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Ahmed, Aisha, Emmanouil S. Brilakis, Karol Mudy, Benjamin Sun, Paul Sorajja, and Mario Gössl. "Future Therapy for Low-Risk Patients With Severe Aortic Stenosis—A Provider Survey." Journal of the Minneapolis Heart Institute Foundation 2, no. 2 (December 2018): 1–3. http://dx.doi.org/10.21925/mplsheartjournal-d-18-00010.
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With the expansion of transcatheter aortic valve replacement in low-risk patients, we sought to explore current implanters' predictions on the future of this therapy by sending a survey to a sample of 8,261 healthcare professionals using Internet-based software. The survey contained six questions regarding physician specialty and experience, transcatheter aortic valve replacement age cutoff, optimal treatment for low-risk patients, transcatheter aortic valve replacement valve sequence, and transcatheter aortic valve replacement concerns. The majority, 29% percent, of all respondents felt that transcatheter aortic valve replacement will become the first-choice therapy for all patients, regardless of age and 70% felt that the optimal treatment would be transcatheter aortic valve replacement, with transcatheter aortic valve replacement valve-in-valve if the first valve degenerates. Regarding the sequence of transcatheter aortic valve replacement valves, 78% preferred the Edwards Sapien 3 valve (ES-3) as the first transcatheter aortic valve replacement valve followed by either a second ES-3 or Medtronic Evolut valve. Despite the high acceptance of transcatheter aortic valve replacement, many respondents (56%) felt that surgical aortic valve replacement might still remain the preferred treatment in low-risk patients due to an unknown durability of transcatheter aortic valve replacement valves. A majority of implanters see transcatheter aortic valve replacement followed by valve-in-valve transcatheter aortic valve replacement as the first-line therapy for low-risk patients with severe aortic stenosis, but long-term durability of transcatheter aortic valve replacement is an unanswered concern.
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Reis, Luciana Araújo dos, Alessandra Campos Brasileira, Gilson De Vasconcelos Torres, Luana Araújo dos Reis, and Claudio Henrique Meira Mascarenhas. "Relationship between elderley care and health and social care provider." Revista de Enfermagem UFPE on line 5, no. 8 (September 23, 2011): 1905. http://dx.doi.org/10.5205/reuol.1262-12560-1-le.0508201113.
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ABSTRACT Objective: to ascertain the relationship between caring for the elderly and the social status and health of the caregiver. Method: it`s about a descriptive character study with transversal delineation, with 20 guards of aged ones registered in the extension project: “Aged`s health in the family, asylum and community: living in a social support net in the care to the aged one”, from the Southwestern State University of Bahia. As instrument was used a Questionnaire of Evaluation of the Guard. The data were analyzed and grouped into three categories: the elderly and the need for caution, care and its influence on the caregiver's life, and management of care for the elderly. This research was approved by the Ethics in Research of the State University of Southwest Bahia (Protocol No. 061/2007). Results: it was verified that 18 of the guards were of the feminine sex, 13 of the guards never had time to take care of themselves, 12 felt negative influence of the care process in their health, and 16 presented some limitation in their social life. Conclusions: in this perspective, it`s necessary that strategies of care to the guard`s health are created to improve the life`s quality of these people and, surely, the aged ones attended for them. Descriptors: aged one; guard; daily life.RESUMO Objetivo: averiguar a relação entre o cuidado ao idoso e o estado social e de saúde do cuidador. Método: trata-se de um estudo de caráter descritivo com delineamento transversal, com 20 cuidadores de idosos cadastrados no projeto de extensão: Saúde do idoso na família, asilo e na comunidade: vivenciando rede de suporte social no cuidado ao idoso, da Universidade Estadual do Sudoeste da Bahia. Como instrumento foi utilizado um Questionário de Avaliação do Cuidador. Os dados foram analisados e agrupados em três categorias: o idoso e a necessidade de cuidado, o cuidado e a sua influencia na vida do cuidador, e o gerenciamento do cuidado ao idoso. Esta pesquisa foi aprovada pelo Comitê de Ética em Pesquisa da Universidade Estadual do Sudoeste da Bahia (Protocolo nº061/2007). Resultados: os dados foram analisados de maneira descritiva e agrupados em três categorias: o idoso e a necessidade de cuidado, o cuidado e a sua influência na vida do cuidador, e o gerenciamento do cuidado ao idoso. Verificou-se que 18 dos cuidadores eram do sexo feminino, 13 dos cuidadores nunca tinham tempo para cuidar de si, 12 sentiam influência negativa do processo de cuidar em sua saúde, e 16 apresentavam alguma limitação em sua vida social. Conclusão: nesta perspectiva, faz-se necessário que estratégias de cuidado à saúde do cuidador sejam criadas no sentido de melhorar a qualidade de vida destes indivíduos e, consequentemente, dos idosos assistidos por eles. Descritores: Idoso; cuidador; vida cotidiana.RESUMENObjetivo: determinar la relación entre el cuidado de los ancianos y la situación social y la salud del cuidador. Método: este es un estudio descriptivo, con diseño cruzado, con 20 cuidadores de adultos mayores inscritos en el proyecto de ampliación: la salud de las personas mayores en la familia, el asilo y la comunidad: la experiencia de apoyo social en el cuidado de ancianos, la Universidad Estatal del Oeste Bahía. Instrumento fue utilizado como un cuidador de Evaluación Cuestionario. Los datos fueron analizados de forma descriptiva y se agrupan en tres categorías: los ancianos y la necesidad de cuidado, atención y su influencia en la vida del cuidador, y la gestión de la atención a las personas mayores. Resultados: se encontró que 18 de los cuidadores eran mujeres, 13 de los médicos nunca han tenido el tiempo para cuidar de sí mismos, el 12 consideró el impacto negativo de cuidar de su salud, y el 16 tienen alguna limitación en su vida social. Conclusiones: desde esta perspectiva, es necesario que las estrategias de atención de la salud de su cuidador que se creó para mejorar la calidad de vida dede las personas y, en consecuencia, los ancianos que atienden. Descriptores: ancianos; encargado del cuidado; la vida cotidiana.
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Schott, Lars, Christian-André Keun, and T. Simon Kaysser. "3Dsupply – Ersatzteilversorgung aus dem 3D-Drucker/3Dsupply – additive manufactured spare parts Qualifying a logistic provider to supply additive manufactured spare parts." wt Werkstattstechnik online 110, no. 07-08 (2020): 551–55. http://dx.doi.org/10.37544/1436-4980-2020-07-08-95.
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Um den disruptiven Risiken der additiven Fertigungstechnologie für die Logistikbranche zu begegnen, wird ein Logistikdienstleister dazu befähigt, die Technologie in seinem Dienstleistungsportfolio einzugliedern. Die Besetzung der Schnittstelle zwischen Kunden und Produzenten ermöglicht es wertschöpfende Elemente in die Prozesskette des Logistikdienstleisters zu integrieren, indem dieser sich als Experte zur technischen und wirtschaftlichen Bewertung von additiven Bauteilen etabliert. In order to counter the disruptive risks of additive manufacturing technology for the logistics industry, a logistics service provider is enabled to integrate the technology into its service portfolio. Filling the interface between customers and producers enables value-adding elements to be integrated into the process chain of the logistics service provider by establishing itself as an expert for the technical and economic evaluation of additive components.
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Coralic, Zlatan, Hendry R. Sawe, Juma A. Mfinanga, Alfredo Cortez, Jennifer Koehl, Hannah Siroker, and Teri A. Reynolds. "Ketamine procedural sedation in the emergency department of an urban tertiary hospital in Dar es Salaam, Tanzania." Emergency Medicine Journal 35, no. 4 (January 22, 2018): 214–19. http://dx.doi.org/10.1136/emermed-2017-206974.
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Study objectiveWe describe ketamine procedural sedations and associated adverse events in low-acuity and high-acuity patients in a resource-limited ED.MethodsThis was a prospective observational study of ketamine procedural sedations at the Emergency Medical Department at the Muhimbili National Hospital in Dar es Salaam, Tanzania. We observed consecutive procedural sedations and recorded patient demographics, medications, vital signs, pulse oximetry, capnography and a priori defined adverse events (using standard definitions in emergency medicine sedation guidelines). All treatment decisions were at the discretion of the treating providers who were blinded to study measurements to simulate usual care. Data collection was unblinded if predefined safety parameters were met. For all significant adverse and unblinding events, ketamine causality was determined via review protocol. Additionally, providers and patients were assessed for sedation satisfaction.ResultsWe observed 54 children (median 3 years, range 11 days–15 years) and 45 adults (median 33 years, range 18–79 years). The most common indications for ketamine were burn management in children (55.6%) and orthopaedic procedures in adults (68.9%). Minor adverse events included nausea/vomiting (12%), recovery excitation (11%) and one case of transient hypertension. There were nine (9%) patients who had decreased saturation readings (SpO2 ≤92%). There were three deaths, all in severely injured patients. After review protocol, none of the desaturations or patient deaths were thought to be caused by ketamine. No patient experienced ketamine-related laryngospasm, apnoea or permanent complications. Overall, ketamine was well tolerated and resulted in high patient and provider satisfaction.ConclusionIn this series of ketamine sedations in an urban, resource-limited ED, there were no serious adverse events attributable to ketamine.
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Patt, Debra A., Jennifer Trageser, Jeffrey A. Howard, Max Rush, Cara Heiman, Rajesh Yalamanchili, Daniel Lodder, et al. "Implementing an oncology-specific health care IT portal to enhance patient-provider communication." Journal of Clinical Oncology 31, no. 31_suppl (November 1, 2013): 31. http://dx.doi.org/10.1200/jco.2013.31.31_suppl.31.
