821 resultados para Value-based leadership


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BACKGROUND: International organisations, e.g. WHO, stress the importance of competent registered nurses (RN) for the safety and quality of healthcare systems. Low competence among RNs has been shown to increase the morbidity and mortality of inpatients. OBJECTIVES: To investigate self-reported competence among nursing students on the point of graduation (NSPGs), using the Nurse Professional Competence (NPC) Scale, and to relate the findings to background factors. METHODS AND PARTICIPANTS: The NPC Scale consists of 88 items within eight competence areas (CAs) and two overarching themes. Questions about socio-economic background and perceived overall quality of the degree programme were added. In total, 1086 NSPGs (mean age, 28.1 [20-56]years, 87.3% women) from 11 universities/university colleges participated. RESULTS: NSPGs reported significantly higher scores for Theme I "Patient-Related Nursing" than for Theme II "Organisation and Development of Nursing Care". Younger NSPGs (20-27years) reported significantly higher scores for the CAs "Medical and Technical Care" and "Documentation and Information Technology". Female NSPGs scored significantly higher for "Value-Based Nursing". Those who had taken the nursing care programme at upper secondary school before the Bachelor of Science in Nursing (BSN) programme scored significantly higher on "Nursing Care", "Medical and Technical Care", "Teaching/Learning and Support", "Legislation in Nursing and Safety Planning" and on Theme I. Working extra paid hours in healthcare alongside the BSN programme contributed to significantly higher self-reported scores for four CAs and both themes. Clinical courses within the BSN programme contributed to perceived competence to a significantly higher degree than theoretical courses (93.2% vs 87.5% of NSPGs). SUMMARY AND CONCLUSION: Mean scores reported by NSPGs were highest for the four CAs connected with patient-related nursing and lowest for CAs relating to organisation and development of nursing care. We conclude that the NPC Scale can be used to identify and measure aspects of self-reported competence among NSPGs.

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O presente trabalho trata da Administração Baseada em Valor (VBM do inglês Value Based Management), que é uma ferramenta de auxílio à administração de empresas, que busca a identificação de value drivers, que são controles internos a serem monitorados, que devem abranger os principais pontos vistos pelo mercado como criadores de valor, pois o objetivo central da VBM é a majoração de valor para o acionista. A VBM também se utiliza do fluxo de caixa descontado (DCF do inglês Discounted Cash Flow). O objetivo central desta dissertação é fazer uma análise comparativa da estrutura interna de funcionamento e acompanhamento e dos controles de uma organização do segmento de telecomunicações com a filosofia da VBM, identificando o distanciamento de uma para com a outra. A empresa pesquisada é a Dígitro Tecnologia Ltda., de Florianópolis, que não utiliza a VBM. É uma pesquisa quantitativa e foi desenvolvida através do método de estudo de caso. Sua investigação foi dividida em três pontos principais: (1) a identificação, na empresa, da estrutura básica necessária para a implantação da Administração Baseada em Valor, (2) os itens necessários para se montar um DCF e (3) os controles internos possuídos pela organização, que possam servir como value drivers ou suas intenções de implantar controles. O estudo de caso foi único e exploratório, contando com a aplicação de entrevistas semi-estruturadas, observação direta e coleta de documentos. Conclui-se que a organização pesquisada está distante da filosofia da VBM, porém, com intenção de utilizar-se de inúmeros conceitos da Administração Baseada em Valor para auxiliar sua gestão.

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O presente estudo de caso investiga a possibilidade de utilização de métricas de gestão de valor na análise econômica de projetos de investimento e, por consequência, objetiva auxiliar no processo de tomada de decisões acerca de investimentos. Para tal, o arcabouço teórico fundamenta-se na teoria de gestão baseada em valor e análises tradicionais de avaliação de projetos de investimentos. O objetivo é verificar a aderência entre as ferramentas tradicionais (VPL – valor presente líquido) e as novas, baseadas em valor (EVA - valor econômico agregado, CVA - valor adicionado base caixa), amplamente utilizadas para medir o desempenho empresarial.

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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The objectives of this study were to evaluate land use and occupation of Permanent Preservation Areas (PPA) as well as its use conflicts by TM (Thematic Mapper) image of the 2010 Landsat-5 satellite, according to the Forest Code. For that purpose, Geographic Information Systems in the Ribeirão Paraíso watershed, São Manuel, SP were used. The combination of Remote Sensing and Geographic Information System technologies allowed representation of spatial distribution of the landscape and data integration in the diagnosis of geographic interest. The 2010 mapping showed 12 use categories, and the sugar cane crop had the largest land occupation, 48.25% of the area. The areas of permanent preservation amounted to 925.74 ha, which is an ideal value based on the Brazilian legislation. Mapping of land use conflicts showed intensive anthropic actions going 80.13% forward on PPAs, with only 19.87% remaining forests, which highlights their negative impact and illegal situations in these areas.

