992 resultados para soft intervention
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Esta investigación describe la manera cómo interviene el Estado Colombiano en la promoción, protección y fortalecimiento de las formas solidarias, partiendo del respeto a los principios de autonomía, autodeterminación y autogobierno en que éstas se fundan.
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Incluye Bibliografía
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In the aftermath of the 2003 U.S.-led invasion of Iraq, scholars of international relations debated how to best characterize the rising tide of global opposition. The concept of “soft balancing” emerged as an influential, though contested, explanation of a new phenomenon in a unipolar world: states seeking to constrain the ability of the United States to deploy military force by using multinational organizations, international law, and coalition building. Soft balancing can also be observed in regional unipolar systems. Multinational archival research reveals how Argentina, Mexico, and other Latin American countries responded to expanding U.S. power and military assertiveness in the early twentieth century through coordinated diplomatic maneuvering that provides a strong example of soft balancing. Examination of this earlier case makes an empirical contribution to the emerging soft-balancing literature and suggests that soft balancing need not lead to hard balancing or open conflict.
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"July 1996."
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There is a growing literature examining the impact of research on informing policy, and of research and policy on practice. Research and policy do not have the same types of impact on practice but can be evaluated using similar approaches. Sometimes the literature provides a platform for methodological debate but mostly it is concerned with how research can link to improvements in the process and outcomes of education, how it can promote innovative policies and practice, and how it may be successfully disseminated. Whether research-informed or research-based, policy and its implementation is often assessed on such 'hard' indicators of impact as changes in the number of students gaining five or more A to C grades in national examinations or a percentage fall in the number of exclusions in inner city schools. Such measures are necessarily crude, with large samples smoothing out errors and disguising instances of significant success or failure. Even when 'measurable' in such a fashion, however, the impact of any educational change or intervention may require a period of years to become observable. This paper considers circumstances in which short-term change may be implausible or difficult to observe. It explores how impact is currently theorized and researched and promotes the concept of 'soft' indicators of impact in circumstances in which the pursuit of conventional quantitative and qualitative evidence is rendered impractical within a reasonable cost and timeframe. Such indicators are characterized by their avowedly subjective, anecdotal and impressionistic provenance and have particular importance in the context of complex community education issues where the assessment of any impact often faces considerable problems of access. These indicators include the testimonies of those on whom the research intervention or policy focuses (for example, students, adult learners), the formative effects that are often reported (for example, by head teachers, community leaders) and media coverage. The collation and convergence of a wide variety of soft indicators (Where there is smoke …) is argued to offer a credible means of identifying subtle processes that are often neglected as evidence of potential and actual impact (… there is fire).
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Objectives To evaluate the feasibility and acceptability of an exergame intervention as a tool to promote physical activity in outpatients with schizophrenia. Design Feasibility/Acceptability Study and Quasi-Experimental Trial. Method Sixteen outpatients with schizophrenia received treatment as usual and they all completed an 8-week exergame intervention using Microsoft Kinect® (20 min sessions, biweekly). Participants completed pre and post treatment assessments regarding functional mobility (Timed Up and Go Test), functional fitness performance (Senior Fitness Test), motor neurological soft signs (Brief Motor Scale), hand grip strength (digital dynamometer), static balance (force plate), speed of processing (Trail Making Test), schizophrenia-related symptoms (Positive and Negative Syndrome Scale) and functioning (Personal and Social Performance Scale). The EG group completed an acceptability questionnaire after the intervention. Results Attrition rate was 18.75% and 69.23% of the participants completed the intervention within the proposed schedule. Baseline clinical traits were not related to game performance indicators. Over 90% of the participants rated the intervention as satisfactory and interactive. Most participants (76.9%) agreed that this intervention promotes healthier lifestyles and is an acceptable alternative to perform physical activity. Repeated-measures MANOVA analyses found no significant multivariate effects for combined outcomes. Conclusion This study established the feasibility and acceptability of an exergame intervention for outpatients with schizophrenia. The intervention proved to be an appealing alternative to physical activity. Future trials should include larger sample sizes, explore patients' adherence to home-based exergames and consider greater intervention dosage (length, session duration, and/or frequency) in order to achieve potential effects.
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This paper proposes a political economy explanation of bailouts to declining industries. A model of probabilistic voting is developed, in which two candidates compete for the vote of two groups of the society through tactical redistribution. We allow politicians to have core support groups they understand better, this implies politicians are more or less effective to deliver favors to some groups. This setting is suited to reproduce pork barrels or machine politics and patronage. We use this model to illustrate the case of an economy with both an efficient industry and a declining one, in which workers elect their government. We present the conditions under which the political process ends up with the lagged-behind industry being allowed to survive.
