To see the other types of publications on this topic, follow the link: Card index.
Dissertations / Theses on the topic 'Card index'
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 dissertations / theses for your research on the topic 'Card index.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse dissertations / theses on a wide variety of disciplines and organise your bibliography correctly.
1
Carlos, Daniele Maria de Oliveira. "Impacto da variabilidade de peso no controle mateb?lico de pacientes transplantados card?acos." Universidade Federal do Rio Grande do Norte, 2009. http://repositorio.ufrn.br:8080/jspui/handle/123456789/13285.
Full textAbstract:
Made available in DSpace on 2014-12-17T14:13:45Z (GMT). No. of bitstreams: 1
CarlosDMO_DISSERT.pdf: 3393165 bytes, checksum: 8775fe07131b0869171353c32e39624c (MD5)
Previous issue date: 2009-11-27<br>Heart transplantation (HT) represents one of the greatest advances in medicine over the last decades. It is indicated for patients with severe heart disease unresponsive to clinical treatment and conventional surgery, poor short-term prognosis and a 1- year mortality rate over 40%. HT has improved survival worldwide (80% in the first year, 70% in five years and 60% in ten years). However, the procedure has been associated with weight change and increased risk of secondary conditions such as
diabetes, hypertension, dyslipidemia and obesity due to immunosuppressive therapy following transplantation. The objective of this study was to determine the impact of
weight change on the metabolic stability of HT patients. The study was retrospective with data collected from the records of 82 adult patients (83% male; average age 45.06?12.04 years) submitted to HT between October 1997 and December 2005 at a
transplantation service in Cear? (Brazil). The selected outcome variables (biopathological profile, weight and body mass index―BMI) were related to biochemical and metabolic change. The results were expressed in terms of frequency, measures of central tendency, Student s t test and Pearson s correlation
coefficients. The analysis showed that following HT the average global BMI increased from 23.77?3.68kg/m2 to 25.48?3.92kg/m2 in the first year and to 28.38?4.97kg/m2 in the fifth. Overweight/obese patients (BMI ≥ 25 kg/m2) had higher average levels of glucose, total cholesterol, low-density lipoprotein and triglycerides than patients with eutrophy/malnutrition (BMI < 25 kg/m2). In conclusion, overweight/obese patients were likely to present higher average levels of glucose, triglycerides, total cholesterol and fractions than patients with eutrophy/malnutrition, indicating a direct and significant relation between nutritional status and weight change in the metabolic
profile of HT patients<br>O Transplante Card?aco (TC) tornou-se um dos grandes avan?os da medicina nas ?ltimas d?cadas. ? um procedimento indicado para pacientes com doen?a card?aca avan?ada, refrat?ria ao tratamento cl?nico e cir?rgico convencional, progn?stico
reservado em curto prazo e mortalidade acima de 40% no prazo de um ano na evolu??o natural da doen?a. Em todo o mundo seus resultados t?m evidenciado melhora significante na sobrevida, sendo considerada de 80% no primeiro ano, 70%
em cinco anos e 60% em dez anos. No entanto, as altera??es de peso ap?s o procedimento frequentemente ocorrem e aumentam os riscos de doen?as secund?rias como diabetes, hipertens?o, dislipidemia e obesidade, complica??es que est?o associadas ? terapia imunossupressora indispens?vel ap?s o TC. O objetivo deste estudo foi determinar o impacto da variabilidade de peso na
estabilidade metab?lica de pacientes transplantados do cora??o. O desenho do estudo foi do tipo retrospectivo documental, realizado com 82 pacientes adultos submetidos ao TC entre outubro de 1997 a dezembro de 2005 em centro transplantador no Cear?, sendo 83% do sexo masculino e 17% do sexo feminino
com idade m?dia de 45,06?12,04 anos. As vari?veis estudadas foram o perfil biopatol?gico, o peso e o ?ndice de massa corporal (IMC), relacionadas ?s altera??es bioqu?micas-metab?licas. Os dados foram descritos usando frequ?ncias, medidas de tend?ncia central, teste t de Student e coeficiente de correla??o de Pearson. Ap?s a an?lise dos dados, verificou-se que a m?dia global do IMC aumentou de 23,77?3,68 kg/m2 antes do TC, para 25,48?3,92 kg/m2 no primeiro ano e para 28,38?4,97 kg/m2 no quinto. Os pacientes com sobrepeso/ obesidade (IMC ≥25 kg/m2)
apresentaram valores m?dios de glicose, colesterol total, lipoprote?na de baixa XIV densidade (LDL) e triglic?rides maiores que os pacientes com eutrofia/ desnutri??o (IMC < 25 kg/m2). Diante dos resultados encontrados nesse estudo, conclui-se que
os pacientes com sobrepeso/ obesidade est?o propensos a apresentar n?veis de glicose, colesterol total, LDL e triglic?rides mais elevados que os pacientes com eutrofia/ desnutri??o, o que demonstra que houve uma rela??o direta e significativa entre o estado nutricional e a variabilidade de peso no perfil metab?lico de pacientes transplantados card?acos
2
Johnson, C. Dustin. "Set-Switching and Learning Transfer." Digital Archive @ GSU, 2008. http://digitalarchive.gsu.edu/psych_hontheses/7.
Full textAbstract:
In this experiment I investigated the relationship between set-switching and transfer learning, both of which presumably invoke executive functioning (EF), which may in turn be correlated with intelligence. Set-switching was measured by a computerized version of the Wisconsin Card Sort Task. Another computer task was written to measure learning-transfer ability. The data indicate little correlation between the ability to transfer learning and the capacity for set-switching. That is, these abilities may draw from independent cognitive mechanisms. The major difference may be requirement to utilize previous learning in a new way in the learning-transfer task.
3
Kaczmarski, Jenna M. "Exploring the effects of BMI health report card letters among 6th grade students and parents : an application of the social cognitive theory." [Tampa, Fla] : University of South Florida, 2009. http://purl.fcla.edu/usf/dc/et/SFE0003198.
Full text
4
Daniels, Karin Elizabeth. "Health promotion : the design of a School Health Index Score Card to assess psychosocial health and well-being in early childhood development at primary schools." University of the Western Cape, 2016. http://hdl.handle.net/11394/5437.
Full textAbstract:
Philosophiae Doctor - PhD<br>Schools, world-wide, have been regarded as important settings for health promotion and health education. Research indicate that schools constitute a crucial setting for programmes that aim at promoting the health of children, young adults, their families and their community, and could make a positive contribution to the overall health of the society. The psychosocial theory of human development proposes to understand and describe the importance of psychosocial health and well-being of children, in their different stages of development, across the life span, as well as how the different environments of the child's rearing could either add, or hinder, optimal development. Healthy Early Childhood Development, which includes physical, social-emotional, as well as linguistic/cognitive development, is fundamental to success and happiness, not only during childhood, but
throughout the course of life. This study, therefore, aimed to design a School Health Index Score Card that assesses psychosocial health and well-being in Early Childhood Development at primary schools in the rural Western Cape. The School Well-Being Model serves as a conceptual framework for this study and is based on Allardt's Sociological Welfare Theory,which assesses well-being as an entity in a school setting. This model takes into account the impact of family, social relationships, personal self-fulfilment and health aspects of children. This study used a mixed methodological sequential explanatory design that consisted of two
distinct phases (with 2 stages in each phase) within a participatory action research
framework. A needs assessment and a systematic review was conducted in phase 1 followed by phase 2, action planning-design of a school health index score card and a Delphi technique study. Quantitative, numeric, data were collected and analysed using the Statistical Package for Social Sciences V23 (SPSS) for descriptive and inferential statistics first, while the qualitative data were collected and analysed secondly in sequence for this design. The qualitative process helped to explain, or elaborate, on the quantitative results obtained from the respondents by means of a self-administered questionnaire that consisted of three sections; demographical information and the adaptation of the (i) Pediatric Quality of Life Inventory (PedsQL) and (ii) Strengths and Difficulties Questionnaire. The data were collected from teachers, principals, community leaders, parents/primary caregivers, members of school governing bodies, school nurses, social workers, health promotion officers, experts in early childhood development and school psychologists of learners in Grade R to Grade 3 at three primary schools in the rural Western Cape, South Africa. The systematic review of previous studies revealed that, (i) instruments are often designed to identify physical ailments, the individual’s ability to adjust to particular situations, psychiatric diagnosis, educational and intellectual abilities, as well as the personal characteristics of children over their entire lifespan, (ii) that promotion of psychosocial health and well-being challenges in early development does promote positive child development outcomes in later life, and (iii) the use of a valid and reliable instrument to assess psychosocial health and well-being in schools could have a number of advantages for children, their families, teachers and the community. The findings of the current study also indicated that, (i) parents/primary perceived their children to be experiencing challenges in school functioning, social functioning and physical functioning continually and, (ii) teachers perceived the learners to be experiencing social behavioural, hyperactive and behavioural challenges continually at school. Schools play an integral part in the lives of children and their families, by supporting children to form social and emotional relationships at school. Overall, this current study suggested that the School Health Index Score Card was considered to be user friendly, as well as a useful tool to assess the psychosocial health and well-being challenges of learners at primary schools in a South African context.<br>National Research Foundation (NRF)<br>2020-04-30
5
Ruggieri, Dominique Grace. "An Investigation of Parents' Perceptions of BMI and BMI-for-age, School-Based BMI Screening Programs and BMI Report Cards: Using Framing Theory and Perceptual Mapping Methods to Develop a Tailored BMI Report Card for the School District of Philadelphia." Diss., Temple University Libraries, 2012. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/185961.
Full textAbstract:
Public Health<br>Ph.D.<br>School-based body mass index (BMI) screenings seek can improve parents' recall about their child's weight, increase concern about excess weight, and correct parents' misperceptions to help them make informed decisions about their child's health. However, schools have questioned parents' understanding of and attitudes about BMI, and have expressed concern about parents' reactions to BMI reports. Using a sample of school nurses (n=7) and parents/guardians (n=125) from the School District of Philadelphia (SDP), this research addressed these concerns by clarifying: 1) parents'/guardians' perceptions and knowledge about BMI; 2) the challenges schools face in communicating with parents/guardians; and 3) the messages that can be communicated to parents/guardians to help them understand their child's BMI-for-age category and why their child's BMI is measured in his/her school. The research used framing theory and perceptual mapping methods to study and improve communication about BMI to parents/guardians in the School District. The four-phase study design incorporated qualitative (focus groups and semi-structured in-depth interviews) and quantitative (cross-sectional survey) methods to assist in the development of an evidence-informed BMI report card template for the SDP. Messages were constructed to meet the needs of four distinct groups of parents/guardians that emerged from the factor and cluster analyses - "Passive Parents," "Neutral Parents," "Confident Advocates" and "Active Worriers." Although each cluster of parents/guardians had their own unique perceptions and varying degrees of assuredness and confidence related to BMI concepts, the majority of parents/guardians in this study shared common favorable perceptions about BMI measures, school-based screening programs and BMI report cards.<br>Temple University--Theses
6
Benetti, Tiago. "Estimativa robusta da frequ?ncia card?aca a partir de sinais de fotopletismografia de pulso." Pontif?cia Universidade Cat?lica do Rio Grande do Sul, 2018. http://tede2.pucrs.br/tede2/handle/tede/8337.
