Influencia de la implantación del Sistema Integrado de Transporte Masivo en los procesos de planeación local. Estudio de caso: Fase 1 y 2- Metrolínea en el Área Metropolitana de Bucaramanga. Periodo 2003-2011.

Esta investigación le permite al lector entender la influencia que tuvo la implantación del Sistema Integrado de Transporte Masivo (SITM) sobre la gestión del ordenamiento territorial en el Área Metropolitana de Bucaramanga. El documento explica y analiza las posibles transformaciones que se podrían generar en los alrededores del sistema, partiendo de reconocer que existen unas áreas denominadas centralidades y otras operaciones estratégicas que son catalogadas no solamente por el rol que cumplen en un contexto municipal y metropolitano, sino también por las posibilidades que ofrecen para el desarrollo de servicios, equipamientos y empleo, que finalmente contribuirán a alcanzar el deseo de un modelo desarrollo policéntrico en el área metropolitana.

Desempeño de las RISS en relación al acceso, coordinación y calidad de la atención en cáncer de mama y diabetes mellitus tipo 2 en Colombia

El objetivo de este capítulo es mostrar los resultados de investigación del desempeño de las redes de servicios de salud frente a diferentes dimensiones relacionadas al acceso, coordinación y calidad de la atención en dos enfermedades crónicas como es el cáncer de mama y la diabetes en Colombia, importantes patologías por su incidencia e impacto así como por la necesidad de la mecanismos efectivos de coordinación para la adecuada atención de los usuarios del sistema de salud. Por tanto, se realiza el análisis del desempeño de dos redes de servicios de salud en la atención de usuarias con diagnostico confirmado de cáncer de mama, vinculadas unas a redes pertenecientes al régimen contributivo y otras al régimen subsidiado. Redes que también fueron consideradas para el análisis del desempeño en la atención de usuarios con diagnostico confirmado de diabetes, en el que de manera adicional participó otra red perteneciente al régimen subsidiado con área de operación en el municipio de Soacha, puesto que las dos anteriores tiene influencia en la ciudad de Bogotá. La fuente primaria de los datos fue la historia clínica y éstos fueron extraídos de acuerdo a ciertos indicadores seleccionados por el equipo investigador a través de un previo proceso de validación y a partir de su importancia para evidenciar el desempeño de las redes de servicios de salud en las dimensiones enunciadas anteriormente. Se muestran los resultados del estudio, a partir de los cuales se propone una breve discusión y conclusiones.

Languages Learning at Key Stage 2. A Longitudinal Study. Final report.

In 2006, The Open University, the University of Southampton and Canterbury Christ Church University were commissioned by the then Department for Education and Skills (DfES), now Department for Children, Schools and Families (DCSF) to conduct a three-year longitudinal study of languages learning at Key Stage 2 (KS2). The qualitative study was designed to explore provision, practice and developments over three school years between 2006/07 and 2008/09 in a sample of primary schools and explore children’s achievement in oracy and literacy, as well as the possible broader cross-curricular impact of languages learning.

Wave-activity conservation laws and stability theorems for semi-geostrophic dynamics: part 2. pseudoenergy-based theory

This paper represents the second part of a study of semi-geostrophic (SG) geophysical fluid dynamics. SG dynamics shares certain attractive properties with the better known and more widely used quasi-geostrophic (QG) model, but is also a good prototype for balanced models that are more accurate than QG dynamics. The development of such balanced models is an area of great current interest. The goal of the present work is to extend a central body of QG theory, concerning the evolution of disturbances to prescribed basic states, to SG dynamics. Part 1 was based on the pseudomomentum; Part 2 is based on the pseudoenergy. A pseudoenergy invariant is a conserved quantity, of second order in disturbance amplitude relative to a prescribed steady basic state, which is related to the time symmetry of the system. We derive such an invariant for the semi-geostrophic equations, and use it to obtain: (i) a linear stability theorem analogous to Arnol'd's ‘first theorem’; and (ii) a small-amplitude local conservation law for the invariant, obeying the group-velocity property in the WKB limit. The results are analogous to their quasi-geostrophic forms, and reduce to those forms in the limit of small Rossby number. The results are derived for both the f-plane Boussinesq form of semi-geostrophic dynamics, and its extension to β-plane compressible flow by Magnusdottir & Schubert. Novel features particular to semi-geostrophic dynamics include apparently unnoticed lateral boundary stability criteria. Unlike the boundary stability criteria found in the first part of this study, however, these boundary criteria do not necessarily preclude the construction of provably stable basic states. The interior semi-geostrophic dynamics has an underlying Hamiltonian structure, which guarantees that symmetries in the system correspond naturally to the system's invariants. This is an important motivation for the theoretical approach used in this study. The connection between symmetries and conservation laws is made explicit using Noether's theorem applied to the Eulerian form of the Hamiltonian description of the interior dynamics.