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Neste percurso sinuoso de longas privações e acontecimentos, esta investigação só foi possível graças à colaboração franca e estreita de várias pessoas, algumas delas ausentes, mas que em muito contribuíram para o sucesso deste estudo, o nosso profundo reconhecimento e sincero agradecimento. Ao Professor Doutor Manuel Jacinto de Ascensão Jardim, que foi uma pessoa sempre disponível e cuja orientação suprema de conhecimento neste estudo, que por vezes se tornou penoso, mas que através da sua sabedoria e experiência, levou-nos a bom porto, por mares claros, lúcidos e objectivos, o nosso muito obrigado. Aos empresários, gestores e aos docentes convidados, que contribuíram decisivamente para a investigação, colaborando na entrevista do estudo, que foram pessoas que pelas suas vivências deram o carácter construtivo e enriquecedor, sem eles, isto não seria o mesmo, a todos eles, o nosso agradecimento muito profundo. Ao ISLA.GAIA e a todos os Docentes que de uma forma directa ou indirecta foram incansáveis na procura de opiniões, sugestões e soluções, que pudessem de alguma forma contribuir para o bom encaminhamento do nosso propósito de estudo, não esquecendo os colaboradores não docentes desta instituição que sempre tiveram uma palavra de encorajamento, o nosso muito obrigado a todos. A Todos os colegas e aos colegas que se tornaram amigos, pela empatia, comunhão, temperança se tornaram pessoas importantes, não só este ano, neste caminho solitário, mas incluindo todos aqueles que pela perseverança e sem dúvida, muita partilha, fazem parte desta meta alcançada, o nosso sincero e sentido obrigado. Aos nossos amigos que nos deram o alento e a força para que nunca perdêssemos o norte, estando sempre atentos aos nossos passos, o nosso muito obrigado a todos. Aos nossos familiares um agradecimento muito especial pelo incansável apoio, disponibilidade e compreensão quando privados da nossa presença, muito particularmente à nossa família nuclear, que sempre nos incentivou e viveu mais de perto todas as nossas dúvidas e angustias estando sempre do nosso lado, o nosso muito particular obrigado.
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This paper makes a theoretical case for using these two systems approaches together. The theoretical and methodological assumptions of system dynamics (SD) and soft system methodology (SSM) are briefly described and a partial critique is presented. SSM generates and represents diverse perspectives on a problem situation and addresses the socio-political elements of an intervention. However, it is weak in ensuring `dynamic coherence'. consistency between the intuitive behaviour resulting from proposed changes and behaviour deduced from ideas on causal structure. Conversely, SD examines causal structures and dynamic behaviours. However, whilst emphasising the need for a clear issue focus, it has little theory for generating and representing diverse issues. Also, there is no theory for facilitating sensitivity to socio-political elements. A synthesis of the two called ‘Holon Dynamics' is proposed. After an SSM intervention, a second stage continues the socio-political analysis and also operates within a new perspective which values dynamic coherence of the mental construct - the holon - which is capable of expressing the proposed changes. A model of this holon is constructed using SD and the changes are thus rendered `systemically desirable' in the additional sense that dynamic consistency has been confirmed. The paper closes with reflections on the proposal and the need for theoretical consistency when mixing tools is emphasised.
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We propose a computationally efficient and biomechanically relevant soft-tissue simulation method for cranio-maxillofacial (CMF) surgery. A template-based facial muscle reconstruction was introduced to minimize the efforts on preparing a patient-specific model. A transversely isotropic mass-tensor model (MTM) was adopted to realize the effect of directional property of facial muscles in reasonable computation time. Additionally, sliding contact around teeth and mucosa was considered for more realistic simulation. Retrospective validation study with postoperative scan of a real patient showed that there were considerable improvements in simulation accuracy by incorporating template-based facial muscle anatomy and sliding contact.
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Percutaneous needle intervention based on PET/CT images is effective, but exposes the patient to unnecessary radiation due to the increased number of CT scans required. Computer assisted intervention can reduce the number of scans, but requires handling, matching and visualization of two different datasets. While one dataset is used for target definition according to metabolism, the other is used for instrument guidance according to anatomical structures. No navigation systems capable of handling such data and performing PET/CT image-based procedures while following clinically approved protocols for oncologic percutaneous interventions are available. The need for such systems is emphasized in scenarios where the target can be located in different types of tissue such as bone and soft tissue. These two tissues require different clinical protocols for puncturing and may therefore give rise to different problems during the navigated intervention. Studies comparing the performance of navigated needle interventions targeting lesions located in these two types of tissue are not often found in the literature. Hence, this paper presents an optical navigation system for percutaneous needle interventions based on PET/CT images. The system provides viewers for guiding the physician to the target with real-time visualization of PET/CT datasets, and is able to handle targets located in both bone and soft tissue. The navigation system and the required clinical workflow were designed taking into consideration clinical protocols and requirements, and the system is thus operable by a single person, even during transition to the sterile phase. Both the system and the workflow were evaluated in an initial set of experiments simulating 41 lesions (23 located in bone tissue and 18 in soft tissue) in swine cadavers. We also measured and decomposed the overall system error into distinct error sources, which allowed for the identification of particularities involved in the process as well as highlighting the differences between bone and soft tissue punctures. An overall average error of 4.23 mm and 3.07 mm for bone and soft tissue punctures, respectively, demonstrated the feasibility of using this system for such interventions. The proposed system workflow was shown to be effective in separating the preparation from the sterile phase, as well as in keeping the system manageable by a single operator. Among the distinct sources of error, the user error based on the system accuracy (defined as the distance from the planned target to the actual needle tip) appeared to be the most significant. Bone punctures showed higher user error, whereas soft tissue punctures showed higher tissue deformation error.
