Distriktssköterskors upplevelser och erfarenheter av patientundervisning till personer med diabetes – utifrån ett personcentrerat förhållningssätt : En kvalitativ studie

Syfte: Syftet med studien var att beskriva distriktssköterskors upplevelser och erfarenheter av patientundervisning till patienter med diabetes samt att identifiera aspekter som kan relateras till ett personcentrerat förhållningssätt. Metod: Deskriptiv design med kvalitativ ansats med semistrukturerade intervjuer användes vid datainsamlingen. Vid urvalet användes strategiskt urval. Nio intervjuer utfördes med distriktssköterskor på sex olika vårdcentraler i Mellansverige. Vid analysen användes kvalitativ innehållsanalys. Resultat: Distriktssköterskorna önskade mer kunskap om invandrares kost- och motionsvanor. Distriktssköterskorna uttryckte att det var roligt och spännande med patientundervisning och att det var viktigt att de var engagerade. Distriktssköterskorna ville arbeta mer i team och de upplevde att de hade för lite tid avsatt för patientundervisning. De ansåg att de arbetade personcentrerat men det var svårare att arbeta personcentrerat vid gruppundervisning än vid enskild undervisning. Slutsats: Distriktssköterskor bör ha god kunskap om kulturella skillnader hos patienter med diabetes. Distriktssköterskorna upplever brist på tid- och resurser och önskar samarbeta mera i team. Det är viktigt med ett personcentrerat förhållningssätt där distriktssköterskorna utgår från den enskilda individen. En distriktssköterska som är engagerad och trivs med sitt arbete kan lättare klara av det ökade trycket och arbetsbelastningen.

Uso do computador em educação: um estudo do Projeto Ciranda

O surgimento do computador provocou uma série de mudanças sócio-culturais. A educação não poderia ficar imune a essas alterações. Várias experiências do seu uso em educação surgiram, inicialmente em computadores de grande porte; posteriormente, com o surgimento dos microcomputadores, essas experiências se multiplicaram. Como esse equipamento vem sendo utilizado, avaliações já realizadas, alguns problemas existentes e perspectivas futuras são discutidas neste trabalho; que procura apresentar o Projeto Ciranda, implantado pela Embratel. Tendo como pano de fundo uma perspectiva educacional, discute a filosofia do projeto, seus objetivos e a população participante.

Os avanços da arbitragem no Brasil e uma análise crítica a respeito dos posicionamentos existentes na Doutrina Nacional sobre o cabimento de ação anulatória contra sentença arbitral que tenha violado a ordem pública

O presente trabalho tem como objetivo o estudo sobre o cabimento da ação anulatória - prevista no artigo 32 da Lei de Arbitragem - contra uma sentença arbitral doméstica que tenha violado a ordem pública. A relevância do tema encontra-se no fato de que o legislador, ao elencar as hipóteses pelas quais poderá ser declarada a invalidade de uma decisão arbitral, excluiu, propositalmente, a violação à ordem pública como uma delas. O Poder Judiciário ainda não teve a oportunidade de analisar o assunto. A preocupação, quando elaborada a Lei de Arbitragem em 1996, era a de que, caso o artigo 32 previsse expressamente a violação à ordem pública, todos os procedimentos arbitrais desembocariam no Judiciário, tendo em vista a indeterminação do conceito. Somava-se a isso o elevado preconceito que o instituto sofria no Brasil, além de seu pouco uso. O debate ganha ainda maior proporção quando se analisa as causas pelas quais o Poder Judiciário poderá negar homologação a uma sentença arbitral estrangeira. Quis o legislador, e o fez de modo expresso, que a violação à ordem pública fosse causa de negativa de homologação, mas nada disse com relação às sentenças domésticas. Analisarei, neste trabalho, todos os avanços pelos quais a arbitragem passou no Brasil, tudo para concluir, na primeira parte do trabalho, que a preocupação do legislador não mais subsiste. Além disso, analisarei os posicionamentos existentes na doutrina nacional para responder a principal pergunta desse trabalho: É possível ajuizar uma ação anulatória contra uma sentença arbitral doméstica que tenha violado a ordem pública, mesmo sem que o artigo 32 da Lei de Arbitragem a preveja, expressamente, como uma das causas de anulabilidade? Finalmente, no último capítulo do trabalho, exporei o meu entendimento sobre o assunto, no sentido de ser possível o ajuizamento de ação anulatória com base na combinação dos artigos 32, IV, com o artigo 2º, § 1º, ambos da Lei de Arbitragem.

