986 resultados para HYPERTENSION MANAGEMENT
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Lunacloud is a cloud service provider with offices in Portugal, Spain, France and UK that focus on delivering reliable, elastic and low cost cloud Infrastructure as a Service (IaaS) solutions. The company currently relies on a proprietary IaaS platform - the Parallels Automation for Cloud Infrastructure (PACI) - and wishes to expand and integrate other IaaS solutions seamlessly, namely open source solutions. This is the challenge addressed in this thesis. This proposal, which was fostered by Eurocloud Portugal Association, contributes to the promotion of interoperability and standardisation in Cloud Computing. The goal is to investigate, propose and develop an interoperable open source solution with standard interfaces for the integrated management of IaaS Cloud Computing resources based on new as well as existing abstraction libraries or frameworks. The solution should provide bothWeb and application programming interfaces. The research conducted consisted of two surveys covering existing open source IaaS platforms and PACI (features and API) and open source IaaS abstraction solutions. The first study was focussed on the characteristics of most popular open source IaaS platforms, namely OpenNebula, OpenStack, CloudStack and Eucalyptus, as well as PACI and included a thorough inventory of the provided Application Programming Interfaces (API), i.e., offered operations, followed by a comparison of these platforms in order to establish their similarities and dissimilarities. The second study on existing open source interoperability solutions included the analysis of existing abstraction libraries and frameworks and their comparison. The approach proposed and adopted, which was supported on the conclusions of the carried surveys, reuses an existing open source abstraction solution – the Apache Deltacloud framework. Deltacloud relies on the development of software driver modules to interface with different IaaS platforms, officially provides and supports drivers to sixteen IaaS platform, including OpenNebula and OpenStack, and allows the development of new provider drivers. The latter functionality was used to develop a new Deltacloud driver for PACI. Furthermore, Deltacloud provides a Web dashboard and REpresentational State Transfer (REST) API interfaces. To evaluate the adopted solution, a test bed integrating OpenNebula, Open- Stack and PACI nodes was assembled and deployed. The tests conducted involved time elapsed and data payload measurements via the Deltacloud framework as well as via the pre-existing IaaS platform API. The Deltacloud framework behaved as expected, i.e., introduced additional delays, but no substantial overheads. Both the Web and the REST interfaces were tested and showed identical measurements. The developed interoperable solution for the seamless integration and provision of IaaS resources from PACI, OpenNebula and OpenStack IaaS platforms fulfils the specified requirements, i.e., provides Lunacloud with the ability to expand the range of adopted IaaS platforms and offers a Web dashboard and REST API for the integrated management. The contributions of this work include the surveys and comparisons made, the selection of the abstraction framework and, last, but not the least, the PACI driver developed.
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RESUMO: A tese de doutoramento visa demonstrar duas proposições: a comorbilidade de 4 situações de doença prevalentes, hipertensão arterial (HTA), diabetes (DM), doença cardíaca isquémica (DCI) e asma é um assunto importante em Medicina Geral e Familiar e o seu estudo tem diversas implicações na forma como os cuidados de saúde são prestados, na sua organização e no ensino-aprendizagem da disciplina. O documento encontra-se dividido em 4 partes: 1) justificação do interesse do tema e finalidades da dissertação; 2) revisão sistemática de literatura publicada entre 1992 e 2002; 3) apresentação de dois trabalhos de investigação, descritivos e exploratórios que se debruçam sobre a mesma população de estudo, o primeiro intitulado “Comorbilidade de quatro doenças crónicas e sua relação com factores sócio demográficos” e o segundo, “Diferenças entre doentes, por médico e por sub-região, na comorbilidade de 4 doenças crónicas”; 4) conclusões e implicações dos resultados dos estudos