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In cranio-maxillofacial surgery, the determination of a proper surgical plan is an important step to attain a desired aesthetic facial profile and a complete denture closure. In the present paper, we propose an efficient modeling approach to predict the surgical planning on the basis of the desired facial appearance and optimal occlusion. To evaluate the proposed planning approach, the predicted osteotomy plan of six clinical cases that underwent CMF surgery were compared to the real clinical plan. Thereafter, simulated soft-tissue outcomes were compared using the predicted and real clinical plan. This preliminary retrospective comparison of both osteotomy planning and facial outlook shows a good agreement and thereby demonstrates the potential application of the proposed approach in cranio-maxillofacial surgical planning prediction.
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OBJECTIVE To assess the indication and timing of soft tissue augmentation for prevention or treatment of gingival recession when a change in the inclination of the incisors is planned during orthodontic treatment. MATERIALS AND METHODS Electronic database searches of literature were performed. The following electronic databases with no restrictions were searched: MEDLINE, EMBASE, Cochrane, and CENTRAL. Two authors performed data extraction independently using data collection forms. RESULTS No randomized controlled trial was identified. Two studies of low-to-moderate level of evidence were included: one of prospective and retrospective data collection and one retrospective study. Both implemented a periodontal intervention before orthodontics. Thus, best timing of soft tissue augmentation could not be assessed. The limited available data from these studies appear to suggest that soft tissue augmentation of bucco-lingual gingival dimensions before orthodontics may yield satisfactory results with respect to the development or progression of gingival recessions. However, the strength of the available evidence is not adequate in order to change or suggest a possible treatment approach in the daily practice based on solid scientific evidence. CONCLUSIONS Despite the clinical experience that soft tissue augmentation of bucco-lingual gingival dimensions before orthodontic treatment may be a clinically viable treatment option in patients considered at risk, this treatment approach is not based on solid scientific evidence. Moreover, the present data do not allow to draw conclusions on the best timing of soft tissue augmentation when a change in the inclination of the incisors is planned during orthodontic treatment and thus, there is a stringent need for randomized controlled trials to clarify these open issues.
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The objective of the present review was to summarize the evidence available on the temporal sequence of hard and soft tissue healing around titanium dental implants in animal models and in humans. A search was undertaken to find animal and human studies reporting on the temporal dynamics of hard and soft tissue integration of titanium dental implants. Moreover, the influence of implant surface roughness and chemistry on the molecular mechanisms associated with osseointegration was also investigated. The findings indicated that the integration of titanium dental implants into hard and soft tissue represents the result of a complex cascade of biological events initiated by the surgical intervention. Implant placement into alveolar bone induces a cascade of healing events starting with clot formation and continuing with the maturation of bone in contact with the implant surface. From a genetic point of view, osseointegration is associated with a decrease in inflammation and an increase in osteogenesis-, angiogenesis- and neurogenesis-associated gene expression during the early stages of wound healing. The attachment and maturation of the soft tissue complex (i.e. epithelium and connective tissue) to implants becomes established 6-8 weeks following surgery. Based on the findings of the present review it can be concluded that improved understanding of the mechanisms associated with osseointegration will provide leads and targets for strategies aimed at enhancing the clinical performance of titanium dental implants.
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This study explores how great powers not allied with the United States formulate their grand strategies in a unipolar international system. Specifically, it analyzes the strategies China and Russia have developed to deal with U.S. hegemony by examining how Moscow and Beijing have responded to American intervention in Central Asia. The study argues that China and Russia have adopted a soft balancing strategy of to indirectly balance the United States at the regional level. This strategy uses normative capabilities such as soft power, alternative institutions and regionalization to offset the overwhelming material hardware of the hegemon. The theoretical and methodological approach of this dissertation is neoclassical realism. Chinese and Russian balancing efforts against the United States are based on their domestic dynamics as well as systemic constraints. Neoclassical realism provides a bridge between the internal characteristics of states and the environment which those states are situated. Because China and Russia do not have the hardware (military or economic power) to directly challenge the United States, they must resort to their software (soft power and norms) to indirectly counter American preferences and set the agenda to obtain their own interests. Neoclassical realism maintains that soft power is an extension of hard power and a reflection of the internal makeup of states. The dissertation uses the heuristic case study method to demonstrate the efficacy of soft balancing. Such case studies help to facilitate theory construction and are not necessarily the demonstrable final say on how states behave under given contexts. Nevertheless, it finds that China and Russia have increased their soft power to counterbalance the United States in certain regions of the world, Central Asia in particular. The conclusion explains how soft balancing can be integrated into the overall balance-of-power framework to explain Chinese and Russian responses to U.S. hegemony. It also suggests that an analysis of norms and soft power should be integrated into the study of grand strategy, including both foreign policy and military doctrine.