Full textAbstract:
Submitted by PPG Engenharia El?trica (engenharia.pg.eletrica@pucrs.br) on 2018-10-29T13:30:23Z
No. of bitstreams: 1
TIAGO BENETTI_DIS.pdf: 5038519 bytes, checksum: 95fa8d1b367b574eee27e772a55a9a49 (MD5)<br>Approved for entry into archive by Caroline Xavier (caroline.xavier@pucrs.br) on 2018-10-30T17:21:55Z (GMT) No. of bitstreams: 1
TIAGO BENETTI_DIS.pdf: 5038519 bytes, checksum: 95fa8d1b367b574eee27e772a55a9a49 (MD5)<br>Made available in DSpace on 2018-10-30T17:27:25Z (GMT). No. of bitstreams: 1
TIAGO BENETTI_DIS.pdf: 5038519 bytes, checksum: 95fa8d1b367b574eee27e772a55a9a49 (MD5)
Previous issue date: 2018-08-31<br>Heart rate monitoring using Photoplethysmography (PPG) signals acquired from the individuals pulse has become popular due to emergence of numerous low cost wearable devices. However, monitoring during physical activities has obstacles because of the influence of motion artifacts in PPG signals. The objective of this work is to introduce a new algorithm capable of removing motion artifacts and estimating heart rate from pulse PPG signals. Normalized Least Mean Square (NLMS) and Recursive Least Squares (RLS) algorithms are proposed for an adaptive filtering structure that uses acceleration signals as reference to remove motion artifacts. The algorithm uses the Periodogram of the filtered signals to extract their heart rates, which will be used together with a PPG Signal Quality Index to feed the input of a Kalman Filter. Specific heuristics and the Quality Index collaborate so that the Kalman filter provides a heart rate estimate with high accuracy and robustness to measurement uncertainties. The algorithm was validated from the heart rate obtained from Electrocardiography signals and the proposed method with the RLS algorithm presented the best results with an absolute mean error of 1.54 beats per minute (bpm) and standard deviation of 0.62 bpm, recorded for 12 individuals performing a running activity on a treadmill with varying speeds. The results make the performance of the algorithm comparable and even better than several recently developed methods in this field. In addition, the algorithm presented a low computational cost and suitable to the time interval in which the heart rate estimate is performed. Thus, it is expected that this algorithm will improve the obtaining of heart rate in currently available wearable devices.<br>O monitoramento da frequ?ncia card?aca utilizando sinais de Fotopletismografia ou PPG (do ingl?s, Photopletismography) adquiridos do pulso de indiv?duos tem se popularizado devido ao surgimento de in?meros dispositivos wearable de baixo custo. No entanto, o monitoramento durante atividades f?sicas tem dificuldades em raz?o da influ?ncia de artefatos de movimento nos sinais de PPG. O objetivo deste trabalho ? introduzir um novo algoritmo capaz de remover artefatos de movimento e estimar a frequ?ncia card?aca de sinais de PPG de pulso. Os algoritmos do M?nimo Quadrado M?dio Normalizado ou NLMS (do ingl?s, Normalized Least Mean Square) e de M?nimos Quadrados Recursivos ou RLS (do ingl?s, Recursive Least Squares) s?o propostos para uma estrutura de filtragem adaptativa que utiliza sinais de acelera??o como refer?ncia para remover os artefatos de movimento. O algoritmo utiliza o Periodograma dos sinais filtrados para extrair suas frequ?ncias card?acas, que ser?o utilizadas juntamente com um ?ndice de Qualidade do Sinal de PPG para alimentar a entrada de um Filtro de Kalman. Heur?sticas espec?ficas e o ?ndice de Qualidade colaboram para que filtro de Kalman forne?a uma estimativa da frequ?ncia card?aca com alta acur?cia e robustez a incertezas de medi??o. O algoritmo foi validado a partir da frequ?ncia card?aca obtida de sinais de Eletrocardiografia e o m?todo proposto com o algoritmo RLS apresentou os melhores resultados com um erro m?dio absoluto de 1,54 batimentos por minuto (bpm) e desvio padr?o de 0,62 bpm, registrados para 12 indiv?duos realizando uma atividade de corrida em uma esteira com velocidades variadas. Os resultados tornam o desempenho do algoritmo compar?vel e at? mesmo melhor que v?rios m?todos desenvolvidos recentemente neste campo. Al?m disso, o algoritmo apresentou um custo computacional baixo e adequado ao intervalo de tempo em que a estimativa da frequ?ncia card?aca ? realizada. Dessa forma, espera-se que este algoritmo melhore a obten??o da frequ?ncia card?aca em dispositivos wearable atualmente dispon?veis.
7
Ghahari, Setareh. "A randomised controlled trial of an online fatigue self-management group intervention for adults with chronic neurological conditions." Thesis, Curtin University, 2009. http://hdl.handle.net/20.500.11937/1988.
Full textAbstract:
Background: Fatigue is one of the most common symptoms of neurological conditions. Although the literature suggests different approaches to treatment of this pervasive symptom, there is not a single, agreed comprehensive and well-supported approach to manage fatigue. There is strong evidence (Mathiowetz, Finlayson, Matuska, Chen, & Luo, 2005; Mathiowetz, Matuska, Finlayson, Luo, & Chen, 2007) that the face-to-face fatigue self-management program designed by Packer et al (1995) is effective in improving fatigue in people with MS. However, in Australia and many other developed and developing countries this program is not available for those people who have difficulty accessing services due to geographical location, transportation problems, work commitments or who lack confidence to participate in face-to-face programs. Equity of access is an important issue not only for this particular program but also for any self-management program in Australia (and internationally) which has a large rural and remote population. Evidence highlights the need for self-management programs to be delivered in different formats to ensure equity of access. One of the suggested ways is delivering the programs online. There is sufficient evidence that people with a disability have access to the internet. Thus, this project was designed to refine and further develop a pre-designed online fatigue self-management (online FSM) program and to evaluate it in a sample of adults with chronic neurological condition through a randomised controlled trial (RCT). Further, the study intended to explore who and how people with fatigue improve in their health outcomes.Methodology and Results: The aims of the project were fulfilled through four studies: 1) a pilot study; 2) a randomised controlled trial of the online FSM program; 3) a comparison with the face-to-face FSM program; and 4) exploration of predictors of improvement.During the pilot study, three pilot tests were conducted for the purposes of formative evaluation and to make necessary changes to improve the program. During the third pilot test, the effectiveness of the online FSM was also tested using a pre-test post-test design on a sample of individuals with multiple sclerosis, Parkinson’s disease or post-polio syndrome. The pilot study resulted in a standardised 7-week online FSM program mimicking its face-to-face version. Participants were offered fatigue self-management skills through structured activities, sharing information and experiences, expressing their ideas or feelings and offering advice and support to one another. The participants in the third pilot study improved significantly on the Fatigue Impact Scale (p<.05) and showed a trend toward significance shown on the Personal Wellbeing Index (p=.08).The RCT, the second study, included 95 participants who were randomised into one of three groups: an online FSM, an information-only FSM (info FSM) and a control group. The groups were compared at three time points (pre-test, post-test and at 3-months follow-up) on Fatigue Impact Scale, Activity Card Sort and Personal Wellbeing Index (FIS, ACS and PWI). Sores on Generalized Self-efficacy (GSE), Duke Social Support Index (SSI) and Depression, Anxiety and Stress Scale (DASS) were also used as covariates. The results showed that although both the online and information-only FSM groups improved over time on the FIS and ACS (p < .05), they were not significantly different from the control group or from each other at any time point. The low power in all analyses when comparing the groups revealed that a larger sample size is required to detect possible differences between the online FSM and control groups. Results of the secondary analysis on a combined group (online FSM group plus info FSM groups) showed that the online FSM and info FSM group complemented each other. The combined group showed significant differences when compared to the control group. This further suggests that the need for a larger sample size.The literature suggests incorporating face-to-face interventions as one of the experimental conditions when testing the effectiveness of an online program. Therefore, in the third study, a face-to-face group was used as a non-randomized comparison group. As the online FSM program was designed to provide service for people who do not have access to the face-to-face program, randomisation of the participants to four groups (face-to-face FSM, online FSM, info FSM and control groups) was not feasible; restricting the inclusion criteria to participants who had access to both the face-to-face and online programs would have excluded the very people for whom the program was designed. Thus, this study compared a sample of 20 participants in a face-to-face FSM program with each of the three other groups (online FSM, info FSM and control groups) using a nonequivalent pre-test post-test study. The findings showed that after controlling for the baseline data these participants had better scores on the FIS than the control group at post-test while these results were not seen in comparison to the online and info FSM groups. The results of this study on the face-to-face FSM program in comparison with online FSM program suggest that the online and info FSM program were successfully mimicking its face-to-face version. Further, the differences in some outcome measures and some clinical and demographic characteristics clearly demonstrated that the participants with access to the face-to-face program were significantly different than those in the RCT study. The participants who volunteered for participation in the online FSM program had lower activity levels and higher fatigue levels than the participants who had access to the face-to-face program. It appears that the two versions of the program provide access to significantly different participants.The fourth study aimed to indicate predictors of improvement on the FIS, ACS and PWI. Regression analyses were performed to find whether baseline demographic, clinical characteristics and/or changes in clinical characteristics from pre-test to follow-up were predictors for positive health outcomes. In this study, 92 participants with complete data set (pre-test, post-test and follow-up) were included. In parallel to the results emerging in systematic reviews (Nolte, Elsworth, Sinclair, & Osborne, 2007; S. Taylor, 2005; Warsi, Wang, LaValley, Avorn, & Solomon, 2004), younger people with more severe baseline scores appear to be more likely to make clinically significant improvements in their health outcomes. Improvement in mood and selfefficacy of people with fatigue were found to be predictors of better results for fatigue. Another interesting finding of this study was that improvement in selfefficacy and stress helps people with neurological conditions to improve in their fatigue regardless of their activity level at baseline.Conclusion: While fatigue is a common problem for people with fatigue secondary to neurological conditions, this online FSM program is the first of its kind to be implemented. The primary purpose of the fatigue self-management program is to help the participants improve their everyday performance and quality of life by incorporating ‘energy conservation techniques’ and self-management principles into their own life. Through the application of the fatigue self-management program, occupational therapists and other health professionals expect that the participants will learn the self-management skills, make corresponding behaviour changes and experience a reduction in the effect of fatigue on their lives. New knowledge gained from this study can further support the idea of providing other self-management programs online. The results of this study also add to the growing body of evidence emerging regarding how information technology may assist with improving health outcomes related to chronic conditions. Further, some predictors of improvement in health outcomes in this group of people were determined. The findings provide some evidence of the potential benefits of online fatigue self-management program for people with chronic neurological conditions. Online interventions like the online FSM program represent an important strategy for bridging the gap in service for those who can not participate in face-to-face programs.
8
Souza, Ivelise Araujo de. "Relação entre o índice de Kessner modificado por Takeda com os indicadores de gravidade nos partos da zona leste da cidade de São Paulo." Universidade Nove de Julho, 2016. http://bibliotecatede.uninove.br/handle/tede/1552.
Full textAbstract:
Submitted by Nadir Basilio (nadirsb@uninove.br) on 2017-01-26T17:03:16Z
No. of bitstreams: 1
Ivelise Araujo de Souza.pdf: 1026049 bytes, checksum: 5a1de7a7cad915295d4cdcafb09adaef (MD5)<br>Made available in DSpace on 2017-01-26T17:03:16Z (GMT). No. of bitstreams: 1
Ivelise Araujo de Souza.pdf: 1026049 bytes, checksum: 5a1de7a7cad915295d4cdcafb09adaef (MD5)
Previous issue date: 2016-12-13<br>The main causes of maternal deaths in developing and underdeveloped countries are mostly preventable and are directly related to morbidities arising from the gestational process, childbirth and puerperium, being the most prevalent postpartum hemorrhages, hypertensive alterations, sepsis, Obstructed deliveries and complications related to unsafe abortion. Morbidity predates death, and maternal death directly and indirectly affects society, impacting at least three families, as well as being a potential source of social problems arising from the child who was left without the mother. This is one of the main reasons to be concerned with studies that address maternal morbidity and its causes. It is a descriptive, cross-sectional quantitative study based on the analysis of the variables of the pregnant woman's card and the diagnoses identified in the discharge summaries. The data were collected through a field survey conducted in the following neighborhoods: Sapopemba, Aricanduva, São Mateus and Cidade Tiradentes (eastern zone of the city of São Paulo). The objective of the present research is to identify the relations of the application of the Kessner Index modified by Takeda in the card of the pregnant woman with the indicators of severity in childbirth. For this, the method used was the analysis and categorization of the data of filling the variables of the pregnant woman's card using the Kessner Index modified by Takeda. Subsequently, considering the SUS procedures table, the severity indicators were identified in the discharge summaries. Diagnoses and special procedures were analyzed in the cards of the pregnant women and high summaries (n = 360) that could include the criterion of maternal morbidity and other procedures not usually used in the pregnancy-puerperal period. Statistical analysis was used to identify associations between categorization by the Kessner Index modified by Takeda and the severity indicators present in the discharge summaries. Regarding the results, it was observed that in the relationship of this categorization with the severity indicators, there is a higher incidence of risks for inappropriate categorization 8.89% when compared to the appropriate 1.67% and the intermediate 4.44%. Prenatal care in the eastern zone of São Paulo was classified as intermediate (56.9%). It is worth mentioning that 84.7% presented some inadequacy if we consider what the Ministry of Health recommends, only 15.3% (adequate) met the requirements. The most relevant inadequacies in the pregnant woman 's card: 79.4% of absence of records in the second request of serology for syphilis and 81.8% of absence of ABO - Rh registries.<br>As causas principais dos óbitos maternos em países em desenvolvimento e em subdesenvolvimento são, em sua maioria, evitáveis e estão diretamente relacionadas a morbidades decorrentes do processo gestacional, parto e puerpério, sendo as de maior prevalência as hemorragias pós-parto, alterações hipertensivas, sepse, partos obstruídos e complicações relacionadas ao aborto inseguro. A morbidade antecede a morte, e a morte materna atinge direta e indiretamente a sociedade, impactando ao menos três famílias, além de ser potencial gerador de problemas sociais advindos da criança que ficou sem a mãe. Esse é um dos principais motivos para se preocupar com estudos que abordem a morbidade materna e as suas causas. Trata-se de um estudo descritivo, transversal de caráter quantitativo baseado na análise das variáveis do cartão da gestante e os diagnósticos identificados nos resumos de alta. Os dados foram coletados por meio de uma pesquisa de campo realizada nos bairros: Sapopemba, Aricanduva, São Mateus e Cidade Tiradentes (zona leste da cidade de São Paulo). O objetivo da presente pesquisa é identificar as relações da aplicação do Índice de Kessner modificado por Takeda no cartão da gestante com os indicadores de gravidade no parto. Para tal, o método utilizado foi a análise e categorização dos dados do preenchimento das variáveis do cartão da gestante utilizando o Índice de Kessner modificado por Takeda. Posteriormente, considerando a tabela de procedimentos SUS, foram identificados nos resumos de alta os indicadores de gravidade. Foram analisados nos cartões das gestantes e resumos de alta (n = 360) diagnósticos e procedimentos especiais que pudessem contemplar o critério de morbidade materna e outros procedimentos não habitualmente utilizados no período gravídico-puerperal. A análise estatística foi utilizada para identificar associações entre categorização pelo Índice de Kessner modificado por Takeda e os indicadores de gravidade presentes nos resumos de alta. No que se refere aos resultados, observou-se que na relação dessa categorização com os indicadores de gravidade, há uma maior incidência de riscos para a categorização inadequado 8,89% quando comparados ao adequado 1,67% e o intermediário 4,44%. A assistência pré-natal da zona leste de São Paulo foi classificada como intermediária (56,9%). Vale ressaltar que 84,7% apresentaram alguma inadequação se considerarmos o que preconiza o Ministério da Saúde, apenas 15,3% (adequado) cumpriram os requisitos. As inadequações mais relevantes no cartão da gestante: 79,4 % de ausência de registros na segunda solicitação da sorologia para sífilis e 81,8% de ausência de registros do ABO – Rh.
