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1
Lau, Norman. "ServiceSketch: A Collaborative Tabletop Tool for Service Design." Research Showcase @ CMU, 2011. http://repository.cmu.edu/theses/7.
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ServiceSketch is a collaborative tabletop tool for service design. It was developed to address some of the challenges designers face when developing service systems, including the dynamic, intangible nature of service and the complexity of coordinating multiple stakeholders over time and space. The concept for the tool draws from literature on service design, tangible user interfaces, and co-creation. It was also informed by user research sessions with graduate design students.
The interface of ServiceSketch consists of a large multi-touch surface display that reacts to finger touches and a provided set of physical objects. Both the hardware and software development of ServiceSketch are described in this document.
ServiceSketch was evaluated with groups of graduate design students who were asked to perform small group service design activities using the tool. These sessions showed that ServiceSketch was successful in supporting common service design processes and even inspired many participants to suggest possible future developments for the tool. ServiceSketch also seemed to encourage a playful, collaborative approach to service design. The results of the project hint at the possibilities for a new breed of service design tool, one that focuses on facilitating conversations about service through an engaging, interactive medium.
2
Ahluwalia, Punit. "A Study of the Quality of Service in Group Oriented Mobile Transactions." Digital Archive @ GSU, 2006. http://digitalarchive.gsu.edu/cis_diss/7.
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In the emerging wireless Internet environment involving m-commerce and other mobile applications, an increasing number of users are likely to adopt mobile transactions. These transactions are likely to have very diverse requirements and some of them may require significant amount of network resources and/or bounded delays. Most quality-of-service research in wireless networks has hitherto focused on call or connection-level QoS. Many mobile transactions are expected to be distinct from the previously investigated applications in their criticality, level of resource required, and in their group characteristics. Examples of such transactions are ones involving a financial value. These unique requirements of mobile transactions necessitate introduction of new metrics for quality-of-service. To measure QoS effectiveness of mobile transactions, two new metrics, namely transaction completion probability and transaction response time are introduced in this research. Moreover, it is well known that wireless networks are constrained for bandwidth. Mobile transactions are expected to require varying degree of bandwidth which makes the resource allocation only at connection level very inefficient. This research proposes a new framework to support QoS requirements of mobile transactions by allocating bandwidth at connection and transaction levels. The proposed framework helps in achieving a balance between transaction completion probability and the response time. Simulation and analytical modeling are used to evaluate the QoS metrics under varying network and traffic scenarios and to validate the effectiveness of the new framework. The results show that the balanced transaction and connection level resource allocation can improve the probability of transactions completion and resource utilization but at the cost of slightly increased response time.
3
Smith, Susan Lee. "Lived Experience of the Advanced Practice Provider on the Burn Surgery Service." Diss., NSUWorks, 2017. https://nsuworks.nova.edu/hpd_hs_stuetd/7.
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The purpose of this qualitative dissertation study was to examine the lived experience and meaning making of challenges, benefits, satisfaction, and professional sustainability for the advanced practice provider in the burn surgery specialty service. The problem addressed was the knowledge gap resulting from a lack of literature describing aspects of the advanced practice provider role in the burn specialty. An interpretive phenomenological analysis, informed by the philosophy of Dr. Martin Heidegger, was undertaken. Participants were solicited from the American Burn Association Advanced Practice Provider (APP) special interest group site. The results provided a thick description of the lived experience of the Burn APP offering, illuminating commonalities and distinctions to promote role gratification and fulfillment leading to professional success and prolonged engagement. Keywords: advanced practice provider, nurse practitioner, physician assistant, interpretive phenomenology, hermeneutics.
4
Perry, Robin K. "Influences of co-teaching in student teaching on pre-service teachers' teacher efficacy." Scholarly Commons, 2016. https://scholarlycommons.pacific.edu/uop_etds/7.
