758 resultados para Pediatric nursing - Psychological aspects - Case studies


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This research book covers the major aspects relating to the use of novel delivery systems in enhancing both transdermal and intradermal drug delivery. It provides a review of transdermal and intradermal drug delivery, including the history of the field and the various methods employed to produce delivery systems from different materials such as device design, construction and evaluation, so as to provide a sound background to the use of novel systems in enhanced delivery applications.

Furthermore, it presents in-depth analyses of recent developments in this exponentially growing field, with a focus on microneedle arrays, needle-free injections, nanoparticulate systems and peptide-carrier-type systems. It also covers conventional physical enhancement strategies, such as tape-stripping, sonophoresis, iontophoresis, electroporation and thermal/suction/laser ablation Discussions about the penetration of the stratum corneum by the various novel strategies highlight the importance of the application method. Comprehensive and critical reviews of transdermal and intradermal delivery research using such systems focus on the outcomes of in vivoanimal and human studies. The book includes laboratory, clinical and commercial case studies featuring safety and patient acceptability studies carried out to date, and depicts a growing area for use of these novel systems is in intradermal vaccine delivery. The final chapters review recent patents in this field and describe the work ongoing in industry.

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Modern control methods like optimal control and model predictive control (MPC) provide a framework for simultaneous regulation of the tracking performance and limiting the control energy, thus have been widely deployed in industrial applications. Yet, due to its simplicity and robustness, the conventional P (Proportional) and PI (Proportional–Integral) control are still the most common methods used in many engineering systems, such as electric power systems, automotive, and Heating, Ventilation and Air Conditioning (HVAC) for buildings, where energy efficiency and energy saving are the critical issues to be addressed. Yet, little has been done so far to explore the effect of its parameter tuning on both the system performance and control energy consumption, and how these two objectives are correlated within the P and PI control framework. In this paper, the P and PI controllers are designed with a simultaneous consideration of these two aspects. Two case studies are investigated in detail, including the control of Voltage Source Converters (VSCs) for transmitting offshore wind power to onshore AC grid through High Voltage DC links, and the control of HVAC systems. Results reveal that there exists a better trade-off between the tracking performance and the control energy through a proper choice of the P and PI controller parameters.

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The research project analysed the role and effectiveness of LIFT via a multi-method study which included semi-structured interviews with policy elites and users, as well as case studies and an exploratory analysis of the financial characteristics of three LIFT Companies. While the team felt that it was able to identify key aspects relating to the advantages and drawbacks surrounding LIFT, some aspects relating to the representativeness of the study was adversely affected by a reluctance of PCTs to participate in the case study analysis and commercial confidentiality restrictions. The study was nonetheless able to identify important issues in relation to the funding and procurement of primary care premises and services.

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Background: Rapid Response Systems (RRS) have been implemented nationally and internationally to improve patient safety in hospital. However, to date the majority of the RRS research evidence has focused on measuring the effectiveness of the intervention on patient outcomes. To evaluate RRS it has been recommended that a multimodal approach is required to address the broad range of process and outcome measures required to determine the effectiveness of the RRS concept. Aim: The aim of this paper is to evaluate the official RRS programme theoretical assumptions regarding how the programme is meant to work against actual practice in order to determine what works. Methods: The research design was a multiple case study approach of four wards in two hospitals in Northern Ireland. It followed the principles of realist evaluation research which allowed empirical data to be gathered to test and refine RRS programme theory [1]. This approach used a variety of mixed methods to test the programme theories including individual and focus group interviews with a purposive sample of 75 nurses and doctors, observation of ward practices and documentary analysis. The findings from the case studies were analysed and compared within and across cases to identify what works for whom and in what circumstances. Results: The RRS programme theories were critically evaluated and compared with study findings to develop a mid-range theory to explain what works, for whom in what circumstances. The findings of what works suggests that clinical experience, established working relationships, flexible implementation of protocols, ongoing experiential learning, empowerment and pre-emptive management are key to the success of RRS implementation.  Conclusion:These findings highlight the combination of factors that can improve the implementation of RRS and in light of this evidence several recommendations are made to provide policymakers with guidance and direction for their success and sustainability.References: 1.Pawson R and Tilley N. (1997) Realistic Evaluation. Sage Publications; LondonType of submission: Concurrent session Source of funding: Sandra Ryan Fellowship funded by the School of Nursing & Midwifery, Queen’s University of Belfast