Escolhas individuais e bem-estar financeiro: três ensaios utilizando microdados

Como orientar políticas públicas de modo a promover o bem-estar da população? Para responder a essa questão a comunidade acadêmica tem enfocado a necessidade de se conhecer melhor as escolhas de consumo individuais. Essa tendência encontra apoio no número, cada vez maior, de bases de microdados disponibilizadas pelos órgãos governamentais e iniciativa privada. O presente trabalho analisa as escolhas dos brasileiros com relação às decisões de financiamento e de oferta de trabalho. O estudo é dividido em três ensaios empíricos distintos. Como a contratação de crédito em mercados informais é motivada pelo déficit de educação financeira é o foco do primeiro ensaio. Considerando mais de 2.000 observações sobre tomadas de crédito, utiliza-se um modelo logit multinomial para estimar a propensão à tomada de crédito na informalidade em contraste com o crédito bancário. Os resultados indicam que a educação financeira pode ter uma relevância maior para a seleção de financiamentos informais do que a restrição de crédito. O segundo ensaio analisa o comportamento de uso de cartões de crédito dentre 1.458 jovens adultos residentes no Brasil, EUA ou França. Um modelo de equações estruturais é utilizado para incorporar relações entre as variáveis latentes. O modelo validado pelo estudo representa uma situação em que o bem-estar financeiro é afetado pela forma com que o indivíduo utiliza o cartão de crédito que, por sua vez, é afetado pelo sentimento de comparação social e pela autoconfiança financeira, essa última sendo impactada também pela educação financeira recebida dos pais. Na comparação entre grupos encontramos evidências de que a comparação social tem um efeito mais forte sobre os jovens brasileiros e que homens são mais dependentes da educação dos pais do que as mulheres. No último ensaio a população pobre brasileira é analisada em relação a um suposto efeito preguiça, que seria causado pela diminuição de oferta de trabalho das famílias que recebem o benefício financeiro do governo via o Programa Bolsa Família. Um modelo de sobrevivência foi usado para comparar a duração no emprego entre beneficiários do programa e um grupo controle, utilizando uma base de dados com mais de 3 milhões de indivíduos. A hipótese de um efeito preguiça é rejeitada. O risco de desligamento do emprego para os beneficiários do Bolsa Família é medido como sendo de 7% a 10% menor, o que é capaz de anular, por exemplo, o maior risco de saída do emprego causado pela presença de filhos pequenos na composição familiar. Uma vez que a rotatividade no emprego dificulta o recebimento de aposentadorias por tempo de contribuição, pode-se concluir que o programa de transferência de renda brasileiro terá um impacto positivo sobre o bem-estar financeiro futuro do trabalhador.

A ação civil pública como meio de concretização do direito à saúde na Constituição de 1988

The work presented here is about aspects of the constitutional extension in which is the public civil action with the objective of verifying its aptitute in tutelaging subjective situations derived from fundamental rights, especially right to health assistance. Thus, it offers a clear analysis of the practical functioning of most aspects of the public civil action (lawsuit), with philosophical foundation and necessary doctrinaire to your comphehension. How it once was (history), how it could be (reform suggestion), how it is (current interpretation of the law) and how it should be (critic analysis of the microsystem of collective tutelaging of rights, its perspectives, as well as the efficacy of the public cilvil action about accomplishment of the right to health as supraindividual right). The objective is to analyse the main version of the theme (for instance: the impacts caused to the dissociation of the Procurations theory), so that it can be extracted the philosophy and the general theory, of the public civil action and collective tutelaging in general, pragmatically applicable to study purposes. With this theorical fountain, the reader will be in a more solid position, not only being able to understand the subtilities of the public civil action, but mainly being able to recognize its faults and present solid reform proposals and improvement. It is know that the Juridical Power (Procuration) does not allow any more inactivity about negating accession to health in its collective dimension (lato sensu: spread, collective stricto sensu and homogeneous individuals), being imputed to it novel usage that consolidates in the assumption of the role instrument set aside to be used by all with organized instancy of solution to collective conflicts in large sense. This happens, overall, because of the current justice politization, understood as juridical activism, connected to the struggle between the groups defending their interests and the acceptance of the constitution about solidifying the public politics of quality health

