922 resultados para Integrated Continued Care National Network


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Esta comunicação enquadra-se num estudo em curso no âmbito de uma rede nacional em que participam o Alto Comissariado para as Migrações (ACM) e várias Instituições de Ensino Superior (IES) portuguesas, designada Rede de Ensino Superior em Mediação Intercultural (RESMI). Esta rede surge da constatação da importância da prossecução de políticas de apoio ao acolhimento e integração de migrantes, da promoção do diálogo entre diversas culturas, etnias e religiões e da necessidade de formação e investigação no âmbito da Mediação Intercultural.

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Dissertação de mestrado em Sociologia (área de especialização em Organizações e Trabalho)

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School-aged children (6-15 years) from the endemic area of Pernambuco were evaluated both as a target group for and an indicator of schistosomiasis control in the community. Parasitological data were drawn from baseline stool surveys of whole populations that were obtained to diagnose Schistosoma mansoni infection. Nineteen representative localities were selected for assessing the prevalence of schistosomiasis among individuals in the following age groups: 0-5, 6-15, 16-25, 26-40 and 41-80 years. For each locality, the prevalence in each age group was compared to that of the overall population using contingency table analysis. To select a reference group, the operational difficulties of conducting residential surveys were considered. School-aged children may be considered to be the group of choice as the reference group for the overall population for the following reasons: (i) the prevalence of schistosomiasis in this age group had the highest correlation with the prevalence in the overall population (r = 0.967), (ii) this age group is particularly vulnerable to infection and plays an important role in parasite transmission and (iii) school-aged children are the main target of the World Health Organization in terms of helminth control. The Schistosomiasis Control Program should consider school-aged children both as a reference group for assessing the need for intervention at the community level and as a target group for integrated health care actions of the Unified Health System that are focused on high-risk groups.

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In European countries and North America, people spend 80 to 90% of time inside buildings and thus breathe indoor air. In Switzerland, special attention has been devoted to the 16 stations of the national network of observation of atmospheric pollutants (NABEL). The results indicate a reduction in outdoor pollution over the last ten years. With such a decrease in pollution over these ten years the question becomes: how can we explain an increase of diseases? Indoor pollution can be the cause. Indoor contaminants that may create indoor air quality (IAQ) problems come from a variety of sources. These can include inadequate ventilation, temperature and humidity dysfunction, and volatile organic compounds (VOCs). The health effects from these contaminants are varied and can range from discomfort, irritation and respiratory diseases to cancer. Among such contaminants, environmental tobacco smoke (ETS) could be considered the most important in terms of both health effects and engineering controls of ventilation. To perform indoor pollution monitoring, several selected ETS tracers can be used including carbon monoxide (CO), carbon dioxide (CO2), respirable particles (RSP), condensate, nicotine, polycyclic aromatic hydrocarbons (PAHs), nitrosamines, etc. In this paper, some examples are presented of IAQ problems that have occurred following the renewal of buildings and energy saving concerns. Using industrial hygiene sampling techniques and focussing on selected priority pollutants used as tracers, various problems have been identified and solutions proposed. [Author]

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Until the 1990's, Switzerland could be classified as either a corporatist, cooperative or coordinated market economy where non-market mechanisms of coordination among economic and political actors were very important. In this respect, Business Interest Associations (BIAs) played a key role. The aim of this paper is to look at the historical evolution of the five main peak Swiss BIAs through network analysis for five assorted dates during the 20th century (1910, 1937, 1957, 1980 and 2000) while relying on a database that includes more than 12,000 people. First, we examine the logic of membership in these associations, which allows us to analyze their position and function within the network of the Swiss economic elite. Until the 1980's, BIAs took part in the emergence and consolidation of a closely meshed national network, which declined during the two last decades of the 20th century. Second, we investigate the logic of influence of these associations by looking at the links they maintained with the political and administrative worlds through their links to the political parties and Parliament, and to the administration via the extra-parliamentary commissions (corporatist bodies). In both cases, the recent dynamic of globalization called into question the traditional role of BIAs.

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This paper offers a general view of changes in health care management in theSpanish Health System. We focus on the organisational, financing andaccountability aspects of health care provision. We do this by encompassingmanagerial changes and social change and well-grounded in theory health economicsliterature. In this way we try to link applied economics and management issues,as we did in a former paper, ten years ago on the same basis(López-Casasnovas, 2002). We emphasise mistakes and milestones in the wayforward to improve health systems by better understanding the public natureof health policies. Key aspects of this are to achieve a better allocation ofresponsibilities to providers on patients health, to incentive the organisationof medical self-managed health care institutions and to build global budgets onrisk-adjusting capitation and better integrated health care providers on acommunity basis.