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31 Background: Our large network of oncology practices (PRs) launched a health IT (HIT) patient portal (PP) to improve patient (PT) access to clinical information (CI) and serve as a platform to enhance PR-to-PT communication (C). Methods: A team of HIT specialists and oncologists engaged in development of the PP to develop a platform to facilitate PR-to-PT C, satisfy meaningful use (MU) requirements, and have brand identification (ID) for PRs. Workflow planning for implementation was conducted including ID and education of key participants at PRs. Educational signage was posted at PRs during initiation partnered with information at check-in at clinic visits to inform PTs about PP benefits and registration steps. After consent was obtained, pts were invited by email to the PP and could access their PP and view and download their secure CI. A review of support calls from both PR personnel and pts highlighted opportunities for enhanced PP engagement. Enrollment (E) was captured monthly. Results: From April 2012 to June 2013 more than 34,000 pts have enrolled in the PP across over 47 PRs (Table). In addition, inclusion of the PR brand and removing extraneous data capture during E are critical to success. Comparing E data from April 2012 to April 2013 after increased PR brand ID and reduction of pt validation changes were implemented, there was an increase of 13% of opened Is and 22% increase in Es. Conclusions: By engaging a development team, and strategically planning content dissemination and education around initiation, implementation of the PP was widely utilized throughout the PRs. By monitoring adoption rates and capturing the PT feedback, incremental enhancements can positively affect PT engagement with PRs. This functional mechanism can now serve as a platform to facilitate C between PRs and PTs, fulfill MU requirements, and plan future dissemination of educational content. [Table: see text]
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Marwa, Rose, and Amani Anaeli. "Perceived Barriers Toward Provider-Initiated HIV Testing and Counseling (PITC) in Pediatric Clinics: A Qualitative Study Involving Two Regional Hospitals in Dar-Es-Salaam, Tanzania." HIV/AIDS - Research and Palliative Care Volume 12 (March 2020): 141–50. http://dx.doi.org/10.2147/hiv.s235818.
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Kriner, Paula, and Yolanda Bernal. "Attitudes, Beliefs, and Practices Regarding Asthma Care Among Providers and Adult Asthmatics in Imperial County." Californian Journal of Health Promotion 1, no. 2 (June 1, 2003): 88–100. http://dx.doi.org/10.32398/cjhp.v1i2.1687.
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Asthma is a major cause of morbidity in children and adults. Imperial County has reported among the highest asthma hospitalization rates in the state. Factors such as poverty, access to care, poor selfmanagement skills, and ethnocultural beliefs may influence asthma exacerbations. Provider and adult asthmatic attitudes, beliefs, and practices regarding asthma were examined using a mixed-methods approach: a survey to evaluate provider conformance with national guidelines, and focus groups targeting medical practitioners and adult asthmatics. Half of all providers who treat asthmatics completed a self-administered survey about asthma diagnosis; clinical monitoring of patients; treatment; patient education; and practice guidelines. Provider focus groups further explored survey results. Adult asthmatics participated in Spanishlanguage focus groups exploring cultural beliefs, attitudes, and practices. El asma es la mayor causa de morbilidad entre niños y adultos. El Condado de Imperial ha reportado las tazas más altas de hospitalización a causa de asma en el estado. Factores como la pobreza, acceso a cuidado médico, falta de experiencia sobre como manejar la enfermedad, y creencias étnicas y culturales pueden tener una influencia en las exacerbaciones del asma. Las actitudes, creencias, y prácticas de proveedores de atención médica y adultos concerniente al asma fueron examinadas utilizando varios métodos: una encuesta con el fin de evaluar el nivel de conformidad de los proveedores según las pautas establecidas a nivel nacional, y grupos foco con médicos y adultos con asma. La mitad de los proveedores que proveen atención a asmáticos completaron una encuesta acerca del diagnosis de asma; el monitoreo clínico de los pacientes; administración de tratamiento; educación a los pacientes; y pautas establecidas para proveer atención a pacientes con asma. Los grupos foco con los proveedores exploraron aun más los resultados de las encuestas. Los adultos con asma participaron en grupos foco dirigidos en español para explorar más a fondo las creencias culturales, actitudes y prácticas.
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Kriner, Paula, and Yolanda Bernal. "Attitudes, Beliefs, and Practices Regarding Asthma Care Among Providers and Adult Asthmatics in Imperial County." Californian Journal of Health Promotion 1, no. 2 (June 1, 2003): 88–100. http://dx.doi.org/10.32398/cjhp.v1i2.432.
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Asthma is a major cause of morbidity in children and adults. Imperial County has reported among the highest asthma hospitalization rates in the state. Factors such as poverty, access to care, poor selfmanagement skills, and ethnocultural beliefs may influence asthma exacerbations. Provider and adult asthmatic attitudes, beliefs, and practices regarding asthma were examined using a mixed-methods approach: a survey to evaluate provider conformance with national guidelines, and focus groups targeting medical practitioners and adult asthmatics. Half of all providers who treat asthmatics completed a self-administered survey about asthma diagnosis; clinical monitoring of patients; treatment; patient education; and practice guidelines. Provider focus groups further explored survey results. Adult asthmatics participated in Spanishlanguage focus groups exploring cultural beliefs, attitudes, and practices. El asma es la mayor causa de morbilidad entre niños y adultos. El Condado de Imperial ha reportado las tazas más altas de hospitalización a causa de asma en el estado. Factores como la pobreza, acceso a cuidado médico, falta de experiencia sobre como manejar la enfermedad, y creencias étnicas y culturales pueden tener una influencia en las exacerbaciones del asma. Las actitudes, creencias, y prácticas de proveedores de atención médica y adultos concerniente al asma fueron examinadas utilizando varios métodos: una encuesta con el fin de evaluar el nivel de conformidad de los proveedores según las pautas establecidas a nivel nacional, y grupos foco con médicos y adultos con asma. La mitad de los proveedores que proveen atención a asmáticos completaron una encuesta acerca del diagnosis de asma; el monitoreo clínico de los pacientes; administración de tratamiento; educación a los pacientes; y pautas establecidas para proveer atención a pacientes con asma. Los grupos foco con los proveedores exploraron aun más los resultados de las encuestas. Los adultos con asma participaron en grupos foco dirigidos en español para explorar más a fondo las creencias culturales, actitudes y prácticas.
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Andrade Rosas, Luis Antonio. "¿Adquirir o integrar al proveedor? El dilema de una empresa: un modelo de teoría de juegos aplicado / Acquire or Integrate the Provider? The Dilemma of a Company: a Model of Game Theory Applied." Revista Internacional de Tecnología, Ciencia y Sociedad 7, no. 2 (March 5, 2019): 89–98. http://dx.doi.org/10.37467/gka-revtechno.v7.1980.
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ABSTRACTSometimes, the size of a company exceeds the level of sales and generates losses; to reduce them, it is proposed that the company incorporates its supplier. Such incorporation can be done in two ways: i) acquire it completely, or ii) associate it. An imperfect information model is built for the company, and the types of suppliers that exist are determined. Based on a signal from the provider, a threshold is derived from which it is beneficial for the company to incorporate the supplier. In addition, 50% could be granted to the provider if it is of healthy finances.RESUMENEn ocasiones, el tamaño de una empresa sobrepasa el nivel de ventas y genera pérdidas; para reducirlas, se propone la incorporación de una proveedora por parte de la empresa. Tal incorporación la puede hacer de dos formas: i) Adquirirla completamente, o ii) asociarla. Se construye un modelo de información imperfecta para la empresa, y se determinan los tipos de proveedoras que existen. Con base en una señal de la proveedora, se deduce un umbral a partir del cual es benéfico para la empresa incorporar a la proveedora. Además, podría otorgarse el 50% a la proveedora si fuera de finanzas sanas.
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Dexheimer, Judith, Eric Kirkendall, Michal Kouril, Philip Hagedorn, Thomas Minich, Leo Duan, Monifa Mahdi, Rhonda Szczesniak, and S. Andrew Spooner. "The Effects of Medication Alerts on Prescriber Response in a Pediatric Hospital." Applied Clinical Informatics 08, no. 02 (April 2017): 491–501. http://dx.doi.org/10.4338/aci-2016-10-ra-0168.
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Summary Objective: More than 70% of hospitals in the United States have electronic health records (EHRs). Clinical decision support (CDS) presents clinicians with electronic alerts during the course of patient care; however, alert fatigue can influence a provider’s response to any EHR alert. The primary goal was to evaluate the effects of alert burden on user response to the alerts. Methods: We performed a retrospective study of medication alerts over a 24-month period (1/2013–12/2014) in a large pediatric academic medical center. The institutional review board approved this study. The primary outcome measure was alert salience, a measure of whether or not the prescriber took any corrective action on the order that generated an alert. We estimated the ideal number of alerts to maximize salience. Salience rates were examined for providers at each training level, by day of week, and time of day through logistic regressions. Results: While salience never exceeded 38%, 49 alerts/day were associated with maximal salience in our dataset. The time of day an order was placed was associated with alert salience (maximal salience 2am). The day of the week was also associated with alert salience (maximal salience on Wednesday). Provider role did not have an impact on salience. Conclusion: Alert burden plays a role in influencing provider response to medication alerts. An increased number of alerts a provider saw during a one-day period did not directly lead to decreased response to alerts. Given the multiple factors influencing the response to alerts, efforts focused solely on burden are not likely to be effective. Citation: Dexheimer JW, Kirkendall ES, Kouril M, Hagedorn PA, Minich T, Duan LL, Mahdi M, Szczesniak R, Spooner SA. The effects of medication alerts on prescriber response in a pediatric hospital. Appl Clin Inform 2017; 8: 491–501 https://doi.org/10.4338/ACI-2016-10-RA-0168
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Schreiber, Delia, Gerd Nagel, and Norbert Marschner. "Nutzen und Bedarf von Empowerment-Support bei Brustkrebs im Frühstadium: Von der Patienteninformation zum Empowerment-Coaching." Deutsche Zeitschrift für Onkologie 49, no. 04 (December 2017): 156–61. http://dx.doi.org/10.1055/s-0043-121426.