Potential-based achievement goals

Background: Self-based achievement goals use one’s own intrapersonal trajectory as a standard of evaluation, and this intrapersonal trajectory may be grounded in one’s past (past-based goals) or one’s future potential potential-based goals). Potential-based goals have been overlooked in the literature to date. Aims: The primary aim of the present research is to address this oversight within the context of the 3 x 2 achievement goal framework. Samples: The Study 1 sample was 381 U.S. undergraduates; the Study 2 sample was 310 U.S. undergraduates. Methods: In Study 1, we developed scales to assess otential-approach and potential-avoidance goals, and tested their factorial validity with exploratory and confirmatory factor analyses. In Study 2, we used confirmatory factor analysis to test both the separability of past-based and potential-based goals and their higher order integration within the self-based category. Results: Study 1 supported the factorial validity of the potential-approach and potential-avoidance goal scales. Study 2 supported the separability of past-based and potential-based goals, as well as their higher order integration within the self-based category. Conclusions: This research documents the utility of the proposed distinction, and paves the way for subsequent work on antecedent and consequences of potential-approach and potential-avoidance goals. It highlights the importance

Disruption of the 2-methylcitric acid cycle and evaluation of poly-3-hydroxybutyrate-co-3-hydroxyvalerate biosynthesis suggest alternate catabolic pathways of propionate in Burkholderia sacchari

The objective of the present work was to evaluate the relevance of the 2-methylcitric acid cycle (2MCC) to the catabolism of propionate in Burkholderia sacchari. Two B. sacchari mutants unable to grow on propionate were obtained: one disrupted in acnM, and the other in acnM and prpC deleted. An operative 2MCC significantly reduces the bacterial ability to incorporate 3-hydroxyvalerate (3HV) into a biodegradable copolyester accumulated from carbohydrates plus propionate. The efficiency of the mutants in converting propionate to 3HV units (Y(3HV/prp)) increased from 0.09 g.g(-1) to 0.81-0.96 g.g(-1), indicating that acnM and prpC are both essential for growth on propionate. None of the mutations resulted in achievement of the maximum theoretical Y(3HV/prp) (1.35 g.g(-1)). When increasing concentrations of propionate were supplied, decreasing values of Y(3HV/prp) were observed. The results obtained corroborate the hypothesis of the presence of other propionate catabolic pathways in B. sacchari. The 2MCC would be the more operative pathway, but a second pathway, which remains to be elucidated, would assume more importance under propionate concentrations of 1 g.L(-1) or higher. The efficiency in converting propionate to 3HV units can be improved by decreasing the propionate concentrations, owing to the role of the 2MCC.

Elevers uppfattningar av vad man bör uppnå efter avslutad kurs i Idrott och Hälsa A : En studie av två gymnasieskolor i årskurs 2 – ett elevperspektiv

The purpose of this work is to see if the students, on two separate high schools, understand what skills you should achieve after completing the course in physical education and health A 100 points. The entire study is based on a student perspective. In order to best answer the purpose, the questionnaire used in the "available groups" in schools. The questions for the work are: To what extent and how students perceive what they should achieve after completing the course in Sport and Health A?, Which is the goal, based on the curriculum in Physical Education, that students feel are important to achieve? and how do a comparison like between these two schools on the basis of what students perceive that they must achieve in Sport and Health A?The result shows that the main goal that finds support in the course objectives is an assertion; Has knowledge of what to eat to maintain or improve health, which over 90% of students had checked in. The least important goal was the claim 14; Know woods and fields and carry out outdoor activities, as 30% of students had checked in. The most important goal that does not find support in the course objectives is claim 10; to be reversed to the lessons, which was 88% in response rate among students. Here was the least important goal, claim 6; to be skilled in various ball games, which received 17% of student responses. The findings revealed that there is a clear health perspective in physical education in the studied groups at the two schools, one can also see that there is an uneven distribution of the elements included in the curriculum of Sport and Health A, and the outdoor life and dance is rare in the teaching of the groups studied at the two schools. Finally, it appeared that the lesson content and teaching are likely to have a significant role in student perceptions of course goals.

