872 resultados para integration of care


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The present study aims to understand whether the foreign students who have different nationalities but the Portuguese are integrated into the school of the 1st Cycle of Basic Education. With this purpose, a descriptive and phenomenological research was conducted, making use of documental analysis, as well as semi-structured interviews and sociometric tests. These two data collecting tools were applied to students attending from the 1st to the 4th school years, in three 1st Cycle of Basic Education schools, within a school grouping in Viseu. The data obtained through the interviews allow us to conclude that foreign students, in general, feel integrated both in the school and in the class they belong to. However, the analysis of the results of the sociometric tests reveals other data, allowing us to conclude that one of the students is neither integrated in the school, nor in the class he is part of.

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The epoc® blood analysis system (Epocal Inc., Ottawa, Ontario, Canada) is a newly developed in vitro diagnostic hand-held analyzer for testing whole blood samples at point-of-care, which provides blood gas, electrolytes, ionized calcium, glucose, lactate, and hematocrit/calculated hemoglobin rapidly. The analytical performance of the epoc® system was evaluated in a tertiary hospital, see related research article “Analytical evaluation of the epoc® point-of-care blood analysis system in cardiopulmonary bypass patients” [1]. Data presented are the linearity analysis for 9 parameters and the comparison study in 40 cardiopulmonary bypass patients on 3 epoc® meters, Instrumentation Laboratory GEM4000, Abbott iSTAT, Nova CCX, and Roche Accu-Chek Inform II and Performa glucose meters.

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The overall aim was to investigate the quality of palliative care from the patient perspective, to adapt and psychometrically evaluate the Quality from Patients’ Perspective instrument specific to palliative care (QPP-PC) and investigate the relationship between the combination of person- and organization-related conditions and patients’ perceptions of care quality. Methods: In the systematic literature review (I), 23 studies from 6 databases and reference lists in 2014 were synthesized by integrative thematic analysis. The quantitative studies (II–IV) had cross-sectional designs including 191 patients (73% RR) from hospice inpatient care, hospice day care, palliative units in nursing homes and home care in 2013–2014. A modified version of QPP was used. Additionally, person- and organization-related conditions were assessed. Psychometric evaluation, descriptive and inferential statistics were used. Main findings: Patients’ preferences for palliative care included living a meaningful life and responsive healthcare personnel, care environment and organization of care (I). The QPP-PC was developed, comprising 12 factors (49 items), 3 single items and 4 dimensions: medical–technical competence, physical–technical conditions, identity–oriented approach, and socio-cultural atmosphere (II). QPP-PC measured patients’ perceived reality (PR) and subjective importance (SI) of care quality. PR differed across settings, but SI did not (III). All settings exhibited areas of strength and for improvement (II, III). Person-related conditions seemed to be related to SI, and person- and organization-related conditions to PR, explaining 18–30 and 22-29% respectively of the variance (IV). Conclusions: The patient perspective of care quality (SI and PR) should be integrated into daily care and improvement initiatives in palliative care. The QPP-PC can measure patients’ perceptions of care quality. Registered nurses and other healthcare personnel need awareness of person- and organization-related conditions to provide high-quality person-centred care.

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This article presents a phenomenological analysis of interview material, in which 12 care professionals in elderly care reflect on the elderly's well-being within the frame of special housing accommodation. The perspective of the care professionals is of special interest. The findings show that the well-being is characterized as the elderly's feelings of being existentially touched. The well-being is an existential experience of being acknowledged as a human being and is an approach that classifies the elderly's needs as those of having, loving, and being. The meaning of the phenomenon is elucidated by the constituents: (1) to feel the freedom of choice, (2) to feel pleasure, and (3) to feel closeness to someone or something. The findings contribute new understanding of well-being in the elderly care by its existential dimension of the well-being as "just being'' and of doing things in order to experience meaningfulness. Accordingly, the well-being of the elderly as it is seen from the perspective of the care professionals involves both carers' subjectivity and intersubjectivity between the care professional and the elderly. An implication for promoting elderly's well-being is to develop awareness of these existential dimensions.

