904 resultados para Policy Design, Analysis, and Evaluation


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The inherent analogue nature of medical ultrasound signals in conjunction with the abundant merits provided by digital image acquisition, together with the increasing use of relatively simple front-end circuitries, have created considerable demand for single-bit  beamformers in digital ultrasound imaging systems. Furthermore, the increasing need to design lightweight ultrasound systems with low power consumption and low noise, provide ample justification for development and innovation in the use of single-bit  beamformers in ultrasound imaging systems. The overall aim of this research program is to investigate, establish, develop and confirm through a combination of theoretical analysis and detailed simulations, that utilize raw phantom data sets, suitable techniques for the design of simple-to-implement hardware efficient  digital ultrasound beamformers to address the requirements for 3D scanners with large channel counts, as well as portable and lightweight ultrasound scanners for point-of-care applications and intravascular imaging systems. In addition, the stability boundaries of higher-order High-Pass (HP) and Band-Pass (BP) Σ−Δ modulators for single- and dual- sinusoidal inputs are determined using quasi-linear modeling together with the describing-function method, to more accurately model the  modulator quantizer. The theoretical results are shown to be in good agreement with the simulation results for a variety of input amplitudes, bandwidths, and modulator orders. The proposed mathematical models of the quantizer will immensely help speed up the design of higher order HP and BP Σ−Δ modulators to be applicable for digital ultrasound beamformers. Finally, a user friendly design and performance evaluation tool for LP, BP and HP  modulators is developed. This toolbox, which uses various design methodologies and covers an assortment of  modulators topologies, is intended to accelerate the design process and evaluation of  modulators. This design tool is further developed to enable the design, analysis and evaluation of  beamformer structures including the noise analyses of the final B-scan images. Thus, this tool will allow researchers and practitioners to design and verify different reconstruction filters and analyze the results directly on the B-scan ultrasound images thereby saving considerable time and effort.

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[EN] The main objective of this project is to analyze Cuban public health policy and the Millennium Development Goals, especially those linked to the issue of health, presenting their potential and strengths with a well-defined time horizon (2000-2015). The Millennium Development Goals are the international consensus on development and was signed as an international minimum agreement, with which began the century. The MDGs promote various goals and targets, with the corresponding monitoring indicators, which should be achieved by all countries for the present year. Health is an area that is at the center of the Millennium Development Goals, which reinforce each other to get a true human development itself. The research was done through theoretical frameworks of social production of health and disease, social justice and the power structure. A retrospective analysis of Cuban economic and social context is performed in order to study whether health-related MDGs are likely to be completed by the deadline on the island and likewise, the main parameters related to health compared with those of the neighboring countries in the Americas.

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We present a systematic, practical approach to developing risk prediction systems, suitable for use with large databases of medical information. An important part of this approach is a novel feature selection algorithm which uses the area under the receiver operating characteristic (ROC) curve to measure the expected discriminative power of different sets of predictor variables. We describe this algorithm and use it to select variables to predict risk of a specific adverse pregnancy outcome: failure to progress in labour. Neural network, logistic regression and hierarchical Bayesian risk prediction models are constructed, all of which achieve close to the limit of performance attainable on this prediction task. We show that better prediction performance requires more discriminative clinical information rather than improved modelling techniques. It is also shown that better diagnostic criteria in clinical records would greatly assist the development of systems to predict risk in pregnancy. We present a systematic, practical approach to developing risk prediction systems, suitable for use with large databases of medical information. An important part of this approach is a novel feature selection algorithm which uses the area under the receiver operating characteristic (ROC) curve to measure the expected discriminative power of different sets of predictor variables. We describe this algorithm and use it to select variables to predict risk of a specific adverse pregnancy outcome: failure to progress in labour. Neural network, logistic regression and hierarchical Bayesian risk prediction models are constructed, all of which achieve close to the limit of performance attainable on this prediction task. We show that better prediction performance requires more discriminative clinical information rather than improved modelling techniques. It is also shown that better diagnostic criteria in clinical records would greatly assist the development of systems to predict risk in pregnancy.

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XVIII IUFRO World Congress, Ljubljana 1986.

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A family of bile acid-based molecular tweezers (7-9) has been constructed readily from simple precursors. Binding experiments with various electron deficient aromatic compounds showed that tweezer 8 binds trinitrofluorenone 10e with an association constant of 220 M(-1) in CDCl3. Single-crystal X-ray analysis of compound 8 shows aromatic-aromatic interactions producing a two-dimensional lattice of pyrene units. Tweezer 8 was immobilized on Merrifield resin, and binding studies have shown that these data compare well with those of the solution state studies.