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Teacher education researchers and policy makers recognize field experience, particularly student teaching, as a critical component of pre-service teacher learning and development. The co-teaching model of student teaching, in which cooperating teachers and student teachers jointly plan and deliver instruction, has been adopted by university-based teacher education programs across the United States. The purpose of this study was to examine the relationship between elements of the co-teaching model of student teaching and teacher efficacy outcomes for student teachers. Research suggests that teacher efficacy, a teacher’s beliefs in his or her capacity to affect student performance, is positively associated with teachers’ behaviors and commitment to teaching as well as student achievement and motivation. This quantitative study utilized multiple regression statistical analyses to examine the relationship between co-teaching overall and the relationship, communication, classroom applications, and knowledge base elements and teacher efficacy overall and the domains of efficacy in student engagement, efficacy in instructional strategies and efficacy in classroom management. Descriptive statistics indicated that the relationship and communication elements of student teaching were more prevalent than the classroom applications and knowledge base elements. Student teachers in the sample reported higher levels of efficacy in instructional strategies than efficacy in classroom management and efficacy in student engagement. A positive and statistically significant relationship between teacher efficacy overall, efficacy in student engagement, efficacy in instructional strategies, and efficacy in classroom management and the co-teaching model of student teaching, after controlling for gender and credential program, was found. The findings of this study substantiate teacher education policy makers’ support for the co-teaching model of student teaching.
5
Fossum, Bjöörn. "Communication in the health service : two examples /." Stockholm : Karolinska inst, 2003. http://diss.kib.ki.se/2003/91-7349-667-7/.
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6
Ozen, Mehtap. "Investigation Of Pre-service Mathematics Teachers." Master's thesis, METU, 2013. http://etd.lib.metu.edu.tr/upload/12615667/index.pdf.
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The aim of the study is to investigate pre-service middle school mathematics
teachers&rsquocritical thinking processes through statistical and probabilistic knowledge in the context of popular media texts. The study was conducted with a qualitative case study method. Participants of the study consisted of four senior pre-service middle school mathematics teachers enrolled in a public university. Data were collected through in-depth interviews with the participants. Analysis of the data was conducted on the basis of two dimentions
critical thinking skills, and statistical and probabilistic knowledge. The results of the study indicated that pre-service middle school mathematics teachers reflected different critical thinking skills and made use of different statistical and probabilistic knowledge in different contexts. They mostly reflected interpretation skill on the basis of their statistical and probabilistic knowledge. Moreover, to what extent they made use of critical thinking skills was differentiated on the basis of their statistical and probabilistic knowledge. They reflected complicated critical thinking process dealing with conditional probability statements. They had difficulty with probabilistic statements underlying conditional probability especially in this process.
7
Eck, Larry R. "Marine Corps Joint Officer Management policy and O-7 Joint Service Officer requirements." Thesis, Monterey, Calif. : Naval Postgraduate School, 2007. http://bosun.nps.edu/uhtbin/hyperion-image.exe/07Jun%5FEck.pdf.
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Thesis (M.S. in Management)--Naval Postgraduate School, June 2007.Thesis Advisor(s): William Hatch. "June 2007." Description based on title screen as viewed on August 14, 2007. Includes bibliographical references (p. 35). Also available in print.
8
Boone, Christopher A. Hanna Joe B. Craighead Christopher W. "Managing service inventory in the supply chain." Auburn, Ala., 2006. http://repo.lib.auburn.edu/Send%208-7-07/BOONE_CHRISTOPHER_34.pdf.
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Savas, Meltem. "Investigating Pre-service Science Teachers." Master's thesis, METU, 2011. http://etd.lib.metu.edu.tr/upload/12613819/index.pdf.
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The purpose of this study was to investigate the preservice science teachers&rsquoperceived technological pedagogical content knowledge (TPACK) on genetics. More specifically, the purpose was to examine the relationships among the components of TPACK and genetics knowledge of the preservice science teachers. Moreover, findings the effect of the demographic information on perceived TPACK was also aimed. This study was conducted with preservice science teachers who were enrolled in elementary science education department of Education Faculties of eight public universities located in Central Anatolia. 1530 preservice science teachers participated to the study. There were two instruments used in this research which were perceived TPACK questionnaire, which was later adopted by the researcher as perceived TPACK on genetics, and genetic concepts test. v Data were analyzed by using descriptive and inferential statistics. In order to answer the first research question, descriptive information about the components of TPACK was given. Correlational analyses were used to identify the relationship between each component of the perceived TPACK on genetics and their genetic knowledge. Another correlational analysis was conducted for the third research question which seeks the relationships among the components of the TPACK. Moreover, MANOVA was conducted to investigate the impact of gender and year of enrollment on perceived TPACK on genetics of preservice science teachers. The results revealed that genetic knowledge was correlated with each component except the perceived project specific technology knowledge. Moreover, there were positive significant correlations among the components of the TPACK. According to the MANOVA results, the mean scores of male and female preservice science teachers differ in five components of TPACK, namely project specific technology knowledge, pedagogical knowledge, pedagogical content knowledge, technological content knowledge and technological pedagogical content knowledge. The results of MANOVA for year of enrollment revealed that the mean ETK, GTK, PSTK, and CK scores of participants with different year of enrollment differ significantly.