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O presente estudo investigou a temática da escrita colaborativa a distância, no Ensino Superior, em Inglês Língua Estrangeira. A escrita foi estudada de uma perspectiva processual, valorizando, portanto, o caminho que os alunos percorrem até ao produto final. O ambiente colaborativo reforçou este processo, na medida em que proporcionou, aos alunos, um espaço de discussão e melhoramento das diversas versões do texto. Por outro lado, a componente de ensino a distância de blended learning contribuiu, também, para um processo mais interactivo, mais colaborativo e, ao mesmo tempo, mais distanciado, o que beneficiaria o desenvolvimento da competência de escrita dos alunos e, simultaneamente, dos próprios alunos enquanto indivíduos. A investigação procurou averiguar diversos aspectos relacionados com o tipo de ensino já referido: aspectos evolutivos do processo de escrita na colaboração a distância – nomeadamente, as alterações efectuadas aos textos e seu impacto –; estratégias postas em prática pelos participantes em trabalho de escrita colaborativa a distância em Inglês Língua Estrangeira (ILE); formas de colaboração presentes no trabalho e a influência do ensino a distância no trabalho de escrita colaborativa. Para atingir as metas enumeradas, foi seleccionada uma turma de Língua e Cultura Inglesa II, 2º ano, da licenciatura em Ensino de Português/Inglês, da Universidade de Aveiro, que levou a cabo as diversas tarefas de escrita processual colaborativa, tarefas essas determinadas e realizadas através do webCT da Universidade de Aveiro (com uma página adaptada especialmente para a turma em questão). Todo o trabalho realizado pelos alunos foi ali registado para posterior análise. Tornou-se claro, ao longo da análise dos dados, que o ambiente a distância criou várias dificuldades aos alunos, implicando a criação de estratégias para as resolver. Por outro lado, a colaboração dentro dos grupos revelou-se um evidente benefício quer em termos de tarefas, quer em termos do desenvolvimento, motivação e envolvimento pessoais dos alunos. Também a abordagem processual à escrita trouxe resultados díspares: um dos grupos escrevia habitualmente segundo este modelo, não notando diferenças significativas, enquanto que o outro grupo valorizou o processo como um benefício para a escrita, sobretudo pelas fases de revisão que incluía. Pretendeu-se, com a análise referida e sumariada, conseguir não só investigar a escrita colaborativa a distância mas, também, identificar estratégias válidas para o ensino desta competência, estratégias essas que possam ajudar ao desenvolvimento de um ensino de escrita com mais sucesso e melhores resultados, sobretudo do ponto de vista dos alunos. É urgente um aprofundamento desta área ainda pouco desenvolvida, uma vez que as práticas de escrita se afastam cada vez mais da realidade actual, uma realidade construída em conjunto, por indivíduos que trabalham em ambientes virtuais e reais, sendo, portanto, relevante integrar os alunos nestes contextos, para melhor os preparar para o mundo de hoje. ABSTRACT: The study presented here has investigated collaborative writing at a distance in English as a Foreign Language (EFL), with University students. Students were encouraged to write according to a process model, which valued the stages of writing rather than the final product resulting from it. The collaborative environment strengthened the process, in the sense that it gave students room for discussion and improvement of the different versions of the text. On the other hand, distance learning contributed to a more collaborative and interactive process and, at the same time, more distanced, which benefited the development of the students’ writing skills and of the students as individuals. The investigation aimed to study several aspects of collaborative writing at a distance: the evolution of the writing process in distance collaboration, strategies used by the participants when writing collaboratively at a distance, initial writing competences of the participants and eventual advantages of distance learning for the collaborative revision phase of the writing process. In order to accomplish the proposed goals, we selected a class from those in the second year taking English Language and Culture II, of the English/ Portuguese Teaching “Licenciatura” degree at the University of Aveiro, and a web page was created for them. This page registered all the work done by the students along the project, establishing the data for future analysis. From this class, two groups were selected as case studies, in order to carry out a deeper and more comprehensive study of the process. We intended not only to investigate collaborative writing at a distance but also to identify valid strategies for the teaching of writing. Such strategies might aid the development of a more successful teaching of this competence, with better and more lasting results in students. Further research in this poorly developed area is urgent, as the practices of writing get further apart from the current reality. Nowadays, it is becoming growingly common to work both in real and virtual environments. It is thus relevant to integrate students in both, in order to prepare them for today’s world – our mission as teachers and educators.