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Background: Physician-rating websites have become a popular tool to create more transparency about the quality of health care providers. So far, it remains unknown whether online-based rating websites have the potential to contribute to a better standard of care. Objective: Our goal was to examine which health care providers use online rating websites and for what purposes, and whether health care providers use online patient ratings to improve patient care. Methods: We conducted an online-based cross-sectional study by surveying 2360 physicians and other health care providers (September 2015). In addition to descriptive statistics, we performed multilevel logistic regression models to ascertain the effects of providers' demographics as well as report card-related variables on the likelihood that providers implement measures to improve patient care. Results: Overall, more than half of the responding providers surveyed (54.66%, 1290/2360) used online ratings to derive measures to improve patient care (implemented measures: mean 3.06, SD 2.29). Ophthalmologists (68%, 40/59) and gynecologists (65.4%, 123/188) were most likely to implement any measures. The most widely implemented quality measures were related to communication with patients (28.77%, 679/2360), the appointment scheduling process (23.60%, 557/2360), and office workflow (21.23%, 501/2360). Scaled-survey results had a greater impact on deriving measures than narrative comments. Multilevel logistic regression models revealed medical specialty, the frequency of report card use, and the appraisal of the trustworthiness of scaled-survey ratings to be significantly associated predictors for implementing measures to improve patient care because of online ratings. Conclusions: Our results suggest that online ratings displayed on physician-rating websites have an impact on patient care. Despite the limitations of our study and unintended consequences of physician-rating websites, they still may have the potential to improve patient care.

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This project was chosen to investigate the criteria, process, procedures and policies in place for transferring patients of the Charleston Dorchester Mental Health Center between programs due to a change in their level of care in efforts to make the process more consistent and prevent or reduce gaps in care for patients.

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Effective and efficient implementation of intelligent and/or recently emerged networked manufacturing systems require an enterprise level integration. The networked manufacturing offers several advantages in the current competitive atmosphere by way to reduce, by shortening manufacturing cycle time and maintaining the production flexibility thereby achieving several feasible process plans. The first step in this direction is to integrate manufacturing functions such as process planning and scheduling for multi-jobs in a network based manufacturing system. It is difficult to determine a proper plan that meets conflicting objectives simultaneously. This paper describes a mobile-agent based negotiation approach to integrate manufacturing functions in a distributed manner; and its fundamental framework and functions are presented. Moreover, ontology has been constructed by using the Protégé software which possesses the flexibility to convert knowledge into Extensible Markup Language (XML) schema of Web Ontology Language (OWL) documents. The generated XML schemas have been used to transfer information throughout the manufacturing network for the intelligent interoperable integration of product data models and manufacturing resources. To validate the feasibility of the proposed approach, an illustrative example along with varied production environments that includes production demand fluctuations is presented and compared the proposed approach performance and its effectiveness with evolutionary algorithm based Hybrid Dynamic-DNA (HD-DNA) algorithm. The results show that the proposed scheme is very effective and reasonably acceptable for integration of manufacturing functions.

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Abstract. The aging of the population has led to an increase in the prevalence of chronic degenerative diseases and dependence. We need to implement humanized health care that will improve the quality of life and well-being of these people and help maintain their autonomy and self-care. Objective: To identify the implications of the caring in Humanitude in promoting self-care in the dependent person. Methods: Integrative review of the literature of the period between 2007 and 2015, using the databases Medline, EBSCO and Google Scholar. In using the PI[C]OD methodology and criteria for inclusion and exclusion, we obtained 54 items where 7 were selected for analysis. Results: There are several health benefits in the promotion of self-care, by ap-plying the Humanitude caring philosophy, mainly regarding the relationship be-tween the nurse and the patient. Conclusions: It is essential to develop further studies focused on the implications of caring in Humanitude in self-care in the dependent person.