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Early Childhood Iowa (ECI) is an alliance of stakeholders in early care, health, and education that affect children age zero to five in the State of Iowa. Its purpose is to support a comprehensive, integrated early care, health and education system for Iowa. All activities of the system are aligned around a common vision for Iowa: Every child, beginning at birth, will be healthy and successful.Membership is voluntary and open to anyone self-identifying as a “stakeholder” in Iowa’s early care, health, and education system. The process for membership will be with as few barriers or constraints as possible. Individuals seeking membership should agree to the vision for an early care, health, and education system in Iowa and to the principles and core beliefs of the ECI Stakeholders. The structure of ECI includes six system component groups that describe the necessary elements of an effective and comprehensive early care, health, and education system, as well as a State Agency Liaison group and a Co-chairs group. Membership in each component group is open to anyone with an interest in the unique responsibilities of a implementing an early care, health and education system.

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The Office of Energy Independence (Office) is the state agency responsible for setting the strategic direction, directing policy, conducting energy related outreach and administering programs that optimize energy production and efficiency to secure Iowa’s clean energy future. The Office performed its duties as set forth in Iowa Code 469.3(2), managed the Iowa Power Fund and federal U.S. Department of Energy (DOE) grants funded through the American Recovery and Reinvestment Act (ARRA), as well as an annual federal appropriation that supports the Office’s operational costs. As part of the national network for energy security, the Office is responsible for ensuring state emer- gency preparedness and quick recovery and restoration from any energy supply disruptions.

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Although interpersonal continuity is commonly assumed to be essential for care, some patients prefer to attend a university outpatient clinic where physicians change regularly and interpersonal continuity of care is not ensured. The aim of this exploratory study was to evaluate the differences between patients attending a university outpatient clinic and patients frequenting a private practice, explore their patterns of care-seeking and their understanding of continued care. We conducted a cross-sectional study of patients attending the university medical outpatient clinic (OC) in Lausanne, Switzerland and ten randomly selected private general practices (PP). Eligible patients were >30 years, Swiss nationals or long term residents, with one or more chronic conditions and attending the same practice for >3 years. They were asked to complete a questionnaire on sociodemographic data, use of medical resources and reasons for choosing and remaining at the same practice. Semi-structured interviews were conducted with a randomly selected subset of 26 patients to further explore their preferences. 329 patient questionnaires were completed, 219 by PP and 110 by OC patients. OC patients tended to be of lower socioeconomic status than PP patients. The main reason for choosing a PP were personal recommendation, while a higher percentage of patients chose the OC because they could obtain a first appointment quickly. A higher percentage of PP patients accorded importance to physician communication skills and trust, whereas a higher percentage of OC patients favoured investigation facilities. Qualitative data suggested that although OC and PP patients reported different reasons for consulting, their expectations on the medical and relationship level were similar. Our study suggests that the two groups of patients belong to different social backgrounds, have different patterns of care-seeking and attach importance to different aspects of care continuity. However, patients' expectations and perceptions of the physician-patient relationship are similar.

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In April 2009, the US government unveiled its blueprint for a national network of high-speed passenger rail (HSR) lines aimed at reducing traffic congestion, cutting national dependence on foreign oil and improving rural and urban environments. In implementing such a program, it is essential to identify the factors that might influence decision making and the eventual success of the HSR project, as well as foreseeing the obstacles that will have to be overcome.

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As technology geometries have shrunk to the deep submicron regime, the communication delay and power consumption of global interconnections in high performance Multi- Processor Systems-on-Chip (MPSoCs) are becoming a major bottleneck. The Network-on- Chip (NoC) architecture paradigm, based on a modular packet-switched mechanism, can address many of the on-chip communication issues such as performance limitations of long interconnects and integration of large number of Processing Elements (PEs) on a chip. The choice of routing protocol and NoC structure can have a significant impact on performance and power consumption in on-chip networks. In addition, building a high performance, area and energy efficient on-chip network for multicore architectures requires a novel on-chip router allowing a larger network to be integrated on a single die with reduced power consumption. On top of that, network interfaces are employed to decouple computation resources from communication resources, to provide the synchronization between them, and to achieve backward compatibility with existing IP cores. Three adaptive routing algorithms are presented as a part of this thesis. The first presented routing protocol is a congestion-aware adaptive routing algorithm for 2D mesh NoCs which does not support multicast (one-to-many) traffic while the other two protocols are adaptive routing models supporting both unicast (one-to-one) and multicast traffic. A streamlined on-chip router architecture is also presented for avoiding congested areas in 2D mesh NoCs via employing efficient input and output selection. The output selection utilizes an adaptive routing algorithm based on the congestion condition of neighboring routers while the input selection allows packets to be serviced from each input port according to its congestion level. Moreover, in order to increase memory parallelism and bring compatibility with existing IP cores in network-based multiprocessor architectures, adaptive network interface architectures are presented to use multiple SDRAMs which can be accessed simultaneously. In addition, a smart memory controller is integrated in the adaptive network interface to improve the memory utilization and reduce both memory and network latencies. Three Dimensional Integrated Circuits (3D ICs) have been emerging as a viable candidate to achieve better performance and package density as compared to traditional 2D ICs. In addition, combining the benefits of 3D IC and NoC schemes provides a significant performance gain for 3D architectures. In recent years, inter-layer communication across multiple stacked layers (vertical channel) has attracted a lot of interest. In this thesis, a novel adaptive pipeline bus structure is proposed for inter-layer communication to improve the performance by reducing the delay and complexity of traditional bus arbitration. In addition, two mesh-based topologies for 3D architectures are also introduced to mitigate the inter-layer footprint and power dissipation on each layer with a small performance penalty.