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Zusammenfassung Hintergrund In den letzten 2 Jahrzehnten fand ein beachtlicher Wandel im Rollenverständnis von Krebspatienten statt. Eine neue Generation kompetenter Patienten erwartet heute neue Formen von Beratungsleistungen zum Empowerment-Support. Fragestellung Wie steht es um den Nutzen von Beratungsleistungen zum Empowerment-Support? Decken sie im Speziellen den Bedarf von Patientinnen mit frühem Brustkrebs ab? Wenn nein, welcher Handlungsbedarf ergibt sich? Methodik Literatur-Review; Befragung institutioneller Health-Care-Provider; Praxiserfahrungen. Ergebnisse Der kurzfristige Nutzen von Empowerment-Interventionen ist gut belegt. Zum langfristigen krankheitsbezogenen Nutzen liegen hingegen nur spärliche Daten vor. Aus der Sicht kompetenter Patientinnen mit Brustkrebs im Frühstadium bestehe eine Lücke im Spektrum der Empowerment-Leistungen. Es fehle am speziellen Coaching zur Förderung der Selbstwirksamkeitserwartung. Die inhaltlichen und methodischen Grundlagen eines solchen Empowerment-Coaching werden beschrieben. Diskussion Im Vergleich zu früher dürfte heute eine bessere wissenschaftliche Ausgangssituation zur Durchführung von prospektiven kontrollierten Studien zum langfristigen Nutzen von Empowerment-Interventionen bestehen.
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Cai, Zhao, Hefu Liu, Qian Huang, Yue Kang, and Liang Liang. "Encouraging client’s knowledge sharing in enterprise system post-implementation through psychological contract and entrepreneurial orientation." Information Technology & People 33, no. 2 (September 30, 2019): 689–709. http://dx.doi.org/10.1108/itp-11-2018-0510.
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Purpose The purpose of this paper is to discuss the relationship between psychological contract and knowledge sharing behavior in the enterprise system (ES) post-implementation stage. The fulfillment and obligation of psychological contract are proposed as antecedents of knowledge sharing behavior performed by client firms. Additionally, entrepreneurial orientation (EO) is considered a moderator in the relationship between psychological contract and knowledge sharing. Design/methodology/approach This study adopted the questionnaire survey to collect data from 132 client firms of a focal ES provider in the garment industry of China. Hierarchical regression analysis was used for data analysis. Findings Psychological contract fulfillment is negatively related to knowledge sharing, whereas the positive role of psychological contract obligation is supported. EOstrengthens the role of both psychological contract fulfillment and obligation in shaping knowledge sharing behavior of client firms. Originality/value This study adopts forward- and backward-looking approaches in decision making as a theoretical lens to investigate how to improve client firms’ knowledge sharing behavior through psychological contract. By figuring out the roles of psychological contract and EO in influencing knowledge sharing, this research benefits both vendor and client firms in maintaining sustainable collaboration and continuous improvement of ES projects.
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Fuente, Iván de la, Eliseo Navarro, and Gregorio Serna. "Reverse Mortgage Risks. Time Evolution of VaR in Lump-Sum Solutions." Mathematics 8, no. 11 (November 17, 2020): 2043. http://dx.doi.org/10.3390/math8112043.
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In this study, we analyzed the risk faced by the reverse mortgage provider in the case of the lump-sum solution, which is increasingly becoming one of the most popular types of reverse mortgages. The risk faced by the mortgage provider was estimated by means of a value at risk (VaR) procedure that involves a Monte Carlo simulation method and an ARMA-EGARCH assumption for modeling house price returns in the United Kingdom from 1952 to 2019. The results showed that the reverse mortgage provider faced higher risk and consequently needed to allocate more funds to meet its regulatory capital requirements in the case of relatively young borrowers, especially when they reached their life expectancy and had high roll-up rates. The risk was even higher in the case of the female population. Furthermore, care must be taken when the rental yield rate is higher than the risk-free rate, as is currently the case, as the value of the no-negative-equity guarantee (NNEG) is relatively high and results in higher value at risk (VaR) and expected shortfall (ES) values. These results have important implications in terms of policy decision making when determining the countercyclical buffer for reverse mortgages in Basel III, as well as from a managerial perspective when determining the economic capital needed to support the risk taken by the lender.
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Ryan, Samuel, Aaron J. Coutts, Joel Hocking, Patrick A. Dillon, Anthony Whitty, and Thomas Kempton. "Physical Preparation Factors That Influence Technical and Physical Match Performance in Professional Australian Football." International Journal of Sports Physiology and Performance 13, no. 8 (September 1, 2018): 1021–27. http://dx.doi.org/10.1123/ijspp.2017-0640.
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Objectives: To examine the collective influence of a range of physical preparation elements on selected performance measures during Australian football match play. Design: Prospective and longitudinal. Methods: Data were collected from 34 professional Australian football players from the same club during the 2016 Australian Football League competition season. Match activity profiles and acute (7-d) and chronic (3-wk) training loads were collected using global positioning system devices. Training response was measured by well-being questionnaires completed prior to the main training session each week. Maximal aerobic running speed (MAS) was estimated by a 2-km time trial conducted during preseason. Coach ratings were collected from the senior coach and 4 assistants after each match on a 5-point Likert scale. Player ratings were obtained from a commercial statistics provider. Fifteen matches were analyzed. Linear mixed models were constructed to examine the collective influence of training-related factors on 4 performance measures. Results: Muscle soreness had a small positive effect (ES: 0.12) on Champion Data rating points. Three-week average high-speed running distance had a small negative effect (ES: 0.14) on coach ratings. MAS had large to moderate positive effects (ES: 0.55 to 0.47) on relative total and high-speed running distances. Acute total and chronic average total running distance had small positive (ES: 0.13) and negative (ES: 0.14) effects on relative total and high-speed running distance performed during matches, respectively. Conclusions: MAS should be developed to enhance players’ running performance during competition. Monitoring of physical preparation data may assist in reducing injury and illness and increasing player availability but not enhance football performance.
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Liao, Hung-Chang, and Ya-huei Wang. "Storytelling in Medical Education: Narrative Medicine as a Resource for Interdisciplinary Collaboration." International Journal of Environmental Research and Public Health 17, no. 4 (February 11, 2020): 1135. http://dx.doi.org/10.3390/ijerph17041135.
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Objective: The study intended to use narrative medicine study for interdisciplinary collaboration to let medical and healthcare students have a chance to interact with one another and listen to patients’ stories to enhance students’ reflective thinking, communication, empathy, and narrative medicine writing skills. Methods: A fifteen-week quasi-experimental design was used to examine the learning outcomes of the intervention. Two groups of students were randomly assigned as the experimental group (33 students) and the control group (32 students). Before and after the intervention, both groups had to fill in a Reflective Thinking Scale for Healthcare Students and Providers (RTS-HSP), Patient–Healthcare Provider Communication Scale (P-HCS), Empathy Scale in Patient Care (ES-PC), and Analytic Narrative Medicine Writing Scoring Rubric (ANMWSR). Results: The findings showed that on the reflective thinking scale, experimental group students had significantly higher reflective thinking posttest scores in “reflective skepticism,” “empathetic reflection,” and “critical open-mindedness,” but not in “self-examination.” As for patient–healthcare provider communication, they had significantly higher posttest scores in all “perception of trust and receptivity,” “patient-centered information giving,” “rapport building,” and “facilitation of patient involvement” factors. As for empathy, they had significant higher posttest scores in “behavioral empathy” and “affective empathy,” but not in “intelligent empathy.” In narrative medical writing skills, they had significant higher posttest scores in the “attention → representation → affiliation,” “depth of reflection,” “focus and context structure,” and “ideas and elaboration” sections, but not in the “language and conventions” section. Conclusion: The findings suggest that narrative medicine is worth recommending for interdisciplinary collaboration for healthcare education.
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Muñoz Acuña, Doraly, Maria Teresa Olarte Castro, and Emilce Salamanca Ramos. "Grado de adherencia terapéutica en pacientes en Unidades de Cuidados Intensivos." Enfermería Global 20, no. 1 (January 1, 2021): 1–22. http://dx.doi.org/10.6018/eglobal.412831.
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Introducción: La adherencia al tratamiento en el escenario del paciente en la unidad de cuidados intensivos con factores de riesgo cardiovascular es fundamental y es de interés en los sistemas de salud. Objetivo: Analizar los factores que influyen en la adherencia terapéutica al tratamiento de los pacientes con riesgo cardiovascular que ingresaron a tres unidades de Cuidados Intensivos. Materiales y Método: Estudio descriptivo con variables cuantitativos con un diseño no probabilístico discrecional, con muestra: 38 pacientes durante un periodo de seis meses. Instrumento utilizado: “Factores que influyen en la adherencia a los tratamientos farmacológicos y no farmacológicos en pacientes con factores de riesgo de enfermedad cardiovascular”. Resultados: El rango de edad más predominante es de 61-70 años (28.8%), el 55,3% fueron hombres, el grado de adherencia al tratamiento farmacológico y no farmacológico mostró situación de ventaja para adherirse 61%, y con un apoyo familiar para atender las necesidades básicas, situación de riesgo para no adherirse 26%, 39.4% que reporta la “dificultades en los cambios de la dieta por el alto costo de los alimentos recomendados” y situación de no adherirse 13%, al tratamiento. Conclusiones: Se destaca la importancia de la relación proveedor-paciente en grado de adherencia de las tres IPS, donde se evidencia la intervención del primer nivel con acciones de autocuidado individual. Sin embargo, se encuentra un porcentaje significativo de riesgo y de no adherencia por factores relacionados con el paciente y el proveedor, lo que influye en los reingresos a la unidad de cuidados intensivos. Introduction. Adherence to treatment in the scenario of patients with cardiovascular risk factors in intensive care units is fundamental and of interest in health systems. Objective. The work sought to analyze factors influencing on therapeutic adherence to treatment by patients with cardiovascular risk admitted to three intensive care units. Materials and Method. Descriptive study with quantitative variables with discretional non-probabilistic design, with a sample of 38 patients during a six-month period. Instrument used: “Factors influencing on adherence to pharmacological and non-pharmacological treatments in patients with risk factors for cardiovascular disease”. Results. The most prevalent age range was 61 - 70 years (28.8%); 55.3% were men; the degree of adherence to pharmacological and non-pharmacological treatment showed 61% advantage for adherence, and with family support to meet basic needs, 26% with situation of risk for not adhering, 39.4% reported “difficulties in changes of diet due to high costs of foods recommended” and 13% in situation of not adhering to the treatment. Conclusions. The work highlights the importance of the provider-patient relation on the degree of adherence from three health provider institutions, evidencing first-level intervention with individual self-care actions. However, a significant percentage of risk and non-adherence are found due to factors related with the patient and the provider, which impacts on readmissions to the intensive care unit.