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This thesis presents advances in integration of photovoltaic (PV) power and energy in practical systems, such as existing power plants in buildings or directly integrated in the public electrical grid. It starts by providing an analyze of the current state of PV power and some of its limitations. The work done in this thesis begins by providing a model to compute mutual shading in large PV plants, and after provides a study of the integration of a PV plant in a biogas power plant. The remainder sections focus on the work done for project PVCROPS, which consisted on the construction and operation of two prototypes composed of a PV system and a novel battery connected to a building and to the public electrical grid. These prototypes were then used to test energy management strategies and validate the suitability of the two advanced batteries (a lithium-ion battery and a vanadium redox ow battery) for households (BIPV) and PV plants. This thesis is divided in 7 chapters: Chapter 1 provides an introduction to explain and develop the main research questions studied for this thesis; Chapter 2 presents the development of a ray-tracing model to compute shading in large PV elds (with or without trackers); Chapter 3 shows the simulation of hybridizing a biogas plant with a PV plant, using biogas as energy storage; Chapters 4 and 5 present the construction, programming, and initial operation of both prototypes (Chapter 4), EMS testing oriented to BIPV systems (Chapter 5). Finally, Chapters 6 provides some future lines of investigation that can follow this thesis, and Chapter 7 shows a synopsis of the main conclusions of this work; Resumo: Avanços na integracão de potência fotovoltaica e producão de energia em sistemas práticos Esta tese apresenta avanços na integração de potência e energia fotovoltaica (PV) em sistemas práticos, tais como centrais existentes ou a rede eléctrica pública. Come ça por analisar o estado corrente do fotovoltaico no mundo e aborda algumas das suas limitações. O trabalho feito para esta tese de doutoramento começou pelo desenvolvimento de um modelo para calcular os sombreamentos que ocorrem em grandes campos fotovoltaicos, e depois apresenta um estudo sobre a integração um sistema fotovoltaico em uma central eléctrica a bióg as. As ultimas secções da tese focam-se no trabalho feito para o projecto PVCROPS, que consistiu na construção e operação de dois demonstratores, cada um formado por um sistema fotovoltaico e bateria conectados a um edíficio e a rede eléctrica pública. Estes protótipos foram posteriormente utilizados para testar estratégias de gestão de energia (EMS) e para validar a operação de duas baterias avançadas (bateria de Iões de Li tio e bateria de Fluxo Redox de Van adio) e a sua utiliza ção para habitações e centrais PV. A tese está dividida em 7 capitulos: O capitulo 1 apresenta uma introdução para explicar e desenvolver as principais questões que foram investigadas nesta tese; O capitulo 2 mostra o desenvolvimento de um modelo baseado em traçados de raios para calcular sombreamentos mútuos em grandes centrais PV (com e sem seguidores); O capitulo 3 mostra a simulação da hibridização de uma central electrica a biogas com uma central PV, e utilizando o biógas como armazenamento de energia. Os capitulos 4 e 5 apresentam a construção, programação e operação inicial dos dois demonstradores (Capitúlo 4), o teste de EMS orientadas para sistemas PV em habitações (Capítulo 5). Finalmente, o capítulo 6 sugere algumas futuras linhas de investigação que poderão seguir esta tese, e o Capítulo 7 faz uma sinopse das principais conclusões deste trabalho.