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Objective
The Australian lifestyle intervention program Life! is only the second reported, large-scale diabetes prevention program. This paper describes the genesis and the successful establishment of Life! and its key outcomes for participants and implementation.

Research
Design and Methods Life!, a behavior change intervention, comprises six group sessions over eight months. The Victorian Department of Health funded Diabetes Australia-Victoria to implement the program. Experience of the Greater Green Triangle diabetes prevention implementation trial was used for intervention design, workforce development, training and infrastructure. Clinical and anthropometric data from participants, used for program evaluation, was recorded on a central database.

Results
Life! has a state-wide workforce of 302 trained facilitators within 137 organizations. 29,000 Victorians showed interest in Life! and 15,000 individuals have been referred to the program. In total, 8,412 participants commenced a Life! program between October 2007 and June 2011. 37% of the original participants completed the eight month program. Participants completing sessions one to five lost an average of 1·4 kg weight (p<0·001) and waist circumference of 2·5cm (p<0.001). Those completing six sessions lost an average of 2·4 kg weight (p<0·001) and waist circumference of 3·8 cm (p<0·001). The weight loss of 2.4 kg represents 2.7% of participants’ starting body weight.

Conclusion
The impact of Life! is attributable to applying available evidence for the systems design of the intervention, and collaboration between policy makers, implementers and evaluators using the principles of continuous quality improvement to support successful, large scale recruitment and implementation.

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Fibre-Reinforced-Plastics are composite materials composed by thin fibres with high mechanical properties, made to work together with a cohesive plastic matrix. The huge advantages of fibre reinforced plastics over traditional materials are their high specific mechanical properties i.e. high stiffness and strength to weight ratios. This kind of composite materials is the most disruptive innovation in the structural materials field seen in recent years and the areas of potential application are still many. However, there are few aspects which limit their growth: on the one hand the information available about their properties and long term behaviour is still scarce, especially if compared with traditional materials for which there has been developed an extended database through years of use and research. On the other hand, the technologies of production are still not as developed as the ones available to form plastics, metals and other traditional materials. A third aspect is that the new properties presented by these materials e.g. their anisotropy, difficult the design of components. This thesis will provide several case-studies with advancements regarding the three limitations mentioned. In particular, the long term mechanical properties have been studied through an experimental analysis of the impact of seawater on GFRP. Regarding production methods, the pre-impregnated cured in autoclave process was considered: a rapid tooling method to produce moulds will be presented, and a study about the production of thick components. Also, two liquid composite moulding methods will be presented, with a case-study regarding a large component with sandwich structure that was produced with the Vacuum-Assisted-Resin-Infusion method, and a case-study regarding a thick con-rod beam that was produced with the Resin-Transfer-Moulding process. The final case-study will analyse the loads acting during the use of a particular sportive component, made with FRP layers and a sandwich structure, practical design rules will be provided.

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Certain proteins contain subunits that enable their active translocation across the plasma membrane into cells. In the specific case of HIV-1, this subunit is the basic domain Tat49–57 (RKKRRQRRR). To establish the optimal structural requirements for this translocation process, and thereby to develop improved molecular transporters that could deliver agents into cells, a series of analogues of Tat49–57 were prepared and their cellular uptake into Jurkat cells was determined by flow cytometry. All truncated and alanine-substituted analogues exhibited diminished cellular uptake, suggesting that the cationic residues of Tat49–57 play a principal role in its uptake. Charge alone, however, is insufficient for transport as oligomers of several cationic amino acids (histidine, lysine, and ornithine) are less effective than Tat49–57 in cellular uptake. In contrast, a 9-mer of l-arginine (R9) was 20-fold more efficient than Tat49–57 at cellular uptake as determined by Michaelis–Menton kinetic analysis. The d-arginine oligomer (r9) exhibited an even greater uptake rate enhancement (>100-fold). Collectively, these studies suggest that the guanidinium groups of Tat49–57 play a greater role in facilitating cellular uptake than either charge or backbone structure. Based on this analysis, we designed and synthesized a class of polyguanidine peptoid derivatives. Remarkably, the subset of peptoid analogues containing a six-methylene spacer between the guanidine head group and backbone (N-hxg), exhibited significantly enhanced cellular uptake compared to Tat49–57 and even to r9. Overall, a transporter has been developed that is superior to Tat49–57, protease resistent, and more readily and economically prepared.

