for the Second Antiplatelet Agent in Non-St Elevation Acute Coronary Syndrome?
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Abstract Dual antiplatelet therapy is a well-established treatment in patients with non-ST elevation acute coronary syndrome (NSTE-ACS), with class I of recommendation (level of evidence A) in current national and international guidelines. Nonetheless, these guidelines are not precise or consensual regarding the best time to start the second antiplatelet agent. The evidences are conflicting, and after more than a decade using clopidogrel in this scenario, benefits from the routine pretreatment, i.e. without knowing the coronary anatomy, with dual antiplatelet therapy remain uncertain. The recommendation for the upfront treatment with clopidogrel in NSTE-ACS is based on the reduction of non-fatal events in studies that used the conservative strategy with eventual invasive stratification, after many days of the acute event. This approach is different from the current management of these patients, considering the established benefits from the early invasive strategy, especially in moderate to high-risk patients. The only randomized study to date that specifically tested the pretreatment in NSTE-ACS in the context of early invasive strategy, used prasugrel, and it did not show any benefit in reducing ischemic events with pretreatment. On the contrary, its administration increased the risk of bleeding events. This study has brought the pretreatment again into discussion, and led to changes in recent guidelines of the American and European cardiology societies. In this paper, the authors review the main evidence of the pretreatment with dual antiplatelet therapy in NSTE-ACS.
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This paper devotes to evaluation of performance bottlenecks and algorithm deficiencies in the area of contemporary reliable multicast networking. Hereby, the impact of packet delay jitter on the end-to-end performance of multicast IP data transport is investigated. A series of tests with two most significant open-source implementations of reliable multicast is performed and analyzed. These are: UDP-based File Transfer Protocol (UFTP) and NACK-oriented Reliable multicast (NORM). Tests were targeted to simulate scenario of content distribution in WAN – sized Content Delivery Networks (CDN). Then, results were grouped and averaged, by round trip time and packet losses. This enabled us to see jitter influence independently on round trip time(RTT) and packet loss rates. Revealed jitter influence for different network conditions. Confirmed, that appearance of even small jitter causes significant data rate reduction.
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Drosophila paulistorum Dobzhansky & Pavan, 1949 had initially been considered absent in anthropogenically disturbed environments, but in 1985 the detection of the species in Porto Alegre city, southern Brazil, suggested its potential to colonize new habitats and laid the foundations for ecologic studies on this species' populations. This study followed the variations in D. paulistorum populations in this town almost 20 years after its first local record. Drosophilid specimens were collected in sites with different urbanization grades and the results point to the expressive decline in D. paulistorum populations in Porto Alegre. This decline may be linked to urban growth and to naturally driven population decline, as imputed to climatic changes like variations in maximum and minimum temperatures as a consequence of a global climate warming. Also, the recent introduction of exotic species Zaprionus indianus Gupta, 1970 seems to play a role in this scenario, changing the interactions between native species.
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ABSTRACT Amphibians are the most threatened vertebrate group according to the IUCN. Land-use and land cover change (LULCC) and climate change (CC) are two of the main factors related to declining amphibian populations. Given the vulnerability of threatened and rare species, the study of their response to these impacts is a conservation priority. The aim of this work was to analyze the combined impact of LULCC and CC on the regionally endemic species Melanophryniscus sanmartini Klappenbach, 1968. This species is currently categorized as near threatened by the IUCN, and previous studies suggest negative effects of projected changes in climate. Using maximum entropy methods we modeled the effects of CC on the current and mid-century distribution of M. sanmartini under two IPCC scenarios - A2 (severe) and B2 (moderate). The effects of LULCC were studied by superimposing the potential distribution with current land use, while future distribution models were evaluated under the scenario of maximum expansion of soybean and afforestation in Uruguay. The results suggest that M. sanmartini is distributed in eastern Uruguay and the south of Brazil, mainly related to hilly and grasslands systems. Currently more than 10% of this species' distribution is superimposed by agricultural crops and exotic forest plantations. Contrasting with a recent modelling study our models suggest an expansion of the distribution of M. sanmartini by mid-century under both climate scenarios. However, despite the rise in climatically suitable areas for the species in the future, LULCC projections indicate that the proportion of modified habitats will occupy up to 25% of the distribution of M. sanmartini. Future change in climate conditions could represent an opportunity for M. sanmartini, but management measures are needed to mitigate the effects of habitat modification in order to ensure its survival and allow the eventual expansion of its distribution.
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In this paper we follow the tradition of applied general equilibrium modelling of the Walrasian static variety to study the empirical viability of a double dividend (green, welfare, and employment) in the Spanish economy. We consider a counterfactual scenario in which an ecotax is levied on the intermediate and final use of energy goods. Under a revenue neutral assumption, we evaluate the real income and employment impact of lowering payroll taxes. To appraise to what extent the model structure and behavioural assumptions may influence the results, we perform simulations under a range of alternative model and policy scenarios. We conclude that a double dividend –better environmental quality, as measured by reduced CO2 emissions, and improved levels of employment– may be an achievable goal of economic policy.