Viktiga faktorer i egenvårdsprogram som främjar livskvaliteten för personer med diabetes typ 2. : En litteraturöversikt

Bakgrund: Diabetes typ 2 är en endokrin sjukdom och är en av de största folksjukdomarna i världen. Förhöjda blodsockervärden gör att både små och stora blodkärl tar skada och detta leder till olika komplikationer såsom hjärtinfarkt, stroke och njurskador. Med hjälp av viktnedgång, kostreglering, regelbundet fysisk aktivitet och övervakning av blodglukosnivåerna kan risken för komplikationer förebyggas. Genom att förebygga komplikationer kan livskvaliteten främja patientens dagliga liv. En del av diabetesvården består av egenvårdsprogram där patienten får stöd och rådgivning att hantera sin diabetes. Syfte: Denna litteraturstudie syftar till att studera vilka faktorer i egenvårdsprogram som främjar livskvaliteten hos patienter med diabetes typ 2. Metod: Litteraturstudie, artiklarna söktes i databaserna CINAHL, PubMed och Web of Science. 14 kvantitativa artiklar inkluderades. Resultat: Resultatet visade att information, individuell målsättning och uppföljning var viktiga faktorer i egenvårdsprogrammen för att främja livskvaliteten hos patienter med diabetes typ 2. Slutsats: Att leva med diabetes typ 2 kräver noggrannhet och planering i det dagliga livet. Egenvårdsprogram kan minska risken för komplikationer där följsamhet till egenvården främjas och livskvaliteten gynnas.

Patient engagement and coaching for health: the PEACH study- a cluster randomised controlled trial using the telephone to coach people with type 2 diabetes to engage with their GPs to improve diabetes care: a study protocol.

Background
The PEACH study is based on an innovative 'telephone coaching' program that has been used effectively in a post cardiac event trial. This intervention will be tested in a General Practice setting in a pragmatic trial using existing Practice Nurses (PN) as coaches for people with type 2 diabetes (T2D). Actual clinical care often fails to achieve standards, that are based on evidence that self-management interventions (educational and psychological) and intensive pharmacotherapy improve diabetes control. Telephone coaching in our study focuses on both. This paper describes our study protocol, which aims to test whether goal focused telephone coaching in T2D can improve diabetes control and reduce the treatment gap between guideline based standards and actual clinical practice.
Methods/design
In a cluster randomised controlled trial, general practices employing Practice Nurses (PNs) are randomly allocated to an intervention or control group. We aim to recruit 546 patients with poorly controlled T2D (HbA1c >7.5%) from 42 General Practices that employ PNs in Melbourne, Australia. PNs from General Practices allocated to the intervention group will be trained in diabetes telephone coaching focusing on biochemical targets addressing both patient self-management and engaging patients to work with their General Practitioners (GPs) to intensify pharmacological treatment according to the study clinical protocol. Patients of intervention group practices will receive 8 telephone coaching sessions and one face-to-face coaching session from existing PNs over 18 months plus usual care and outcomes will be compared to the control group, who will only receive only usual care from their GPs. The primary outcome is HbA1c levels and secondary outcomes include cardiovascular disease risk factors, behavioral risk factors and process of care measures.
Discussion
Understanding how to achieve comprehensive treatment of T2D in a General Practice setting is the focus of the PEACH study. This study explores the potential role for PNs to help reduce the treatment and outcomes gap in people with T2D by using telephone coaching. The intervention, if found to be effective, has potential to be sustained and embedded within real world General Practice.

The impact of using a pedometer on time spent walking in older adults with Type 2 diabetes

Purpose

The purpose of this study was to investigate the impact of using a pedometer on time spent walking, in sedentary and overweight adults with type 2 diabetes participating in a coaching intervention. It was hypothesized that participants using a pedometer would spend more time walking than would nonpedometer participants.

