996 resultados para process description
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Background: increasing numbers of patients are surviving critical illness, but survival may be associated with a constellation of physical and psychological sequelae that can cause on going disability and reduced health-related quality of life. Limited evidence currently exists to guide the optimum structure, timing, and content of rehabilitation programmes. There is a need to both develop and evaluate interventions to support and expedite recovery during the post-ICU discharge period. This paper describes the construct development for a complex rehabilitation intervention intended to promote physical recovery following critical illness. The intervention is currently being evaluated in a randomised trial (ISRCTN09412438; funder Chief Scientists Office, Scotland). Methods: the intervention was developed using the Medical Research Council (MRC) framework for developing complex healthcare interventions. We ensured representation from a wide variety of stakeholders including content experts from multiple specialties, methodologists, and patient representation. The intervention construct was initially based on literature review, local observational and audit work, qualitative studies with ICU survivors, and brainstorming activities. Iterative refinement was aided by the publication of a National Institute for Health and Care Excellence guideline (No. 83), publicly available patient stories (Healthtalkonline), a stakeholder event in collaboration with the James Lind Alliance, and local piloting. Modelling and further work involved a feasibility trial and development of a novel generic rehabilitation assistant (GRA) role. Several rounds of external peer review during successive funding applications also contributed to development. Results: the final construct for the complex intervention involved a dedicated GRA trained to pre-defined competencies across multiple rehabilitation domains (physiotherapy, dietetics, occupational therapy, and speech/language therapy), with specific training in post-critical illness issues. The intervention was from ICU discharge to 3 months post-discharge, including inpatient and post-hospital discharge elements. Clear strategies to provide information to patients/families were included. A detailed taxonomy was developed to define and describe the processes undertaken, and capture them during the trial. The detailed process measure description, together with a range of patient, health service, and economic outcomes were successfully mapped on to the modified CONSORT recommendations for reporting non-pharmacologic trial interventions. Conclusions: the MRC complex intervention framework was an effective guide to developing a novel post-ICU rehabilitation intervention. Combining a clearly defined new healthcare role with a detailed taxonomy of process and activity enabled the intervention to be clearly described for the purpose of trial delivery and reporting. These data will be useful when interpreting the results of the randomised trial, will increase internal and external trial validity, and help others implement the intervention if the intervention proves clinically and cost effective.
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Humans have a high ability to extract visual data information acquired by sight. Trought a learning process, which starts at birth and continues throughout life, image interpretation becomes almost instinctively. At a glance, one can easily describe a scene with reasonable precision, naming its main components. Usually, this is done by extracting low-level features such as edges, shapes and textures, and associanting them to high level meanings. In this way, a semantic description of the scene is done. An example of this, is the human capacity to recognize and describe other people physical and behavioral characteristics, or biometrics. Soft-biometrics also represents inherent characteristics of human body and behaviour, but do not allow unique person identification. Computer vision area aims to develop methods capable of performing visual interpretation with performance similar to humans. This thesis aims to propose computer vison methods which allows high level information extraction from images in the form of soft biometrics. This problem is approached in two ways, unsupervised and supervised learning methods. The first seeks to group images via an automatic feature extraction learning , using both convolution techniques, evolutionary computing and clustering. In this approach employed images contains faces and people. Second approach employs convolutional neural networks, which have the ability to operate on raw images, learning both feature extraction and classification processes. Here, images are classified according to gender and clothes, divided into upper and lower parts of human body. First approach, when tested with different image datasets obtained an accuracy of approximately 80% for faces and non-faces and 70% for people and non-person. The second tested using images and videos, obtained an accuracy of about 70% for gender, 80% to the upper clothes and 90% to lower clothes. The results of these case studies, show that proposed methods are promising, allowing the realization of automatic high level information image annotation. This opens possibilities for development of applications in diverse areas such as content-based image and video search and automatica video survaillance, reducing human effort in the task of manual annotation and monitoring.
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Home Automation holds the potential of realizing cost savings for end users while reducing the carbon footprint of domestic energy consumption. Yet, adoption is still very low. High cost of vendor-supplied home automation systems is a major prohibiting factor. Open source systems such as FHEM, Domoticz, OpenHAB etc. are a cheaper alternative and can drive the adoption of home automation. Moreover, they have the advantage of not being limited to a single vendor or communication technology which gives end users flexibility in the choice of devices to include in their installation. However, interaction with devices having diverse communication technologies can be inconvenient for users thus limiting the utility they derive from it. For application developers, creating applications which interact with the several technologies in the home automation systems is not a consistent process. Hence, there is the need for a common description mechanism that makes interaction smooth for end users and which enables application developers to make home automation applications in a consistent and uniform way. This thesis proposes such a description mechanism within the context of an open source home automation system – FHEM, together with a system concept for its application. A mobile application was developed as a proof of concept of the proposed description mechanism and the results of the implementation are reflected upon.