Export growth in Latin America: policies and performance

Includes bibliography

Expenditures, investment and financing for sustainable development in Trinidad and Tobago

Includes bibliography

A genetic algorithm for crop rotation

In the last few years, crop rotation has gained attention due to its economic, environmental and social importance which explains why it can be highly beneficial for farmers. This paper presents a mathematical model for the Crop Rotation Problem (CRP) that was adapted from literature for this highly complex combinatorial problem. The CRP is devised to find a vegetable planting program that takes into account green fertilization restrictions, the set-aside period, planting restrictions for neighboring lots and for crop sequencing, demand constraints, while, at the same time, maximizing the profitability of the planted area. The main aim of this study is to develop a genetic algorithm and test it in a real context. The genetic algorithm involves a constructive heuristic to build the initial population and the operators of crossover, mutation, migration and elitism. The computational experiment was performed for a medium dimension real planting area with 16 lots, considering 29 crops of 10 different botanical families and a two-year planting rotation. Results showed that the algorithm determined feasible solutions in a reasonable computational time, thus proving its efficacy for dealing with this practical application.

A concepção de criança e alei de nove anos

The historical analysis of the conception of child is essential to understand the speeches, public policies and actions that are set aside for them. The 20th century ´ social-economic changes and the consequent need for women's work produced a restructuring not only in the family, but also in the care and attention focused on childhood. The present article under the perspective of Cultural-historical approach aims to make a reflection about the conception of child in the educational context, especially in the face of recent public policies that favor education´s advance in state schools. Besides, they also intend to point out some consequences and possible problems that may arise with their implementation and discuss the implications for the teacher´s organization of methodological practice and the relationship between development and learning.

A problemática trazida pela homologação de sentenças arbitrais estrangeiras anuladas em seu país de origem na segurança jurídica dos contratos internacionais do comercio

Pós-graduação em Direito - FCHS

Analysis of effectiveness of three forest interventionist techniques and proposal of a new and integrated model of forest restoration

We assessed the efficacy of three different forest intervention techniques, in terms of phytosociological and edaphic responses, that were implemented in 2007. In a farm where trees are planted and managed for cellulose production as well as set aside for environmental conservation, four stands were analysed: three of them were considered degraded and were managed using different intervention techniques (transposition, perch, and abandonment), and a fourth stand comprising pristine vegetation was considered a control (reference). Floristic and phytosociology data were collected in three 10 × 10 m plots established in each stand. Also, a total of 48 soil samples were collected to analyse physical and chemical attributes of the topsoil for the different stands. In terms of biodiversity, all the treatments showed significantly lower values when compared to the reference area. However, the soils in all the treatment and reference stands are similar in terms of physical and chemical attributes. Taking into account the specificities of each restoration technique, we verified that the integrated use of a set of management practices, constituted by the (1) abandonment of the area and (2) following a selective killing of the eucalyptus, is the most suitable and promising model to provide fast and effective restoration in terms of environmental indicators.

L'Architettura religiosa di Luis Moya Blanco. La costruzione come principio compositivo

