863 resultados para Intervention in home context


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Differentiated dendritic cells (DC) have been identified by the presence of nuclear RelB (nRelB) and HLA-DR, and the absence of CD20 or high levels of CD68, in lymph nodes and active rheumatoid arthritis synovial tissue. The current studies aimed to identify conditions in which nRelB is expressed in human tissues, by single and double immunohistochemistry of formalin-fixed peripheral and lymphoid tissue. Normal peripheral tissue did not contain nRelB(+) cells. nRelB(+) DC were located only in T- or B-cell areas of lymphoid tissue associated with normal organs or peripheral tissues, including tonsil, colon, spleen and thymus, or in association with T cells in inflamed peripheral tissue. Inflamed sites included skin delayed-type hypersensitivity reaction, and a wide range of tissues affected by autoimmune disease. Nuclear RelB(+) -HLA-DR- follicular DC were located in B-cell follicles in lymphoid organs and in lymphoid-like follicles of some tissues affected by autoimmune disease. Lymphoid tissue T-cell areas also contained nRelB(-) -HLA-DR+ cells, some of which expressed CD123 and/or CD68. Nuclear RelB(+) cells are found in normal lymphoid organs and in peripheral tissue in the context of inflammation, but not under normal resting conditions.

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In a retrospective review, the telemedical management of 65 outpatients from a randomized controlled trial (RCT) of telemedicine for non-urgent referrals to a consultant neurologist was compared with the management of 76 patients seen face to face in the same trial, with that of 150 outpatients seen in the neurology clinics of district general hospitals and with that of 102 neurological outpatients seen by general physicians. Outcome measures were the numbers of investigations and of patient reviews. The telemedicine group did not differ significantly from the 150 patients seen face to face by neurologists in hospital clinics in terms of either the number of investigations or the number of reviews they received. Patients from the RCT seen face to face had significantly fewer investigations but a similar number of reviews to the other 150 patients seen face to face by neurologists (the disparity in the number of investigations may explain the negative result for telemedicine in that RCT). Patients with neurological symptoms assessed by general physicians had significantly more investigations and were reviewed significantly more often than all the other groups. Patients from the RCT seen by telemedicine were not managed significantly differently from those seen face to face by neurologists in hospital clinics but had significantly fewer investigations and follow-ups than those patients managed by general physicians. The results suggest that management of new neurological outpatients by neurologists using telemedicine is similar to that by neurologists using a face-to-face consultation, and is more efficient than management by general physicians.

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Peer support interventions for people with cancer, their families, and friends have been widely used throughout the world. The present study reviewed the research literature on psychosocial oncology over the past decade to assess the prevalence and contribution of articles on peer support. Using CD-Rom databases, 25 articles were retrieved for review. In each article, patients or their family members were the target group for supportive interventions, which were primarily for the delivery of peer support and included either a qualitative or quantitative evaluation of the program. A definitional taxonomy for peer support interventions, which identified eight discrete settings, was derived from three key dimensions: style of supervision, interpersonal context, and mode of delivery. The studies suggested that peer support programs help by providing emotional and informational support from the perspective of shared personal experience. However, a paucity of research-particularly randomized controlled trials-was noted. The reasons may include inherent difficulties in isolating for study what is essentially a naturalistically occurring interpersonal dynamic from the complex social and community contexts from which it emanates. The authors discuss the gap between practice and theory in this area and recommend a broader and more inclusive view of supportive care for people with cancer. (C) 2003 by The Haworth Press, Inc. All rights reserved.

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This paper aims to describe the processes of teaching illustration and animation, together, in the context of a masters degree program. In Portugal, until very recently, illustration and animation higher education courses, were very scarce and only provided by a few private universities, which offered separated programs - either illustration or animation. The MA in Illustration and Animation (MIA) based in the Instituto Politécnico do Cávado e Ave in Portugal, dared to join these two creative areas in a common learning model and is already starting it’s third edition with encouraging results and will be supported by the first international conference on illustration and animation (CONFIA). This masters program integrates several approaches and techniques (in illustration and animation) and integrates and encourages creative writing and critique writing. This paper describes the iterative process of construction, and implementation of the program as well as the results obtained on the initial years of existence in terms of pedagogic and learning conclusions. In summary, we aim to compare pedagogic models of animation or illustration teaching in higher education opposed to a more contemporary and multidisciplinary model approach that integrates the two - on an earlier stage - and allows them to be developed separately – on the second part of the program. This is based on the differences and specificities of animation (from classic techniques to 3D) and illustration (drawing the illustration) and the intersection area of these two subjects within the program structure focused on the students learning and competencies acquired to use in professional or authorial projects.

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In this work, we consider the numerical solution of a large eigenvalue problem resulting from a finite rank discretization of an integral operator. We are interested in computing a few eigenpairs, with an iterative method, so a matrix representation that allows for fast matrix-vector products is required. Hierarchical matrices are appropriate for this setting, and also provide cheap LU decompositions required in the spectral transformation technique. We illustrate the use of freely available software tools to address the problem, in particular SLEPc for the eigensolvers and HLib for the construction of H-matrices. The numerical tests are performed using an astrophysics application. Results show the benefits of the data-sparse representation compared to standard storage schemes, in terms of computational cost as well as memory requirements.

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The State Reform processes combined with the emergence and use of Information and Communication Technology (ICT) originated electronic government policies and initiatives in Brazil. This paper dwells on Brazilian e-government by investigating the institutional design it assumed in the state's public sphere, and how it contributed to outcomes related to e-gov possibilities. The analyses were carried out under an interpretativist perspective by making use of Institutional Theory. From the analyses of interviews with relevant actors in the public sphere, such as state secretaries and presidents of public ICT companies, conclusions point towards low institutionalization of e-gov policies. The institutional design of Brazilian e-gov limits the use of ICT to provide integrated public services, to amplify participation and transparency, and to improve public policies management.