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Socio-economic changes, alterations in societal expectations and new public policies have put pressures on higher education public funding, bringing the issue of funding diversification to the forefront. Income diversification, namely, generation of funds from private, as well as from competitive public sources, has become increasingly important in European higher education due to a complex financial environment and perceived deficit of innovation transfer. Although there are numerous studies about changes in national funding systems and allocation mechanisms, few have focused on diversification of funding sources, especially in the European context, making Portugal no exception. Thus, this study aims at exploring income diversification at the institutional level and its influence on the internal organisational structures. For this purpose two Portuguese public universities were chosen as case studies. The empirical material was collected through semi-structured interviews with top management and middle management of each university and through documentary analysis. Data analysis demonstrated that both universities are in the process of institutionalizing and formalising practices of income diversification, notably by getting more professional in how they are dealing with external stakeholders, such as businesses, local community, and students. However, the study also revealed that there is no formal, organised strategy to deal with income diversification. In general, the universities are reacting to external demands rather than pro-actively exploring opportunities. In this respect, the analysis determined several factors that promote or inhibit income diversification activities. Quality and favourable organizational culture were named by the interviewees as the most relevant factors for successful income diversification. External factors such as legal arrangements and funding conditions were cited as major constraints. This research has also revealed that revenue diversification activities tend to develop along the continuum towards higher sophistication and systematisation of activities that are supported by a powerful infrastructure. Together with efforts at the institutional level, the role of government policies proves to be crucial in providing tools and incentives to higher education institutions and creating a harmonious higher education system.

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Ao longo da última década, a crescente preocupação com as ameaças suscitadas pelas mudanças climáticas e o esgotamento dos recursos naturais tem-se tornado evidente em diversas indústrias e na população global. Além da salvaguarda do ambiente natural, espera-se, das empresas, que respeitem princípios de equidade social nas suas práticas e processos produtivos. Existe uma perceção generalizada de que as empresas e os diversos governos nacionais devem ser mais eficientes na utilização dos recursos naturais e humanos, de modo a promover um desenvolvimento ambiental, social e económico equilibrado e sustentável. Consequentemente, todas as indústrias serão desafiadas a reorganizar as suas cadeias de abastecimento, preservando o ambiente natural e respeitando as comunidades locais. É neste contexto que se insere a presente investigação, que visa contribuir para a consolidação da teoria da gestão sustentável da cadeia de abastecimento. O objetivo geral deste trabalho é o de identificar e analisar os fatores que induzem e instigam as empresas à implementação de práticas ambientais e sociais, identificar e caracterizar as práticas sustentáveis utilizadas e perceber a relação destas práticas com o desempenho económico, ambiental e social. Para responder aos propósitos fixados para o estudo fez-se uso de uma abordagem qualitativa que integrou estudos de caso múltiplos, constituídos a partir de oito empresas de diferentes setores de atividade, que operam em Portugal, destinados a analisar as estratégias de sustentabilidade desenvolvidas e implementadas por essas das organizações. Ao longo da investigação empírica, identificam-se as práticas ambientais e sociais implementadas nas empresas e nas suas cadeias de abastecimento e os diferentes indicadores que as mesmas utilizam para medição do seu desempenho. Nos casos analisados, são apresentadas evidências de que a gestão sustentável da cadeia de abastecimento requer das empresas a criação de mecanismos formais de cooperação entre os vários membros da cadeia de abastecimento e de que existe uma relação entre a aplicação de práticas sustentáveis e o desempenho económico, ambiental e social.

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This co-written chapter was included in an edited book featuring invited authors from different countries and different areas of museum research and practice. The chapter uses a theory of play by Johan Huizinga (1938) to frame case studies of play-based interactive experiences in museums in various countries. The aim was to use theory to ground museum practice, in order to evaluate existing practical implementations as well as to inform the design of new ones. The book was nominated as one of the 10 best museum education books of 2011 by Museum Education Monitor, and the chapter led to a subsequent technology residency the author undertook in the Spike Island gallery, Bristol in 2012, funded by the National Endowment for Science, Technology and the Arts, Arts and Humanities Research Council and Arts Council England. It also informed his subsequent postgraduate teaching, an example of which is a recent MA project, which deconstructs play from a computational perspective. Collaborations have continued with the co-author, which have resulted in a number of invited lectures. In this chapter the authors explore play as a structure for supporting visitor learning, drawing from international research in museums and interaction design. Four aspects of play first proposed by Huizinga are explored – the free-choice aspect of play, play as distinct from real life, play as an ordering structure, and the role of play in bridging communities. The chapter argues that play provides museums with ready-made structures and concepts, which can help planning for visitor learning. The research was equally divided between the co-authors, who developed the conceptual and theoretical aspects of the article by drawing on their own research alongside key examples of museum design and digital media.