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This study aimed to build two databases, the first on the historic effort and catches of the traditional small-scale fisheries from 1999 till 2014, and the second one on the traditional management of fishing licenses. The first database allows for a synthetic analysis of the results obtained on the fishing activities of beach-seine, fishing rod and on octopuses, in terms of effort and catch per area and year. Technical and scientific supports were supplied implementing survey protocols and supervision of a student, both within the framework of the small-scale traditional fisheries. The study supported traditional fishermen with the mediation process for regulation revisions for the fishing activities in the MPA areas.
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INTRODUCTION: The orthotopic left lung transplantation model in rats has been developed to answer a variety of scientific questions in transplant immunology and in the related fields of respiratory diseases. However, its widespread use has been hampered by the complexity of the procedure. AIM OF THE RESEARCH: Our purpose is to provide a detailed description of the procedure of this technique, including the complications and difficulties from the very first microsurgical step until the ultimate successful completion of the transplant procedure. MATERIALS AND METHODS: The transplant procedures were performed by two collaborating transplant surgeons with microsurgical and thoracic surgery skills. A total of 150 left lung transplants in rats were performed. Twenty-seven syngeneic (Lewis to Lewis) and 123 allogeneic (Brown-Norway to Lewis) lung transplants were performed using the cuff technique. RESULTS: In first 50 transplant procedures, post-transplant survival rate was 74% of which 54% reached the end-point of 3 or 7 days post-transplant; whole complication rate was 66%. In the subsequent 50 transplant surgeries (from 51 to 100) post-transplant survival rate increased to 88% of which 56% reached the end-point; whole complication rate was 32 %. In the final 50 transplants (from 101 to 150) post-transplant survival rate was confirmed to be 88% of which 74% reached the end-point; whole complication rate was again 32 %. CONCLUSIONS: One hundred-fifty transplants can represent a reasonable number of procedures to obtain a satisfactory surgical outcome. Training period with simpler animal models is mandatory to develop anesthesiological and microsurgical skills required for successfully develop this model. The collaboration between at least two microsurgeons is mandatory to perform all the simultaneous procedures required for completing the transplant surgery.
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The Subaxial Injury Classification (SLIC) system and severity score has been developed to help surgeons in the decision-making process of treatment of subaxial cervical spine injuries. A detailed description of all potential scored injures of the SLIC is lacking. We performed a systematic review in the PubMed database from 2007 to 2014 to describe the relationship between the scored injuries in the SLIC and their eventual treatment according to the system score. Patients with an SLIC of 1-3 points (conservative treatment) are neurologically intact with the spinous process, laminar or small facet fractures. Patients with compression and burst fractures who are neurologically intact are also treated nonsurgically. Patients with an SLIC of 4 points may have an incomplete spinal cord injury such as a central cord syndrome, compression injuries with incomplete neurologic deficits and burst fractures with complete neurologic deficits. SLIC of 5-10 points includes distraction and rotational injuries, traumatic disc herniation in the setting of a neurological deficit and burst fractures with an incomplete neurologic deficit. The SLIC injury severity score can help surgeons guide fracture treatment. Knowledge of the potential scored injures and their relationships with the SLIC are of paramount importance for spine surgeons who treated subaxial cervical spine injuries.
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Systemic lupus erythematosus is an autoimmune disease that causes many psychological repercussions that have been studied through qualitative research. These are considered relevant, since they reveal the amplitude experienced by patients. Given this importance, this study aims to map the qualitative production in this theme, derived from studies of experiences of adult patients of both genders and that had used as a tool a semi-structured interview and/or field observations, and had made use of a sampling by a saturation criterion to determine the number of participants in each study. The survey was conducted in Pubmed, Lilacs, Psycinfo e Cochrane databases, searching productions in English and Portuguese idioms published between January 2005 and June 2012. The 19 revised papers that have dealt with patients in the acute phase of the disease showed themes that were categorized into eight topics that contemplated the experienced process at various stages, from the onset of the disease, extending through the knowledge of the diagnosis and the understanding of the manifestations of the disease, drug treatment and general care, evolution and prognosis. The collected papers also point to the difficulty of understanding, of the patients, on what consists the remission phase, revealing also that this is a clinical stage underexplored by psychological studies.
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This paper describes a method for leaf vein shape characterization using Hermite polynomial cubic representation. The elements associated with this representation are used as secondary vein descriptors and their discriminatory potential are analyzed based on the identification of two legume species (Lonchocarpus muehlbergianus Hassl. and L. subglaucescens Mart, ex Benth.). The elements of Hermite geometry influence a curve along all its extension allowing a global description of the secondary vein course by a descriptor of low dimensionality. The obtained results shown the analyzed species can be discriminated by this method and it can be used in addition to commonly considered elements in the taxonomic process.
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Universidade Estadual de Campinas . Faculdade de Educação Física
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Universidade Estadual de Campinas . Faculdade de Educação Física
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Universidade Estadual de Campinas. Faculdade de Educação Física
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Universidade Estadual de Campinas. Faculdade de Educação Física
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Universidade Estadual de Campinas. Faculdade de Educação Física
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Universidade Estadual de Campinas. Faculdade de Educação Física