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Develop a new model of Absorptive Capacity taking into account two variables namely Learning and knowledge to explain how companies transform information into knowledge

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Background: Malaria, schistosomiasis and geohelminth infection are linked to maternal and child morbidity and mortality in sub-Saharan Africa. Knowing the prevalence levels of these infections is vital to guide governments towards the implementation of successful and cost-effective disease control initiatives. Methodology/Principal Findings: A cross-sectional study of 1,237 preschool children (0–5 year olds), 1,142 school-aged children (6–15 year olds) and 960 women (.15 year olds) was conducted to understand the distribution of malnutrition, anemia, malaria, schistosomiasis (intestinal and urinary) and geohelminths in a north-western province of Angola. We used a recent demographic surveillance system (DSS) database to select and recruit suitable households. Malnutrition was common among children (23.3% under-weight, 9.9% wasting and 32.2% stunting), and anemia was found to be a severe public health problem (i.e., .40%). Malaria prevalence was highest among preschool children reaching 20.2%. Microhematuria prevalence levels reached 10.0% of preschool children, 16.6% of school-aged children and 21.7% of mothers. Geohelminth infections were common, affecting 22.3% of preschool children, 31.6% of school-aged children and 28.0% of mothers. Conclusions: Here we report prevalence levels of malaria, schistosomiasis and geohelminths; all endemic in this poorly described area where a DSS has been recently established. Furthermore we found evidence that the studied infections are associated with the observed levels of anemia and malnutrition, which can justify the implementation of integrated interventions for the control of these diseases and morbidities.

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OBJECTIVE: The results of an evaluative longitudinal study, which identified the effects of health care decentralization on health financing in Mexico, Nicaragua and Peru are presented in this article. METHODS: The methodology had two main phases. In the first, secondary sources of data and documents were analyzed with the following variables: type of decentralization implemented, source of financing, funds for financing, providers, final use of resources, mechanisms for resource allocation. In the second phase, primary data were collected by a survey of key personnel in the health sector. RESULTS: Results of the comparative analysis are presented, showing the changes implemented in the three countries, as well as the strengths and weaknesses of each country in matters of financing and decentralization. CONCLUSIONS: The main financing changes implemented and quantitative trends with respect to the five financing indicators are presented as a methodological tool to implement corrections and adjustments in health financing.

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Power systems have been through deep changes in recent years, namely with the operation of competitive electricity markets in the scope and the increasingly intensive use of renewable energy sources and distributed generation. This requires new business models able to cope with the new opportunities that have emerged. Virtual Power Players (VPPs) are a new player type which allows aggregating a diversity of players (Distributed Generation (DG), Storage Agents (SA), Electrical Vehicles, (V2G) and consumers), to facilitate their participation in the electricity markets and to provide a set of new services promoting generation and consumption efficiency, while improving players` benefits. A major task of VPPs is the remuneration of generation and services (maintenance, market operation costs and energy reserves), as well as charging energy consumption. This paper proposes a model to implement fair and strategic remuneration and tariff methodologies, able to allow efficient VPP operation and VPP goals accomplishment in the scope of electricity markets.

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Demand response is assumed an essential resource to fully achieve the smart grids operating benefits, namely in the context of competitive markets. Some advantages of Demand Response (DR) programs and of smart grids can only be achieved through the implementation of Real Time Pricing (RTP). The integration of the expected increasing amounts of distributed energy resources, as well as new players, requires new approaches for the changing operation of power systems. The methodology proposed aims the minimization of the operation costs in a smart grid operated by a virtual power player. It is especially useful when actual and day ahead wind forecast differ significantly. When facing lower wind power generation than expected, RTP is used in order to minimize the impacts of such wind availability change. The proposed model application is here illustrated using the scenario of a special wind availability reduction day in the Portuguese power system (8th February 2012).

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Smart grids are envisaged as infrastructures able to accommodate all centralized and distributed energy resources (DER), including intensive use of renewable and distributed generation (DG), storage, demand response (DR), and also electric vehicles (EV), from which plug-in vehicles, i.e. gridable vehicles, are especially relevant. Moreover, smart grids must accommodate a large number of diverse types or players in the context of a competitive business environment. Smart grids should also provide the required means to efficiently manage all these resources what is especially important in order to make the better possible use of renewable based power generation, namely to minimize wind curtailment. An integrated approach, considering all the available energy resources, including demand response and storage, is crucial to attain these goals. This paper proposes a methodology for energy resource management that considers several Virtual Power Players (VPPs) managing a network with high penetration of distributed generation, demand response, storage units and network reconfiguration. The resources are controlled through a flexible SCADA (Supervisory Control And Data Acquisition) system that can be accessed by the evolved entities (VPPs) under contracted use conditions. A case study evidences the advantages of the proposed methodology to support a Virtual Power Player (VPP) managing the energy resources that it can access in an incident situation.

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Cyber-Physical Intelligence is a new concept integrating Cyber-Physical Systems and Intelligent Systems. The paradigm is centered in incorporating intelligent behavior in cyber-physical systems, until now too oriented to the operational technological aspects. In this paper we will describe the use of Cyber-Physical Intelligence in the context of Power Systems, namely in the use of Intelligent SCADA (Supervisory Control and Data Acquisition) systems at different levels of the Power System, from the Power Generation, Transmission, and Distribution Control Centers till the customers houses.