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Musalam, Kauther, Karpal S. Sohal, Sira S. Owibingire, and Baraka Kileo. "Magnitude and Determinants of Dental Anxiety among Adult Patients Attending Public Dental Clinics in Dar-Es-Salaam, Tanzania." International Journal of Dentistry 2021 (May 8, 2021): 1–7. http://dx.doi.org/10.1155/2021/9965204.
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Introduction. It is estimated that, about 40% of the population suffer from dental anxiety. Dental anxiety is considered to be complex and multifactorial with a wide range of provoking factors which may be patient, provider, or environment-related. Aim. This study aimed to assess the magnitude and determinants of dental anxiety among adult patients attending public dental clinics in Dar es Salaam, Tanzania. Methodology. This was a descriptive cross-sectional study carried out in 4 public hospitals in Dar es Salaam, Tanzania. It included 300 adult patients who had dental caries, periodontal diseases, or dental trauma. Data were collected using a self-administered Modified Dental Anxiety Scale (MDAS) questionnaire. Data were analyzed using the SPSS computer software version 23. A one-way Analysis of Variance (ANOVA) was used to assess the association between variables, and the significance level was set at p < 0.05 . Results. The mean age of participants was 32.18 years (±11.06 SD) with a male-to-female ratio of 1 : 1.43. The means MDAS score was 12.84 ± 4.99. Tooth extraction had the highest mean MDAS score. The majority (261, 87%) of participants had mild-to-severe anxiety. The most common (72.2%) anxiety-provoking factor was an unsympathetic dentist; others included unawareness of the procedure to be carried out (58.3%) and the presence of apprehensive patients (52.0%). The level of anxiety was found to be statistically significantly associated ( p < 0.05 ) with young age [ p = 0.009 , AOR 3.06 (95% CI, 1.32, 7.09), female patients [ p < 0.001 , AOR 4.45 (95% CI, 2.05, 9.70)], and a higher education level [ p < 0.05 , AOR 2.32 (95% CI, 1.03, 5.25)]. Conclusion. The prevalence of dental anxiety was high among the participants of this study. Female gender, young age, and a higher level of education constituted determinants of dental anxiety. An unsympathetic practitioner, unawareness of the procedure, and presence of apprehensive patients were the common anxiety-provoking factors.
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Stevens, L. A., E. S. Mailes, B. A. Goad, C. A. Longhurst, and J. L. Pantaleoni. "Successful Physician Training Program for Large Scale EMR Implementation." Applied Clinical Informatics 06, no. 01 (2015): 80–95. http://dx.doi.org/10.4338/aci-2014-09-cr-0076.
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SummaryEnd-user training is an essential element of electronic medical record (EMR) implementation and frequently suffers from minimal institutional investment. In addition, discussion of successful EMR training programs for physicians is limited in the literature. The authors describe a successful physician-training program at Stanford Children’s Health as part of a large scale EMR implementation. Evaluations of classroom training, obtained at the conclusion of each class, revealed high physician satisfaction with the program. Free-text comments from learners focused on duration and timing of training, the learning environment, quality of the instructors, and specificity of training to their role or department. Based upon participant feedback and institutional experience, best practice recommendations, including physician engagement, curricular design, and assessment of proficiency and recognition, are suggested for future provider EMR training programs. The authors strongly recommend the creation of coursework to group providers by common workflow.Citation: Pantaleoni JL, Stevens LA, Mailes ES, Goad BA, Longhurst CA. Successful physician training program for large scale EMR implementation. Appl Clin Inf 2015; 6: 80–95http://dx.doi.org/10.4338/ACI-2014-09-CR-0076
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Munn, M., C. Phillips, J. Laraya, and G. Boivin-Arcouette. "P056: Gastric ultrasound in stable patients with decreased level of consciousness and recreational substance use -- are presumed full stomachs full?" CJEM 22, S1 (May 2020): S84. http://dx.doi.org/10.1017/cem.2020.262.
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Introduction: Intoxicated patients with decreased Glasgow Coma Scale (GCS) are common presentations to emergency departments. These patients are often intubated due to presumed full stomachs and perceived aspiration risk. Gastric ultrasound (GUS) -- a simple, non-invasive and objective option -- could be applied to this problem. This pilot study uses GUS alongside usual care at a music festival; a bounded, intoxication-dense environment where airways are often managed using non-invasive airway strategies. We aim to (1) clarify the gastric contents of any intubated patients, and (2) assess if patients managed without intubation go on to have a lack of aspiration sequelae because of empty stomachs or in spite of full stomachs. Methods: A prospective cohort study was conducted at a multi-day music festival. Patients presenting to on-site medical services with GCS ≤ 13 and known or suspected substance use were included. Patients with trauma, instability, metabolic derangements or additional aspiration risk factors (eg morbid obesity, pregnancy) were excluded. Standard GUS was performed by a trained provider and results were categorized according to convention as FS (full stomach, ie solids or liquids >1.5mL/kg) or ES (empty stomach, ie empty or liquids <1.5mL/kg). Additional patient data were extracted from linked medical records post event. Results: 33 patients met inclusion criteria and 27 remained after exclusions were applied and consent obtained. 25 patients reported substance use and 19 polysubstance use. The FS group had 15 patients (7 solid & 8 liquid > 1.5), and the ES group had 12 patients (5 empty & 12 liquid < 1.5). The median low GCS documented for FS and ES was 7 and 11 respectively, and 10 patients total had a GCS of 8 or less (6 FS & 4 ES). No patients were intubated and all were managed conservatively according to usual care. 3 patients (2 FS, 1 ES) were transferred to hospital. No patients re-registered at medical for clinically significant aspiration. Conclusion: This pilot study demonstrates the potential utility of GUS in stratifying aspiration risk in intoxicated patients with decreased GCS. “Empty” stomachs might avoid intubation, while the implications and true risks of “full” stomachs for aspiration sequelae in the absence of intubation remain unclear. Due to the small numbers in this pilot study and the quoted GUS sensitivity (only 95%), further research is needed to evaluate the safe application of this modality to clinical decision-making in intoxicated patients.
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Vuletić, Dijana, Silvija Krajter Ostoić, Ljiljana Keča, Mersudin Avdibegović, Kristina Potočki, Stjepan Posavec, Aleksandar Marković, and Špela Pezdevšek Malovrh. "Water-Related Payment Schemes for Forest Ecosystem Services in Selected Southeast European (SEE) Countries." Forests 11, no. 6 (June 8, 2020): 654. http://dx.doi.org/10.3390/f11060654.
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This paper examines the level of payment for ecosystem services (PES) concept implementation in the financing of water-related forest ecosystem services (ES) in the Republic of Croatia, the Federation of Bosnia and Herzegovina (FB&H), the Republic of Slovenia, and the Republic of Serbia. The focus is on water-related forest ES recognised by the millennium ecosystem assessment (MEA). For the purpose of this paper, the term pure PES describes schemes that comply to all five conditions set by Wunder definition and term PES like for those schemes that miss some of those conditions. In the first step, the most important legislative documents related to forests, water, and environmental protection were selected. The second consists of a content analysis; focusing on the definition of ES; the definition of fees or payments; the establishment of ‘forest funds’, ‘water funds’, or ‘environmental funds’; and the way these funds were spent. Here we looked at the flow of funding into the forestry sector recognising forest management as the main water-related forest ES provider. Research revealed existence of well-established payments schemes in forestry in Croatia for almost 30 years and in FB&H for some 20 years which were assessed as closest to pure PES. In Serbia and Slovenia, there were no PES or PES like schemes in the forestry sector. In the water sector the well-established PES like payments schemes existing in all four countries. The environmental protection sector, however, rely more on the tax like rather than on the PES like schemes. Legislation in general recognised the link between forests and water, but this was much more evident in the forestry than in the water or environment sector. The role of the state is strongly pronounced in all countries studied, and was the main driving force behind all payments. However, this position of the state represents also the main obstacle for the development of pure PES schemes, together with underdeveloped private forestry and complex socio-economic conditions. Nevertheless, there is room for further development of pure PES and PES like schemes based on EU or global experiences.
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Mader, Marius, and Margarete Menz. "Steuerung im Elementarbereich – Qualitätssicherung und -entwicklung aus Sicht von Trägern." Diskurs Kindheits- und Jugendforschung / Discourse Journal of Childhood and Adolescence Research 14, no. 2-2019 (July 1, 2019): 213–26. http://dx.doi.org/10.3224/diskurs.v14i2.07.
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Mit der zunehmenden Bedeutung von Kindertageseinrichtungen als Bildungsorten wächst auch die Relevanz der Qualitätssteuerung in den Einrichtungen. Einen zentralen Stellenwert in diesem Prozess nehmen Träger von Kindertageseinrichtungen ein, denen zunehmend Verantwortung für die Implementierung von Qualitätsentwicklungsmaßnahmen zukommt. Dennoch fehlt es bislang an einschlägigen Studien zu trägereigenen Steuerungsprozessen. Der vorliegende Artikel geht in explorativer Hinsicht auf Basis von Expert_inneninterviews der Frage nach, wie Träger die an sie herangetragene Aufgabe der Qualitätssteuerung bearbeiten. Trägerspezifische Stile der Steuerung von Qualität verweisen im Ergebnis auf die zentrale Figur des ‚Erzieher_innensubjekts‘ als Adressat_in und Produkt der Maßnahmen.