9
Wiggins, Sandra. "Utilization management of acute care services : evaluation of the SWITCH index system." Thesis, University of British Columbia, 1988. http://hdl.handle.net/2429/28355.
Full textAbstract:
In recent years, concern about the rising costs of health care has prompted the development of programs aimed at reducing utilization of hospital services and facilities while maintaining an acceptable standard of care. One of the major strategies that has emerged in the effort to accomplish these dual objectives, is utilization management. Although there are a number of different approaches, the primary aim of all utilization management programs is to identify and eliminate unnecessary and inappropriate hospital use.
To date, most of the utilization research and program development has taken place in the United States. To a great extent, this effort has focussed on the development and use of norms for utilization based on a breakdown of length of stay data by diagnostic-related groups (DRG's). Canadian interest in this type of approach is reflected in the recent development of data bases defined by case-mix groups (CMG's). However, while continued efforts are being made to refine these schemes, they have been vulnerable to the criticism that they do not provide adequately objective criteria for establishing what constitutes appropriate patterns of hospital use. In addition, because they are based on statistically derived norms, they have been criticized as lacking sufficient clinical relevance to encourage physician support. Since hospital utilization is largely determined by the medical staff, utilization management programs that fail to obtain physician support are unlikely to succeed.
An alternative approach, which appears to be gaining in popularity, involves the formulation of criteria which can be used to determine what constitutes appropriate and necessary hospital use. Essentially, it is argued that by directly identifying the source and nature of misutilization, it should be possible to develop more effective strategies for the resolution of identified problems. The American Appropriateness Evaluation Protocol designed by Gertman & Restuccia (1981) is one of the earliest and most highly tested examples of a criterion-based system. In Canada, interest in this type of approach is more recent and, consequently, little attention has as yet been focussed on the development and use of clinical criteria in utilization review and management.
One exception, however, is the SWITCH Index System. This system, which was developed and implemented in 1984 by the Peace Arch District Hospital (White Rock, B.C.), makes a direct attempt to identify and eliminate days of hospital stay during which no appropriate acute care services are being provided. The criteria used in this system are classified under the headings Signs, Wind, Intramuscular Therapy, Tubes, Consultant, and Hospice. Patients are considered to be appropriately placed in the hospital if, on any given day, at least one of the specified criteria are met. Otherwise they are classified as Off-Index and action is taken to identify the source of the problem and to initiate corrective action.
Since a major objective of the SWITCH system is to identify and eliminate inappropriate use, an observable outcome, if the program is successful, should be a reduction in length of stay. The present study investigated this hypothesis by comparing pre- and post- intervention length of stay trends at the Peace Arch District Hospital. In addition, to take into account any general secular trends in length of stay over time, the Peace Arch length of stay was compared to the length of stay observed for a control group of three peer-group member hospitals. Although data covering the four year period 1982 to 1985, indicated that the length of stay at the Peace Arch District Hospital had been decreasing over time, no component of this general decline could be attributed to the SWITCH Index System. Time series regression analyses failed to detect changes in either the slope or the height of the estimated response curve. However, limitations in the study design do not permit any conclusions regarding the potential effectiveness of this system. Characteristics specific to the Peace Arch District Hospital may have prevented the detection of an effect. In addition, because it is likely that there would be a lag between when the program was implemented and when it might be expected to effect a reduction in length of stay, the follow-up period of eleven months may have been too short for the determination of the program's effectiveness.<br>Medicine, Faculty of<br>Population and Public Health (SPPH), School of<br>Graduate
10
Fornstedt, Cecilia, and Mattias Fendukly. "The Feasibility of the Speech Intelligibility Index in the Clinical Hearing Care." Thesis, KTH, Skolan för teknik och hälsa (STH), 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-169927.
Full textAbstract:
Hearing-impaired individuals that use hearing aids often experience problems when exposed to daily situations in life. The dierent environments include for example classrooms, oces and public areas. For the hearing impaired, the correct adjustments of the hearing aids are of great importance. For these settings to be proper, a measurement called the Speech Intelligibility Index (SII), is questioned to be implemented in the clinical hearing care. To answer this question of issue whether feasibility lay in the implementation of SII in the clinical hearing care with the interface of hearing aids, a literature study ordered by the Hearing- & Balance Clinic (H&B) at Karolinska University Hospital situated at Rosenlund Hospital, was initiated. The focus of the study was primarily held in concern of SII as a hearing aid validation measurement and later extended to SII as a room acoustic measurement disregarding the eect of hearing aids. The result of the study showed that the use of SII in the clinical hearing care is troubled and further that the implementation as a room acoustic measurement is probable but has to be additionally investigated.<br>Horselskadade personer som anvander horhjalpmedel upplever ofta problem nar de benner sig i vardagliga situationer i livet. De olika situationerna innefattar exempelvis vistelse i klassrum, pa kontor eller i oentliga miljoer. For den horselskadade ar diverse justeringar av horapparaturer av stor betydelse. Dessa installationer kraver skilda matmetoder som utnyttjas inom horselvarden. Dock nns det en hel del parametrar som inte tas med i berakningarna som utfors av metoderna. I dagslaget ifragasatts darfor om ett matt som kallas taluppfattbarhetsindex (SII) har mojlighet att gora intrade i den kliniska horselvarden. Med den kliniska horselvarden menas om hansyn till horapparatur tar vid matningarna. For att besvara fragan om det nns en genomforbarthet for SII initierades en litteraturstudie som bestallts av Horsel- & Balans Kliniken (H&B) vid Karolinska Universitetssjukhuset pa Rosenlund Sjukhus. Fokus for studien var framst att utvardera SII som ett valideringsmatt da hansyn till horapparatur togs och utvidgades senare till att betrakta SII som ett rumsakustiskts matt, dvs da eekten av horapparater fransags. Resultatet av studien visade att anvandningen av SII i den kliniska horselvarden ar problematisk och vidare att intradandet av SII som ett rumsakustisk matt ar troligt men maste undersokas ytterligare.
11
Gephart, Sheila Maria. "Validating a Neonatal Risk Index to Predict Necrotizing Enterocolitis." Diss., The University of Arizona, 2012. http://hdl.handle.net/10150/228155.
Full textAbstract:
Necrotizing enterocolitis (NEC) is a costly and deadly disease in neonates. Composite risk for NEC is poorly understood and consensus has not been established on the relevance of risk factors. This two-phase study attempted to validate and test a neonatal NEC risk index, GutCheck(NEC). Phase I used an E-Delphi methodology in which experts (n=35) rated the relevance of 64 potential NEC risk factors. Items were retained if they achieved predefined levels of expert consensus or stability. After three rounds, 43 items were retained (CVI=.77). Qualitative analysis revealed two broad themes: individual characteristics of vulnerability and the impact of contextual variation within the NICU on NEC risk. In Phase II, the predictive validity of GutCheck(NEC) was evaluated using a sample from the Pediatrix BabySteps Clinical Data Warehouse (CDW). The sample included infants born<1500 grams, before 36 weeks, and without congenital anomalies or spontaneous intestinal perforation (N=58,818, of which n=35,005 for empiric derivation and n=23,813 for empiric validation). Backward stepwise likelihood-ratio method regression was used to reduce the number of predictive factors in GutCheck(NEC) to 11 and derive empiric weights. Items in the final GutCheck(NEC) were gestational age, history of a transfusion, NICU-specific NEC risk, late onset sepsis, multiple infections, hypotension treated with Inotropic medications, Black or Hispanic race, outborn status, metabolic acidosis, human milk feeding on both day 7 and day 14 (reduces risk) and probiotics (reduces risk).Discrimination was fair in the case-control sample (AUC=.67, 95% CI .61-.73) but better in the validation set (AUC=.76, 95% CI .75-.78) and best for surgical NEC (AUC=.84, 95% CI .82-.84) and infants who died from NEC (AUC=.83, 95% CI .81-.85). A GutCheck(NEC) score of 33 (range 0-58) yielded a sensitivity of .78 and a specificity of .74 in the validation set. Intra-individual reliability was acceptable (ICC (19) =.97, p<.001). Future research is needed to repeat this procedure in infants between 1500 and 2500 grams, complete psychometric testing, and explore unit variation in NEC rates using a comprehensive approach.
12
Leverentz-Brady, Kristen M. "Relationship Between Service Intensity, Care Coordination, And Child Outcomes." ScholarWorks @ UVM, 2008. http://scholarworks.uvm.edu/graddis/138.
Full textAbstract:
The current study examines the relationship between service utilization and child outcomes, and the role fidelity to the principles of the wraparound care coordination process plays in mediating that relationship. One hundred and twenty-one participants at three separate Children’s Mental Health Services (CMHS)-funded Systems of Care national evaluation sites in three states were administered the Wraparound Fidelity Index (WFI), designed to measure adherence to the principles of wraparound; child outcomes measures, including the Child Behavior Checklist (CBCL) and the Child and Adolescent Functional Assessment Scale (CAFAS); and the Multi-Sector Service Contact Questionnaire (MSSC), designed to assess services received. Data were analyzed using hierarchical multiple regression and linear mixed models in order to examine the mediational role fidelity plays at two levels, children and wraparound facilitators, and at three different time points, baseline, six-month follow-up, and twelve-month follow-up. No statistically significant relationships were found between wraparound fidelity and child outcomes at six-month follow-up. Also, at six-month follow-up, the level of services the child and family received significantly predicted child outcomes related to externalizing symptoms but not to internalizing symptoms or functional impairment; however, this relationship was not mediated by fidelity to the wraparound process. From baseline to six-month follow-up and twelve-month follow-up, no statistically significant relationships were found between wraparound fidelity and child outcomes across wraparound facilitators. Also, no statistically significant relationships were found between the level of services the child and family received and child outcomes. A mediation model from baseline to six-month follow-up and twelve-month follow-up was not viable due to the null findings. Exploratory analyses were conducted. Implications of these findings and directions for future studies are discussed.
