Readmission of older patients after hospital discharge for hip fracture: a multilevel approach

ABSTRACT OBJECTIVE To identify individual and hospital characteristics associated with the risk of readmission in older inpatients for proximal femoral fracture in the period of 90 days after discharge. METHODS Deaths and readmissions were obtained by a linkage of databases of the Hospital Information System of the Unified Health System and the System of Information on Mortality of the city of Rio de Janeiro from 2008 to 2011. The population of 3,405 individuals aged 60 or older, with non-elective hospitalization for proximal femoral fracture was followed for 90 days after discharge. Cox multilevel model was used for discharge time until readmission, and the characteristics of the patients were used on the first level and the characteristics of the hospitals on the second level. RESULTS The risk of readmission was higher for men (hazard ratio [HR] = 1.37; 95%CI 1.08–1.73), individuals more than 79 years old (HR = 1.45; 95%CI 1.06–1.98), patients who were hospitalized for more than two weeks (HR = 1.33; 95%CI 1.06-1.67), and for those who underwent arthroplasty when compared with the ones who underwent osteosynthesis (HR = 0.57; 95%CI 0.41–0.79). Besides, patients admitted to state hospitals had lower risk for readmission when compared with inpatients in municipal (HR = 1.71; 95%CI 1.09–2.68) and federal hospitals (HR = 1.81; 95%CI 1.00–3.27). The random effect of the hospitals in the adjusted model remained statistically significant (p < 0.05). CONCLUSIONS Hospitals have complex structures that reflect in the quality of care. Thus, we propose that future studies may include these complexities and the severity of the patients in the analysis of the data, also considering the correlation between readmission and mortality to reduce biases.

Automated design of microwave discrete tuning differential capacitance circuits in Si-integrated technologies

A genetic algorithm used to design radio-frequency binary-weighted differential switched capacitor arrays (RFDSCAs) is presented in this article. The algorithm provides a set of circuits all having the same maximum performance. This article also describes the design, implementation, and measurements results of a 0.25 lm BiCMOS 3-bit RFDSCA. The experimental results show that the circuit presents the expected performance up to 40 GHz. The similarity between the evolutionary solutions, circuit simulations, and measured results indicates that the genetic synthesis method is a very useful tool for designing optimum performance RFDSCAs.

Response rate in the Study of Cardiovascular Risks in Adolescents – ERICA

ABSTRACT OBJECTIVE To describe the response rate and characteristics of people who either took part or not in from the Study of Cardiovascular Risks in Adolescents (ERICA) , according to information subsets. METHODS ERICA is a school-based, nation-wide investigation with a representative sample of 12 to 17-year-old adolescents attending public or private schools in municipalities with over 100,000 inhabitants in Brazil. Response rate of eligible subjects were calculated according to macro-regions, sex, age, and type of school (public or private). We also calculated the percentages of replacement schools in comparison with the ones originally selected as per the sample design, according to the types of schools in the macro-regions. The subjects and non-subjects were compared according to sex, age, and average body mass indices (kg/m2). RESULTS We had 102,327 eligible adolescents enrolled in the groups drawn. The highest percentage of complete information was obtained for the subset of the questionnaire (72.9%). Complete information regarding anthropometric measurements and the ones from the questionnaire were obtained for 72.0% of the adolescents, and the combination of these data with the 24-hour dietary recall were obtained for 70.3% of the adolescents. Complete information from the questionnaire plus biochemical blood evaluation data were obtained for 52.5% of the morning session adolescents (selected for blood tests). The response percentage in private schools was higher than the one in public schools for most of the combination of information. The ratio of older and male adolescents non-participants was higher than the ratio among participants. CONCLUSIONS The response rate for non-invasive procedures was high. The response rate for blood collection – an invasive procedure that requires a 12-hour fasting period and the informed consent form from legal guardians – was lower. The response rate observed in public schools was lower than in the private ones, and that may reflect lower school frequency of registered students.

Reliability and availability in reconfigurable computing: a basis for a common solution

Dynamically reconfigurable SRAM-based field-programmable gate arrays (FPGAs) enable the implementation of reconfigurable computing systems where several applications may be run simultaneously, sharing the available resources according to their own immediate functional requirements. To exclude malfunctioning due to faulty elements, the reliability of all FPGA resources must be guaranteed. Since resource allocation takes place asynchronously, an online structural test scheme is the only way of ensuring reliable system operation. On the other hand, this test scheme should not disturb the operation of the circuit, otherwise availability would be compromised. System performance is also influenced by the efficiency of the management strategies that must be able to dynamically allocate enough resources when requested by each application. As those resources are allocated and later released, many small free resource blocks are created, which are left unused due to performance and routing restrictions. To avoid wasting logic resources, the FPGA logic space must be defragmented regularly. This paper presents a non-intrusive active replication procedure that supports the proposed test methodology and the implementation of defragmentation strategies, assuring both the availability of resources and their perfect working condition, without disturbing system operation.