10
Maccani, King Heidi. "How does service learning in the Washburn School District , grades 7-12 affect students' citizenship and academic achievement?" Online version, 2008. http://www.uwstout.edu/lib/thesis/2008/2008maccanikingh.pdf.
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11
Isbilir, Erdinc. "Investigation Of Pre-service Science Teachers'." Master's thesis, METU, 2010. http://etd.lib.metu.edu.tr/upload/12612456/index.pdf.
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The purpose of this study was to investigate pre-service science teachers&rsquo(PST) quality of written argumentations about socio-scientific issues in an online discussion environment in relation to their epistemic beliefs and argumentativeness. A total of 30 pre-service elementary science teachers who will teach elementary school science from 6th through 8th grade students after graduation voluntarily participated in this study. The sample was chosen by purposive and convenience sampling from the PSTs registered for the course named &ldquo
Science, Technology, and Society&rdquo
in the fall semester of 2009-2010 academic year at a public university in Ankara. In this study, the PSTs participated in an online discussion environment in which climate change, nuclear power, genetically modified foods, and human genome project issues were discussed for a total of four week period. The major data of this study were collected through the Epistemic Beliefs Questionnaire developed by Kuhn, Cheney and Weinstock (2000) and the Argumentativeness Scale by Infante and Rancer (1982). For the analysis of the quality of argumentations, an adapted version of Sadler and Fowler&rsquo
s (2006) argumentation analysis framework was employed. The results of the study illustrated that the PSTs frequently generated high quality argumentations for each socio-scientific issue which was interpreted as a positive indication that the online discussion environment was effective in promoting students&rsquo
argumentation. In addition, the results also showed that argumentation quality levels varied across socio-scientific issues. Another result of this study was that the PSTs&rsquo
argumentation qualities were higher for multiplist and evaluativist levels. Finally, the correlation results between argumentativeness and argumentation quality levels did not reveal a significant correlation between these variables. However, there was a significant correlation between epistemic belief levels and argumentativeness.
12
MTIOUI, ROY BEATRICE. "Evaluation de l'activite medicale dans un service de reanimation medicale : interet de l'outil informatique ; etude realisee au chu d'angers sur 7 annees." Angers, 1992. http://www.theses.fr/1992ANGE1078.
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13
Messias, Melissa. "Construção coletiva de programas educativos: potencialidade para consecução da educação permanente em saúde." Universidade de São Paulo, 2015. http://www.teses.usp.br/teses/disponiveis/7/7140/tde-25062015-163002/.
Full textAbstract:
Introdução: Visando uma construção coletiva de ações educativas que privilegiem as necessidades dos trabalhadores e as condições de trabalho, com sustentação nas diretrizes da Política Nacional de Educação Permanente em Saúde e nos princípios dos Núcleos de Educação em Urgências, este estudo teve como Objetivos: Caracterizar o ambiente dos prontos socorros quanto aos insumos; conhecer o processo de educação oferecido pelas instituições à equipe de enfermagem; identificar e avaliar as necessidades de treinamento dos profissionais de Enfermagem dos prontos socorros; construir um programa de educação para estes profissionais, baseado no diagnóstico de necessidades de treinamento, considerando o ambiente de trabalho como suporte à aprendizagem contínua. Metodologia: Pesquisa quantitativa e qualitativa, com desenhos exploratório e descritivo, desenvolvida em três prontos socorros de duas instituições, uma pública e uma privada do município de São Paulo. A população constituiu-se de 31 enfermeiros, 84 técnicos ou auxiliares de enfermagem, três gestores de Enfermagem e cinco enfermeiros de Serviço de Educação. A caracterização do ambiente foi realizada por meio de entrevistas com os três gestores de enfermagem; para avaliação das necessidades de treinamento, foi aplicado um questionário a toda a equipe de enfermagem; a construção do programa de educação foi operacionalizada por meio de três encontros de grupo focal em cada pronto socorro, do qual participaram, no total, 14 profissionais; entrevistas com dois enfermeiros dos serviços de educação viabilizaram dados para caracterização do processo de educação da equipe de enfermagem. Resultados: Dentre os principais resultados, destacam-se que os treinamentos técnicos foram os mais prevalentes no levantamento de necessidades (75,6%); a maioria das sugestões de mudanças nos treinamentos foi relacionada às estratégias instrucionais (32%) e ao horário (19,7%); os treinamentos