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Positive psychology has tended to be defined in terms of a concern with ‘positive’ psychological qualities and states. However, critics of the field have highlighted various problems inherent in classifying phenomena as either ‘positive’ or ‘negative.’ For instance, ostensibly positive qualities (e.g., optimism) can sometimes be detrimental to wellbeing, whereas apparently negative processes (like anxiety) may at times be conducive to it. As such, over recent years, a more nuanced ‘second wave’ of positive psychology has been germinating, which explores the philosophical and conceptual complexities of the very idea of the ‘positive.’ The current paper introduces this emergent second wave by examining the ways in which the field is developing a more subtle understanding of the ‘dialectical’ nature of flourishing (i.e., involving a complex and dynamic interplay of positive and negative experiences). The paper does so by problematizing the notions of positive and negative through seven case studies, including five salient dichotomies (such as optimism versus pessimism) and two complex processes (posttraumatic growth and love). These case studies serve to highlight the type of critical, dialectical thinking that characterises this second wave, thereby outlining the contours of the evolving field.

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This programme of research used a developmental psychopathology approach to investigate females across the adolescent period. A two-sided story is presented; first, a study of neuroendocrine and psychosocial parameters in a group of healthy female adolescents (N = 63), followed by a parallel study of female adolescents with anorexia nervosa (AN) (N = 8). A biopsychosocial, multi-method measurement approach was taken, which utilised self-report, interview and hypothalamic-pituitary-adrenocortical (HPA) axis measures. Saliva samples for the measurement of cortisol and DHEA were collected using the best-recommended methodology: multiple samples over the day, strict reference to time of awakening, and two consecutive sampling weekdays. The research was adolescent-orientated: specifically, by using creative and ageappropriate strategies to ensure participant adherence to protocol, as well as more generally by adopting various procedures to facilitate engagement with the research process. In the healthy females mean (± SD) age 13.9 (± 2.7) years, cortisol and DHEA secretion exhibited typical adult-like diurnal patterns. Developmental markers of chronological age, menarche status and body mass index (BMI) had differential associations with cortisol and DHEA secretory activity. The pattern of the cortisol awakening response (CAR) was sensitive to whether participants had experienced first menses, but not to chronological age or BMI. Those who were post-menarche generally reached their peak point of cortisol secretion at 45 minutes post-awakening, in contrast to the pre-menarche group who were more evenly spread. Subsequent daytime cortisol levels were also higher in post-menarche females, and this effect was also noted for increasing age and BMI. Both morning and evening DHEA were positively associated with developmental markers. None of the situational or self-report psychosocial variables that were measured modulated any of the key findings regarding cortisol and DHEA secretion. The healthy group of girls were within age-appropriate norms for all the self-report measures used, however just under half of this group were insecurely attached (as assessed by interview). Only attachment style was associated with neuroendocrine parameters. In particular, those with an anxious insecure style exhibited a higher awakening sample (levels were 7.16 nmol/l, 10.40 nmol/l and 7.93 nmol/l for secure, anxious and avoidant groups, respectively) and a flatter CAR (mean increases over the awakening period were 6.38 nmol/l, 2.32 nmol/l and 8.61 nmol/l for secure, anxious and avoidant groups, respectively). The afore-mentioned pattern is similar to that consistently associated with psychological disorder in adults, and so this may be a pre-clinical vulnerability factor for subsequent mental health problems. A group of females with AN, mean (± SD) age 15.1 (± 1.6) years, were recruited from a specialist residential clinic and compared to the above group of healthy control (HC) female adolescents. A general picture of cortisol and DHEA hypersecretion was revealed in those with AN. The mean (± SD) change exhibited in cortisol levels over the 30 minute post-awakening period was 7.05 nmol/l (± 5.99) and 8.33 nmol/l (± 6.41) for HC and AN groups, respectively. The mean (± SD) evening cortisol level for the HC girls was 1.95 nmol/l (± 2.11), in comparison to 6.42 nmol/l (± 11.10) for the AN group. Mean (± SD) morning DHEA concentrations were 1.47 nmol/l (± 0.85) and 2.25 nmol/l (± 0.88) for HC and AN groups, respectively. The HC group’s mean (± SD) concentration of 12 hour DHEA was 0.55 nmol/l (± 0.46) and the AN group’s mean level was 0.89 nmol/l (± 0.90). This adrenal steroid hypersecretion evidenced by the AN group was not associated with BMI or eating disorder symptomatology. Insecure attachment characterised by fearfulness and anger was most apparent; a style which was unparalleled in the healthy group of female adolescents. The causal directions of the AN group findings remain unclear. Examining some of the participants with AN as case studies one year post-discharge from the clinic illustrated that for one participant who was recovered, in terms of returning to ordinary school life and no longer exhibiting clinical levels of eating disorder symptomatology, her CARs were no longer inconsistent over sampling days and her DHEA levels were also now generally comparable to the healthy control group. For another participant who had not recovered from her AN one year later, the profile of her CAR continued to be inconsistent over sampling days and her DHEA concentrations over the diurnal period were significantly higher in comparison to the healthy control group. In its entirety, this work’s unique contribution lies in its consideration of methodological and developmental issues specifically pertaining to adolescents. Findings also contribute to knowledge of AN and understanding of vulnerability factors, and how these may be used to develop interventions dedicated to improving adolescent health.