13
Mastro, Fernando Del. "Alumno héroe, Profesor espíritu: Aproximación al vínculo entre profesor y alumno desde Carl G. Jung y Carl R. Rogers." En Blanco y Negro, 2014. http://repositorio.pucp.edu.pe/index/handle/123456789/117337.
Full textAbstract:
Preocupado por el quiebre de los vínculos dentro de la sociedad actual, el autor se dedica a reflexionar en torno a la relación entre profesor y alumno. El artículo explora la naturaleza de este vínculo a través del cine, mitos y cuentos de hadas, pasando por las ideas de Carl G. Jung y Carl R. Rogers. El artículo propone la necesidad de un vínculo que vaya más allá de los contenidos de los cursos, un vínculo más cercano y genuino, impulsado por una auténtica preocupación del profesor porel desarrollo y bienestar del alumno.
14
Silveira, Luana Claudia Jacoby. "Adaptação transcultural e fidedignidade da self-care of hypertension index para uso no Brasil." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2015. http://hdl.handle.net/10183/129636.
Full textAbstract:
As taxas de adesão ao tratamento farmacológico e não farmacológico que envolvem aspectos relacionados ao autocuidado e mudanças no estilo de vida de pacientes hipertensos ainda são subótimas. Nesta perspectiva, desenvolveu-se este estudo para adaptar transculturalmente e avaliar a fidedignidade da Self Care of Hypertension Index, uma escala americana de avaliação de autocuidado de pacientes hipertensos. Trata-se de um estudo metodológico, no qual foi realizada a adaptação transcultural do instrumento através das seguintes etapas: tradução, síntese da tradução, retrotradução, síntese da retrotradução, revisão por um comitê de especialistas e o pré-teste. Durante o processo de adaptação transcultural foram implementadas algumas orientações e modificações semânticas e culturais nas questões. O comitê de especialistas conferiu ao instrumento validade e equivalência transcultural. Após esta etapa, foram realizadas análises de concordância interobservador e fidedignidade do instrumento em que os resultados demonstraram concordância substancial e concordância quase perfeita, respectivamente. A versão adaptada para o português do Brasil foi denominada de Escala de Autocuidado de Hipertensão versão Brasileira (EAC-HI). Concluímos com estes resultados que a EAC-HI está adaptada transculturalmente e traduzida para o português do Brasil. A partir deste processo sugerimos a realização de análises psicométricas mais elaboradas a fim de tornar a escala apta para ser utilizada nessa população.
15
Ortega, San Martín Luis. "Popular Science: “The Demon-Haunted World”, Carl Sagan." Revista de Química, 2012. http://repositorio.pucp.edu.pe/index/handle/123456789/100769.
Full text
16
Hernando, Nieto Eduardo. "Carl Schmitt y los desafíos al Estado constitucional." Pontificia Universidad Católica del Perú, 1996. http://repositorio.pucp.edu.pe/index/handle/123456789/97297.
Full text
17
Tsawe, Mluleki. "Inequalities in the use of maternal and reproductive health services in Sierra Leone." University of the Western Cape, 2019. http://hdl.handle.net/11394/6660.
Full textAbstract:
Philosophiae Doctor - PhD<br>This thesis extends the literature on the trends and magnitude of health inequalities in the area of maternal and reproductive health services in Sierra Leone, and particular across sub-Saharan Africa. It attempted to provide a good understanding of, not only the determinants of maternal and reproductive healthcare use, but also factors that enable health inequalities to exist in Sierra Leone. This is an appropriate topic in population health studies as it aims to address important questions on the research agenda in the context of sub-Saharan Africa, particularly in a country with poor health outcomes such as Sierra Leone. A proper understanding of not only the coverage rates of population health outcomes but also the extent of health inequalities as well as the factors that contribute to these inequalities is crucial for any government. The thesis applied various techniques in the analysis of DHS data (from 2008 and 2013 rounds) in an attempt to answer the research questions.
18
Vrbka, Marek. "Dynamická karta rozpočtového ukazatele rodinného domu." Master's thesis, Vysoké učení technické v Brně. Fakulta stavební, 2016. http://www.nusl.cz/ntk/nusl-240123.
Full textAbstract:
This master thesis describes a detached house, requirements for the detached house, price, technical-economic index and card of cost indicator. The author performed an analysis of selected houses and itemized budgets of selected houses. Different shapes, technologies and solutions of materials are included in the analysis. The author, from the analysis, inferred the behavior of technical-economic index (TEI) of detached houses. The author described behavior in the particular and sub models. The author suggested methodology of calculation of the price data, the spatial data and the structure of price TEICF2 (technical-economic index, complex formula, version 2) of planned detached house. The author founded his methodology on particular and sub models. The principle of methodology TEICF2 consists in the analogy of the planned detached house with the model with same parameters. The author implemented TEICF2 into application dyCBI. Application dyCBI is working on Microsoft Excel.
19
Schneider, Hermel Júlia, Adolfo Pizzinato, and Uribe Magaly Calderón. "Women with breast cancer: perceived social support and self-care." Pontificia Universidad Católica del Perú, 2015. http://repositorio.pucp.edu.pe/index/handle/123456789/101728.
Full textAbstract:
This study aimed to understand the way women diagnosed with breast cancer perceive the social support they receive and how it relates to their self-care. Four participants were selected for biographical narrative interviews: two possessed high levels of social support and two possessed low levels. Axes were created to reflect the content of the interviews, such as history of the illness and the beginning of care, self-care as empowerment and as a way of looking at one’s self, care, and social support. Findings suggest that a diagnosis of breast cancer plays a key role in the development of self-care despite the obvious health risks and fragile support networks.<br>Este estudio tuvo como objetivo comprender la percepción de las mujeres con diagnóstico de cáncer de mama, sobre el apoyo social y la relación de este con el autocuidado. Fueron seleccionadas cuatro participantes, dos con elevados niveles de apoyo social y dos con bajos niveles de apoyo social para hacer las entrevistas biográficas de carácter narrativo. Se crearon ejes que relacionan los principales contenidos de las entrevistas, como la historia de la enfermedad y el despertar del cuidado, autocuidado como empoderamiento y como una mirada de sí, cuidado y apoyo social. Se identifica que el diagnóstico del cáncer de mama ejerció un papel clave en el despertar de prácticas de autocuidado a pesar de los riesgos de salud y de las vivencias de apoyo fragilizado.
20
Zarei, Anahita. "A novel assessment index and intelligent predictive models for orthodontics /." Thesis, Connect to this title online; UW restricted, 2007. http://hdl.handle.net/1773/6093.
Full text
21
Palmeros, y. Ávila Guadalupe, and Sallán Joaquín Gairin. "The care of people with disabilities in Mexican and Spanish universities." Pontificia Universidad Católica del Perú, 2016. http://repositorio.pucp.edu.pe/index/handle/123456789/117493.
Full textAbstract:
Worldwide, the subject of inclusion in higher education has become moreimportant in recent years and has brought about actions for the full inclusion ofstudents. In this work the substantive and contextual aspects that are present inMexican and Spanish universities to the attention of students with disabilities areanalysed, considering the historical development axis of the process of inclusiveeducation in both countries and identifying similarities, differences, needs anddeficiencies to the attention of those students. Likewise the different programsand actions that have to finally make some considerations to overcome somefactors that still persist and limit the effectiveness in dealing with diversity andintegration of the group of persons with disabilities will be analysed.<br>A nivel mundial, el tema de la inclusión en la educación superior ha cobrado mayorimportancia en los últimos años y ha propiciado que se realicen acciones para laplena incorporación de los estudiantes En este trabajo se analizan los aspectossustantivos y contextuales que están presentes en las universidades mexicanasy españolas en relación con la atención del estudiantado con discapacidad,considerando como eje el desarrollo histórico del proceso de inclusión educativaen ambos países e identificando las semejanzas, diferencias, necesidades ycarencias para la atención de dichos estudiantes. De igual forma se analizan losdistintos programas y acciones que se tienen para finalmente realizar algunasconsideraciones para superar algunos factores que todavía persisten y limitan laeficacia en la atención a la diversidad así como la integración del colectivo depersonas con discapacidad.<br>A nível mundial, o tema da inclusão no ensino superior adquiriu uma maiorimportância nos últimos anos e conduziu à realização de ações no sentido daplena integração dos estudantes. Neste trabalho, analisam-se os aspetos concretose contextuais que estão presentes nas universidades mexicanas e espanholas,relativamente aos estudantes com necessidades educativas especiais, considerandocomo eixo o desenvolvimento histórico do processo de inclusão educativa emambos os países e identificam-se as semelhanças, diferenças, necessidades, ecarências desses estudantes. De igual modo, analisam-se individualmente os doisprogramas e ações para, finalmente, tecer algumas considerações de modo a tornarpossível ultrapassar alguns fatores que, apesar de tudo, persistem e limitam aeficácia da atenção à diversidade, tal como a integração das pessoas com deficiência.
22
Marshall, Molly J. "Relationship between oral health status and body mass index for residents in a transitional care center." Virtual Press, 1999. http://liblink.bsu.edu/uhtbin/catkey/1154773.
Full textAbstract:
The purpose of this study was to determine the relationship between oral health status and body mass index for residents in a Transitional Care Center. The population utilized in this study were 193 males and females between the ages of 16-98 years old who were admitted to the Transitional Care Center at Columbus Regional Hospital in Columbus, Indiana. The researcher obtained informed consent from each participant upon admission to the subacute unit. The information used for this study was obtained from the Minimum Data Set located in each resident's medical record. Subjects were divided in two groups according to age, less than 75 years old and > 75 years old to determine whether age had an effect on oral health status and body mass index.The conclusion was that there was a difference between males and females. Women had a higher BMI than males for both age groups. Participants less than 75 years old were more likely to have a higher body mass index compared with subjects > 75 years of age. Seventy-four percent of those aged > 75 years old wore dentures or a removable bridge compared with 56% of younger subjects (< 75 years old).Although no statistically significant relationship was found between oral health status and body mass index, a trend was noted. As the number of oral health problems increased for individuals, body mass index decreased. The types and prevalence of specific oral health problems were reported indicating a need for further research into relationship between obesity, oral health, lifestyle factors, availability of dental care, and nutrient intakes for the elderly population.<br>Department of Family and Consumer Sciences
23
Maniadakis, Nikolaos. "A cost Malmquist index approach to productivity measurement with an application to health care services provision." Thesis, University of Warwick, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.323208.
Full text
24
Zhao, Wenxia (Helen). "Comorbidity in prediction of in-hospital mortality among diabetic patients: A study-derived index." Thesis, University of Ottawa (Canada), 2005. http://hdl.handle.net/10393/27100.
Full textAbstract:
The present study developed and validated a comorbidity index specifically for prediction of in-hospital mortality among diabetic inpatients in Canada. The analysis was based on data from the Hospital Person-Oriented Information Database (HPOI) for the study period from 1995/96 through 2000/01. The study included all the hospitalizations with a primary or secondary diagnosis of diabetes (ICD-9 code: 250.x) in acute care hospitals for patients aged 45 years or older with a length of stay of 90 days or less in ten provinces. All episodes of hospitalization for each patient were linked using a unique patient identifier, and one was randomly selected for the analyses. The study population of 578,222 diabetic inpatients was randomly divided into two parts, which were used either to develop or to validate the index. Multiple logistic regression models were used to develop and validate the index. A total of 22 diabetic comorbidities including 14 coexistent general medical conditions and 8 diabetic complications were included in the study-derived index, which had a better predictive performance as compared with D'Hoore-Charlson index and the simple count of comorbidities. The study-derived index can be used to control for potential confounding caused by comorbidity in the exploratory data analysis of diabetes research, to assist in creating more effective diabetes management system and to evaluate the prognosis of diabetic inpatients for health care provider.
25
Sikorski, Claudia, Melanie Luppa, Siegfried Weyerer, et al. "Obesity and associated lifestyle in a large sample of multi-morbid German primary care attendees." Universitätsbibliothek Leipzig, 2014. http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-149566.