foram apontados como úteis na prática (72,7%), por possibilitarem aperfeiçoamento profissional (62,5%); participariam do planejamento dos treinamentos 77,7% dos enfermeiros e 46,3% dos profissionais de nível técnico; as unidades oferecem condições para aplicação dos conhecimentos aprendidos nos treinamentos, na opinião de 70,3%, principalmente, no que se refere ao ambiente e insumo. Os programas de educação construídos pelos grupos apresentam temas técnicos; modalidade de entrega presencial; domínios e objetivos, predominantemente, cognitivos, nos níveis do conhecimento, compreensão, aplicação e análise; estratégias participativas e práticas. Os processos de educação desenvolvidos nas instituições apresentam fragilidades nas fases de avaliação de necessidades e avaliação de resultados de treinamentos. A participação no grupo focal foi avaliada positivamente pelos participantes. Considerações Finais: Construir programas educativos baseados nas diretrizes da Política Nacional de Educação Permanente em Saúde e nos princípios dos Núcleos de Educação em Urgências é uma ação possível e promissora, pois problematiza a prática do trabalho e a transforma em necessidade de educação. É essencial, todavia, que os programas sejam executados e avaliados para os ajustes necessários para contemplar o paradigma educacional que fundamenta essa Política, pois aspectos culturais e políticos são indissociáveis da educação. Assim, este estudo tem potencialidade para ser replicado nas demais estruturas que compõem a Rede de Atenção às Urgências e a Rede de Assistência à Saúde, envolvendo a equipe de Enfermagem e as equipes multiprofissionais.Introduction: This study aims at a collective construction of educational actions that take into account workers needs and working conditions, based on the guidelines of the National Permanent Health Education Policy and the principles of the Emergency Education Centres. Objectives: to characterize the emergency room environment according to the inputs; to know the education process provided by the institutions for nursing staff; to identify and to assess training needs of nursing professionals in emergency rooms; and to develop an education program for these professionals, based on the diagnosis of training needs, considering the work environment to support continuous learning. Methodology: Quantitative and qualitative research, with exploratory and descriptive designs, developed in three emergency rooms of two institutions, one public and one private, in São Paulo city. The population consists of 31 nurses, 84 nursing technicians or assistants, three nursing managers, and five nurses of education services. To characterize the environment, three nursing managers were interviewed; to assess the training needs, a questionnaire was applied to all nursing staff; to develop the education program, there were three focus group meetings in the three emergency rooms, attended by a total of 14 professionals; to the description of the nursing staffs education process, two nurses of education services were interviewed. Results: Among the main results, it was observed that technical training was the most prevalent in the needs assessment (75,6%); most of the suggestions of changes in training concerned instructional strategies (32%) and schedule (19,7%); training was identified as useful in practice (72,7%) because it enable professional improvement (62,5%); 77,7% of the nurses and 46,3% of the nursing technicians or assistants would take part in the planning of the trainings; the units provide conditions to apply knowledge learned in trainings (70,3%), mainly in relation to environment and input. The education programs developed by the groups contain technical topics; face-to-face delivery method; predominantly cognitive domains and objectives, at the knowledge, comprehension, application, and analysis levels; and participation strategies and practices. The education processes carried out by the institutions show signs of weaknesses in training needs and results assessment. Participants assessed positively the focus group meetings. Final Thoughts: To construct educational programs based on the guidelines of the National Permanent Health Education Policy and the principles of the Emergency Education Centres is a possible and promising action, discussing the work practice and turning it into a training need. However, it is essential that programs are implemented and assessed, considering necessary adjustments to take into account the National Policys educational paradigm, since cultural and political aspects are inseparable from education. Finally, this study has the potential to be replicated in other settings of the Emergency Care Network, involving the nursing staff and the multidisciplinary teams.
14
Valera, Rangel Biscaro. "Caracterização dos pacientes readmitidos em um serviço de emergência." Universidade de São Paulo, 2005. http://www.teses.usp.br/teses/disponiveis/7/7139/tde-20122006-100006/.