na gestão da prática clínica, nos serviços, no ensino da disciplina da MGF e no desenvolvimento posterior de uma linha de investigação nesta área. O primeiro estudo tem como objectivos: descrever a prevalência da comorbilidade entre as 4 doenças-índice; verificar se existe relação entre o tempo da primeira doença e o tempo decorrido até ao aparecimento da 2ª e da 3ª doença, nas 4 doenças; determinar a comorbilidade associada às 4 doenças; identificar eventuais agrupamentos de doenças e verificar se existe relação entre comorbilidade e factores sociais e demográficos. O segundo estudo pretende verificar se existem diferenças na comorbilidade a nível local, por médico, e por Sub-Região de Saúde. O trabalho empírico é descritivo e exploratório. A população é constituída pelos doentes, com pelo menos uma das 4 doenças crónicas índice, das listas de utentes de 12 Médicos de Família a trabalharem em Centros de Saúde urbanos, suburbanos e rurais dos distritos de Lisboa e Beja. Os dados foram colhidos durante um ano através dos registos médicos. As variáveis sócio demográficas estudadas são: sexo, idade, etnia/raça, escolaridade, situação profissional, estado civil, tipo de família, funcionalidade familiar, condições de habitação. A comorbilidade é definida pela presença de duas ou mais doenças e estudada pelo número de doenças coexistentes. O tempo de duração da doença é definido como o número de anos decorridos entre o ano de diagnóstico e 2003. Os problemas de saúde crónicos são classificados pela ICPC2. Nas comparações efectuadas aplicaram-se os testes de Mann-Whitney e de Friedman, de homogeneidade e de análise de resíduos. A Análise Classificatória Hierárquica foi utilizada para determinar o agrupamento de doenças e a Análise de Regressão Categórica e Análise de Correspondências na relação entre as características sócio demográficas e a comorbilidade. Identificaram-se 3998 doentes. A idade média é de 64,3 anos (DP=15,70). Há uma correlação positiva significativa (r =0,350 r=0) entre “anos com a primeira doença”e “idade dos doentes” em todos os indivíduos (homens r=0,129 mulheres r=0,231). A comorbilidade entre as quatro doenças crónicas índice está presente em 1/3 da população. As associações mais prevalentes são HTA+DM (14,3%) e HTA+DCI (6,25%). Existe correlação positiva, expressiva, entre a duração da primeira doença, quando esta é a HTA ou a DM, e o intervalo de tempo até ao aparecimento da 2ª e da 3ª doenças. Identificaram-se 18 655 problemas crónicos de saúde que se traduziram em 244 códigos da ICPC2. O número médio de problemas foi de 5,94 (DP=3,04). A idade, a actividade profissional, a funcionalidade familiar e a escolaridade foram as variáveis que mais contribuíram para diferenciar os indivíduos quanto à comorbilidade. Foram encontradas diferenças significativas entre médicos(c2=1165,368 r=0) e entre os agrupamentos de doentes por Sub-Região de Saúde (c2= 157,108 r=0) no respeitante à comorbilidade. Na partição por Lisboa o número médio de problemas é de 6,45 e em Beja de 5,35. Deste trabalho ressaltam várias consequências para os profissionais, para os serviços, para o ensino e para a procura de mais saber nesta área. Os médicos, numa gestão eficiente de cuidados são chamados a desempenhar um papel de gestores da complexidade e de coordenadores assim como a trabalhar num modelo organizativo apoiado numa colaboração em equipa. Por sua vez os serviços de saúde têm que desenvolver medidas de avaliação de cuidados que integrem a comorbilidade como medida de risco. O contexto social da cronicidade e da comorbilidade deverá ser incluído como área de ensino. A concluir analisa-se o impacto do estudo nos colaboradores e o possível desenvolvimento da investigação nesta área.----------------------------------------ABSTRACT: The PhD Thesis has two propositions, co-morbidity of four chronic conditions (hypertension, asthma, diabetes, cardiac ischaemic disease) is a prevalent and complex issue and its study has several implications in the way care is provided and organised as well as in the learning and teaching of the discipline of General Practice. In the first part of the document arguments of different nature are given in order to sustain the dissertation aims; the second part describes a systematic study of literature review from 1992 to 2002; the third presents two research studies "Comorbidity of four chronic diseases and its relation with