Full textAbstract:
Background: Obesity and the accompanying increased morbidity and mortality risk is highly prevalent among older adults. As obese elderly might benefit from intentional weight reduction, it is necessary to determine associated and potentially modifiable factors on senior obesity. This cross-sectional study focuses on multi-morbid patients which make up the majority in primary care. It reports on the prevalence of senior obesity and its associations with lifestyle behaviors. Methods: A total of 3,189 non-demented, multi-morbid participants aged 65–85 years were recruited in primary care within the German MultiCare-study. Physical activity, smoking, alcohol consumption and quantity and quality of nutritional intake were classified as relevant lifestyle factors. Body Mass Index (BMI, general obesity) and waist circumference (WC, abdominal obesity) were used as outcome measures and regression analyses were conducted. Results: About one third of all patients were classified as obese according to BMI. The prevalence of abdominal obesity was 73.5%. Adjusted for socio-demographic variables and objective and subjective disease burden, participants with low physical activity had a 1.6 kg/m2 higher BMI as well as a higher WC (4.9 cm, p<0.001). Current smoking and high alcohol consumption were associated with a lower BMI and WC. In multivariate logistic regression, using elevated WC and BMI as categorical outcomes, the same pattern in lifestyle factors was observed. Only for WC, not current but former smoking was associated with a higher probability for elevated WC. Dietary intake in quantity and quality was not associated with BMI or WC in either model. Conclusions:
Further research is needed to clarify if the huge prevalence discrepancy between BMI and WC also reflects a difference in obesity-related morbidity and mortality. Yet, age-specific thresholds for the BMI are needed likewise. Encouraging and promoting physical activity in older adults might a starting point for weight reduction efforts.
26
Mastro, Puccio Fernando del. "Shadow Government: unconscious motivations in our critiques to Paternalism from Carl Jung." Pontificia Universidad Católica del Perú, 2015. http://repositorio.pucp.edu.pe/index/handle/123456789/116703.
Full textAbstract:
With the present paper we seek to use Carl Jung´s theoretical approach to the “Projection of the Shadow” as a framework to reveal posible unconscious motivations in our critiques to the Government´s paternalistic attitudes and regulations. Our proposal is that certain aspects of ourselves as individuals and society, which we do not like and do not accept (our Shadow), are seen exclusively as attributable to the Government. We argue that this unconscious dynamic limits our understanding of ourselves and prevents us to comprehend the essence of paternalism, both in our relation with the Government and in our daily life. We do not intend to discuss the logical or empirical validity of the arguments against this form of Government but to point out that those arguments might be influence by unconscious motivations.<br>El presente artículo busca utilizar el marco teórico de Carl G. Jung, referido a la proyección de la sombra, para dar cuenta de posibles motivaciones inconscientes presentes en nuestras críticas al estado paternalista. La propuesta central es que ciertos aspectos y características propios, los cuales no nos gustan y, por ende, no comprendemos ni aceptamos como nuestros (aspectos sombríos), son vistos de modo exclusivo en el Estado. Lo criticamos, entonces, por aquello que no aceptamos en nosotros mismos, reflejando en él nuestra propia sombra. Consideramos que esta dinámica es problemática, en tanto limita nuestra comprensión de nosotros mismos, de nuestro vínculo con el Estado y de la esencia del paternalismo. Como advertimos en el texto, este artículo no busca reflexionar sobre la validez de las críticas desde un punto de vista argumentativo o empírico, sino que pretende, tan solo, postular la existencia de motivaciones inconscientes en ellas.
27
Andrews, Curtis Kyo-shin. "Validity and Reliability of Peer Assessment Rating Index Scores of Digital and Plaster Models." The Ohio State University, 2008. http://rave.ohiolink.edu/etdc/view?acc_num=osu1208136018.
Full text
28
Li, Meng. "Relationships between body mass index of adolescents and consumption of fast food and sugar soda." Thesis, California State University, Long Beach, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=1527390.
Full text
29
Taveras, Michelle P. "Access to Health Care and Patient Safety: A Model for Measurement and Analysis." Scholarly Repository, 2011. http://scholarlyrepository.miami.edu/oa_dissertations/697.
Full textAbstract:
The purpose of this dissertation is to effectively understand, measure, and model the impact of Access to Care (AC) on Patient Safety (PS) through the creation of a model that evaluates their interdependence. Through the use of statistical tools and through the combination of variables that define patient access to health care and patient safety, a Patient Access and Safety (PACSA) index is developed. The calculated Patient Access and Safety index provides information to both providers and patients about the impact of access and safety on treatment outcomes. The input variables used to support this research are Patient Access Factors (PAF) (Age, Insurance Type, Visit Type, List Price, and Days To an Appointment) and Patient Safety Factors (PSF) (Severity of Diagnosis, Race, and Gender). In this model, 7,535 observations were used from a single organization based in South Florida, in order to develop the index. The PACSA index offers a tool that helps providers, healthcare staff and patients evaluate patient safety as it is impacted by access to healthcare through the calculated index. This index produces an equation that examines the relationship between access to care and patient safety using the following relationship: PACSA=∑_(i=0)〖(.645〖PSF〗_i- .645〖PAF〗_i )+0.399〗An extensive literature review identifies the connection between AC and PS and the relationships governing these two concepts. Although large organizations like the World Health Organization (WHO), Agency for Healthcare Research and Quality (AHRQ), and Institute of Healthcare Improvement (IHI) have studied these concepts independently, there has not been a study that used a factor or index to describe the relationship. As the healthcare delivery system becomes more complex, and consumers demand better treatment outcomes, there is a growing need to analyze these concepts jointly. This study focuses on diabetic retinopathy (DR). This is a condition experienced by chronic Diabetic patients, and it is one of the major causes of blindness (National Eye Institute, 2009). The increase in the occurrence of Diabetes worldwide has heightened the disease and inspired clinical research. In 2002, it was estimated that the disease stemming from Diabetes, namely DR, accounted for about 5% of world blindness, representing almost 5 million blind people. If left untreated or undetected, about 2% of people become blind, and about 10% develop severe visual impairment. By the year 2030, a possible 36 million people will have acute visual impairments and 7.2 million people will possibly be blind worldwide. In the United States, there are 18 million people with Diabetes, and 30% have Diabetic Retinopathy (5.3 million Americans over the age of 18) (ATA Report 2004; AHRQ, 2004; WHO, 2004). Although this study focused on DR, the model has been designed with the ability to be applied to other diseases and conditions. The goal of creating the PACSA index is to help healthcare workers understand when to schedule patients within the context of access and safety. Current appointment schedules, which are the tools used by healthcare workers, use a “New patient vs. Follow up patient” design. The PACSA challenges the current scheduling schema. No longer will patients be categorized into “New vs. Follow Up” visits. Instead, they will be evaluated for access to care requirements and patient safety needs from the initial point of entry into the health system. The recommendation is to start designing schedules based on PACSA (low PACSA, medium PACSA, and high PACSA). In this new paradigm, the low PACSA would describe patients that have low disease complexity, low number of risk factors, and can wait a little longer for their appointment without having complications of disease from lack of treatment. On the contrary, the high PACSA would include a subset of patients that have high disease complexity, high number of risk factors, and require immediate appointment and medical continuity of care to have the best treatments and outcomes. The PACSA index can serve as a visual guide for decisions regarding access and patient safety requirements. Two key components of quality within healthcare include access to care and patient safety. To create “congruent system integration” (Maier-Speredelozzi, 2007), there must exist synchronization of all healthcare delivery operations. The Patient Access and Safety Index (PACSA) provides a framework for integrating these two components. This research and the indices developed can offer benefits to health care organizations, patients, physicians, and government entities by providing a versatile tool to help improve access to health care and patient safety.
30
Lübbe, Nils. "A Probabilistic Re-assesment of the Index of New Cars’ Climate Impact : Benefits of Biofuels in Sweden." Thesis, Linnéuniversitetet, Institutionen för naturvetenskap, NV, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-12239.
Full textAbstract:
Introduction: The index of new cars’ climate impact (Trafikverket 2010) calculated a reduction factor to quantify the positive impact of renewable fuels on CO2 emissions for new cars in Sweden 2009. Although uncertainty for many input parameters is acknowledged, all calculations were made with point estimates. Aim: The aim of this study was to verify consumer recommendations based on carbon dioxide emissions of new cars by re-assessing the CO2 emissions considering the uncertainty in input data. The data uncertainty was quantified by using probabilistic risk assessment methodology. The objectives were (1) to calculate the possible reduction of CO2 emissions for new cars in Sweden accounting for uncertainties; (2) to identify the most influential factors by conducting a sensitivity analysis; and (3) to assess the implications of interval analysis and probabilistic modelling for epistemic uncertainty in this context and thereby to contribute to the discussion on which method is the most appropriate to support decision making. Method: Calculations were performed with the deterministic model proposed by Trafikverket (2010) using probability distributions (Bayesian probability distributions assigned by expert judgements) and intervals as model input. Probabilistic modelling was implemented as Monte Carlo simulation with uniform distributions and triangular distributions in Matlab. Interval calculations were done by hand. Results: The best estimate from probabilistic modelling of CO2 reduction when using E85 as a fuel of 30% (95% confidence interval = 10% to 52%) is in a similar range as the 20% given by Trafikverket (2010). The best estimate of 28% decrease for gas cars (95% confidence interval = 3% to 44%) is lower than the originally proposed 42%, but still in a similar range. The difference is due to the large extent of optimistic values taken by Trafikverket (2010). The interval analysis produced a wider range. For ethanol driven cars, a CO2 reduction of 68%, an increase of 14% or anything in between is calculated, for cars operated on gas the result is a CO2 reduction of 59%, an increase of 29% or anything in between. Conclusions: The use of biofuels most likely reduces CO2 emissions. The CO2 emissions from the production of the biofuel are the most influential factors. The recommendations of Trafikverket to the consumers are still valid after probabilistic recalculation. Probabilistic modelling is more appropriate than interval analysis to guide authority and consumer decisions as it allows conclusions to be drawn and therefore can support decision making.
31
Ávila, Christiane Wahast. "Adaptação transcultural e validação da Self-Care of Heart Failure Index versão 6.2 para uso no Brasil." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2012. http://hdl.handle.net/10183/55507.