La presente ricerca, L’architettura religiosa di Luis Moya Blanco. La costruzione come principio compositivo, tratta i temi inerenti l’edificazione di spazi per il culto della religione cristiana che l’architetto spagnolo progetta e realizza a Madrid dal 1945 al 1970. La tesi è volta ad indagare quali siano i principi alla base della composizione architettonica che si possano considerare immutati, nel lungo arco temporale in cui l’autore si trova ad operare. Tale indagine, partendo da una prima analisi riguardante gli anni della formazione e gli scritti da lui prodotti, verte in particolare sullo studio dei progetti più recenti e ancora poco trattati dalla critica. L’obbiettivo della presente tesi è dunque quello di apportare un contributo originale sull’aspetto compositivo della sua architettura. Ma analizzare la composizione significa, in Moya, analizzare la costruzione che, a dispetto del susseguirsi dei linguaggi, rimarrà l’aspetto principale delle sue opere. Lo studio dei manufatti mediante categorie estrapolate dai suoi stessi scritti – la matematica, il numero, la geometria e i tracciati regolatori - permette di evidenziare punti di contatto e di continuità tra le prime chiese, fortemente caratterizzate da un impianto barocco, e gli ultimi progetti che sembrano cercare invece un confronto con forme decisamente moderne. Queste riflessioni, parallelamente contestualizzate nell’ambito della sua consistente produzione saggistica, andranno a confluire nell’idea finale per cui la costruzione diventi per Luis Moya Blanco il principio compositivo da cui non si può prescindere, la regola che sostanzia nella materia il numero e la geometria. Se la costruzione è dunque la pietrificazione di leggi geometrico-matematiche che sottendono schemi planimetrici; il ricorso allo spazio di origine centrale non risponde all’intenzione di migliorare la liturgia, ma a questioni di tipo filosofico-idealista, che fanno corrispondere alla somma naturalezza della perfezione divina, la somma perfezione della forma circolare o di uno dei suoi derivati come l’ellisse.

TRENDS IN PARTICULATE MATTER AND MORTALITY: AN APPROACH TO THE ASSESSMENT OF UNMEASURED CONFOUNDING

We propose a method for diagnosing confounding bias under a model which links a spatially and temporally varying exposure and health outcome. We decompose the association into orthogonal components, corresponding to distinct spatial and temporal scales of variation. If the model fully controls for confounding, the exposure effect estimates should be equal at the different temporal and spatial scales. We show that the overall exposure effect estimate is a weighted average of the scale-specific exposure effect estimates. We use this approach to estimate the association between monthly averages of fine particles (PM2.5) over the preceding 12 months and monthly mortality rates in 113 U.S. counties from 2000-2002. We decompose the association between PM2.5 and mortality into two components: 1) the association between “national trends” in PM2.5 and mortality; and 2) the association between “local trends,” defined as county-specificdeviations from national trends. This second component provides evidence as to whether counties having steeper declines in PM2.5 also have steeper declines in mortality relative to their national trends. We find that the exposure effect estimates are different at these two spatio-temporalscales, which raises concerns about confounding bias. We believe that the association between trends in PM2.5 and mortality at the national scale is more likely to be confounded than is the association between trends in PM2.5 and mortality at the local scale. If the association at the national scale is set aside, there is little evidence of an association between 12-month exposure to PM2.5 and mortality.

Razor Thin Win: The 1972 Constitution Ballot, Campaign, Ratification & the Courts -- Mae Nan (Robinson) Ellingson & Mick McKeon “In the Crucible of Change”