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The aim of this work is to derive precise reddenings for 31 Cepheids using multiphase high-resolution spectroscopic observations and literature-derived colors. Each individual reddening value was determined as a difference between the observed (B - V) value and a calculated (B - V) value based on Castelli stellar model atmospheres and atmosphere parameters (effective temperature and gravity) previously determined through high-resolution spectroscopic analysis. This procedure was repeated for all pulsational phases at which spectra were obtained (typically 11 spectra for each star). After that, the mean reddening value for a given Cepheid was obtained. The reddening values derived were compared to values based on the use of distances and multiband photometry, reaching the general conclusion that reddening derived in this manner agrees with those from other methods.

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There are no studies investigating the effect of the contrast infusion on the sensitivity and specificity of the main Doppler criteria of renal artery stenosis (RAS). Our aim was to evaluate the accuracy of these Doppler criteria prior to and following the intravenous administration of perfluorocarbon exposed sonicated albumin (PESDA) in patients suspected of having RAS. Thirty consecutive hypertensive patients (13 males, mean age of 57 ± 10 years) suspected of having RAS by clinical clues, were submitted to ultrasonography (US) of renal arteries before and after enhancement using continuous infusion of PESDA. All patients underwent angiography, and haemodynamically significant RAS was considered when ≥50%. At angiography, it was detected RAS ≥50% in 18 patients, 5 with bilateral stenosis. After contrast, the examination time was slightly reduced by approximately 20%. In non-enhanced US the sensitivity was better when based on resistance index (82.9%) while the specificity was better when based on renal aortic ratio (89.2%). The predictive positive value was stable for all indexes (74.0%–88.0%) while negative predictive value was low (44%–51%). The specificity and positive predictive value based on renal aortic ratio increased after PESDA injection respectively, from 89 to 97.3% and from 88 to 95%. In hypertensives suspected to have RAS the sensitivity and specificity of Duplex US is dependent of the criterion evaluated. Enhancement with continuous infusion of PESDA improves only the specificity based on renal aortic ratio but do not modify the sensitivity of any index.

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The aSPECT spectrometer has been constructed to measure, with high precision, the integral proton spectrum of the free neutron decay. From this spectrum the neutrino electron angular correlation coefficient a can be inferred. The coefficient a is involved in several Standard Model tests, like the unitarity test of the Cabibbo-Kobayashi-Maskawa quark mixing matrix. aSPECT has been designed to determine the coefficient a with an accuracy better than 3×10−4, that is, one order of magnitude better than the best current accuracy. First measurements with neutron beam with the aSPECT spectrometer were performed in the Forschungsneutronenquelle Heinz Maier-Leibnitz, in Munich. A study of the data taken in this period is presented in this thesis, demonstrating the proof of principle of the spectrometer. However, the observation of situation and time-dependent background instabilities impedes the report of a new value of the coefficient a. A thorough data analysis is carried out to identify sources of these background instabilities in order to improve the aSPECT experiment for future beam times. The investigation indicates that trapped particles are most likely the reason for the background problems. Furthermore, it has been observed that measurements containing less trapped particles provide a-values closer to the currently Particle Data Group value. Based on this findings, different measures are proposed to eliminate potential traps in the spectrometer. Indeed, with the proposed modifications realized for the following beam-times, the observed background instabilities were greatly reduced.

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Dimensional modeling, GT-Power in particular, has been used for two related purposes-to quantify and understand the inaccuracies of transient engine flow estimates that cause transient smoke spikes and to improve empirical models of opacity or particulate matter used for engine calibration. It has been proposed by dimensional modeling that exhaust gas recirculation flow rate was significantly underestimated and volumetric efficiency was overestimated by the electronic control module during the turbocharger lag period of an electronically controlled heavy duty diesel engine. Factoring in cylinder-to-cylinder variation, it has been shown that the electronic control module estimated fuel-Oxygen ratio was lower than actual by up to 35% during the turbocharger lag period but within 2% of actual elsewhere, thus hindering fuel-Oxygen ratio limit-based smoke control. The dimensional modeling of transient flow was enabled with a new method of simulating transient data in which the manifold pressures and exhaust gas recirculation system flow resistance, characterized as a function of exhaust gas recirculation valve position at each measured transient data point, were replicated by quasi-static or transient simulation to predict engine flows. Dimensional modeling was also used to transform the engine operating parameter model input space to a more fundamental lower dimensional space so that a nearest neighbor approach could be used to predict smoke emissions. This new approach, intended for engine calibration and control modeling, was termed the "nonparametric reduced dimensionality" approach. It was used to predict federal test procedure cumulative particulate matter within 7% of measured value, based solely on steady-state training data. Very little correlation between the model inputs in the transformed space was observed as compared to the engine operating parameter space. This more uniform, smaller, shrunken model input space might explain how the nonparametric reduced dimensionality approach model could successfully predict federal test procedure emissions when roughly 40% of all transient points were classified as outliers as per the steady-state training data.