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A grande procura pelo Serviço de Emergência e a conseqüente permanência dos pacientes em repetidas admissões representam entraves para os enfermeiros, os quais são responsáveis pelo gerenciamento desses serviços. Objetivos: Caracterizar o perfil dos pacientes readmitidos em um Serviço de Emergência de um hospital filantrópico; identificar o perfil sócio-demográfico e de morbidade dos pacientes readmitidos; caracterizar a utilização do Serviço de Emergência e identificar os fatores relacionados às readmissões. Casuística e Método: estudo transversal, descritivo e exploratório realizado em um Serviço de Emergência de um hospital filantrópico de ensino, de atenção terciária, na cidade de São Paulo. A amostra foi composta por pacientes maiores de 14 anos considerados internados no Serviço de Emergência, com mais de uma admissão, nos seis meses anteriores ao dia da coleta de dados. A coleta de dados foi realizada por meio de instrumento estruturado com questões abertas e fechadas, e as informações foram obtidas do prontuário do paciente e por entrevista direta ao paciente ou familiares, durante todo o mês de maio de 2004. Resultados: a incidência de readmissões foi de 23,3%. Houve predomínio de pacientes do sexo masculino (61,9%), idade de 40 a 90 anos (85,9%), baixa escolaridade (57,8%) e 46,7% pertenciam à área de regionalização do SUS para o serviço estudado. Quase a totalidade (92,8%) não era cadastrada no PSF, sendo que grande parte (45,4%) referiu desconhecer o programa. As principais hipóteses diagnósticas foram as doenças do aparelho circulatório (33,7%) seguidas pelas neoplasias (24,1%). A maioria dos pacientes (57,6%) foi readmitido com o mesmo diagnóstico e 23,9% devido a complicações. Na visão dos entrevistados, como fatores desencadeantes da readmissão, 40,9% referiram causas potencialmente evitáveis. A maioria dos entrevistados referiu que seu problema não foi resolvido na internação anterior, sendo o principal motivo a continuidade dos sintomas. Conclusões: A incidência de readmissões foi elevada, podendo ter sido ocasionada por evolução da doença crônico-degenerativa, idade avançada, baixo seguimento das orientações recebidas, complicações pós-operatórias, necessidade de cuidado domiciliar e não resolução do problema na admissão anteriorThe great need for the Emergency Department and the resultant length of stay of the patients in repeated admissions become a hard situation for nurses, who are responsible for the administration on this units. Objectives: characterize the readmitted patients at the Emergency Department in a philanthropyc hospital; identify the socialdemographic and morbity profile of the readmitted patients; characterize the use of the Emergency Department; identify factors associated with readmissions. Methods: transversal, descriptive and exploratory study, at the Emergency Department on a tertiary health service of a philanthropic teaching hospital in São Paulo city, the sample was made by patients over fourteen years old that became inpatient at the Emergency Department, with over than one admission until six months before the data collection day. It was used an instrument with opened and closed questions for the data collection. Data were obtained from patient records and by interview to the patient or responsible, during May 2004. Results: the readmission incidence was 23,3%. The patients were predominantly males (61,9%), age 40 to 90 years old (85,9%), low level education (57,8%); 46,7% lived at areas regarding the regionalization of the health service. Almost of all (92,8%) wasnt registered at Family Health Program, and a high proportion of patients (45,4%) were unaware of this program. The main diagnosis were circulatory disease (33,7%) followed by cancer (24,1%). Most of patients (57,6%) was readmitted with the same diagnosis and 23,9% due to complications. On the perception of 40,9% of the patients, the related factors to readmissions were classified as potentially avoidable causes. Conclusions: The readmission incidence was raised, it was can be caused by problems in adherence to treatment, gravity of chronic disease, not enough orientation, or by complications
15
Renner, Anna-Theresa. "Inefficiencies in a healthcare system with a regulatory split of power: a spatial panel data analysis of avoidable hospitalisations in Austria." Springer Berlin Heidelberg, 2019. http://dx.doi.org/10.1007/s10198-019-01113-7.