socio demographic factors” and “Differences between patients among GPs at local and regional level”; implications of study results for practice management, teaching and research are presented in the last part. The prevalence of the four chronic diseases co-morbidity, the relation of the first disease duration with the time of diagnose of the next index condition, the burden of co-morbidity in the four chronic diseases, the clustering of those diseases, the relation between demographic and social characteristics and co-morbidity, are the objectives of the first study. The second intends to verify differences in comorbidity between patients at local and regional level of practice. Research studies were descriptive and exploratory. The population under study were patients enlisted in 12 GPs working in urban and rural health centres, in Lisbon and Beja districts, with at least one of the four mentioned diseases. Data were collected through medical records during one year (2003) and 3998 patients were identified. The social demographic variables were: sex, age, ethnicity/race, education, profession, marriage status, family status, family functionality, home living conditions. Co-morbidity is defined by the presence of two or more diseases, and studied by the number of co-existing diseases. The time duration of the disease is defined by the number of years between the diagnostic year and 2003. The chronic disease problems are classified in accord with ICPC2. The characterization of population is descriptive. The effected comparisons applied the Mann-Whitney, Friedman, homogeneity and analysis of residuals tests. The Classificatory Hierarchy Analysis was utilized to determine the grouping of diseases and the Regression Categorization and Correspondences Analysis was used to study the relation of socio-demographic and co-morbidity. The median age of the population under study is 64,3 (SD= 15,70). There is a significant positive correlation (r =0,350 r=0)between “years with the first disease” and “patient age” for all individuals (men r=0,129 women r=0,231). Co-morbidity of the four index diseases is present in 1/3 of the studied population. The most prevalent associations for the four diseases are HTA+DM (14,03%) and HTA+IHD (6,25%). Expressive positive correlation between the duration of the first disease and the second and the third index disease interval is found. For the 3988 patients, 18 655 chronic health problems, translated in 244 ICPC2 codes, were identified. The mean number of problems is 5,94 (SD=3,04). Age, professional activity, family functionality and education level are the socio demographic characteristics that most contribute to differentiate individuals concerning the overall co-morbidity. Significant differences in co-morbidity between GP patients at local (c2=1165,368 r=0) and regional level (c2= 157,108 r=0) are found. This study has several consequences for professionals, for services, for the teaching and learning of General Practice and for the pursuit of knowledge in this area. New competences and performances have to be implemented. General Practitioners, assuming a role of co-ordination, have to perform the role of complexity managers in patient's care, working in practices supported by a strong team in collaboration with other specialists. In order to assess provided care, services have to develop tools where co-morbidity is included as a risk measure. The social context of comorbidity and chronicity has to be included in the curricula of General Practice learning and teaching areas. The dissertation ends describing the added value to participant's performance for their participation in the research and an agenda for further research, in this area, based on a community of practice.