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Identifying and comparing different steady states is an important task for clinical decision making. Data from unequal sources, comprising diverse patient status information, have to be interpreted. In order to compare results an expressive representation is the key. In this contribution we suggest a criterion to calculate a context-sensitive value based on variance analysis and discuss its advantages and limitations referring to a clinical data example obtained during anesthesia. Different drug plasma target levels of the anesthetic propofol were preset to reach and maintain clinically desirable steady state conditions with target controlled infusion (TCI). At the same time systolic blood pressure was monitored, depth of anesthesia was recorded using the bispectral index (BIS) and propofol plasma concentrations were determined in venous blood samples. The presented analysis of variance (ANOVA) is used to quantify how accurately steady states can be monitored and compared using the three methods of measurement.

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This exploratory, qualitative study examined practitioners' perceptions about family preservation practice. Findings reveal a wide range of identified strengths as well as the limitations of such a model. Interestingly, the most frequently identified strengths were value based rather than practice based in perspective whereas limitations were practice based. Keeping families together was the most common perceived strength but concern about children's safety by keeping the family intact was a frequently reported limitation. Further, lack of support and a lack of theoretical clarity were identified as considerable limitations. Implications suggest these practitioners (mostly child welfare/mental health workers) believe in the approach for the sake of keeping families together but are concerned with endangering the child in the process and recognize the need for theoretical guidance.

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Malbec es la variedad de uva tinta más importante en la vitivinicultura argentina, especialmente en Mendoza, donde se produce más del 80% del total nacional. Las zonas ubicadas a mayor altitud están experimentando un aumento en la superficie cultivada, ya que en ellas se producen uvas con altos contenidos de compuestos fenólicos, responsables de muchas de las características deseadas en los vinos tintos, por su valor organoléptico y capacidad antioxidante. A partir de estos antecedentes, se plantea como objetivo caracterizar la radiación UV-B que reciben los viñedos ubicados a mayor altitud en Mendoza, estudiando los efectos de UV-B, las aplicaciones de ABA y de su interacción, sobre aspectos fisiológicos y bioquímicos que afectan el crecimiento de las bayas (rendimiento cuantitativo) y la calidad enológica de Vitis vinifera L. cv. Malbec.

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C2-C8 hydrocarbon concentrations (about 35 compounds identified, including saturated, aromatic, and olefinic compounds) from 38 shipboard sealed, deep-frozen core samples of Deep Sea Drilling Project Sites 585 (East Mariana Basin) and 586 (Ontong-Java Plateau) were determined by a gas stripping-thermovaporization method. Total concentrations, which represent the hydrocarbons dissolved in the pore water and adsorbed on the mineral surfaces of the sediment, vary from 20 to 630 ng/g of rock at Site 585 (sub-bottom depth range 332-868 m). Likewise, organic-carbon normalized yields range from 3*10**4 to 9*10**5 ng/g Corg, indicating that the organic matter is still in the initial, diagenetic evolutionary stage. The highest value (based on both rock weight and organic carbon) is measured in an extremely organic-carbon-poor sample of Lithologic Subunit VB (Core 585-30). In this unit (504-550 m) several samples with elevated organic-carbon contents and favorable kerogen quality including two thin "black-shale" layers deposited at the Cenomanian/Turonian boundary (not sampled for this study) were encountered. We conclude from a detailed comparison of light hydrocarbon compositions that the Core 585-30 sample is enriched in hydrocarbons of the C2-C8 molecular range, particularly in gas compounds, which probably migrated from nearby black-shale source layers. C2-C8 hydrocarbon yields in Site 586 samples (sub-bottom depth range 27-298 m) did not exceed 118 ng/g of dry sediment weight (average 56 ng/g), indicating the immaturity of these samples.

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A major challenge in the engineering of complex and critical systems is the management of change, both in the system and in its operational environment. Due to the growing of complexity in systems, new approaches on autonomy must be able to detect critical changes and avoid their progress towards undesirable states. We are searching for methods to build systems that can tune the adaptability protocols. New mechanisms that use system-wellness requirements to reduce the influence of the outer domain and transfer the control of uncertainly to the inner one. Under the view of cognitive systems, biological emotions suggests a strategy to configure value-based systems to use semantic self-representations of the state. A method inspired by emotion theories to causally connect to the inner domain of the system and its objectives of wellness, focusing on dynamically adapting the system to avoid the progress of critical states. This method shall endow the system with a transversal mechanism to monitor its inner processes, detecting critical states and managing its adaptivity in order to maintain the wellness goals. The paper describes the current vision produced by this work-in-progress.

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A major challenge in the engineering of complex and critical systems is the management of change, both in the system and in its operational environment. Due to the growing of complexity in systems, new approaches on autonomy must be able to detect critical changes and avoid their progress towards undesirable states. We are searching for methods to build systems that can tune the adaptability protocols. New mechanisms that use system-wellness requirements to reduce the influence of the outer domain and transfer the control of uncertainly to the inner one. Under the view of cognitive systems, biological emotions suggests a strategy to configure value-based systems to use semantic self-representations of the state. A method inspired by emotion theories to causally connect to the inner domain of the system and its objectives of wellness, focusing on dynamically adapting the system to avoid the progress of critical states. This method shall endow the system with a transversal mechanism to monitor its inner processes, detecting critical states and managing its adaptivity in order to maintain the wellness goals. The paper describes the current vision produced by this work-in-progress.