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Linde, Ditte Søndergaard, Vibeke Rasch, Julius D. Mwaiselage, and Tine M. Gammeltoft. "Competing needs: a qualitative study of cervical cancer screening attendance among HPV-positive women in Tanzania." BMJ Open 9, no. 2 (February 2019): e024011. http://dx.doi.org/10.1136/bmjopen-2018-024011.
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ObjectivesThe aim of this study was to understand causes of attendance and non-attendance to a follow-up cervical cancer screening among human papillomavirus (HPV)-positive women.DesignSemistructured, individual interviews with HPV-positive women and cervical cancer screening nurses. The interview guide and initial data analysis were guided by existing health behaviour theories. However, as the theories limited the potential of the data material, a grounded theory framework guided the final data analysis.SettingInterviews were conducted in Dar es Salaam, Tanzania, at Ocean Road Cancer Institute (ORCI) or in the homes of screening clients.Participants15 interviews were conducted with women who had tested HPV-positive during a patient-initiated screening and been appointed for a follow-up screening 14 months later. Nine women had not attended the follow-up appointment, four had delayed attendance and two had attended on the scheduled date. Further, individual interviews were conducted with the two nurses working at ORCI’s screening clinic.ResultsPerceived benefits for attending a patient-initiated screening include treatment of gynaecological symptoms and prevention of disease. The key perceived benefit of a health provider-initiated follow-up screening is prevention, which is challenged by the circumstance that it is seen by women as having merely potential benefit and therefore can be postponed when competing needs are present. Perceived challenges for screening attendance include emotional costs, in the form of fear of the disease, fear of the gynaecological examination as well as direct and indirect economic costs, such as transportation costs, lost income and waiting time.ConclusionCervical cancer screening is one among many tasks that women living in a low-income setting must attend to. Since health provider-initiated follow-up screening is seen as having only potential benefit, attendance can be postponed when competing needs exist.Trial registration numberNCT02509702.
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Hochfelder, David. "A Comparison of the Postal Telegraph Movement in Great Britain and the United States, 1866–1900." Enterprise & Society 1, no. 4 (December 2000): 739–61. http://dx.doi.org/10.1093/es/1.4.739.
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This article places the British and American postal telegraph movements in the broader context of a transatlantic reform tradition. More specifically, British nationalization in 1870 gave American reformers both a rallying point and a rationale for postalizing the telegraphs. The legacies of both movements were mixed. In Britain, the postal telegraph provided inexpensive and accessible service, but it soon ran a large deficit and retarded the development of the telephone industry. In the United States, reformers failed to nationalize the telegraph or to secure a place in historical memory, but they succeeded in pressuring Western Union to provide better service, and they provided the impetus for the municipal ownership movement of the Progressive Era.
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Jariyah, Jariyah, Sri Djajati, and Anugerah Dany Priyanto. "PELATIHAN PENGOLAHAN ES PUTER DAN ES KRIM PADA KELOMPOK BANK SAMPAH BINTANG MANGROVE, GUNUNG ANYAR SURABAYA." LOGISTA - Jurnal Ilmiah Pengabdian kepada Masyarakat 5, no. 1 (June 30, 2021): 266. http://dx.doi.org/10.25077/logista.5.1.266-271.2021.
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Pemanfaatan buah mangrove sebagai bahan dasar minuman belum dilakukan secara optimal, untuk itu, perlu dikembangkan lebih lanjut menjadi produk minuman yang mempunyai kandungan nutrisi yang tinggi. Implementasi dari penelitian tersebut yaitu pada kegiatan pengabdian masyarakat pada kelompok Bank Sampah Bintang Mangrove (BSBM). Ketrampilan yang diberikan yaitu pembuatan minuman beku berupa es puter dan es krim dengan bahan dasar buah mangrove. Metode yang digunakan dalam memfasilitasi peningkatan ketrampilan kelompok BSBM dengan memberikan pelatihan berupa metode ceramah, praktik dan pendampingan. Metode ceramah dengan memberikan teori dasar dalam pengolahan buah mangrove menjadi es puter dan es krim, sehingga mempunyai nilai tambah baik dari segi rasa maupun nutrisi dari minuman tersebut. Metode praktik yaitu memberikan pelatihan yang ditekankan pada kemampuan kelompok BSBM dalam membuat minuman yang mempunyai rasa dan kandungan nutrisi tinggi, memiliki fungsi terhadap kesehatan. Pelatihan ini lebih mengedepankan partisipasi aktif kelompok BSBM serta memberikan pendampingan untuk keberlanjutan kegiatan usaha dan pemasaran. Luaran dari kegiatan ini adalah dihasilkan produk minuman yang mempunyai kandungan nutrisi dan produk inovatif, sehingga dapat membantu menambah pendapatan kelompok BSBM.
Kata kunci: Es Puter, Es Krim, Buah Mangrove, Gunung Anyar, Pengabdian Masyarakat
ABSTRACT
Utilizarion of mangrove fruit as a main ingredient for drinks has not been carried out optimally, therefore, it is necessary to develop into beverage products within higly nutrition value. Implementation of research result by community service to Bank Sampah Bintang Mangrove (BSBM) group (BSBM). The given skills are production of frozen drinks into es puter and ice cream with mangrove fruit as the main ingredient. The method used in facilitating the improvement of the skills from BSBM group were conducted by training of lecture method, practice and mentoring. The lecture method provided a basic theory of processing mangrove fruit into es puter and ice cream, so that it has added value in terms of both taste and nutrition from the drink. The practical method was to provide training that emphasizes the ability of the BSBM group in making drinks that have high taste and nutritional value, which have a function for health. This training emphasizes the active participation of the BSBM group and provides assistance for the sustainability of business and marketing activities. The output of this activity is to produce beverage products that have nutritional value and innovative product, in order to increase their income from BSBM group.
Keywords: Es Puter, Ice Cream, Mangrove Fruit, Gunung Anyar, Community Service
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Sánchez Ruiz, Mercedes. "La regulación europea actual sobre emplazamiento de producto y la propuesta de reforma de la directiva de servicios de comunicación audiovisual = The current European rules governing product placement and the new legislative proposal amending the audiovisual media services directive." CUADERNOS DE DERECHO TRANSNACIONAL 9, no. 2 (October 5, 2017): 506. http://dx.doi.org/10.20318/cdt.2017.3884.
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Resumen: La Directiva 2010/13/UE, de Servicios de Comunicación Audiovisual (DSCA) establece la regulación europea vigente sobre emplazamiento de producto. Algunas de sus previsiones son principios que resultan difíciles de aplicar en la práctica (“prominencia indebida”, “influencia que afecta a la independencia editorial del prestador de servicios”). Asimismo, el emplazamiento de producto, por su propia naturaleza, no puede distinguirse con facilidad de la publicidad encubierta. El 25 de mayo de 2016, la Comisión Europea hizo pública una propuesta legislativa para modificar la Directiva de servicios de comunicación audiovisual que incide sobre esta materia. Este artículo examina el régimen de la DSCA sobre emplazamiento de producto y las modificaciones proyectadas. La principal conclusión alcanzada es que la propuesta de Directiva publicada por la Comisión podría dificultar aún más la interpretación y aplicación del régimen jurídico de esta figura.Palabras clave: comunicación comercial audiovisual, emplazamiento de producto, publicidad encubierta, competencia desleal.Abstract: The Directive 2010/13/EU on Audiovisual Media Services (AVMSD) provides the EU current rules on product placement. Some of its provisions are standards, so that they may be difficult to apply (“undue prominence”, “influence that affects the editorial independence of the media service provider”). By its very nature, product placement cannot be clearly distinguished from surreptitious advertising. On 25 May 2016 the European Commission published a legislative proposal for amending the AVMS Directive that affects this issue. The research article examines the rules on product placement under the AVMSD and the proposed amendments. The main conclusion is the proposal published by the EU Commission would not make the rules on product placement clearer and easier to apply.Keywords: audiovisual commercial communication, product placement, surreptitious advertising, unfair competition.
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Pena Sueiro, Nieves, and Ángeles Saavedra Places. "Obsolescencia y resiliencia en Humanidades digitales. El caso de la Biblioteca Digital de Relaciones de Sucesos." Artnodes, no. 23 (January 15, 2019): 79–88. http://dx.doi.org/10.7238/a.v0i23.3243.
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En este trabajo se plantea el problema de la obsolescencia de las aplicaciones de Humanidades digitales a partir de la experiencia con la base de datos CBDRS (Catálogo y Biblioteca Digital de Relaciones de Sucesos), y se presentan las diferentes estrategias que pasan por la adopción de flujos de trabajo para adaptarnos a las nuevas tecnologías y para mantener, conservar y ampliar o mejorar nuestros datos y objetos digitales. La rapidez del avance y desarrollo tecnológico y los cambios en los paradigmas o metodologías inherentes implican la necesidad de reingenierías de las aplicaciones para que funcionen correctamente y podamos hacer uso de la información que nos brindan. En el seno del grupo SIELAE se creó, en el año 1994, una base de datos relacional para almacenar información bibliográfica sobre Relaciones de sucesos con tecnologías que entonces eran punteras pero que hoy resultan anticuadas (a pesar de que el software se fue actualizando y de que se han realizado ya diversos ajustes); al mismo tiempo, los progresos en el conocimiento del campo de investigación, propiciados gracias al trabajo con la base de datos, dieron lugar a algunos cambios en el modelo de datos y a la necesidad de gestionar un volumen de información que no se había previsto. Todas estas razones (los avances tecnológicos, las modificaciones en el modelo de datos o el volumen ingente de información) justifican que, dos décadas después, nos planteásemos la necesidad de soportar una reingeniería de la base de datos CBDRS, pues la aplicación presentaba problemas de rendimiento (el tiempo de espera tras una búsqueda es elevado) y, además, el usuario espera ahora más usabilidad y mayores prestaciones en los catálogos digitales. Pues bien, en este trabajo presentamos los avances en la reingeniería de la base de datos CBDRS, que se construye como data provider del protocolo OAI-PMH, en el formato Dublin Core, y así poder integrarse en metabuscadores que implementen dicho protocolo, como ARACNE. Red de Humanidades Digitales y Letras Hispánicas, que, además, es agregador de otros recolectores como Hispana (portal de acceso al patrimonio digital y agregador nacional) y Europeana (portal de acceso al patrimonio digital europeo). Las actualizaciones y modificaciones a las que fue sometida la base de datos CBDRS la han convertido en una base de datos mucho más potente, capaz de almacenar gran cantidad de información y de devolverla al usuario según múltiples criterios de búsqueda en un tiempo de espera mínimo; además, permite exportar los resultados de búsquedas a otros formatos y enviarlos automáticamente. Una de las grandes novedades de CBDRS es que se completa con un sistema GIS, que permite visualizar la información resultado de las consultas en mapas. Por último, es una aplicación multidispositivo, con una interfaz capaz de adaptarse automáticamente a diferentes dispositivos (teléfonos móviles, tabletas, ordenadores…) y garantizar así la accesibilidad total contenido.