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The purpose of this paper is to share a proposal for teacher’s labor market integration in contexts of high social5 vulnerability. This paper is the result of a research conducted in a priority attention primary school6 of the central canton of Heredia7. It explored the labor market integration process of teachers, considering the community, family and student reality of a population social risk. The research that supports this proposal is based on a qualitative approach, since the diagnosis process is not intended to provide answers that could be commonly applied to other education centers in similar contexts, but to make an exploratory approach of teachers’ reality and their integration process into education institutions of high social vulnerability. Therefore, although this paper intends to share this experience, it does not aim to unify integration practices, but to be an input in carrying out similar processes.  (5) The concept of high social vulnerability is understood based on Sojo’s approach (2003), which defines it as marginal urban communities in areas considered by the Costa Rican government as priority areas with the greatest social, economic backwardness in the country, and high rates of violence, leisure, unemployment and drug addiction. (6) Translator’s note: The Costa Rican education system is composed of primary education (1st-6th grade) and secondary education (7th-11th grade). (7)A public primary school in the circuit 02 of the Province of Heredia.

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Psychological characterisation of the somatosensory system often focusses on minimal units of perception, such as detection, localisation, and magnitude estimation of single events. Research on how multiple simultaneous stimuli are aggregated to create integrated, synthetic experiences is rarer. This thesis aims to shed a light on the mechanisms underlying the integration of multiple simultaneous stimuli, within and between different sub-modalities of the somatosensory system. First, we investigated the ability of healthy individuals to perceive the total intensity of composite somatosensory patterns. We found that the overall intensity of tactile, cold, or warm patterns was systematically overestimated when the multiple simultaneous stimuli had different intensities. Perception of somatosensory totals was biased towards the most salient element in the pattern. Furthermore, we demonstrated that peak-biased aggregation is a genuine perceptual phenomenon which does not rely on the discrimination of the parts, but is rather based on the salience of each stimulus. Next, we studied a classical thermal illusion to assess participants’ ability to localise thermal stimuli delivered on the fingers either in isolation, or in uniform and non-uniform patterns. We found that despite a surprisingly high accuracy in reporting the location of a single stimulus, when participants were presented with non-uniform patterns, their ability to identify the thermal state of a specific finger was completely abolished. Lastly, we investigated the perceptual and neural correlates of thermo-nociceptive interaction during the presentation of multiple thermal stimuli. We found that inhibition of pain by warmth was independent from both the position and the number of thermal stimuli administered. Our results suggest that nonlinear integration of multiple stimuli, within and between somatosensory sub-modalities, may be an efficient way by which the somatosensory system synthesises the complexity of reality, providing an extended and coherent perception of the world, in spite of its deep bandwidth limitations.

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Against a backdrop of rapidly increasing worldwide population and growing energy demand, the development of renewable energy technologies has become of primary importance in the effort to reduce greenhouse gas emissions. However, it is often technically and economically infeasible to transport discontinuous renewable electricity for long distances to the shore. Another shortcoming of non-programmable renewable power is its integration into the onshore grid without affecting the dispatching process. On the other hand, the offshore oil & gas industry is striving to reduce overall carbon footprint from onsite power generators and limiting large expenses associated to carrying electricity from remote offshore facilities. Furthermore, the increased complexity and expansion towards challenging areas of offshore hydrocarbons operations call for higher attention to safety and environmental protection issues from major accident hazards. Innovative hybrid energy systems, as Power-to-Gas (P2G), Power-to-Liquid (P2L) and Gas-to-Power (G2P) options, implemented at offshore locations, would offer the opportunity to overcome challenges of both renewable and oil & gas sectors. This study aims at the development of systematic methodologies based on proper sustainability and safety performance indicators supporting the choice of P2G, P2L and G2P hybrid energy options for offshore green projects in early design phases. An in-depth analysis of the different offshore hybrid strategies was performed. The literature reviews on existing methods proposing metrics to assess sustainability of hybrid energy systems, inherent safety of process routes in conceptual design stage and environmental protection of installations from oil and chemical accidental spills were carried out. To fill the gaps, a suite of specific decision-making methodologies was developed, based on representative multi-criteria indicators addressing technical, economic, environmental and societal aspects of alternative options. A set of five case-studies was defined, covering different offshore scenarios of concern, to provide an assessment of the effectiveness and value of the developed tools.