Beyond the challenge of crafting a new state Constitution that empowered the people and modernized and opened up state and local government in Montana, the Constitutional Convention delegates, as they signed the final document, looked forward to the arduous task of getting it ratified by the electorate in a short ten week period between the end of the convention on March 24 and the ratification election of June 6, 1972. While all 100 delegates signed the draft Constitution, not all supported its adoption. But the planning about how to get it adopted went back to the actions of the Convention itself, which carefully crafted a ballot that kept “hot political issues” from potentially killing the entire document at the polls. As a result, three side issues were presented to the electorate on the ballot. People could vote for or against those side issues and still vote to ratify the entire document. Thus, the questions of legalizing gambling, having a unicameral legislature and retaining the death penalty were placed separately on the ballot (gambling passed, as did the retention of the death penalty, but the concept of a one-house legislature was defeated). Once the ballot structure was set, delegates who supported the new Constitution organized a grassroots, locally focused effort to secure ratification – thought hampered by a MT Supreme Court decision on April 28 that they could not expend $45,000 in public monies that they had set aside for voter education. They cobbled together about $10,000 of private money and did battle with the established political forces, led by the MT Farm Bureau, MT Stockgrowers’ Assn. and MT Contractors Assn., on the question of passage. Narrow passage of the main document led to an issue over certification and a Montana Supreme Court case challenging the ratification vote. After a 3-2 State Supreme Court victory, supporters of the Constitution then had to defend the election results again before the federal courts, also a successful effort. Montana finally had a new progressive State Constitution that empowered the people, but the path to it was not clear and simple and the win was razor thin. The story of that razor thin win is discussed in this chapter by the two youngest delegates to the 1972 Constitutional Convention, Mae Nan Ellingson of Missoula and Mick McKeon, then of Anaconda. Both recognized “Super Lawyers in their later professional practices were also significant players in the Constitutional Convention itself and actively participated in its campaign for ratification. As such, their recollections of the effort provide an insider’s perspective of the struggle to change Montana for the better through the creation and adoption of a new progressive state Constitution “In the Crucible of Change.” Mae Nan (Robinson) Ellingson was born Mae Nan Windham in Mineral Wells, TX and graduated from Mineral Wells High School in 1965 and Weatherford College in Weatherford, TX in 1967. Mae Nan was the youngest delegate at the 1972 Convention from Missoula. She moved to Missoula in 1967 and received her BA in Political Science with Honors from the University of MT in 1970. She was a young widow known by her late husband’s surname of Robinson while attending UM graduate school under the tutelage of noted Professor Ellis Waldron when he persuaded her to run for the Constitutional Convention. Coming in a surprising second in the delegate competition in Missoula County she was named one of the Convention’s “Ten Outstanding Constitutional Convention Delegates,” an impressive feat at such a young age. She was 24 at the time, the youngest person to serve at the ConCon, and one of 19 women out of 100 delegates. In the decade before the Convention, there were never more than three women Legislators in any session, usually one or two. She was a member of the American Association of University Women, a Pi Sigma Alpha political science honorary, and a Phi Alpha Theta historical honorary. At the Convention, she led proposals for the state's bill of rights, particularly related to equal rights for women. For years, Ellingson kept a copy of the preamble to the Constitution hanging in her office; while all the delegates had a chance to vote on the wording, she and delegate Bob Campbell are credited with the language in the preamble. During the convention, she had an opportunity that opened the door to her later career as an attorney. A convention delegate suggested to her that she should go to law school. Several offered to help, but at the time she couldn't go to school. Her mom had died in Texas, and she ended up with a younger brother and sister to raise in Missoula. She got a job teaching, but about a year later, intrigued with the idea of pursuing the law as a career, she called the man back to ask about the offer. Eventually another delegate, Dave Drum of Billings, sponsored her tuition at the UM School of Law. After receiving her JD with Honors (including the Law Review and Moot Court) from the UM Law School Ellingson worked for the Missoula city attorney's office for six years (1977-83), and she took on landmark projects. During her tenure, Missoula became the first city to issue open space bonds, a project that introduced her to Dorsey & Whitney. The city secured its first easement on Mount Sentinel, and it created the trail along the riverfront with a mix of playing fields and natural vegetation. She also helped develop a sign ordinance for the city of Missoula. She ended up working as bond counsel for Dorsey & Whitney, and she opened up the firm's full-fledged Missoula office after commuting a couple of years to its Great Falls office. She was a partner at Dorsey Whitney, working there from 1983 until her retirement in 2012. The area of law she practiced