--------RÉSUMÉ:Cette thèse de doctorat prétend démontrer deux postulats : le premier, que la comorbidité de quatre maladies fréquentes, hypertension artérielle (HTA), diabète (DM), maladie cardiaque ischémique (DCI) et asthme, est un thème important en Médecine Générale et Familiale et que son étude a plusieurs implications au niveau de l'approche pour dispenser les soins, de leur organisation et de l'enseignement/apprentissage de la discipline. Le document comprend quatre parties distinctes : 1) justification de l'intérêt du sujet et objectifs de la dissertation ; 2) étude systématique de publications éditées entre 1992 et 2002 ; 3) présentation de deux travaux de recherche, descriptifs et exploratoires, un premier intitulée « Comorbidité de quatre maladies chroniques et leur relation avec des facteurs sociodémographiques » et un deuxième « Différences entre malades, selon le médecin et la sous région, dans la comorbilité de quatre maladies chroniques» ; 4) conclusions et conséquences des résultats des études dans la gestion de la pratique clinique, dans les services, dans l'enseignement de la discipline de MGF et dans le développement postérieur de la recherche dans ce domaine. Les objectifs de la première étude sont les suivants : décrire la prévalence de la comorbidité entre les quatre maladies chroniques, vérifier s'il existe une relation entre temps de durée de la première maladie et l'espace de temps jusqu'à le diagnostic de la 2ème ou 3ème maladie; déterminer la comorbidité entre les 4 maladies ; identifier d'éventuelles groupements de maladies et vérifier s'il existe une relation entre comorbidité et facteurs sociodémographiques. La deuxième étude prétend vérifier s'il existe des différences de comorbidité entre médecins et par groupement régional. Le travail empirique est descriptif et exploratoire. La population est composée des malades ayant au moins une des quatre maladies chroniques parmi les listes de malades de douze Médecins de Famille qui travaillent dans des Centres de Santé urbains, suburbains et ruraux (Districts de Lisbonne et Beja). Les données ont été extraites pendant l'année 2003 des registres des médecins. Les variables sociodémographiques étudiées sont : le sexe, l'âge, l'ethnie/race, la scolarité, la situation professionnelle, l'état civil, le type de famille, sa fonctionnalité, les conditions de logement. La comorbidité est définie lorsqu'il existe deux ou plusieurs maladies et est étudiée d'après le nombre de maladies coexistantes. La durée de la maladie est établie en comptant le nombre d'années écoulées entre le diagnostique et 2003. Les problèmes de santé chroniques sont classés par l'ICPC 2. Pour les comparaisons les tests de Mann-Whitney et Friedman, de homogénéité et analyse de résidues ont été appliqués. L'Analyse de Classification Hiérarchique a été utilisée pour procéder au regroupement des maladies et l'Analyse de Régression Catégorique et l'Analyse de Correspondances pour étudier la relation entre les caractéristiques sociodémographiques et la comorbilité. Les principaux résultats sont les suivants : les 3998 malades identifiés ont 64,3 ans d'âge moyen (DP=15,70). Il existe une corrélation positive significative (r =0,350 r=0) entre « les années avec la première maladie » et « l'âge des malades », chez tous les individus (hommes r=0,129 femmes r=0,231). La comorbidité entre les quatre maladies chroniques est une réalité chez 1/3 des patients. Les associations les plus fréquentes sont HTA+DM (14%) et HTA+DCI (6,25%). Il existe une corrélation positive significative entre la durée de la première maladie, HTA ou DM, et l'écart jusqu'à l'apparition de la deuxième et de la troisième maladie. Chez les malades, 18.655 problèmes chroniques de santé ont été identifiés et traduits en 244 codes de l'ICPC2. La moyenne des problèmes a été de 5,94 (DP=3,04). L'âge, l'activité professionnelle, la fonctionnalité familiale et la scolarité sont les variables qui ont le plus contribué à différencier les individus face à la comorbilité. Des différences notoires ont été trouvées entre médecins (c2=1165,368 r=0) et entre les groupements régionaux (c2=157,108 r=0) en ce qui concerne la comorbidité. Dans le groupe de patients de Lisbonne, le chiffre moyen de problèmes est de 6,45 et à Beja il est de 5,35. Cette étude met en évidence plusieurs conséquences pour les professionnels, les services, l'enseignement et l'élargissement du savoir dans ce domaine. Les médecins, soucieux de gérer efficacement les soins sont appelés à jouer un rôle de gestionnaires de la complexité et de coordinateurs, de même qu'à travailler dans un modèle d'organisation soutenus par un travail d'équipe. D'autre part, les services de santé doivent eux aussi développer des mesures d'évaluation des soins qui intègrent la comorbidité comme mesure de risque. Le contexte social de la chronicité et de la comorbidité devra être inclus comme domaines à étudier. La fin de cette thèse décrit l'impact de cette étude sur les collaborateurs et le développement futur de la recherche dans ce domaine.