Full textAbstract:
Estudos ao longo dos últimos anos têm enfatizado a importância da educação sobre o autocuidado na insuficiência cardíaca (IC), assim como a avaliação da efetividade de sua implementação por meio de instrumentos validados. Pesquisadores americanos desenvolveram uma escala denominada Self-Care of Heart Failure Index version 6.2 (SCHFI v 6.2) que permite a avaliação do autocuidado nas etapas de manutenção, manejo e confiança possibilitando identificar em que etapa o autocuidado está prejudicado. No Brasil, não existem escalas validadas que avaliem o autocuidado em pacientes com IC contemplando essas etapas. Este estudo teve como objetivo adaptar transculturalmente e validar a versão em português da SCHFI v 6.2. Realizou-se um estudo metodológico desenvolvido no Ambulatório de Insuficiência Cardíaca do Hospital de Clínicas de Porto Alegre. A SCHFI v 6.2 apresenta 22 itens divididos em três subescalas (Manutenção do Autocuidado, Manejo do Autocuidado e Confiança do Autocuidado) que podem ser aplicadas separadamente, com escores máximos de 100 pontos (escores acima de 70 pontos indicam um autocuidado adequado). A versão adaptada e validada para o Brasil foi denominada de Escala de Autocuidado para Pacientes com Insuficiência Cardíaca (EAC-IC).As propriedades psicométricas testadas foram a validade de face e de conteúdo (comitê de juízes), validade de constructo convergente (coeficiente de correlação de Pearson) com a European Heart Failure Self-care Behavior Scale (EHFScBS) versão brasileira (com 12 itens, que apresenta um escore que varia de 12 a 60 e que escores menores indicam melhor autocuidado) validada no Brasil e a EAC-IC. A fidedignidade foi avaliada quanto à consistência interna de seus itens (alfa de Cronbach) e quanto à estabilidade (concordância interobservador). Incluíram-se 190 pacientes, com idade média de 61 ± 13 anos. A validade de face e conteúdo conferiu ao instrumento sua equivalência semântica, idiomática, experimental e conceitual. A validade de constructo convergente foi demonstrada através de uma correlação inversa, moderada e significativa de r=-0,30 quando comparados todos os itens da EAC-IC com os da EHFScBS versão brasileira (escores originais dos dois instrumentos e de r=-0,51 (escores das questões equivalentes da EAC-IC com os da EHFScBS versão brasileira indicando uma correlação inversa forte e significativa. A fidedignidade das três subescalas foi demonstrada quanto a consistência interna através de um alfa de Cronbach de 0,77 (total da escala), 0,43 (Manutenção do Autocuidado), 0,76 (Manejo do Autocuidado) e 0,94 (Confiança do Autocuidado), respectivamente. Podemos concluir que a versão adaptada da SCHFI v 6.2 para o português mostrou-se válida e confiável para uso no Brasil.<br>During the past years, several studies have been emphasizing the importance of self-care education for patients with heart failure (HF), as well as the evaluation of effectiveness of its implementation through valid instruments. American researchers developed a scale named Self-Care of Heart Failure Index v 6.2 (SCHFI v 6.2), which allows for the evaluation of selfcare maintenance, self-care management, and self-care confidence. The scale helps identifying which level in self-care needs improvement. In Brazil, there is no valid scale for the evaluation of self-care in patients with HF that takes into consideration these levels. The objective of this study was transculturally adapt and validate the Portuguese version of SCHFI v 6.2. It was conducted a methodological study developed at Ambulatório de Insuficiência Cardíaca do Hospital de Clínicas de Porto Alegre (Outpatient Heart Failure Clinic at Hospital de Clínicas, Porto Alegre). The SCHFI v 6.2 has 22 items divided in three levels (self-care maintenance, self-care management, and self-care confidence) that may be applied separately, with maximum score of 100 (scores higher than 70 indicate adequate self-care). The adapted and validated version for Brazilian Portuguese was named Escala de Autocuidado para Pacientes com Insuficiência Cardíaca (EAC-IC). The psychometric properties tested were face and content validity (committee of judges), convergent construct validity (Pearson’s correlation coefficient) with the European Heart Failure Self-care Behavior Scale (EHFScBS) brazilian version (12 items, with a score of 12-60 range, were lower scores indicate better self-care) validated in Brazil and EAC-IC. Reliability was evaluated according its internal consistency (Cronbach’s Alpha) and according to its stability (interobserver agreement). It were included 190 patients, age 61 ± 13 years old, were included. The face and content validity conferred to the instrument its semantics, language, experimental and conceptual equivalency. The convergent construct validity was demonstrated through an inverse and significant correlation of r=-0.30 when compared to other items present in EAC-IC and EHFScBS brazilian version original scores in both instruments, and r=-0.51 for equivalent questions score of EAC-IC and EHFScBS brazilian version indicating significant correlation of large magnitude. The reliability of three subscales was demonstrated by Cronbach’s Alpha of 0.77 (total), 0.43 (Self-care maintenance), 0.76 (Self-care management), and 0.94 (Self-care confidence), respectively. We can conclude that the adapted version of SCHFI v 6.2 for Portuguese proved to be valid and reliable for its use in Brazil.<br>Estudios a lo largo de los últimos años han enfatizado la importancia de la educación sobre el autocuidado en la insuficiencia cardiaca (IC), así como la evaluación de la efectividad de su implementación por medio de instrumentos válidos. Investigadores americanos desarrollaron una escala nominada Self-Care of Heart Failure Index version 6.2 (SCHFI v 6.2) que permite la evaluación del autocuidado en las etapas de manutención, manejo y confianza favoreciendo identificar en cual etapa el autocuidado está perjudicado. En Brasil, no existen escalas subsistentes que evalúen el autocuidado en pacientes con IC considerando dichas etapas. El objetivo del este estudio fue adaptar transculturalmente y validar la versión en portugués de SCHFI v 6.2. Se realizó un estudio metodológico desarrollado en el Ambulatorio de Insuficiencia Cardiaca del Hospital de Clínicas/ Porto Alegre. SCHFI v 6.2 presenta 22 añadiduras divididas en tres subescalas (Manutención del Autocuidado, Manejo del Autocuidado y Confianza del Autocuidado) que pueden ser aplicadas separadamente, con escores máximos de 100 puntos (escores superiores a 70 puntos indican un autocuidado adecuado). La versión adaptada y válida para Brasil fue nominada de Escala de Autocuidado para Pacientes con Insuficiencia Cardiaca (EAC-IC). Las propiedades psicométricas evaluadas fueron la validez de fase y de contenido (comité de jueces), validez de constructo convergente (coeficiente de correlación de Pearson) con la European Heart Failure Self-care Behavior Scale (EHFScBS versión brasileña (con ítem que presenta un escore variable de 12 a 60 y cuyos escores menores indican mejor autocuidado) válida en Brasil y EAC-IC. La veracidad fue evaluada con base en la consistencia interna de sus añadiduras (alfa de Cronbach) y en la estabilidad (concordancia inter observador). Se incluyeron 190 pacientes, con edad de 61= 13 años. La validez de fase y contenido confirieron al instrumento su equivalencia semántica, experimental y conceptual. La validez de Validez convergente fue demostrada a través de una correlación invertida moderada y significativa r=-0,30 cuando comparadas todas las añadiduras de EAC-IC e de EHFScBS versión brasileña (escores originales de dos instrumentos e de r=-0,51 (escores de cuestiones equivalentes de EAC-IC y de EHFScBS versión brasileña) indicando una correlación inversa excelente y significativa. La veracidad de las tres subescalas fue demostrada por alfa de Cronbach de 0,77 (total), 0,43 (Manutención del Autocuidado), 0,76 (Manejo del Autocuidado) y 0,94 (Confianza del Autocuidado), respectivamente. Se concluye que la versión adaptada de SCHFI v 6.2 para el portugués se muestra válida y confiable para uso en Brasil.
32
Pokorski, Simoni Chiarelli da Silva. "Tradução, adaptação transcultural e fidedignidade da Self-Care of Chronic Angina Index para o uso no Brasil." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2013. http://hdl.handle.net/10183/77988.
Full textAbstract:
Estudos indicam a importância da prática do autocuidado aliada ao tratamento farmacológico de pacientes com doença arterial coronariana (DAC). Neste estudo, considerou-se a definição de autocuidado como um processo de tomada de decisão que consiste na busca da estabilidade fisiológica através de manutenção da adesão farmacológica e das adaptações para um estilo de vida saúdavel, bem como a capacidade do paciente em monitorar os sintomas e tomar decisões adequadas na ocorrência destes. A necessidade da avaliação das habilidades dos pacientes em desempenhar o autocuidado, assim como a necessidade de verificar a efetividade das orientações fornecidas e o impacto dessas em desfechos clínicos demandaram o desenvolvimento de escalas de medida de autocuidado. Pesquisadores americanos desenvolveram a Self-Care of Chronic Angina Index (SCCAI), que permite a avaliação do autocuidado nas etapas de manutenção, manejo e confiança. A SCCAI é composta por 22 itens e dividida em três escalas. No Brasil, não temos escalas validadas que avaliem o autocuidado em pacientes com angina crônica nas diferentes etapas de manutenção, de manejo e de autoconfiança. Baseados nessa prerrogativa, desenvolveu-se um estudo metodológico com o objetivo de realizar a adaptação transcultural, validação de conteúdo e a fidedignidade da SCCAI. A escala adaptada e validada foi denominada Escala de Autocuidado para Angina Crônica – Versão Brasileira. As propriedades psicométricas testadas foram a validade de conteúdo e face e a fidedignidade. A validade de conteúdo e face foi relizada por meio do comitê de juízes e estudo piloto. A fidedignidade foi avaliada quanto à consistência interna de seus itens (Alfa de Cronbach) com a inclusão de 78 pacientes. Na avaliação das três escalas, o Alfa foi de 0,385, 0,149 e 0,671 para manutenção, manejo e autoconfiança, respectivamente. Pode-se concluir que a adaptação transcultural e a validação inicial da versão em português da SCCAI resultou em uma escala adaptada para uso no Brasil. Os resultados da fidedignidade foram insatisfatórios, sugerindo ampliar outros métodos de fidedignidade e validade para que a escala possa ser utilizada na prática clínica.<br>Studies indicate that the practice of self-care is an important ally to the pharmacological treatment of patients with coronary artery disease (CAD). In this study, we consider self-care a decision-making process that consists in the search of physiological stability through the adherence to pharmacological therapy and adaptation to a healthy lifestyle. In such concept is also included the patient’s ability to monitor symptoms and make proper decisions when they occur. The need for assessing patients’ abilities to perform self-care, along with the need of a health team to verify the effectiveness of the guidelines given and the impact of them in clinical outcomes demanded the development of scales to measure self-care. Researchers from the United States developed a Self-Care of Chronic Angina Index (SCCAI), composed of 22 items divided into three subscales that allow the assessment of selfcare through the stages of Maintenance, Management, and Self-confidence. In Brazil, there are no validated scales to assess self-care in patients with chronic angina, therefore, based on this prerogative, a methodological study was developed to create a cross-cultural adaptation, verify the content validation and the reliability of SCCAI. The scale was adapted and named as Escala de Autocuidado Para Angina Crônica – Versão Brasileira. The psychometric properties tested were content and face validity, and reliability. The property content and face validity was verified by the committee of experts and by a pilot study. Reliability was assessed based on internal consistency of the items (Cronbach's Alpha), considering 78 patients. For the assessment of the three scales, Alpha was of 0.385, 0.149, and 0.671 to respectively Maintenance, Management, and Self-Confidence. We may conclude that the crosscultural adaptation and initial validation of the Portuguese version of SCCAI resulted in a scale adapted to be used in Brazil. The results for reliability were unsatisfactory, suggesting that other methods for verifying reliability and validity for the scale may be used in clinical practice.<br>Estudios indican que la práctica del autocuidado es importante aliada al tratamiento farmacológico de pacientes con enfermedad arterial coronaria (DAC). En este estudio, se ha considerado la definición de la estabilidad fisiológica a través de manutención de la adhesión farmacológica y de las adaptaciones para un estilo de vida saludable, bien como la capacidad del paciente en monitorear los síntomas y tomar decisiones adecuadas en la ocurrencia de estos. La necesidad de evaluación de las habilidades de los pacientes en desempeñar el autocuidado, así como la necesidad del equipo de salud en verificar la efectividad de las orientaciones conferidas y el impacto de ellas en deshechos clínicos entablaron el desarrollo de escalas de medida de autocuidado. Investigadores americanos desarrollaron la Self- Care of Chronic Angina Index (SCCAI), compuesta por 22 artículos, dividida en tres sub escalas, que permite la evaluación del autocuidado en las etapas de manutención, manejo y confianza. En Brasil, no tenemos graduaciones subsistentes que evaluen el autocuidado en pacientes con angina crónica en las diferentes sucesiones de manutención, de manejo y de autoconfianza. Con base en dicha exención, se desarrolló un estudio metodológico que tuvo como objetivo realizar la adaptación transcultural, validación de contenido y la fidedignidad de la SCCAI. La graduación adaptada y validada fue nombrada de Escala de Autocuidado Para Angina Crónica – Versión Brasileña. Las propiedades psicométricas examinadas fueron la validez de contenido y de fase y la fidedignidad. La validez de contenido y de fase fue hecha a través de comité de jueces y estudio modelo. La fidedignidad fue evaluada con relación a la consistencia interna de sus artículos (Alfa de Cronbach) con la inclusión de 78 pacientes. En la evaluación de las tres escalas Alfa fue de 0,385, 0,149 e 0,671 para Manutención, Manejo y Autoconfianza, respectivamente. Puede concluirse que la adaptación transcultural y la validación inicial de la versión en portugués de SCCAI resultó una graduación adaptada para uso en Brasil. Los resultados de la fidedignidad fueron muy poco satisfactorios, sugiriendo ampliar otros métodos de fidedignidad y validez para que la graduación pueda ser utilizada en la práctica-clínica.
33
Lohmeyer, Adam M. "Larval Asian carp in the upper and middle Mississippi River : an index of establishment and dispersal potential /." Available to subscribers only, 2008. http://proquest.umi.com/pqdweb?did=1559854851&sid=20&Fmt=2&clientId=1509&RQT=309&VName=PQD.
Full text
34
Calou, Cinthia Gondim Pereira. "The mother generated index: assessment of quality of life related to health in low-risk pregnant women." Universidade Federal do CearÃ, 2015. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=13434.