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Background: Improving the transparency of information about the quality of health care providers is one way to improve health care quality. It is assumed that Internet information steers patients toward better-performing health care providers and will motivate providers to improve quality. However, the effect of public reporting on hospital quality is still small. One of the reasons is that users find it difficult to understand the formats in which information is presented. Objective: We analyzed the presentation of risk-adjusted mortality rate (RAMR) for coronary angiography in the 10 most commonly used German public report cards to analyze the impact of information presentation features on their comprehensibility. We wanted to determine which information presentation features were utilized, were preferred by users, led to better comprehension, and had similar effects to those reported in evidence-based recommendations described in the literature. Methods: The study consisted of 5 steps: (1) identification of best-practice evidence about the presentation of information on hospital report cards; (2) selection of a single risk-adjusted quality indicator; (3) selection of a sample of designs adopted by German public report cards; (4) identification of the information presentation elements used in public reporting initiatives in Germany; and (5) an online panel completed an online questionnaire that was conducted to determine if respondents were able to identify the hospital with the lowest RAMR and if respondents’ hospital choices were associated with particular information design elements. Results: Evidence-based recommendations were made relating to the following information presentation features relevant to report cards: evaluative table with symbols, tables without symbols, bar charts, bar charts without symbols, bar charts with symbols, symbols, evaluative word labels, highlighting, order of providers, high values to indicate good performance, explicit statements of whether high or low values indicate good performance, and incomplete data (“N/A” as a value). When investigating the RAMR in a sample of 10 hospitals’ report cards, 7 of these information presentation features were identified. Of these, 5 information presentation features improved comprehensibility in a manner reported previously in literature. Conclusions: To our knowledge, this is the first study to systematically analyze the most commonly used public reporting card designs used in Germany. Best-practice evidence identified in international literature was in agreement with 5 findings about German report card designs: (1) avoid tables without symbols, (2) include bar charts with symbols, (3) state explicitly whether high or low values indicate good performance or provide a “good quality” range, (4) avoid incomplete data (N/A given as a value), and (5) rank hospitals by performance. However, these findings are preliminary and should be subject of further evaluation. The implementation of 4 of these recommendations should not present insurmountable obstacles. However, ranking hospitals by performance may present substantial difficulties.

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This paper describes a methodological proposal for the design, creation and evaluation of Learning Objects (LOs). This study arises from the compilation and analysis of several LO design methodologies currently used in Ibero-America. This proposal, which has been named DICREVOA, defines five different phases: analysis, design (instructional and multimedia), implementation (LO and metadata), evaluation (from the perspective of both the producer and the consumer of the LO), and publishing. The methodology focuses not only on the teaching inexperienced, but also on those having a basic understanding of the technological and educational aspects related to LO design; therefore, the study emphasizes LO design activities centered around the Kolb cycle and the use of the ExeLearning tool in order to implement the LO core. Additionally, DICREVOA was used in a case study, which demonstrates how it provides a feasible mechanism for LO design and implementation within different contexts. Finally, DICREVOA, the case study to which it was applied, and the results obtained are presented

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Sea level rise and other effects of climate change on oceans and coasts around the world are major reasons to halt the emissions of greenhouse gases to the maximum extent. But historical emissions and sea level rise have already begun so steps to adapt to a world where shorelines, coastal populations, and economies could be dramatically altered are now essential. This presents significant economic challenges in four areas. (1) Large expenditures for adaptation steps may be required but the extent of sea level rise and thus the expenditures are unknowable at this point. Traditional methods for comparing benefits and costs are severely limited, but decisions must still be made. (2) It is not clear where the funding for adaptation will come from, which is a barrier to even starting planning. (3) The extent of economic vulnerability has been illustrated with assessments of risks to current properties, but these likely significantly understate the risks that lie in the future. (4) Market-based solutions to reducing climate change are now generally accepted, but their role in adaptation is less clear. Reviewing the literature addressing each of these points, this paper suggests specific strategies for dealing with uncertainty in assessing the economics of adaptation options, reviews the wide range of options for funding coastal adaption, identifies a number of serious deficiencies in current economic vulnerability studies, and suggests how market based approaches might be used in shaping adaptation strategies. The paper concludes by identifying a research agenda for the economics of coastal adaptation that, if completed, could significantly increase the likelihood of economically efficient coastal adaptation.

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Dragon is a word-based stream cipher. It was submitted to the eSTREAM project in 2005 and has advanced to Phase 3 of the software profile. This paper discusses the Dragon cipher from three perspectives: design, security analysis and implementation. The design of the cipher incorporates a single word-based non-linear feedback shift register and a non-linear filter function with memory. This state is initialized with 128- or 256-bit key-IV pairs. Each clock of the stream cipher produces 64 bits of keystream, using simple operations on 32-bit words. This provides the cipher with a high degree of efficiency in a wide variety of environments, making it highly competitive relative to other symmetric ciphers. The components of Dragon were designed to resist all known attacks. Although the design has been open to public scrutiny for several years, the only published attacks to date are distinguishing attacks which require keystream lengths greatly exceeding the stated 264 bit maximum permitted keystream length for a single key-IV pair.