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Despite generous universal social health insurance with little formal restrictions of outpatient utilisation, Austria exhibits high
rates of avoidable hospitalisations, which indicate the inefficient provision of primary healthcare and might be a consequence
of the strict regulatory split between the Austrian inpatient and outpatient sector. This paper exploits the considerable regional
variations in acute and chronic avoidable hospitalisations in Austria to investigate whether those inefficiencies in primary
care are rather related to regional healthcare supply or to population characteristics. To explicitly account for inter-regional
dependencies, spatial panel data methods are applied to a comprehensive administrative dataset of all hospitalisations from
2008 to 2013 in the 117 Austrian districts. The initial selection of relevant covariates is based on Bayesian model averaging.
The results of the analysis show that supply-side variables, such as the number of general practitioners, are significantly
associated with decreased chronic and acute avoidable hospitalisations, whereas characteristics of the regional population,
such as the share of population with university education or long-term unemployed, are less relevant. Furthermore, the spatial
error term indicates that there are significant spatial dependencies between unobserved characteristics, such as practice style
or patients' utilization behaviour. Not accounting for those would result in omitted variable bias.
16
Matushima, Reinaldo. "Desenvolvimento de aplicações multimídia baseado em arquitetura orientada a serviços e nos padrões MPEG-7 e MPEG-21." Universidade de São Paulo, 2007. http://www.teses.usp.br/teses/disponiveis/3/3141/tde-08012008-150321/.
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Aplicações multimídia caracterizam-se por necessitar de grandes recursos computacionais e de rede. Frente a estes requisitos, os modelos de desenvolvimento sempre consideraram arquiteturas altamente especializadas e integradas, resultando em estruturas monolíticas que restringem o reuso, bem como exigem grande esforço para realização de alterações. Este tipo de direcionamento limita e dificulta o desenvolvimento de aplicações multimídia complexas e de larga escala. Existe uma demanda por diretrizes de desenvolvimento que consigam atender escopos cada vez mais amplos, suportando aplicações escaláveis, flexíveis, interoperáveis e de fácil programação. Neste contexto, este trabalho propõe o uso conjunto de Arquiteturas Orientadas a Serviço e os padrões MPEG-7 e MPEG-21. Apresenta-se como estas tecnologias podem facilitar o desenvolvimento de novas aplicações multimídia, diminuindo o custo e o esforço de desenvolvimento, e dando suporte às crescentes e diversificadas demandas por novos tipos de aplicações multimídia. O que deu base para o trabalho foi a busca por uma solução que atendesse a alguns requisitos adicionais verificados ao longo do projeto de uma Plataforma de Gerência de Vídeo. Entre outras coisas, é apresentado como as tecnologias que dão suporte ao desenvolvimento de arquiteturas orientadas a serviço se posicionam frente ao desenvolvimento de aplicações multimídia e, como elas, conjuntamente com os padrões MPEG-7 e MPEG-21 estão sendo utilizadas para melhorar a plataforma citada. É apresentado também um processo para modelagem de aplicações segundo os princípios de orientação a serviço, generalizando a solução apresentada para o desenvolvimento de aplicações multimídia quaisquer. Como resultado, pode-se verificar que, apesar de ainda existirem algumas questões a serem tratadas, as tecnologias apresentadas representam conjuntamente uma ferramenta ampla para o desenvolvimento de aplicações multimídia.Multimedia applications are characterized for demanding huge network and computing resources. Because these demands, the current development models always were based on highly specialized and integrated architectures. Thus, they present monolithic structures which limits reuse, as well requiring a lot of efforts to perform changes. This approach limits the development of complex and large scale multimedia applications. There are demand for development models for enabling larger scopes application, supporting scalable, flexible and ease programming applications. In this context this work proposes the conjugated use of Service Oriented Architectures and the MPEG-7 and MPEG-21 standards. It presents how these technologies can allow multimedia applications ease development, minimizing coasts and efforts. Besides, it is also showed how they answer for the raising and multiple demands for new multimedia applications types. This work motivation was to create a solution to support some additional requirements verified during the design of a Video Management Platform. Among the diversified issues treated in this work, it is presented how technologies supporting Service Oriented Architectures are positioned regarding multimedia applications development, and how they together MPEG-7 and MPEG-21 standards are being used to improve the Platform. It is also presented an analysis process for applying the principles of Service Orientation in the multimedia applications development. The aim is generalizing the presented solution to be applied in any multimedia application development. As result from the whole work, it can be verified that, although there are some issues to be covered, the technologies presented represent a complete tool for multimedia applications development.
17
Dogan, Sumeyra. "An Investigation Of Pre-service Elementary Mathematics Teachers." Master's thesis, METU, 2009. http://etd.lib.metu.edu.tr/upload/12610673/index.pdf.