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Jamouli, Aya, and Khali Allali. "Economic valuation of ecosystem services in Africa." E3S Web of Conferences 183 (2020): 01002. http://dx.doi.org/10.1051/e3sconf/202018301002.
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Ecosystems provide vital services that improve and support livelihoods and human well-being. Consequently, scientific research on ecosystem services (ES) has increased, over the past two decades globally, as well as in Africa. This study provides an overview of existing economic ES valuation methods in Africa using the Web of Science databases. The results highlighted that South Africa recorded the high number of ES valuation publications. The most evaluated ES category was provisioning then regulating services. In terms of economic valuation methods, the market price was the most popular, followed by the contingent valuation and the choice experiment methods. Recommendations are provided for future research in this filed.
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Wyss, Kaspar, Peter Kilima, and Nicolaus Lorenz. "Costs of tuberculosis for households and health care providers in Dar es Salaam, Tanzania." Tropical Medicine and International Health 6, no. 1 (January 2001): 60–68. http://dx.doi.org/10.1046/j.1365-3156.2001.00677.x.
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Calvario Parra, José Eduardo, and Rolando Enríque Díaz Caravantes. "Salud, género y clima en migrantes internos e internacionales por Sonora, México." RIEM. Revista internacional de estudios migratorios 8, no. 2 (July 11, 2019): 171. http://dx.doi.org/10.25115/riem.v8i2.2317.
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Introducción: La experiencia migratoria tanto interna como internacional está compuesta por un conjunto de situaciones de peligros y riesgos que ponen en jaque la integridad física y emocional de las personas. El objetivo de este artículo es documentar las experiencias de los/as migrantes ante altas temperaturas y su salud tanto de quienes se dirigen de México o Centroamérica hacia los Estados Unidos de América como los que se desplazan al interior de México rumbo a los campos agrícolas del noroeste.Método: Este trabajo se basa en un estudio de corte cualitativo por medio de entrevistas semiestructuradas sobre el riesgo climático y la salud en migrantes internacionales e internos en la frontera norte de México, particularmente en el estado de Sonora.Resultados: La migración es un punto de inflexión en la vida de las personas entrevistadas. Existe una asocación cualitativa entre la masculinidad y el hecho de emigrar; la noción de proveduria e idea de la aventura son cruciales para entender el proceso migratorio. El afrontar distintos peligros como la violencia y los factores medioambientales generan daños físicos y emocionales.Discusión y/o Conclusión: Existe un proceso de relativización del riesgo climático, en este caso, la minimización de los daños en la salud por las altas temperaturas. La idea de la autosuficiencia e independencia es parte de las identidades de género en los varones migrantes entrevistados. Introduction: The migrational experience, both internal and international is composed by a combination of hazardous and risk situations that threaten the physical and emotional integrity of individuals. The goal of this article is to document the experiences and the health of migrants facing high temperatures when heading from Mexico or Central America towards the United States of America, as well as those that transit through the interior of Mexico towards the agricultural fields of the Northwest.Method: These findings are based on a qualitative method study that used semistructured interviews that delve into weather and health risks in international and internal migrants on the Mexican northern border, particularly in the state of Sonora.Results: Migration is a turning point in the lives of the people interviewed. There exists a qualitative association between masculinity and the act of migrating; the notion of being a provider and the idea of adventure are crucial for understanding the migrational process. Facing different hazards like violence and environmental factors generates physical and emotional damage.Conclusion: There exists a relativization process of weather risks, on this case, the minimization of the damage to health due to high temperatures. The idea of selfsufficiency and independence is part of the gender identities of the migrant males interviewed.
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Mercer, Helen. "Retailer–Supplier Relationships before and after the Resale Prices Act, 1964: A Turning Point in British Economic History?" Enterprise & Society 15, no. 1 (March 2014): 132–65. http://dx.doi.org/10.1093/es/kht056.
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This article provides an analysis of the impact of the abolition of individual resale price maintenance (irpm) in 1964 on the relationships between retailers and suppliers and, wider, on defining features of the UK economic structure. It describes the role of irpm prior to 1964 in a complex competitive environment that existed across a range of goods and services. A key feature of this environment was the influence manufacturers had over retail margins and pricing. It shows how the 1964 Resale Price Act both unraveled this system and provided the legal prerequisite of today’s dominance by large retailers, as oligopolists and oligopsonists. The study delineates how a different set of business relationships came to dominate the retailing sector: in place of retailing as a manufacturer’s marketing strategy, conditions of supply were determined by the business strategies of multiple retailers. Retailing was further characterized by mutual dependencies among multiple retailers, commercial property investors, and the financial sector. In tracking this shift in business relationships, a historical analogy suggests itself that the Act has parallels with the Repeal of the Corn Laws in 1846, for both changed the balance of economic power between two key business sectors in Britain.
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Perskaya, Viktoriya V. "COVID-2019 Pandemic — a Catalyst for the Possible Loss of the Democratic Foundations of Society." Economic Strategies 144 (June 20, 2020): 30–41. http://dx.doi.org/10.33917/es-4.170.2020.30-41.
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The ongoing COVID-19 pandemic began quite unexpectedly for all countries of the world community, although WHO has repeatedly warned about its possibility. It turned out that spreading of infection in all countries of the world depends not only on the level of urbanization and population density per 1 km2, but on the capability to effectively mobilize the national health system and on the quality of medical services, on their accessibility to all sectors of society, on the ability of the states leaders to provide appropriate regulation of public life. The most effective tools in the world became self-isolation, remote work (distance working) and introduction of quarantine regimes. Continuance of such measures implies, on the one hand, developing technologies for monitoring and ensuring social contact between citizens, and on the other, tightening control over the citizens behavior, including in remote work mode. The article provides a comparative analysis of these control systems, including the “social credit” in China, and concludes that remote working and opportunities that modern tracking and person re-identification technologies provide can be used even after the 2020 pandemic.
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García Goldar, Mónica. "La calidad en los contenidos o servicios digitales prestados por Inteligencia Artificial desde el derecho de consumo: un breve ensayo." IUS ET SCIENTIA 1, no. 7 (2021): 357–69. http://dx.doi.org/10.12795/ietscientia.2021.i01.18.
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En este trabajo analizaremos si la normativa europea de consumo se adecúa a las especificidades de los contenidos o servicios digitales generados por Inteligencia Artificial. De forma más concreta, evaluaremos cuál es la repercusión de la calidad como criterio de valoración de la satisfacción y las opciones de las que dispone el consumidor en caso de que dicho resultado generado por IA (bien sea un contenido, bien un servicio) no le satisfaga. Ello nos llevará a defender que la omisión de la calidad como un criterio de conformidad objetivo no resulta justificable y que debería interpretarse aplicable igualmente, toda vez que la IA es una tecnología en desarrollo y puede que no siempre conduzca a resultados satisfactorios.
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Sandoval Zapata, Karina. "Del dicho al hecho… Las ideologías de género que sustentan las masculinidades hegemónicas." La Manzana de la Discordia 9, no. 2 (April 1, 2016): 57. http://dx.doi.org/10.25100/lamanzanadeladiscordia.v9i2.1605.
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Resumen: La masculinidad es una construcción sociocultural cambiante y heterogénea en la que intervienen significativamente el contexto, la cultura, la clase, la etnia, la edad, la familia, la escuela, los medios de comunicación, la política, entre otras. Sin embargo, existe una expresión dominante de masculinidad en Occidente, que se funda en la idea de que los hombres son violentos, hipersexuales y superiores a las mujeres. El presente artículo analiza los núcleos que constituyen dicha masculinidad, siendo aspectos como la negación de emociones, sus efectos en la salud mental de los hombres, la hipersexualidad masculina y la violencia contra las mujeres, el rol proveedor económico y el lugar de los hombres en las actividades del cuidado.Palabras clave: Masculinidad hegemónica, ideologías de género, hipersexualidad, homofobia, heteronormatividadEasier Said than Done. Gender Ideologies Underpinning Hegemonic MasculinitiesAbstract: Masculinity is a changing and diverse socio-culture construction and heterogeneous in which the context, culture, class, ethnicity, age, family, school, media, politics, among others aspects are involved significantly. However, there is a dominant expression of masculinity in the West that is based on the idea that men are violent, hyper sexual and superior to women. The present article analyzes the core that comprised such masculinity, being aspects like the denial of emotions, their effects on the mental health of men, the male hyper sexuality and violence against women, the economic provider role and the place of men in care activities..Key Words: Hegemonic masculinity, gender ideologies, hypersexuality, homophobia, heteronormativity
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EL-MADKOURI MAATAOUI, Mohamed. "ترجمة عبارات الجنس في قطاع الخدمات العمومية/Interpreting Expressions of Sexual Contents in Public Services." FITISPos International Journal 1 (April 3, 2014): 51–65. http://dx.doi.org/10.37536/fitispos-ij.2014.1.0.14.