there is a narrow specialty - it requires knowledge of constitutional law, state and local government law, and a slice of federal tax law - but for Ellingson it meant working on great public projects – schools, sewer systems, libraries, swimming pools, ire trucks. At the state level, she helped form the Montana Municipal Insurance Authority, a pooled insurance group for cities. She's shaped MT’s tax increment law, and she was a fixture in the MT Legislature when they were debating equal rights. As a bond lawyer, though, Ellingson considers her most important work for the state to be setting up the Intercap Program that allowed local governments to borrow money from the state at a low interest rate. She has been a frequent speaker at the League of Cities and Towns, the Montana Association of Counties, and the Rural Water Users Association workshops on topics related to municipal finance, as well as workshops sponsored by the DNRC, the Water and Sewer Agencies Coordination Team, and the Montana State University Local Government Center. In 2002, she received an outstanding service award from the Montana Rural Water Users Association. In addition to being considered an expert on Montana state and constitutional law, local government law and local government finance, she is a frequent teacher at the National Association of Bond Lawyers (NABL) Fundamentals of Municipal Bond Law Seminar and the NABL Bond Attorney’s Workshop. For over 30 years Mae Nan has participated in the drafting of legislation in Montana for state and local finance matters. She has served on the Board of Directors of NABL, as Chairman of its Education Committee, was elected as an initial fellow in 1995 to the American College of Bond Counsel, and was recognized as a Super Lawyer in the Rocky Mountain West. Mae Nan was admitted to practice before the MT and US Supreme Courts, was named one of “America’s Leading Business Lawyers” by Chambers USA (Rank 1), a Mountain States Super Lawyer in 2007 and is listed in Best Lawyers in America; she is a member and former Board Member of NABL, a Fellow of the American College of Bond Counsel and a member of the Board of Visitors of the UM Law School. Mae Nan is also a philanthropist who serves on boards and applies her intelligence to many organizations, such as the Missoula Art Museum. [Much of this biography was drawn from a retirement story in the Missoulian and the Dorsey Whitney web site.] Mick McKeon, born in Anaconda in 1946, is a 4th generation Montanan whose family roots in this state go back to the 1870’s. In 1968 he graduated from Notre Dame with a BA in Communications and received a Juris Doctorate degree from the University of Montana Law School in 1971. Right after graduating from law school, Mick was persuaded by his father, longtime State Senator Luke McKeon, and his uncle, Phillips County Attorney Willis McKeon, to run for delegate to Montana’s Constitutional Convention and was elected to represent Deer Lodge, Philipsburg, Powell, and part of Missoula Counties. Along with a coalition of delegates from Butte and Anaconda, he fought through the new Constitution to eliminate the legal strangle hold, often called “the copper collar,” that corporate interests -- the Anaconda Company and its business & political allies -- had over state government for nearly 100 years. The New York Times called Montana’s Constitutional Convention a “prairie revolution.” After helping secure the ratification of the new Constitution, Mick began his practice of law in Anaconda where he engaged in general practice for nearly 20 years. Moving to Butte in 1991, Mick focused has practice in personal injury law, representing victims of negligence and corporate wrongdoing in both Montana district courts and federal court. As such, he participated in some of the largest cases in the history of the state. In 1992 he and his then law partner Rick Anderson obtained a federal court verdict of $11.5 million -- the largest verdict in MT for many years. Mick’s efforts on behalf of injured victims have been recognized by many legal organizations and societies. Recently, Mick was invited to become a member of the International Academy of Trial Lawyers - 600 of the top lawyers in the world. Rated as an American Super Lawyer, he has continuously been named one of the Best Lawyers in America, and an International Assn. of Trial Lawyers top 100 Trial Lawyer. In 2005, he was placed as one of Montana’s top 4 Plaintiff’s lawyers by Law Dragon. Mick is certified as a civil trial specialist by the National Board of Trial Advocacy and has the highest rating possible from Martindale-Hubble. Mick was awarded the Montana Trial Lawyers Public Service Award and provided pro bono assistance to needy clients for his entire career. Mick’s law practice, which he now shares with his son Michael, is limited to representing individuals who have been injured in accidents, concentrating on cases against insurance companies, corporations, medical providers and hospitals. Mick resides in Butte with his wife Carol, a Butte native. Mick, Carol, Michael and another son, Matthew, who graduated from Dartmouth College and was recently admitted to the Montana bar, enjoy as much of their time together in Butte and at their place on Flathead Lake.

MetaCampus REAL – ein europäischer Marktplatz für E-Learning Leistungen

This article addresses the discussion about open source solutions in the e-learning business. In contrast to critics by commercial suppliers this article comes to different conclusions. On the one hand such a discussion seems to be useless in this early state of the e-learning market. On the other hand solutions without costs might have a strong influence of which commercial suppliers could profit as well.