Full textAbstract:
FundaÃÃo Cearense de Apoio ao Desenvolvimento Cientifico e TecnolÃgico<br>Como parte integrante do processo saÃde-doenÃa a gestaÃÃo à um perÃodo em que a inserÃÃo social da mulher pode influenciar, de maneira positiva ou negativa, o decorrer do ciclo gravÃdico-puerperal. Assim, avaliar a qualidade de vida dessa populaÃÃo, pode redirecionar a implementaÃÃo de prÃticas inovadoras na busca de tornÃ-las mais eficazes e reais para a promoÃÃo de um cuidado mais humanizado. Dentre os objetivos do estudo, destacam-se: avaliar a Qualidade de Vida Relacionada à SaÃde das gestantes acompanhadas em prÃ-natal de baixo risco, descrever as principais Ãreas afetadas na qualidade de vida das gestantes; avaliar as principais Ãreas afetadas na qualidade de vida das gestantes; correlacionar as Ãreas afetadas da qualidade de vida relacionada à saÃde com as variÃveis sÃcio demogrÃficas e obstÃtricas das gestantes e comparar a QVRS em gestantes acompanhadas nos sistemas pÃblico e privado. Trata-se de um estudo correlacional, quantitativo e de corte transversal, realizado em trÃs unidades pÃblicas que oferecem serviÃo de assistÃncia ao prÃ-natal, e uma privada, na cidade de Fortaleza â CearÃ. A amostra foi composta por 261 gestantes que realizavam prÃ-natal de baixo risco e que foram entrevistadas no perÃodo de setembro a novembro de 2014. Os instrumentos de coleta foram um questionÃrio contendo variÃveis sÃcio demogrÃficas, obstÃtricas e relacionadas a qualidade de vida, alÃm da versÃo brasileira da escala the Mother Generated Index. A anÃlise do perfil sÃcio demogrÃfico das gestantes estudadas, apontou para uma maioria de jovens, com companheiro fixo, com ensino superior completo, renda familiar elevada e trabalho fora de casa. Quanto aos dados obstÃtricos das participantes, a maioria iniciou o prÃ-natal no primeiro trimestre de gestaÃÃo, eram nulÃparas e tinham IMC adequado para a semana gestacional. Quanto aos dados relacionados a qualidade de vida, a maioria das gestantes planejaram e desejaram a gravidez, contaram com o apoio do parceiro, porÃm nÃo receberam orientaÃÃo educativa durante as consultas. Dentre as oito Ãreas que interferiram positivamente a qualidade de vida das gestantes, tÃm-se: relacionamento com o parceiro, relacionamento com a famÃlia, feliz por ser mÃe, alimentaÃÃo, ansiosa pelo nascimento do bebÃ, auto estima, imagem corporal e sono. Em contraponto, as dimensÃes negativas influenciadoras na qualidade de vida foram: sono, cansaÃo, polaciÃria, nÃusea e vÃmito, trabalho, imagem corporal, estresse e labilidade emocional. Dentre as gestantes que foram atendidas no serviÃo privado, observou-se que as Ãreas feliz por ser mÃe e imagem corporal interferiram positivamente na qualidade de vida; enquanto o trabalho interferiu de forma negativa. Conclui-se que as mudanÃas ocorridas durante a gestaÃÃo influenciam de maneira positiva e negativa na qualidade de vida, cabendo ao enfermeiro oferecer uma assistÃncia individualizada, holÃstica e compartilhada com a gestante e seus familiares.
35
Hernando, Nieto Eduardo. "¿Teología Política o Filosofía Política?: La amistosa conversación entre Carl Schmitt y Leo Strauss." Foro Jurídico, 2017. http://repositorio.pucp.edu.pe/index/handle/123456789/120100.
Full text
36
Carrera, César. "Walsh, Carl. Monetary Theory and Policy. Tercera edición. Cambridge: The MIT Press. 640 pp." Economía, 2012. http://repositorio.pucp.edu.pe/index/handle/123456789/118298.
Full text
37
Turner, John Scott. "Outcome prediction in intensive care with special reference to cardiac surgery." Doctoral thesis, University of Cape Town, 1995. http://hdl.handle.net/11427/27057.
Full textAbstract:
The development, use, and understanding of severity of illness scoring systems has advanced rapidly in the last decade; their weaknesses and limitations have also become apparent. This work follows some of this development and explores some of these aspects. It was undertaken in three stages and in two countries. The first study investigated three severity of illness scoring systems in a general Intensive Care Unit (ICU) in Cape Town, namely the Acute Physiology and Chronic Health Evaluation (APACHE II) score, the Therapeutic Intervention Scoring System (TISS), and a locally developed organ failure score. All of these showed a good relationship with mortality, with the organ failure score the best predictor of outcome. The TISS score was felt to be more likely to be representative of intensiveness of medical and nursing management than severity of illness. The APACHE II score was already becoming widely used world-wide and although it performed less well in some diagnostic categories (for example Adult Respiratory Distress Syndrome) than had been hoped, it clearly warranted further investigation. Some of the diagnosis-specific problems were eliminated in the next study which concentrated on the application of the APACHE II score in a cardiothoracic surgical ICU in London. Although group predictive ability was statistically impressive, the predictive ability of APACHE II in the individual patient was limited as only very high APACHE II scores confidently predicted death and then only in a small number of patients. However, there were no deaths associated with an APACHE II score of less than 5 and the mortality was less than 1 % when the APACHE II score was less than 10. Finally, having recognised the inadequacies in mortality prediction of the APACHE II score in this scenario, a study was undertaken to evaluate a novel concept: a combination of preoperative, intraoperative, and postoperative (including APACHE II and III) variables in cardiac surgery patients admitted to the same ICU. The aim was to develop a more precise method of predicting length of stay, incidence of complications, and ICU and hospital outcome for these patients. There were 1008 patients entered into the study. There was a statistically significant relationship between increasing Parsonnet (a cardiac surgery risk prediction score), APACHE II, and APACHE III scores and mortality. By forward stepwise logistic regression a model was developed for the probability of hospital death. This model included bypass time, need for inotropes, mean arterial pressure, urea, and Glasgow Coma Scale. Predictive performance was evaluated by calculating the area under the receiver operating characteristic (ROC) curve. The derived model had an area under the ROC curve 0.87, while the Parsonnet score had an area of 0.82 and the APACHE II risk of dying 0.84. It was concluded that a combination of intraoperative and postoperative variables can improve predictive ability.
38
Dueñas, Bejar Juan. "Continuidad geométrica de orden 1 y 2 en el CAGD." Universidad Nacional de Ingeniería. Programa Cybertesis PERÚ, 1998. http://cybertesis.uni.edu.pe/uni/1998/duenas_bj/html/index-frames.html.
Full textAbstract:
El presente trabajo enfoca el problema de la unión de dos curvas o super¬ficies de modo que sea visualmente sea suave. Sabemos que la forma usual o tradicional de medir la suavidad de funciones paramétricas se requiere que sus derivadas coincidan en el extremo común de las curvas ó en el borde común para el caso de superficies. A este tipo de continuidad se conoce como CONTINUIDAD PARAMETRICA. Existen ejemplos que este tipo de continuidad realmente no refleja la idea intituiva de suavidad, Esto se debe básicamente a que la continuidad paramétrica depende de la parametrización. Para solucionar este inconveniente, investigadores como Brian Barsky, Wolf-gang Bodun, Tony De Rose, etc., definieron la medida de la continuidad de manera que sea independiente de la parametrización y a este tipo de con¬tinuidad se conoce como CONTINUIDAD GEOMÉTRICA. Esta clase de continuidad esta basada en la existencia de una reparametrización de modo que sus curvas (superficies) se unan con continuidad paramétrica. El objetivo de este trabajo es aplicar este tipo de continuidad para unir curvas, superficies de Bézier de modo que visualmente sea suave. Además, se obtendrá algoritmos para v-splines (ó Nu-splines) y los -7-splines (ó Gamma-spline) los cuales splines interpolantes con continuidad geométrica. Estos apunes son la generalización de los splines cúbicos clásicos.
39
Joish, Vijay. "Development of the Diabetes Resource Consumption Index and profiling quality of diabetes care in the Veterans Health Administration." Diss., The University of Arizona, 2003. http://hdl.handle.net/10150/280360.
Full textAbstract:
The purpose of this study was to develop and validate a risk-adjustment index for one year healthcare resource use specific to diabetic patients, based on severity of illness measures; and to profile quality of diabetes care between outpatient clinics. The data for this study was collected from four outpatient clinics within the Southern Arizona Veterans Affairs Healthcare System, Tucson, AZ. The DRCI was developed using a sample size of 367 diabetic subjects that had complete information on diabetes-specific variables. Individual DRCI weights, based on the magnitude of one year healthcare resource use and socio-demographic characteristics, ranged from -471.5 to 3,081.2 for total healthcare costs, from -304.3 to 1,582.1 for outpatient costs, and -0.19 to 0.93 for risk of hospitalization. The DRCI was better than or equivalent to the Chronic Disease Score in predicting health care costs. Diabetics in the second cohort were predominantly elderly (mean = 66yrs ± 11.1), married (61%), white (73%), males (96%), had a high BMI (31 ± 6.3 kg/m²), and mean comorbidity score of 4.2 ± 1.8 conditions. Screening for HbA1c and microalbuminuria was frequently performed in all clinics. Overall, 61% and 36% of study patients did not have evidence of foot or eye examinations during the entire study period, respectively. Approximately, 27% (n = 408), 41% (n = 643), and 26% (n = 515) of the study patients had poor glycemic, renal function, and lipid control, respectively. Significant differences (p < .05) in HbA1c and creatinine clearance rates between the clinics were observed after adjusting for patient case-mix. However, differences between the clinics in cardiovascular outcome were not observed after adjusting for patient case-mix. This study demonstrated an association between diabetes severity with healthcare resource and costs. The DRCI, using laboratory data, is a diabetes-specific severity measure for prediction of one year healthcare resource use. Future studies are needed to validate this index in other settings. Finally, the results from this study emphasize the need to adjust for case-mix variable when comparing quality of diabetic care outcomes between outpatient clinics.
40
Lino, Margarete Marques. "Satisfação profissional entre enfermeiras de UTI: adaptação transcultural do Index of Work Satisfaction (IWS)." Universidade de São Paulo, 1999. http://www.teses.usp.br/teses/disponiveis/7/7138/tde-12112004-163915/.
Full textAbstract:
Satisfação profissional é um fenômeno complexo e multivariado, vivenciado pelos indivíduos como um estado comportamental derivado de fontes internas e externas. Considerando o ambiente das Unidades de Terapia Intensiva (UTIs) como fontes geradoras de estímulos externos - positivos e negativos, é essencial uma investigação sistemática para examinar o nível de satisfação das enfermeiras de terapia intensiva em relação ao seu contexto de trabalho. Para atender a essa proposta, o objetivo desse estudo foi adaptar o Index of Work Satisfaction (IWS) - Índice de Satisfação Profissional (ISP) para a cultura das enfermeiras brasileiras de terapia intensiva e identificar seu nível de satisfação profissional. O ISP compreende uma escala de 44 ítens que mede o nível atual de satisfação profissional e comparações pareadas que medem a importância relativa de seis componentes de satisfação profissional: autonomia, interação, status profissional, requisitos do trabalho, normas organizacionais e remuneração. A estrutura metodológica que orientou o estudo baseou-se nas diretrizes de adaptação e validação transcultural de medidas, como propostas pela literatura. A abordagem metodológica compreendeu um comjunto de etapas padronizadas para atingir equivalência idiomática, cultural e conceitual, e para avaliar as propriedades psicométricas do instrumento adaptado, pelo uso de traduções, re-tradução, revisões por especialistas e testes estatísticos. A validade aparente e de conteúdo da versão traduzida do ISP foi analisada através dos julgamentos de especialistas, sustentando sua adequação. A amostra do estudo consistiu de 84 enfermeiras representando oito UTIs, que responderam a um questionário específico para o alcance dos objetivos. Os dados analisados nesse estudo foram provenientes de 70 questionários utilizáveis. A maioria das respondentes era do sexo feminino (90.0%). A idade média foi 30,42 anos e o tempo médio de experiência em UTIs foi de 5,49 anos. Após a eliminação de cinco ítens da escala total, o coeficiente alfa de Cronbach indicou uma confiabilidade de 0,74 e o tau de Kendall entre o escore total ponderado e o escore não ponderado foi de 0,98. As enfermeiras de terapia intensiva classificaram a importância dos componentes de sua satisfação profissional: autonomia, remuneração, interação, requisitos do trabalho, status profissional e normas organizacionais, do mais importante para o menos importante. Os níveis atuais de satisfação profissional classificados de acordo com os componentes da escala, do mais satisfatório para o menos satisfatório, foram os seguintes: status profissional, interação, autonomia, requisitos do trabalho, normas organizacionais e remuneração. Houve, portanto, dissonância entre o nível de importância atribuído e o nível de satisfação percebido. A abordagem metodológica utilizada assegurou que o instrumento traduzido mantivesse a equivalência com o original e preservasse suas propriedades de medida. Possibilitou, também, obter informações valiosas relacionadas ao nível de satisfação profissional das enfermeiras brasileiras de terapia intensiva.<br>Work satisfaction ie a complex and multifaced phenomenon experienced by individuals as a comportamental state derived from internal and external sources. Considering Intensive Care Units'setting as generating sources of external - positive and negative - stimuli, it's essential a systematic investigation to examine the level of critical care nurses'satisfaction with their work context. In order to meet that purpose, the aim of the present study was to adapt the Index of Work Satisfaction (IWS) to Brazilian critical care nurses culture and to identify their level of work satisfaction. The IWS comprises a 44 item scale that measures the current level of work satisfaction and paired comparisons that masures the relative importance of six work satisfaction' components: autonomy, interaction, professional status, task requirements, organizational policies and pay. The methodological framework that guided the study was the guidelines for cross-cultural adaptation and validation of measures, as proposed by the literature. The methodological approach comprised a set of standardized steps to achieve idiomatic, cultural and conceptual equivalence and to assess the psychometric properties of the adapted instrument, by the use of translations, back-translation, reviews by experts, and statistical tests. Face and content validity of the translated version of the IWS was assessed by experts'judgements supporting its adequacy. The study sample consisted of 84 critical care nurses, representing eight ICUs. Data were collected from 70 useable questionnaires. The majority of the respondents were female (90,0%). The mean age was 30,42 years and mean lenght of experience in ICUs was 5,49. After the reduction of five items of the total scale, Cronbach's alfa coefficient indicated a reliability of 0,74 and Kendall's Tau between the total weighted score and the unweighted score was 0,98. Critical care nurses rank-ordered autonomy,pay, interaction, task requirements, professional status and organizational policies from the most to the least important component to their work satisfaction. The ranking of their current levels of work satisfaction was professional status, interaction, autonomy, task requirements, organizational policies and pay from the most to the least satisfying, indicating dissonances between level of importance expected and level of satisfaction perceived. That methodological approach ensured that the translated instrument kept equivalence to the original and preserved its a measurement properties. Furthermore, it was possible to gain valuable informations concerning the level of Brazilian critical care nurses'work satisfaction.
