940 resultados para Balanced Score Card (BSC®)
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O principal objetivo deste artigo é contribuir com a adoção do modelo de referência MPS para Software (MPS-SW). Para isso, é proposta uma ontologia dos níveis G e F do modelo, visando apoiar a compreensão e implementação desses níveis. O modelo MPS-SW é adequado a micro, pequenas e médias empresas (mPME), assim como a empresas de grande porte. A proposta pretende mitigar os investimentos técnicos e financeiros na implantação e treinamento do modelo, principalmente nas mPME. Neste contexto, este artigo apresenta a metodologia utilizada para o desenvolvimento da ontologia, com a inclusão de conhecimentos de especialistas no modelo, conceitos do PMBOK (Project Management Body of Knowledge) e indicadores do BSC (Balanced Scorecard). A partir de testes centrados no usuário, foi gerada uma versão beta da ontologia, que está disponível em repositórios livres e gratuitos.
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Indicadores de desempenho são importantes recursos para a gestão da qualidade no desenvolvimento de software. O volume de dados produzido por esses indicadores tende a aumentar significativamente com o tempo de monitoração, dificultando análises e tomadas de decisão. As bases históricas tornam-se complexas, considerando a quantidade de dados monitorados e a diversidade de indicadores (diferentes tipos, granularidade e frequência). Este trabalho propõe o uso de técnicas de aprendizagem de máquina para análise dessas bases, utilizando redes neurais artificiais combinadas com técnicas de visualização de informação. É utilizado um modelo de indicadores, com base nos processos do modelo de referência MPS para Software (MPS-SW), agrupados segundo as perspectivas estratégicas do Balanced Scorecard (BSC).
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The Patient Classification System has become essential concerning to the practice in management and care from a nurse. This study analyzed the implementation of Assistance Sites in an intensive care unit for adults as a way of organization and classification of patients, as well as the impact of this process on the quality of care according to the Nursing Activities Score and the relation with the Hospital Infection. This is a quantitative, prospective, descriptive and transversal study. The data collection was realized from July until October 2010. The sample was consisted of 214 patients, mostly male, neurosurgical and with a mid age of 57 years. The NAS was on the average of 71.72%. Regarding the Hospital Infection before and after implantation, there was a reduction in the rates of pneumonia. However, the nursing workload remained the same. Moreover, It was evident the importance of using the Nursing Activities Score and the implementation of new ways for classification of patients to improve the organization of the care.
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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This collection consists of an autographed copy of Herman F. Arnold’s “Dixie”. The music scale is inscribed with “At the request of Miss Minnie Parker the copy of Dixie is presented to Winthrop College [in 1923] by Prof. Herman F. Arnold + the score in 159 of + who wrote Dixie and was made the war tune of the south at the inauguration of Jefferson Davis Feb. 18th 1861 at Montgomery, Ala.” There is also a note stating that this score is “One of the Four Autograph Copies of the Score of Dixie.” Minnie Barker was curator of the Winthrop museum and the music score was displayed there until Tillman Science Building was razed in 1962 which housed the museum.
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The “Dixie” Music Score Collection consists of two photographs of one of the four original autographed copies of the musical score Dixie which was presented to Winthrop College in 1923 by Professor Herman F. Arnold and a photograph of Professor Herman F. Arnold. The Dixie Score is inscribed "At the request of Miss Minnie Barker the copy of Dixie is presented to Winthrop College by Prof. Herman F. Arnold who wrote Dixie and was made the war tune of the south at the inauguration of Jefferson Davis Feb 18th 1861 at Montgomery, Ala." Minnie Barker was curator of the Winthrop museum and the music score was displayed there until Tillman Science Building was razed in 1962 which housed the museum. The collection also contains newspaper clippings and correspondence relating to the controversy surrounding Dixie and whether it is racially insensitive.
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Collectively, the observations indicate that the overall warming of the Arctic system continued in 2007. There are some elements that are stabilizing or returning to climatological norms. These mixed tendencies illustrate the sensitivity and complexity of the Arctic System. Atmosphere: Hot spot shifts toward Europe Ocean: North Pole Temperatures at depth returning to 1990s values Sea Ice: Summer extent at record minimum Greenland: Recent warm temperatures associated with net ice loss Biology: increasing tundra shrub cover and variable treeline advance; up to 80% declines in some caribou herds while goose populations double Land: Increase in permafrost temperatures The Arctic Report Card 2007 is introduced as a means of presenting clear, reliable and concise information on recent observations of environmental conditions in the Arctic, relative to historical time series records. It provides a method of updating and expanding the content of the State of the Arctic Report, published in fall 2006, to reflect current conditions. Material presented in the Report Card is prepared by an international team of scientists and is peer-reviewed by topical experts nominated by the US Polar Research Board. The audience for the Arctic Report Card is wide, including scientists, students, teachers, decision makers and the general public interested in Arctic environment and science. The web-based format will facilitate future timely updates of the content.