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التي ترتبط معرفتها والتعبير عنها واستقبالها بالبعدين الاجتماعي والثقافي بعيداً عن المظاهر الشكلية البحثة، ففي بعض الأحيان قد نفهم مجموع معاني الكلمات من غير إدراك للمغزى الخفي المراد منها لأننا قد نرفض بعض التركيبات اللغوية ونصفها بالغرابة؛ فتصبح بالتالي فاقدة للمعنى من منظورنا الاجتماعي والثقافي الخاص، في الوقت الذي تكون فيه محملة بالمعاني من وجهة نظر قائلها بحسب السياقين الاجتماعي والثقافي الموجِّهَيْن لعملية القول.تماشيا مع هذا الطرح، ولإظهار مثل هذا النوع من التراكيب اللغوية، سأتناول الإشارات والتعبيرات ذات المضامين الجنسيّة التي يتعيّن ترجمتها من العربية إلى الإسبانية في قطاع الخدمات العامة، مركزا بصفة خاصة على الترجمة الفورية لأنها، بعكس الترجمة المكتوبة، تتطلب وجود الأضلاع الثلاثة لعملية التواصل وهم: مقدّم الخدمة والمستفيد منها والمترجم.ترجمة شفهية، عبارات ذات محتوى جنسي، الخدمات الإجتماعية الكلمات المحورية Resumen: El objeto de este trabajo es analizar y describir algunos aspectos de la lengua, cuyo conocimiento, expresión y recepción incumbe al ámbito social y cultural, más que a lo puramente formal. Es decir, que en ocasiones podemos entender la totalidad de las palabras, sin captar el mensaje implícito, o incluso podemos rechazar algún tipo de construcción lingüística juzgándola rara o anómala, y por tanto poco significativa desde nuestra perspectiva social y cultural propia, aunque la misma sea altamente significativa desde el punto de vista del emisor y de su marco social y cultural. Para poner de relieve este tipo de construcciones lingüísticas, abordaré aquellas referencias y expresiones con contenido sexual que se precisa traducir del árabe al español en el ámbito de la Interpretación en los Servicios Públicos. Por ello, este trabajo se centrará exclusivamente en la interpretación, porque es ella, frente a la traducción, la que precisa de la presencia física y efectiva de los tres actores de la comunicación, a saber: el proveedor del servicio, el usuario del mismo y el intérprete.Abstract: The objective of this project is to analyze and describe some aspects of language, whose knowledge, expression and reception is relevant to social and cultural scope, more than just the formal scope. It is to say that, in specific occasions, we can understand the totality of words, without understanding the implicit message, or we can even reject some type of linguistic construction, considering it weird or abnormal, and therefore of little significance from our own social and cultural perspective, even though the same is highly significant from the emitter’s point of view and their social and cultural frame of reference. To highlight these types of linguistic constructions, I will address those references and expressions of sexual content needing to be translated from Arabic to Spanish in the field of Public Service Interpreting. For this reason, this project will focus specifically on interpreting, as opposed to translation, because interpreting requires the physical and effective existence of the three actors in communication: the service provider, the user of the service, and the interpreter.
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Brandejsky, Tomas. "Dependency of GPA-ES Algorithm Efficiency on ES Parameters Optimization Strength." Journal of Advanced Engineering and Computation 3, no. 1 (March 31, 2019): 304. http://dx.doi.org/10.25073/jaec.201931.226.
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In herein presented work, the relation between a number of ES iterations and convergence of the whole GPA-ES hybrid algorithm will be studied due to increasing needs to analyze and model large data sets. Evolutionary algorithms are applicable in the areas which are not covered by other artificial intelligence or soft computing techniques like neural networks and deep learning like a search of an algebraic model of data. The difference between time and algorithmic complexity will be also mentioned as well as the problems of multitasking implementation of GPA, where external influences complicate increasing of GPA efficiency via Pseudo Random Number Generator (PRNG) choice optimization. Hybrid evolutionary algorithms like GPA-ES uses GPA for solution structure development and Evolutionary Strategy (ES) for parameters identification are controlled by many parameters. The most significant are sizes of GPA population and sizes of ES populations related to each particular individual in GPA population. There is also a limit of ES algorithm evolutionary cycles. This limit plays two contradictory roles. On one side the bigger number of ES iterations means less chance to omit good solution for wrongly identified parameters, on the opposite side large number of ES iterations significantly increases computational time and thus limits application domain of GPA-ES algorithm. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium provided the original work is properly cited.
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Garcia-Webb, M., and ES Chen. "An Analysis of Free-Text Alcohol Use Documentation in the Electronic Health Record." Applied Clinical Informatics 05, no. 02 (2014): 402–15. http://dx.doi.org/10.4338/aci-2013-12-ra-0101.
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SummaryBackground: Alcohol use is a significant part of a patient’s history, but details about consumption are not always documented. Electronic Health Record (EHR) systems have the potential to improve assessment of alcohol use and misuse; however, a challenge is that critical information may be documented primarily in free-text rather than in a structured and standardized format, thereby limiting its use.Objective: To characterize the use and contents of free-text documentation for alcohol use in the social history module of an EHR.Methods: This study involved a retrospective analysis of 500 alcohol use entries that include structured fields as well as a free-text comment field. Two coding schemes were developed and used to analyze these entries for: (1) quantifying the reasons for using free-text comments and (2) categorizing information in the free-text into separate elements. In addition, for entries indicating possible alcohol misuse, a preliminary review of other structured parts of the EHR was conducted to determine if this was also documented elsewhere.Results: The top three reasons for using free-text were limited ability to describe alcohol use frequency (75%), amount (22%), and status (18%) with available structured fields. Within the free-text, descriptions of frequency were most common (79%) using words or phrases conveying occasional (61%), daily (13%), or weekly (12%) use. Of the 36 cases suggesting alcohol misuse, 44% had mention of alcohol problems in the problem list or past medical history.Conclusions: Based on the early findings, implications for improving the structured collection and use of alcohol use information in the EHR are provided in four areas: (1) system enhancements, (2) user training, (3) decision support, and (4) standards. Next steps include examining how alcohol use is documented in other parts of the EHR (e.g., clinical notes) and how documentation practices vary based on patient, provider, and clinic characteristics.Citation: Chen ES, M. Garcia-Webb M. An analysis of free-text alcohol use documentation in the electronic health record: Early findings and implications. Appl Clin Inf 2014; 5: 402–415 http://dx.doi.org/10.4338/ACI-2013-12-RA-0101
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Kamuhabwa, Appolinary, and Reena Chavda. "Health-care providers’ preparedness for H1N1/09 influenza prevention and treatment in Dar es Salaam, Tanzania." Journal of Infection in Developing Countries 6, no. 03 (November 30, 2011): 262–70. http://dx.doi.org/10.3855/jidc.1635.
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Introduction: In Tanzania, the first case of H1N1/09 influenza was reported in September 2009. By March 2010, the reported number of cases was 770 with one death. Due to shortage of qualified human resources, essential medicines and laboratory supplies in health facilities, it was not known how well health-care providers in the country were prepared to deal with the pandemic. Methodology: The study was conducted from December 2009 to May 2010 in public hospitals and private community pharmacies in Dar es Salaam, Tanzania. Fifty-three prescribers and 200 dispensers were interviewed to assess their knowledge on the prevention and treatment of H1N1/09 influenza, and dissemination of correct information to the public regarding the pandemic. Results: Most participants had inadequate knowledge on the transmission, prevention and management of H1N1/09 influenza. The majority of prescribers knew neither the antiviral drugs recommended for the treatment of H1N1 influenza (64%) nor their adverse effects (92.5%). The drug dispensers' knowledge was also inadequate regarding the transmission, prevention and treatment of H1N1/09 influenza. Forty-one (20.5%) salespersons without formal training in pharmaceutical or medical sciences were found dispensing and supervising the pharmacies. Most participants had misconceptions on how H1N1/09 virus was transmitted. Conclusion: The results of the study revealed gaps in the knowledge of the health-care providers on the prevention and treatment of H1N1/09 influenza infection. This indicates the need for strengthening of health-care systems and provision of continuing education and professional development for health-care providers on new and re-emerging diseases in the community.
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KANJI, NAJMI, PETER KILIMA, NICK LORENZ, and PAUL GARNER. "Quality of primary outpatient services in Dar-es-Salaam: a comparision of government and voluntary providers." Health Policy and Planning 10, no. 2 (1995): 186–90. http://dx.doi.org/10.1093/heapol/10.2.186.
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Yue, Wucheng, He Yang, Yipei Chen, Jun Wang, Xiaowen Chen, Xin Hou, Hua Han, and Chenghui Wang. "RNA interference provides insights into the multi-functional profiles of Es-MSTN gene in Eriocheir sinensis." Aquaculture Reports 17 (July 2020): 100310. http://dx.doi.org/10.1016/j.aqrep.2020.100310.
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Frohn, Martin. "COVID-19 und Reglementierung von Berufen – gibt es auch Lichtblicke?" Zeitschrift für Wirtschaftspolitik 69, no. 2 (September 25, 2020): 140–47. http://dx.doi.org/10.1515/zfwp-2020-2036.
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AbstractThe Covid-19 crisis has had a severe impact on society and the economy. Some countries reacted with regulatory relaxations to cope with the crisis and digitisation of services provided possibilities to maintain service activities during the general lockdown measures. It became even more apparent that regulating access to and exercise of professional activities can have negative effects on adaptability of businesses and development of new and innovative business models. The recent adoption of an EU directive on a proportionality test, obliging Member States to carry out a thorough assessment of the effects of regulation before its adoption, provides guidance and a toolbox to ensure monitoring and adaptation of regulatory frameworks in view of developments such as those we have witnessed very recently. Regulatory trends in Member States and in particular in Germany go in opposite directions: While tightening of access requirements in craft professions, the German government considers significant reforms in legal services. In particular as regards the tightening of restrictions, it is expected that the EU directive on a proportionality test will lead to more sound and fact-based regulatory decisions.