41
Wahl, Grendi Heidi. "Measuring Patient Experience in Hospital Maternity Care." Thesis, KTH, Skolan för elektroteknik och datavetenskap (EECS), 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-281290.
Full textAbstract:
This thesis concerns Patient Experience (PX), in hospital maternity care in Sweden. The focus lies in the development of a measure to describe the current state of PX. The thesis uses a semi-sequential mixed-methods study design; exploration of the patient journey, through qualitative methods, informs the adaptation of an existing maternity care experience survey instrument. The resulting survey instrument is tried in a pilot study and renders a composite measure of PX. Part of the analysis is dedicated to understanding the e!ect of information and communication in PX; Exploratory Factor Analysis is used to test the model and attempt an answer. The results show that it is possible to describe PX using the proposed survey instrument. The composite measure preserves di!erences in perceptions better than an arithmetic average of two discrete VAS-1 type measurements, and is more appropriate when measuring attitudes, and opinions using Likert-type measures. A three component solution describes 65.44% of the total sample variance. Determining to what degree PX is influenced by information and communication remains di"cult to quantify, but these initial results indicate that the manner of the attending sta! during aftercare and the respondent’s mastery of information during discharge are important dimensions of patients’ total PX (ANOVA R .695, R Square .483). The model’s three components are almost entirely built from items that address interpersonal skills and information assimilation. These correspond to two of the three Service Quality Dimensions, namely Interaction Quality and Outcome Quality. Most important of the three is the component “Chemistry in aftercare”. The predictive strength of the model shows merit under the context of the study and could advise further e!orts to develop measurements for PX in maternity care in a Swedish hospital setting. Lastly, this study contextualises Service Design in hospital maternity healthcare; the study therefore o!ers ample opportunity for innovation.<br>Arbetet handlar om Patientupplevelse (PU), i förlossningsvården i Sverige. Fokus ligger på utvecklingen av ett mätvärde att beskriva den nuvarande patientupplevelsen. Arbetet använder kvalitativa och kvantitativa metoder (mixed-methods), i en semi-sekventiell design; utforskning av patientresan ligger till grund för anpassningen av ett existerande mätinstrument. Det nya mätinstrumentet testas i en pilotstudie och ger ett kompositmätvärde av PU. En del av analysen ägnas åt att förstå vilken e!ekt information och kommunikation har på PU; Explorativ faktoranalys används för ändamålet. Resultaten visar att det är möjligt att beskriva PU genom det föreslagna mätinstrumentet. Det resulterande kompositvärdet är bättre på att beskriva skillnader i uppfattning än ett medelvärde av två diskreta variabler av VAS-1 typen, och är också lämpligare när attityder och åsikter mäts med hjälp av Likert-skalor. En trekomponentslösning beskriver 65.44% av den totala stickprovsvariansen. Att avgöra hur mycket PU påverkas av information och kommunikation förblir svårt att kvantifiera, men dessa inledande resultat visar att patientbemötande under eftervårdstiden och patientens förmåga att bemästra information under utskrivningen är viktiga dimensioner av patienters totala PU (ANOVA R .695, R Square .483). Modellens tre komponenter är nästan uteslutande uppbyggda av variabler som fångar upp personliga relationer och assimilering av information. Dessa motsvarar två av de tre dimensionerna i Servicekvalitetsmodellen, nämligen Interaktionskvalitet och Utfallskvalitet. Viktigaste komponenten är Personlig kemi under eftervården. Modellens förutsägningsstyrka visar förtjänst under studiens kontext och kunde informera framtida ansträngningar att utveckla mätvärden för förlossningsvården inom svensk sjukhusmiljö. Till sist kan nämnas att studien kontextualiserar Service Design inom förlossningsvården; studien erbjuder därför omfattande möjligheter för innovation.
42
Zeeshan, Muhammad Fazal. "Use of an Electronic Reporting System to Determine Adverse Event Rates, Adverse Event Costs, and the Relationship of Adverse Events with Patients’ Body Mass Index." The Ohio State University, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=osu1372765526.
Full text
43
Venables, Heather. "In emergency department patients requiring resuscitation room care, can Renal Resistive Index measurements predict the development of acute kidney injury?" Thesis, University of Bath, 2019. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.767596.
Full textAbstract:
PURPOSE: Doppler renal resistive index (RRI) has emerged in the last decade as a useful prognostic indicator for transient (fluid responsive) and persistent acute kidney injury (AKI). The determinants of RRI are largely systemic and recent studies confirm that RRI measurement could also be a useful early marker for sub-clinical AKI and post procedural AKI risk. This study aimed to determine the feasibility of RRI measurement in an Emergency Department (ED) resuscitation room setting using a pointofcare ultrasound system. METHODS: In this prospective single centre study, RRI measurement was attempted in 20 non-consecutive patients (meeting the inclusion criteria) by a single expert sonographer. RRI measurements were evaluated against context specific feasibility criteria and target outcomes. RESULTS: 20 patients (11 male, 9 female) were recruited to the study. Age of patients ranged from 33 years to 91 years (mean 62.3 years). Adequate visualisation of both kidneys was achieved in 60% of patients (n=12). In patients where it was not possible to achieve adequate views of both kidneys (n=8), limiting technical factors were shortness of breath (SOB) (n=6), high BMI (n=2). At least one measurement of RRI was achieved in 70% of patients (n=14). However, in 9 of these patients (64.3%) the Doppler spectral traces achieved were substandard and did not meet the measurement criteria for RRI as specified in the study protocol. In 30% of patients (n=6) no usable spectral trace was achieved and it was not possible to measure RRI. SOB was noted as a technical difficulty in 60% of patients (n=12) including three for whom RRI measurements were achieved. In 9 patients (45%) SOB was recorded as the primary reason for failure to acquire a usable Doppler trace. All criteria for RRI measurements were met in only 3 patients (15%). CONCLUSION: Measurement of RRI was not feasible in patients requiring resuscitation room care using a current point of care ultrasound system. If RRI is to play a useful role in this high priority patient group, adaptation of the available technology is required to mitigate the problem of image blur due to patient breathing movement.
44
Wintersberger, Sophie, Muhammad Azmat, and Sebastian Kummer. "Are We Ready to Ride Autonomous Vehicles? A Pilot Study on Austrian Consumers' Perspective." MDPI, 2019. http://dx.doi.org/10.3390/logistics3040020.
Full textAbstract:
Automotive manufacturers are competing to be the first to introduce customer-ready autonomous vehicles. Some manufacturers are claiming to launch their first self-driving cars as early as 2020. Which all sounds very good and futuristic; however, the question arises, are customers even ready to adopt this new technological advancement? Therefore, this pilot study is aimed at finding out the answer to this question in the Austrian market. This study discovers the standpoint of Austrian consumers concerning the acceptance of self-driving cars for daily usage and gives an overview of the current point of view regarding autonomous vehicles (AVs). The data for this study was collected using an online, user-friendly, Likert scale survey. The collected data were processed and analyzed for empirical significance in SPSS using Spearman's rank correlation and the Mann-Whitney U test supported by descriptive analysis. The results of the study indicate that Austrian consumers are well aware of autonomous vehicles and their technology. However, they have specific concerns about reliability, cybersecurity, and futuristic car-sharing models. Therefore, these concerns about AVs should be addressed by auto manufactures in order to gain consumers' trust and sell them a new form of mobility.
45
Followell, Timothy B. "Effect of Dental Treatment on Parental Stress as Measured by the Parenting Stress Index." The Ohio State University, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=osu1276567183.
Full text
46
Satterwhite, Monica L. "A Retrospective Study: The Relationship Between Health Care Costs, Absenteeism and Body Mass Index in a Group of Municipal Employees." Thesis, University of North Texas, 2000. http://www.oregonpdf.org.
Full textAbstract:
Thesis (M.S.)--University of North Texas, 2000.<br>Includes bibliographical references (leaves 46-50). Also available online (PDF file) by a subscription to the set or by purchasing the individual file.
47
Dirmaier, Jörg, Birgit Watzke, Uwe Koch, et al. "Diabetes in Primary Care: Prospective Associations between Depression, Nonadherence and Glycemic Control." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2012. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-100111.
Full textAbstract:
Background: Findings are inconsistent regarding the degree to which depression may exert a negative impact on glycemic control in patients with type 2 diabetes. We therefore aimed to examine the longitudinal relationship between depression, behavioral factors, and glycemic control.
Methods: In a prospective component of a nationally representative sample, 866 patients with type 2 diabetes aged ≧18 years completed a standardized assessment including a laboratory screening, questionnaires, and diagnostic measures. Subsequent to baseline (t0), patients were tracked over a period of 12 months (t1). Depression was assessed according to DSM-IV and ICD-10 criteria. Glycemic control was determined by levels of glycosylated hemoglobin (HbA1c); a level of ≧7% was judged as unsatisfactory. Regression analyses were performed to analyze the prospective relationship between depression, medication adherence, diabetes-related health behavior, and HbA1c.
Results: Patients with depression at t0 revealed increased rates of medication nonadherence (adjusted OR: 2.67; CI: 1.38–5.15) at t1. Depression (adjusted regression coefficient: β = 0.96; p = 0.001) and subthreshold depression (β = 1.01; p < 0.001) at t0 also predicted increased problems with diabetes-related health behavior at t1. Adjusted ORs for poor glycemic control (HbA1c ≧7%) at t1 were also increased for patients with baseline depression (2.01; CI: 1.10–3.69). However, problems with medication adherence as well as problems with diabetes-related health behavior at t0 did not predict poor glycemic control at t1.
Conclusions: In a prospective representative study of patients with type 2 diabetes, baseline depression predicted problems with medication adherence, problems with health-related behaviors, and unsatisfactory glycemic control at follow-up.
48
González, Delgado Gabriel, Rincón Johanna Holz, Morante Augusto Ruiloba, Núñez Luis Miguel Silva, and Sobenes Katherine Torres. "¡Pero si es más caro reclamar! La class action: una alternativa para solucionar conflictos de intereses con pretensiones de reducida cuantía." IUS ET VERITAS, 2016. http://repositorio.pucp.edu.pe/index/handle/123456789/122623.
Full text
49
Elías, Laroza Enrique. "Lo barato sale caro: mata y no engorda. La inacción de INDECOPI ante los productos basura, los cañazos y los yonques." IUS ET VERITAS, 2016. http://repositorio.pucp.edu.pe/index/handle/123456789/123168.
Full text
50
Garatea, Yori Carlos L. "LUIS FLOREZ: El español hablado en Segovia y Remedios. Bogotá. Instituto Caro y Cuervo. 1952. 95 pp. (Separata del BICC-VII)." Pontificia Universidad Católica del Perú, 2017. http://repositorio.pucp.edu.pe/index/handle/123456789/113937.
Full text