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The expansion of sugarcane growing in Brazil, spurred particularly by increased demand for ethanol, has triggered the need to evaluate the economic, social, and environmental impacts of this process, both on the country as a whole and on the growing regions. Even though the balance of costs and benefits is positive from an overall standpoint, this may not be so in specific producing regions, due to negative externalities. The objective of this paper is to estimate the effect of growing sugarcane on the human development index (HDI) and its sub-indices in cane producing regions. In the literature on matching effects, this is interpreted as the effect of the treatment on the treated. Location effects are controlled by spatial econometric techniques, giving rise to the spatial propensity score matching model. The authors analyze 424 minimum comparable areas (MCAs) in the treatment group, compared with 907 MCAs in the control group. The results suggest that the presence of sugarcane growing in these areas is not relevant to determine their social conditions, whether for better or worse. It is thus likely that public policies, especially those focused directly on improving education, health, and income generation/distribution, have much more noticeable effects on the municipal HDI.
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This paper examines the local power of the likelihood ratio, Wald, score and gradient tests under the presence of a scalar parameter, phi say, that is orthogonal to the remaining parameters. We show that some of the coefficients that define the local powers remain unchanged regardless of whether phi is known or needs to be estimated, where as the others can be written as the sum of two terms, the first of which being the corresponding term obtained as if phi were known, and the second, an additional term yielded by the fact that phi is unknown. The contribution of each set of parameters on the local powers of the tests can then be examined. Various implications of our main result are stated and discussed. Several examples are presented for illustrative purposes
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Background and Purpose: Oropharyngeal dysphagia is a common manifestation in acute stroke. Aspiration resulting from difficulties in swallowing is a symptom that should be considered due to the frequent occurrence of aspiration pneumonia that could influence the patient's recovery as it causes clinical complications and could even lead to the patient's death. The early clinical evaluation of swallowing disorders can help define approaches and avoid oral feeding, which may be detrimental to the patient. This study aimed to create an algorithm to identify patients at risk of developing dysphagia following acute ischemic stroke in order to be able to decide on the safest way of feeding and minimize the complications of stroke using the National Institutes of Health Stroke Scale (NHISS). Methods: Clinical assessment of swallowing was performed in 50 patients admitted to the emergency unit of the University Hospital, Faculty of Medicine of Ribeirao Preto, Sao Paulo, Brazil, with a diagnosis of ischemic stroke, within 48 h after the beginning of symptoms. Patients, 25 females and 25 males with a mean age of 64.90 years (range 26-91 years), were evaluated consecutively. An anamnesis was taken before the patient's participation in the study in order to exclude a prior history of deglutition difficulties. For the functional assessment of swallowing, three food consistencies were used, i.e. pasty, liquid and solid. After clinical evaluation, we concluded whether there was dysphagia. For statistical analysis we used the Fisher exact test, verifying the association between the variables. To assess whether the NIHSS score characterizes a risk factor for dysphagia, a receiver operational characteristics curve was constructed to obtain characteristics for sensitivity and specificity. Results: Dysphagia was present in 32% of the patients. The clinical evaluation is a reliable method of detection of swallowing difficulties. However, the predictors of risk for the swallowing function must be balanced, and the level of consciousness and the presence of preexisting comorbidities should be considered. Gender, age and cerebral hemisphere involved were not significantly associated with the presence of dysphagia. NIHSS, Glasgow Coma Scale, and speech and language changes had a statistically significant predictive value for the presence of dysphagia. Conclusions: The NIHSS is highly sensitive (88%) and specific (85%) in detecting dysphagia; a score of 12 may be considered as the cutoff value. The creation of an algorithm to detect dysphagia in acute ischemic stroke appears to be useful in selecting the optimal feeding route while awaiting a specialized evaluation. Copyright (C) 2012 S. Karger AG, Basel
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Objective: To translate, culturally adapt and validate the "Knee Society Score"(KSS) for the Portuguese language and determine its measurement properties, reproducibility and validity. Method: We analyzed 70 patients of both sexes, aged between 55 and 85 years, in a cross-sectional clinical trial, with diagnosis of primary osteoarthritis,undergoing total knee arthroplasty surgery. We assessed the patients with the English version of the KSS questionnaire and after 30 minutes with the Portuguese version of the KSS questionnaire, done by a different evaluator. All the patients were assessed preoperatively, and again at three, and six months postoperatively. Results: There was no statistical difference, using Cronbach's alpha index and the Bland-Altman graphical analysis, for the knees core during the preoperative period (p=1), and at three months (p=0.991) and six months postoperatively (p=0.985). There was no statistical difference for knee function score for all three periods (p=1.0). Conclusion: The Brazilian version of the Knee Society Score is easy to apply, as well providing as a valid and reliable instrument for measuring the knee score and function of Brazilian patients undergoing TKA. Level of Evidence: Level I - Diagnostic Studies Investigating a Diagnostic Test- Testing of previously developed diagnostic criteria on consecutive patients (with universally applied 'gold' reference standard).