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Le cancer du poumon a une incidence et une létalité parmi les plus hautes de tous les cancers diagnostiqués au Canada. En considérant la gravité du pronostic et des symptômes de la maladie, l’accès au traitement dans les plus brefs de délais est essentiel. Malgré l’engagement du gouvernement fédéral et les gouvernements provinciaux de réduire les délais de temps d’attente, des balises pour les temps d’attente pour le traitement d’un cancer ne sont toujours pas établis. En outre, le compte-rendu des indicateurs des temps d’attente n’est pas uniforme à travers les provinces. Une des solutions proposées pour la réduction des temps d’attente pour le traitement du cancer est les équipes interdisciplinaires. J’ai complété un audit du programme interdisciplinaire traitant le cancer du poumon à l’Hôpital général juif (l’HGJ) de 2004 à 2007. Les objectifs primaires de l’étude étaient : (1) de faire un audit de la performance de l’équipe interdisciplinaire à l’HGJ en ce qui concerne les temps d’attente pour les intervalles critiques et les sous-groupes de patients ; (2) de comparer les temps d’attente dans la trajectoire clinique des patients traités à l’HGJ avec les balises qui existent ; (3) de déterminer les facteurs associés aux délais plus longs dans cette population. Un objectif secondaire de l’étude était de suggérer des mesures visant à réduire les temps d’attente. Le service clinique à l’HGJ a été évalué selon les balises proposées par le British Thoracic Society, Cancer Care Ontario, et la balise pan-canadienne pour la radiothérapie. Les patients de l’HGJ ont subi un délai médian de 9 jours pour l’intervalle «Ready to treat to first treatment», et un délai médian de 30 jours pour l’intervalle entre le premier contact avec l’hôpital et le premier traitement. Les patients âgés de plus de 65 ans, les patients avec une capacité physique diminuée, et les patients avec un stade de tumeur limité étaient plus à risque d’échouer les balises pour les temps d’attente.

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Depuis le début de son histoire, l’être humain cherche, pour de nombreuses raisons à s’associer et développer le milieu où il vit. Ces caractéristiques culminèrent dans les phénomènes de mondialisation et de révolution technologique responsables de la diminution des distances physiques et temporelles du monde contemporain. Ces facteurs ont stimulé les processus d’intégration régionaux, lesquels ont pour but le renforcement de ses adhérents face à la nouvelle réalité mondiale. Parmi ces processus, on note le Mercosur qui vise à la création d’un marché commun entre l’Argentine, le Brésil, le Paraguay et l’Uruguay. Fondé sur l’intergouvernabilité et avec une structure organisationnelle définie, ce bloc économique possède un cadre normatif en évolution, cherchant constamment la sécurité juridique dans divers secteurs. Quant à la protection des droits de propriété intellectuelle, on constate une ancienne préoccupation de la région sur le thème. Toutefois, le peu de normes existantes au sein du bloc confèrent des droits subjectifs minimaux et la plupart d’entre eux ne sont pas intégrés dans les législations nationales, lesquelles sont alignées sur les traités internationaux. Dans ses relations internationales, le Mercosur a une longue histoire de négociations avec l’Union Européenne et une histoire plus modeste avec le Canada, dans lesquelles l’attention portée aux droits de propriété intellectuelle n’est pas uniforme. De plus, sa participation dans les organismes internationaux responsables de ces droits est faible. Dans ce contexte, même avec un futur incertain le Mercosur présente de grandes expectatives. Toutefois, la préoccupation à protéger les droits de propriété intellectuelle est présente et réelle et commence à prendre de l’ampleur dans ses relations internes et externes.