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With the introduction of the electrics cars into the market new technologies regarding the battery are being developed and new problems to be solved, one of them the battery management system because each type of cell requires a specific way of handling. This research is done using the active research method to find out the actual problem on this subject and features a BMS should have, understand how they work and how to develop them applied to the purpose on this work. Once the features the BMS should have are clarified, it’s possible to develop a BMS for an electric racing car. The decisions are made taking into consideration the nature of the vehicle being developed. After the project done it’s clear to see that what was developed was not only the BMS itself but all the other factors around it, such as CAN communication, safety control, diagnostics and so on.
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The intensive use of distributed generation based on renewable resources increases the complexity of power systems management, particularly the short-term scheduling. Demand response, storage units and electric and plug-in hybrid vehicles also pose new challenges to the short-term scheduling. However, these distributed energy resources can contribute significantly to turn the shortterm scheduling more efficient and effective improving the power system reliability. This paper proposes a short-term scheduling methodology based on two distinct time horizons: hour-ahead scheduling, and real-time scheduling considering the point of view of one aggregator agent. In each scheduling process, it is necessary to update the generation and consumption operation, and the storage and electric vehicles status. Besides the new operation condition, more accurate forecast values of wind generation and consumption are available, for the resulting of short-term and very short-term methods. In this paper, the aggregator has the main goal of maximizing his profits while, fulfilling the established contracts with the aggregated and external players.
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The implementation of smart homes allows the domestic consumer to be an active player in the context of the Smart Grid (SG). This paper presents an intelligent house management system that is being developed by the authors to manage, in real time, the power consumption, the micro generation system, the charge and discharge of the electric or plug-in hybrid vehicles, and the participation in Demand Response (DR) programs. The paper proposes a method for the energy efficiency analysis of a domestic consumer using the SCADA House Intelligent Management (SHIM) system. The main goal of the present paper is to demonstrate the economic benefits of the implemented method. The case study considers the consumption data of some real cases of Portuguese house consumption over 30 days of June of 2012, the Portuguese real energy price, the implementation of the power limits at different times of the day and the economic benefits analysis.
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Recent changes in electricity markets (EMs) have been potentiating the globalization of distributed generation. With distributed generation the number of players acting in the EMs and connected to the main grid has grown, increasing the market complexity. Multi-agent simulation arises as an interesting way of analysing players’ behaviour and interactions, namely coalitions of players, as well as their effects on the market. MASCEM was developed to allow studying the market operation of several different players and MASGriP is being developed to allow the simulation of the micro and smart grid concepts in very different scenarios This paper presents a methodology based on artificial intelligence techniques (AI) for the management of a micro grid. The use of fuzzy logic is proposed for the analysis of the agent consumption elasticity, while a case based reasoning, used to predict agents’ reaction to price changes, is an interesting tool for the micro grid operator.
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Environmental Training in Engineering Education (ENTREE 2001) - integrated green policies: progress for progress, p. 329-339 (Florence, 14-17 November 2001; proceedings published as book)
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Electricity Markets are not only a new reality but an evolving one as the involved players and rules change at a relatively high rate. Multi-agent simulation combined with Artificial Intelligence techniques may result in very helpful sophisticated tools. This paper presents a new methodology for the management of coalitions in electricity markets. This approach is tested using the multi-agent market simulator MASCEM (Multi-Agent Simulator of Competitive Electricity Markets), taking advantage of its ability to provide the means to model and simulate Virtual Power Players (VPP). VPPs are represented as coalitions of agents, with the capability of negotiating both in the market and internally, with their members in order to combine and manage their individual specific characteristics and goals, with the strategy and objectives of the VPP itself. A case study using real data from the Iberian Electricity Market is performed to validate and illustrate the proposed approach.
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Management Information Systems 2000, p. 103-111
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The use of demand response programs enables the adequate use of resources of small and medium players, bringing high benefits to the smart grid, and increasing its efficiency. One of the difficulties to proceed with this paradigm is the lack of intelligence in the management of small and medium size players. In order to make demand response programs a feasible solution, it is essential that small and medium players have an efficient energy management and a fair optimization mechanism to decrease the consumption without heavy loss of comfort, making it acceptable for the users. This paper addresses the application of real-time pricing in a house that uses an intelligent optimization module involving artificial neural networks.