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Peng, Bo, Feng Zhang, Jun Liang, Lei Ding, and Qiuwei Wu. "An optimal control and sizing strategy for a coordinated WTG-ES system to provide frequency support." International Journal of Electrical Power & Energy Systems 113 (December 2019): 251–63. http://dx.doi.org/10.1016/j.ijepes.2019.05.052.
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Mortensen, R. M., D. A. Conner, S. Chao, A. A. Geisterfer-Lowrance, and J. G. Seidman. "Production of homozygous mutant ES cells with a single targeting construct." Molecular and Cellular Biology 12, no. 5 (May 1992): 2391–95. http://dx.doi.org/10.1128/mcb.12.5.2391.
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We have developed a simple method for producing embryonic stem (ES) cell lines whereby both alleles have been inactivated by homologous recombination and which requires a single targeting construct. Four different ES cell lines were created that were heterozygous for genes encoding two guanine nucleotide-binding protein subunits, alpha i2 and alpha i3, T-cell receptor alpha, and beta-cardiac myosin heavy chain. When these heterozygous cells were grown in high concentrations of G418, many of the surviving cells were homozygous for the targeted allele and contained two copies of the G418 resistance gene. This scheme provides an easy method for obtaining homozygous mutationally altered cells, i.e., double knockouts, and should be generally applicable to other genes and to cell lines other than ES cells. This method should also enable the production of cell lines in which more than one gene have had both alleles disrupted. These mutant cells should provide useful tools for defining the role of particular genes in cell culture.
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Mortensen, R. M., D. A. Conner, S. Chao, A. A. Geisterfer-Lowrance, and J. G. Seidman. "Production of homozygous mutant ES cells with a single targeting construct." Molecular and Cellular Biology 12, no. 5 (May 1992): 2391–95. http://dx.doi.org/10.1128/mcb.12.5.2391-2395.1992.
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We have developed a simple method for producing embryonic stem (ES) cell lines whereby both alleles have been inactivated by homologous recombination and which requires a single targeting construct. Four different ES cell lines were created that were heterozygous for genes encoding two guanine nucleotide-binding protein subunits, alpha i2 and alpha i3, T-cell receptor alpha, and beta-cardiac myosin heavy chain. When these heterozygous cells were grown in high concentrations of G418, many of the surviving cells were homozygous for the targeted allele and contained two copies of the G418 resistance gene. This scheme provides an easy method for obtaining homozygous mutationally altered cells, i.e., double knockouts, and should be generally applicable to other genes and to cell lines other than ES cells. This method should also enable the production of cell lines in which more than one gene have had both alleles disrupted. These mutant cells should provide useful tools for defining the role of particular genes in cell culture.
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Hamerski, Henrique, and Márcio de Lima Pereira. "A qualidade dos serviços prestados e a satisfação dos alunos com o núcleo de atendimento ao aluno de uma instituição de ensino superior de Vitória-ES a partir da ferramenta Servqual." Revista Científica Faesa 16, no. 2 (August 1, 2020): 59–84. http://dx.doi.org/10.5008/1809.7367.177.
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Conger, Scott A., Gordon L. Warren, Michelle A. Hardy, and Mindy L. Millard-Stafford. "Does Caffeine Added to Carbohydrate Provide Additional Ergogenic Benefit for Endurance?" International Journal of Sport Nutrition and Exercise Metabolism 21, no. 1 (February 2011): 71–84. http://dx.doi.org/10.1123/ijsnem.21.1.71.
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Context:Carbohydrate (CHO) and caffeine (CAF) both improve endurance performance.Purpose:To determine by systematic literature review coupled with meta-analysis whether CAF ingested with CHO (CHO+CAF) improves endurance performance more than CHO alone.Methods:Databases were searched using the keywords caffeine, endurance, exercise, carbohydrate, and performance. Criteria for inclusion were studies that used human subjects performing an endurance-exercise performance task and included both a CHO and CHO+CAF condition. Effect sizes (ESs) were calculated as the standardized mean difference.Results:Twenty-one studies met the criteria for analysis. ESs for individual studies ranged from –0.08 (trivial effect favoring CHO) to 1.01 (large effect favoring CHO+CAF). The overall ES equaled 0.26 (95% CI 0.15–0.38, p < .001), indicating that CHO+CAF provides a small but significant performance benefit over CHO. ES was not significantly (p > .05) related to CAF dose, exercise duration, or performance-assessment method. To determine whether ES of CHO+CAF vs. CHO was different than CAF compared with water (placebo), a subgroup meta-analysis compared 36 CAF vs. placebo studies against the 21 CHO+CAF vs. CHO studies. The overall ES for the former group of studies (ES = 0.51, 95% CI 0.40–0.61) was nearly 2-fold greater than in CHO+CAF vs. CHO studies (p = .006).Conclusions:CHO+CAF ingestion provides a significant but small effect to improve endurance performance compared with CHO alone. However, the magnitude of the performance benefit that CAF provides is less when added to CHO than when added to placebo.
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Patterson, Shirley L., and Flavio Francisco Marsiglia. "“Mi Casa Es Su Casa”: Beginning Exploration of Mexican Americans' Natural Helping." Families in Society: The Journal of Contemporary Social Services 81, no. 1 (February 2000): 22–31. http://dx.doi.org/10.1606/1044-3894.1089.
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This article presents the findings of a pilot study on natural helping among Mexican Americans conducted in a large urban area of the Southwest. Twelve community-identified natural helpers were interviewed using the “Natural Helper Interview Schedule” utilized in previous studies in other parts of the country with European American subjects. As expansion of the earlier studies, the interview schedule was translated into Spanish and assessed for cultural appropriateness. The similarities found between the findings of the Mexican American sample and previous samples may suggest that natural helping is a cross-cultural phenomenon. At the same time, the unique trends identified among Mexican American respondents may indicate a stronger family connection to natural helping processes in this community. Respondents narrated the helping incidents as if the recipients and providers of help were all family members. A series of common trends emerged from the data gathered on helping incidents. Some of these trends suggest that natural helpers assisting recent immigrants used a doing type of helping style, but a facilitating style of helping was also reported for other recipients. Although these findings cannot be generalized, they provide important information about community-based natural helping networks and provide beginning comparison about natural helping characteristics among different ethnic groups. These findings can be of use by practitioners and policy makers as they attempt to reach the Mexican American community in a culturally competent manner.
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Carnahan, Leslie R., Stacie E. Geller, Sebalda Leshabari, Willy Sangu, Bailey Hanselman, and Crystal L. Patil. "Healthcare providers’ knowledge and practices associated with postpartum hemorrhage during facility delivery in Dar es Salaam, Tanzania." International Journal of Gynecology & Obstetrics 135, no. 3 (August 11, 2016): 268–71. http://dx.doi.org/10.1016/j.ijgo.2016.05.013.
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Soufas, C. Christopher. "Thinking in La vida es sueño." PMLA/Publications of the Modern Language Association of America 100, no. 3 (May 1985): 287–99. http://dx.doi.org/10.2307/462083.
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Examining the epistemological assumptions governing Calderón's theocentric view of life provides an accessible framework to overcome the many difficulties in reading La vida es sueño as a document of human experience. Segismundo's problems arise from an incomplete understanding of himself and the world. A prisoner since birth, the prince overcompensates intellectually for a life of sensual deprivation. Alienated from both the world and the sensitive centers of his humanity, he thinks to excess because his principal conduit to the world, his imagination, has remained underdeveloped. Through his palace experiences and his three encounters with Rosaura, Segismundo learns to adapt his inappropriate thinking by understanding that he must dialogue with the world rather than construct arguments against it.
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Dhotre, S. B., P. P. Malavadkar, and M. M. Shikare. "On 3-connected es-splitting binary matroids." Asian-European Journal of Mathematics 09, no. 01 (February 22, 2016): 1650017. http://dx.doi.org/10.1142/s1793557116500170.
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The es-splitting operation on a [Formula: see text]-connected binary matroid may not preserve the [Formula: see text]-connectedness of the matroid. In this paper, we provide a sufficient condition for a [Formula: see text]-connected binary matroid to yield a [Formula: see text]-connected binary matroid under the es-splitting operation. We derive a splitting lemma for [Formula: see text]-connected binary matroids as an application of this result.
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Hammer, J., M. Pruckmayer, H. Bergmann, K. Kletter, and A. Gangl. "The distal colon provides reserve storage capacity during colonic fluid overload." Gut 41, no. 5 (November 1, 1997): 658–63. http://dx.doi.org/10.1136/gut.41.5.658.
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Background—In addition to its absorptive function the capacity of the colon to retain fluid might be relevant in compensating for increased fluid loads and prevention of diarrhoea. The distal colon is considered to be mainly a conduit without extensive storage function.Aims—To evaluate colonic volume capacity in a model of pure osmotic diarrhoea.Methods—A non-absorbable, iso-osmotic solution (OS) containing polyethylene glycol (500 ml) was infused into the caecum of nine healthy volunteers; the control group (n=5) received an equal amount of an easily absorbable electrolyte solution (ES). Fluids were radiolabelled with technetium-99m and gamma camera images were obtained for 48 hours. Counts in the proximal and distal colon were measured and regional and overall colonic transit and stool output were quantified.Results—After OS, in contrast to ES, faecal output was increased significantly (p<0.05), but colonic transit after OS was not different from transit after ES (p>0.05). This indicates storage of OS in the colon: after OS infusion, counts in the proximal colon decreased linearly while the distal colon stored approximately 30% of radioactivity for the whole 48 hour study period. After OS, stool output correlated with distal (p<0.01), but not with proximal (p>0.05), colonic transit. In constrast, after ES, stool output was determined by proximal colonic transit (p<0.05) but not by transit through the distal colon (p>0.05).Conclusion—The distal colon retains non-absorbable fluid volumes extensively. In our model transit through the distal colon—but not the proximal colon—determined the time at which diarrhoea occurred.