Method

A sample of 57 men and women with a mean age of 62 years participated in a randomized controlled trial in a community setting. Participants were allocated to either a pedometer and coaching (intervention) group or a coaching-only (control) group. Coaching for both groups involved education, goal setting, and supportive/ motivational strategies to increase time spent walking. The duration of the study was 6 months, with blood pressure, glycosylated hemoglobin, anthropometric, and fitness measurements assessed at baseline and at 3-month intervals.

Results

A repeated-measures analysis of variance indicated that the coaching-only group spent significantly more time walking than did the pedometer group. However, when an analysis of covariance with all the other variables as covariates was performed, group membership had no influence on time spent walking. Significant reductions in waist circumference and weight were achieved for both groups from baseline to 6 months. Cardiovascular fitness also increased significantly for both groups.

Conclusion

The study demonstrated that previously sedentary older adults with type 2 diabetes, supported with a coaching intervention, were able to achieve the physical activity targets known to be beneficial to health. However, using a pedometer added no further benefit. Further research on the impact of specific coaching strategies in diabetes management is warranted.

Diabetes MILES - Australia (Management and Impact for Long-Term Empowerment and Success) : methods and sample characteristics of a national survey of the psychological aspects of living with type 1 or type 2 diabetes in Australian adults

Background Successful management of diabetes requires attention to the behavioural, psychological and social aspects of this progressive condition. The Diabetes MILES (Management and Impact for Long-term Empowerment and Success) Study is an international collaborative. Diabetes MILES-Australia, the first Diabetes MILES initiative to be undertaken, was a national survey of adults living with type 1 or type 2 diabetes in Australia. The aim of this study was to gather data that will provide insights into how Australians manage their diabetes, the support they receive and the impact of diabetes on their lives, as well as to use the data to validate new diabetes outcome measures.

Methods The survey was designed to include a core set of self-report measures, as well as modules specific to diabetes type or management regimens. Other measures or items were included in only half of the surveys. Cognitive debriefing interviews with 20 participants ensured the survey content was relevant and easily understood. In July 2011, the survey was posted to 15,000 adults (aged 18-70 years) with type 1 or type 2 diabetes selected randomly from the National Diabetes Services Scheme (NDSS) database. An online version of the survey was advertised nationally. A total of 3,338 eligible Australians took part; most (70.4%) completed the postal survey. Respondents of both diabetes types and genders, and of all ages, were adequately represented in both the postal and online survey sub-samples. More people with type 2 diabetes than type 1 diabetes took part in Diabetes MILES-Australia (58.8% versus 41.2%). Most respondents spoke English as their main language, were married/in a de facto relationship, had at least a high school education, were occupied in paid work, had an annual household income > $AUS40,000, and lived in metropolitan areas.

Discussion A potential limitation of the study is the under-representation of respondents from culturally and linguistically diverse backgrounds (including Aboriginal and Torres Strait Islander origin). Diabetes MILES-Australia represents a major achievement in the study of diabetes in Australia, where for the first time, the focus is on psychosocial and behavioural aspects of this condition at a national level.

A profissionalização de 2. grau em São Luís do Maranhão

O presente trabalho destina-se a caracterizar e a delinear o conteúdo expresso no texto da Lei n9 5.692/71 enfatizando a questão do ensino profissionalizante. O estudo está esquematizado em seis capitulos. O primeiro, discorre sobre o processo educativo como vem ocorrendo em nossa sociedade capitalista. O segundo segue a linha de contextualização histórica e tem como escopo aflorar a ideologia do texto da Lei n9 5.692/71. O terceiro, apresenta o problema e a metodologia de um estudo de caso reali zado em são Luís do Maranhão sendo seus resultados descritos no quarto capítulo e analisados no quinto. O último capítulo contém as conclusões da autora. A pesquisa torna evidente que o texto da Lei em estudo empreende perfeitamente as funções ideológicas trabalhadas pelo Estado para atender à realidade da sociedade através da ordem vigente e dos mecanismos de conservaçao e de reprodução sociais, apesar de ser constatada a alienação dos alunos pela sua não absorçao pelo mercado de trabalho, deixando transparecer que as diferenças intelectuais e o desempenho escolar são as barreiras que ficam evidentes na sociedade de classes, permitindo ao aparelho escolar ficar livre para manter suas funções. O resultado da pesquisa nos mostra que a escola assegura a preparação da mão-de-obra, através do mecanismo camuflado de "não profissionalização" uma vez que a grande maioria dos alunos egressos se encontram desempregados. A conclusão mostra a necessidade de dinamizar o ensino profissionalizante para que ele possa contribuir mais ativa e poderosamente em relação as necessidades do contexto, pois a profissionalização como hoje é feita, não se distingue muito da confecção de máquinas ou ferramentas de produção, porque ela está muito mais a serviço do sistema de produção do que do homem, tanto assim que nela não está incluída a garantia de emprego, levando por conseguinte a "desominização" do homem.