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The purpose of this study was to investigate the nature of changes in preservice elementary mathematics teachers&rsquoviews and reflections about elementary mathematics classes based on their observations in School Experience I and School Experience II courses. Specifically, this study investigated pre-service elementary mathematics teachers&rsquo
views and reflections about instruction, assessment, and classroom management issues in elementary mathematics classes based on their observations in School Experience I and School Experience II courses. The sample consisted of 19 pre-service elementary mathematics teachers from a teacher education program at Middle East Technical University (METU). Pre-service elementary mathematics teachers involved in this study made their observations in their cooperating schools for 3 months during the spring semester of 2004-2005 academic year and the fall semester of 2007-2008 academic year. The data were collected by means of their School Experience I and School Experience II course reports. The results indicated that although there was commonality in the views and reflections of pre-service elementary mathematics teachers&rsquo
about instruction, assessment, and classroom management issues in elementary mathematics classes, there were differences in their knowledge in the way they perceive instruction, assessment, and classroom management as they progressed through their education. In other words, when School Experience I course reports were compared with School Experience II course reports, pre-service teachers perceived the mathematics instruction as more student-centered and they gave more importance to the alternative assessment strategies in their School Experience II course reports. Furthermore, they defended more positive classroom management methods in their School Experience II course reports.
18
Martin, Lelia Gonçalves Rocha. "Dimensionamento de profissionais de enfermagem em ambulatório de oncologia e hematologia." Universidade de São Paulo, 2013. http://www.teses.usp.br/teses/disponiveis/7/7140/tde-17072014-140727/.
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Introdução: Os ambulatórios de oncologia vêm atendendo, a cada dia, um número crescente de pacientes que necessitam de cuidados clínicos complexos; todavia, boa parte desses serviços não possui informações que possam dar suporte às decisões relativas ao dimensionamento de profissionais de enfermagem. Objetivos: Identificar e analisar as intervenções / atividades realizadas pelos profissionais de enfermagem e definir parâmetros para dimensionar o quadro de pessoal de enfermagem em ambulatório especializado em oncologia e hematologia. Método: Pesquisa metodológica de campo que utiliza a técnica de amostragem de trabalho realizada em um ambulatório de oncologia e hematologia de uma organização de saúde privada localizada na cidade de São Paulo. Os dados foram coletados de 15 a 19 de abril de 2013 e foram organizados nas etapas seguintes: (1) Construção do instrumento de medida da frequência e do tempo despendido em intervenções de enfermagem; (2) Validação das intervenções / atividades do instrumento; (3) Identificação da frequência e do tempo despendido pelos profissionais de enfermagem em intervenções / atividades; (4) Dimensionamento de profissionais de enfermagem em ambulatório de oncologia e hematologia. Resultados: O instrumento construído e validado englobou 34 intervenções e três atividades. Foram registradas pelos observadores de campo 3694 observações dos profissionais de cada categoria na execução das intervenções / atividades de enfermagem. A documentação foi a intervenção que despendeu maior tempo da equipe (24,1%). Seguida desta, as intervenções que mais interferiram na carga de trabalho dos enfermeiros foram: Manutenção de dispositivos de acesso venoso (9,2%), Controle da quimioterapia (7,9%), Acompanhamento por telefone (5,1%) e Presença (4,7%); e, para os técnicos de enfermagem: Controle do ambiente em conforto (12,3%), Punção de vaso para amostra de sangue venoso (11,9%), Presença (10,1%) e Monitorização de Sinais Vitais (9,4%). A média diária dos pacientes correspondeu a 37,2 (±4,4) pacientes. O tempo médio de cuidado por paciente relativo aos cuidados de enfermagem, atividades associadas, tempo de espera e atividades pessoais correspondeu a 3,3h (80% de enfermeiros e 20% de técnicos de enfermagem). A produtividade encontrada foi de 81,3%. Conclusão: Este estudo possibilitou indicar parâmetros para o dimensionamento, bem como identificar o tipo e a proporção das intervenções de enfermagem que interferem na carga de trabalho e aplicar equações para o cálculo de profissionais de enfermagem. Entretanto, ainda constitui-se em uma visão restrita da realidade, necessitando ser replicado em vários e diferentes ambulatórios especializados em oncologiaIntroduction: Oncology outpatient units have been receiving an increasing number of patients who need complex clinical care; however, most of them do not have appropriate information to support nursing staffing decisions. Objectives: To identify and analyze interventions/ activities performed by nursing professionals and to define parameters used to determine nursing staffing in a specialized oncology and hematology outpatient centers. Methods: Field methodology study that uses sampling technique, carried out in an