Evidences for direct magnetic patterning via diffusive transformations using femtosecond laser interferometry

The application of femtosecond laser interferometry to direct patterning of thin-film magnetic alloys is demonstrated. The formation of stripe gratings with submicron periodicities is achieved in Fe1-xVx (x=18-34wt. %) layers, with a difference in magnetic moments up to Delta mu/mu similar to 20 between adjacent stripes but without any significant development of the topographical relief (<1% of the film thickness). The produced gratings exhibit a robust effect of their anisotropy shape on magnetization curves in the film plane. The obtained data witness ultrafast diffusive transformations associated with the process of spinodal decomposition and demonstrate an opportunity for producing magnetic nanostructures with engineered properties upon this basis.

How human schematization and systematic errors take effect on sketch map formalizations

Dissertation submitted in partial fulfilment of the requirements for the Degree of Master of Science in Geospatial Technologies

O que é ser menino ou menina do ponto de vista das crianças no jardim de infância

Relatório da Prática Profissional Supervisionada Mestrado em Educação Pré-Escolar

A promoção da autonomia numa sala do movimento da escola moderna

Relatório da Prática Profissional Supervisionada Mestrado em Educação Pré-Escolar

A inclusão de uma criança com nee – papel do adulto e dos pares na sua participação ativa no jardim de infância

Relatório da Prática Profissional Supervisionada Mestrado em Educação Pré-Escolar

Simulação de um Pool Simétrico com validação técnica do despacho provisório e apresentação de medidas corretivas baseadas num despacho ótimo

Os mercados de energia elétrica são atualmente uma realidade um pouco por todo o mundo. Contudo, não é consensual o modelo regulatório a utilizar, o que origina a utilização de diferentes modelos nos diversos países que deram início ao processo de liberalização e de reestruturação do sector elétrico. A esses países, dado que a energia elétrica não é um bem armazenável, pelo menos em grandes quantidades, colocam-se questões importantes relacionadas com a gestão propriamente dita do seu sistema elétrico. Essas questões implicam a adoção de regras impostas pelo regulador que permitam ultrapassar essas questões. Este trabalho apresenta um estudo feito aos mercados de energia elétrica existentes um pouco por todo o mundo e que o autor considerou serem os mais importantes. Foi também feito um estudo de ferramentas de otimização essencialmente baseado em meta-heurísticas aplicadas a problemas relacionados com a operação dos mercados e com os sistemas elétricos de energia, como é o exemplo da resolução do problema do Despacho Económico. Foi desenvolvida uma aplicação que simula o funcionamento de um mercado que atua com o modelo Pool Simétrico, em que são transmitidas as ofertas de venda e compra de energia elétrica por parte dos produtores, por um lado, e dos comercializadores, consumidores elegíveis ou intermediários financeiros, por outro, analisando a viabilidade técnica do Despacho Provisório. A análise da viabilidade técnica do Despacho Provisório é verificada através do modelo DC de trânsito de potências. No caso da inviabilidade do Despacho Provisório, por violação de restrições afetas ao problema, são determinadas medidas corretivas a esse despacho, com base nas ofertas realizadas e recorrendo a um Despacho Ótimo. Para a determinação do Despacho Ótimo recorreu-se à meta-heurística Algoritmos Genéticos. A aplicação foi desenvolvida no software MATLAB utilizando a ferramenta Graphical User Interfaces. A rede de teste utilizada foi a rede de 14 barramentos do Institute of Electrical and Electronics Engineers (IEEE). A aplicação mostra-se competente no que concerne à simulação de um mercado com tipo de funcionamento Pool Simétrico onde são efetuadas ofertas simples e onde as transações ocorrem no mercado diário, porém, não reflete o problema real relacionado a este tipo de mercados. Trata-se, portanto, de um simulador básico de um mercado de energia cujo modelo de funcionamento se baseia no tipo Pool Simétrico.

Ser menina é gostar de cor-de-rosa: desocultar questões de género no jardim de infância

Relatório da Prática Profissional Supervisionada apresentado à Escola Superior de Educação de Lisboa para obtenção de grau de mestre em Educação Pré-Escolar

A música nos momentos de transição

Relatório da Prática Profissional Supervisionada Mestrado em Educação Pré-Escolar

São diferentes porque a menina tem saia e o menino tem calças: as questões de género no jardim de infância

Relatório da Prática Profissional Supervisionada Mestrado em Educação Pré-Escolar

O desenvolvimento de competências sociais na educação de infância: a música como estratégia de intervenção

Relatório da Prática Profissional Supervisionada Mestrado em Educação Pré-Escolar

Relação entre pares em brincadeira livre no exterior

Relatório da Prática Profissional Supervisionada