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The aggregation and management of Distributed Energy Resources (DERs) by an Virtual Power Players (VPP) is an important task in a smart grid context. The Energy Resource Management (ERM) of theses DERs can become a hard and complex optimization problem. The large integration of several DERs, including Electric Vehicles (EVs), may lead to a scenario in which the VPP needs several hours to have a solution for the ERM problem. This is the reason why it is necessary to use metaheuristic methodologies to come up with a good solution with a reasonable amount of time. The presented paper proposes a Simulated Annealing (SA) approach to determine the ERM considering an intensive use of DERs, mainly EVs. In this paper, the possibility to apply Demand Response (DR) programs to the EVs is considered. Moreover, a trip reduce DR program is implemented. The SA methodology is tested on a 32-bus distribution network with 2000 EVs, and the SA results are compared with a deterministic technique and particle swarm optimization results.
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The reactive power management in distribution network with large penetration of distributed energy resources is an important task in future power systems. The control of reactive power allows the inclusion of more distributed recourses and a more efficient operation of distributed network. Currently, the reactive power is only controlled in large power plants and in high and very high voltage substations. In this paper, several reactive power control strategies considering a smart grids paradigm are proposed. In this context, the management of distributed energy resources and of the distribution network by an aggregator, namely Virtual Power Player (VPP), is proposed and implemented in a MAS simulation tool. The proposed methods have been computationally implemented and tested using a 32-bus distribution network with intensive use of distributed resources, mainly the distributed generation based on renewable resources. Results concerning the evaluation of the reactive power management algorithms are also presented and compared.
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The rising usage of distributed energy resources has been creating several problems in power systems operation. Virtual Power Players arise as a solution for the management of such resources. Additionally, approaching the main network as a series of subsystems gives birth to the concepts of smart grid and micro grid. Simulation, particularly based on multi-agent technology is suitable to model all these new and evolving concepts. MASGriP (Multi-Agent Smart Grid simulation Platform) is a system that was developed to allow deep studies of the mentioned concepts. This paper focuses on a laboratorial test bed which represents a house managed by a MASGriP player. This player is able to control a real installation, responding to requests sent by the system operators and reacting to observed events depending on the context.
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Demand response concept has been gaining increasing importance while the success of several recent implementations makes this resource benefits unquestionable. This happens in a power systems operation environment that also considers an intensive use of distributed generation. However, more adequate approaches and models are needed in order to address the small size consumers and producers aggregation, while taking into account these resources goals. The present paper focuses on the demand response programs and distributed generation resources management by a Virtual Power Player that optimally aims to minimize its operation costs taking the consumption shifting constraints into account. The impact of the consumption shifting in the distributed generation resources schedule is also considered. The methodology is applied to three scenarios based on 218 consumers and 4 types of distributed generation, in a time frame of 96 periods.
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In the smart grids context, distributed energy resources management plays an important role in the power systems’ operation. Battery electric vehicles and plug-in hybrid electric vehicles should be important resources in the future distribution networks operation. Therefore, it is important to develop adequate methodologies to schedule the electric vehicles’ charge and discharge processes, avoiding network congestions and providing ancillary services. This paper proposes the participation of plug-in hybrid electric vehicles in fuel shifting demand response programs. Two services are proposed, namely the fuel shifting and the fuel discharging. The fuel shifting program consists in replacing the electric energy by fossil fuels in plug-in hybrid electric vehicles daily trips, and the fuel discharge program consists in use of their internal combustion engine to generate electricity injecting into the network. These programs are included in an energy resources management algorithm which integrates the management of other resources. The paper presents a case study considering a 37-bus distribution network with 25 distributed generators, 1908 consumers, and 2430 plug-in vehicles. Two scenarios are tested, namely a scenario with high photovoltaic generation, and a scenario without photovoltaic generation. A sensitivity analyses is performed in order to evaluate when each energy resource is required.