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The chapter considers the role that urban consolidation centres (UCCs) can play in helping to reduce goods vehicle traffic and its environmental impacts in urban areas. A UCC is a logistics facility that is situated in relatively close proximity to the area that it serves. Goods destined for this area are dropped off at the UCC, and are sorted and consolidated onto goods vehicles for delivery to their final destinations, often using environmentally friendly vehicles such as electric and gas-powered goods vehicles, and electrically-assisted cycles. The development of UCCs since their first appearance in the 1970s is reviewed and the various types of UCC categorised. The freight transport and logistics advantages offered by UCCs are discussed. Case studies of four recent UCC trials are included. The objectives, operational and financial aspects and impacts of these UCCs are compared and their critical success factors identified.

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The paper considers how urban consolidation centres (UCCs) can be used in the supply chain to reduce goods vehicle traffic and its associated environmental impacts, while also helping to make supply chains more responsive and efficient and thereby generate commercial benefits. The role of UCCs is presented and the various types discussed. The potential supply chain impacts of UCCs are considered. Case studies of six UCC schemes and trials are included, with their objectives, operational characteristics and impacts compared. The critical success factors associated with UCCs are identified.

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The study examines the relationship between law, technology and water conflicts from colonial days to the present in traditional (water) tank systems in the south Indian state of Tamil Nadu. Tanks are man-made water systems developed for irrigation and many other purposes in semi-arid areas. The thesis adopts a historical approach to study the development of law, particularly property rights, and takes an empirical approach to investigate the tank conflicts. Archival documents on irrigation development, Case laws, Focus Group Discussions, Open ended Interviews and Field visits to selected tank chains are used as source material for the discussion. Case studies of conflicts are described and analyzed at three levels - Vaigai river basin for a macro level, Kothai Anicut system in Cauvery basin for a meso level, and twenty other interconnected tanks for a micro-level. The thesis deviates from the conventional understanding that tanks as traditional systems as simple and local technologies but considers them to be complex. It argues that the use of commonly held systems such as tanks within the colonial and post colonial laws as state ownership has been the source of many conflicts. In particular, it finds most tank conflicts are a product of progressive and absolute state control over water and the systems established using colonial land revenue administrative law. The law continues to treat tanks as pieces of landed property held by state and the individuals rather than as technology systems that presupposed the regime of property rights introduced after the colonial times. The modern interventions in water including the reservoir building, and altering the hydraulics of rivers and streams aggravate tank conflicts and lead to their further detriment. The study brings the focus to ground realities, and offers new perspectives on understanding tank systems in dynamic ways.

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Dissertação para obtenção do grau de Mestre em Engenharia Civil na Área de especialização em Edificações

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A set of radiation measurements were carried out in several public and private institutions. These were selected with basis on the people affluence and passage to these sites. These measurements were registration formed either indoor, outdoor or underground and were compiled in three Case Studies. Radiation doses measurements were also made, surface and underground locations, and compiled in other two Case Studies. There were sampled, at the same time, humidity, temperature, atmospheric pressure and relevant construction materials at sampling locations. They were collected and registration formed to analyse if there is any relation or contribution for the measured value in each specific place. Geostatistical models were used to elaborate maps of the results both for radiation values and for doses. Preliminary relations were established among the measured parameters.