Voice over IP 2.0: an analysis of limits and potential of IP2IP telecommunication

Internet Telephony (VoIP) is changing the telecommunication industry. Oftentimes free, VoIP is becoming more and more popular amongst users. Large software companies have entered the market and heavily invest into it. In 2011, for instance, Microsoft bought Skype for 8.5bn USD. This trend increasingly impacts the incumbent telecommunication operators. They see their main source of revenue – classic telephony – under siege and disappear. The thesis at hand develops a most-likely scenario in order to determine how VoIP is evolving further and it predicts, based on a ten-year forecast, the impact it will have on the players in the telecommunication industry.The paper presents a model combining Rogers’ diffusion and Christensen’s innovation research. The model has the goal of explaining the past evolution of VoIP and to isolate the factors that determine the further diffusion of the innovation. Interviews with industry experts serve to assess how the identified factors are evolving.Two propositions are offered. First, VoIP operators are becoming more important in international, corporate, and mobile telephony. End-to-end VoIP (IP2IP) will exhibit strong growth rates and increasingly cannibalize the telephony revenues of the classic operators. Second, fix-net telephony in SMEs and at home will continue to be dominated by the incumbents. Yet, as prices for telephony fall towards zero also they will implement IP2IP in order to save costs. By 2022, up to 90% of the calls will be IP2IP. The author recommends the incumbents and VoIP operators to proactively face the change, to rethink their business strategies, and to even be open for cooperation.

Pesquisa orientada a resultado : proposta de um método estruturado para disponibilizar uma nova tecnologia para o mercado : um caso aplicado ao projeto etanol de 2ª geração

Esta dissertação de mestrado teve como objetivo principal propor um método estruturado suportado for ferramentas gerenciais que permitisse orientar e sistematizar o desenvolvimento de um projeto de pesquisa na disponibilização de uma nova tecnologia para o mercado. O “Projeto Etanol de 2ª Geração”, etanol produzido a partir de biomassas lignocelulósicas, aqui selecionado para estudo de caso, foi extraído da carteira de projetos do Centro de Tecnologia Canavieira (CTC). O método estruturado sugerido é constituído, fundamentalmente, por oito requisitos arranjados de forma cronológica ao longo do desenvolvimento do projeto, que visam auxiliar na prospecção, entendimento, avaliação, valoração, priorização, planejamento e implantação de, por exemplo, uma tecnologia inovadora, otimizando tempo, capital e recursos humanos aplicados. Um dos principais pontos do método proposto refere-se à escolha adequada das ferramentas gerenciais a serem utilizadas em cada requisito (brainstorm, análise de patentes, painel de especialistas, análise SWOT, dentre outras). O êxito na aplicação do método requer o entendimento de todos os (potenciais) efeitos, inclusive os colaterais, no processo como um todo. Ou seja, uma vez que toda ferramenta gerencial apresenta pontos fortes e fracos, o importante é adaptá-las ao sistema de negócio e não vice-versa. A partir do gerenciamento do projeto por um gestor com domínio das ferramentas gerenciais, a escolha destas ocorre de forma dinâmica, onde a cada passo de avaliação novas ferramentas (simples e/ou complexas) podem ser incluídas ou excluídas da matriz do método. Neste trabalho ficou demonstrada a importância de se trabalhar com métodos estruturados e flexíveis, que permitem retroalimentação de informações geradas internamente durante o desenvolvimento da pesquisa ou advindas de fontes externas. O projeto Etanol de 2ª Geração do CTC vem aplicando o método proposto em seu desenvolvimento e obtendo grande êxito em seus resultados, uma vez que a equipe envolvida permanece focada no objetivo principal, obedecendo prazos e recursos inicialmente definidos, com constância do propósito do projeto, sem retrocesso ou recomeço.