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Cannabidiol (CBD), a non-psychoactive constituent of cannabis, has been reported to induce neuroprotective effects in several experimental models of brain injury. We aimed at investigating whether this drug could also improve locomotor recovery of rats submitted to spinal cord cryoinjury. Rats were distributed into five experimental groups. Animals were submitted to laminectomy in vertebral segment T10 followed or not by application of liquid nitrogen for 5 s into the spinal cord at the same level to cause cryoinjury. The animals received injections of vehicle or CBD (20 mg/kg) immediately before, 3 h after and daily for 6 days after surgery. The Basso, Beattie, and Bresnahan motor evaluation test was used to assess motor function post-lesion one day before surgery and on the first, third, and seventh postoperative days. The extent of injury was evaluated by hematoxylin-eosin histology and FosB expression. Cryogenic lesion of the spinal cord resulted in a significant motor deficit. Cannabidiol-treated rats exhibited a higher Basso, Beattie, and Bresnahan locomotor score at the end of the first week after spinal cord injury: lesion + vehicle, day 1: zero, day 7: four, and lesion + Cannabidiol 20 mg/kg, day 1: zero, day 7: seven. Moreover, at this moment there was a significant reduction in the extent of tissue injury and FosB expression in the ventral horn of the spinal cord. The present study confirmed that application of liquid nitrogen to the spinal cord induces reproducible and quantifiable spinal cord injury associated with locomotor function impairments. Cannabidiol improved locomotor functional recovery and reduced injury extent, suggesting that it could be useful in the treatment of spinal cord lesions.
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Background Support for the adverse effect of high income inequality on population health has come from studies that focus on larger areas, such as the US states, while studies at smaller geographical areas (eg, neighbourhoods) have found mixed results. Methods We used propensity score matching to examine the relationship between income inequality and mortality rates across 96 neighbourhoods (distritos) of the municipality of Sao Paulo, Brazil. Results Prior to matching, higher income inequality distritos (Gini >= 0.25) had slightly lower overall mortality rates (2.23 per 10 000, 95% CI -23.92 to 19.46) compared to lower income inequality areas (Gini <0.25). After propensity score matching, higher inequality was associated with a statistically significant higher mortality rate (41.58 per 10 000, 95% CI 8.85 to 73.3). Conclusion In Sao Paulo, the more egalitarian communities are among some of the poorest, with the worst health profiles. Propensity score matching was used to avoid inappropriate comparisons between the health status of unequal (but wealthy) neighbourhoods versus equal (but poor) neighbourhoods. Our methods suggest that, with proper accounting of heterogeneity between areas, income inequality is associated with worse population health in Sao Paulo.
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Background: The six-minute-walk-test (6MWT) has been increasingly used in cystic fibrosis (CF) patients. However, few studies in children have correlated 6MWT with current parameters used to evaluate CF severity. Moreover, no study transformed the values of distance walked from meters into Z scores to avoid bias like age and gender, which are sources of 6MWT variability. Methods: A cross-sectional descriptive study was performed to analyze the correlations (Spearman) among forced expiratory volume in one second (FEV1), body mass index (BMI), chest radiography (CXR), chest tomography (CT), and 6MWT Z score (Z-6MWT). Clinically stable CF patients, aged 6-21 years, were included. Results: 34 patients, 14F/20M, mean age 12.1 +/- 4.0 years were studied. The mean Z-6MWT was -1.1 +/- 1.106. The following correlations versus Z-6MWT were found: FEV1 (r=0.59, r(2)=0.32, p=0.0002), BMI Z score (r=0.42, r(2)=0.17, p=0.013), CXR (r=0.34, r(2)=0.15, p=0.0472) and CT (r=-0.45, r(2)=0.23, p=0.0073). Conclusions: In conclusion there was a significant, but poor, correlation between the six minute walk test Z score and the cystic fibrosis severity markers currently in use. (C) 2011 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.