oncology and hematology outpatient center of a private healthcare organization located in the city of Sao Paulo. Data were collected between April 15 to 19, 2013 and organized into steps: (1) Design a tool to measure frequency and duration of nursing interventions; (2) Validation of interventions/ activities of the tool; (3) Identification of frequency and time spend by nursing professionals in their interventions/ activities; (4) Dimensioning of nurses in an oncology and hematology outpatient unit. Results: The tool was designed and validated and encompassed 34 interventions and three activities. The field observers documented 3,694 observations of professionals in each category of nursing interventions/ activities. Documenting (24.1%) was the intervention that required more time from the team. Next, the activities that required more time from the nursing team were: maintenance of devices: venous access (9.2%), chemotherapy control (7.9%), telephone follow-up (5.1%) and person-to-person follow-up (4.7%). To nursing technicians, the activities were: environment control - comfort (12.3%); venous puncture - venous blood sample (11.9%); presence (10.1%), and monitoring of vital signs (9.4%). The mean daily number of patients corresponded to 37.2 (±4.4) patients. The average time spent on patient care, related to nursing care, associated activities, waiting time and personal activities corresponded to 3.3 hours (80% of nurses and 20% of nursing technicians). Productivity was 81.3%. Conclusion: This study led to the definition of parameters for staffing, plus the identification of type and proportion of nursing interventions that interfered on the workload and the application of equations to calculate nursing staffing. However, it still is a restricted view of the reality, which has to be multiplied in several and different specialized oncology outpatient centers.
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Ucar, Duzan Canan. "An Evaluation Of The In-service Teacher Training Program For The Newly Hired Instructors In The School Of Foreign Languages At Middle East Technical University." Master's thesis, METU, 2006. http://etd.lib.metu.edu.tr/upload/2/12607055/index.pdf.
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The purpose of this study was to evaluate the effectiveness of the in-service teacher training program implemented for the newly hired teachers in the School of Foreign Languages (SFL) at Middle East Technical University. The study was conducted with the help of three groups of participants who were the trainees who participated in the training program in the 2004-2005 academic year, the experienced teachers who were current members of the SFL and the teacher trainers. Data from the 12 trainees were collected through two questionnaires which were developed to identify the needs of the trainees at the start of the program and their degree of satisfaction at the end. Moreover, an interview was conducted with the trainees. Data from the 4 teacher trainers were collected through a questionnaire and it aimed to identify their expectations from and satisfaction with the program. 45 experienced teachers, on the other hand, were involved in the study to understand whether they need in-service training. The questionnaires included both Likert scale and open-ended items.
Data collected through the instruments were analyzed both quantitatively and qualitatively. Closed-ended items were analyzed via the SPSS program and mean scores for each item were calculated. To identify if there is any statistically significant difference between the mean scores, a paired-sample t-test was calculated. The qualitative data were analyzed through content analysis.
The results of the study revealed that the trainees especially need to improve their practical teaching skills which are immediately necessary in the new setting. Their degree of satisfaction was also found to be high. The results about the experienced teachers showed that they did not feel the need to enroll in an in-service training program. The findings about the teacher trainers revealed that they are generally happy with the program although they listed some suggestions for improvement.
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Koyuncu, Ilhan. "Investigating The Use Of Technology On Pre-service Elementary Mathematics Teachers." Master's thesis, METU, 2013. http://etd.lib.metu.edu.tr/upload/12615588/index.pdf.
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The purpose of this study was to investigate plane geometry problem solving strategies of pre-service elementary mathematics teachers in technology and paper-and-pencil environments after receiving an instruction with GeoGebra. Qualitative research strategies were used to investigate teacher candidates&lsquosolution strategies. The data was collected and analyzed by means of a multiple case study design. The study was carried out with 7 pre-service elementary mathematics teachers. The main data sources were classroom observations and interviews. After receiving a three-week instructional period, the participants experienced data collection sessions during a week. The data was analyzed by using records of the interviews, answers to the instrument, and transcribing and examining observation records. Results revealed that the participants developed three solution strategies: algebraic, geometric and harmonic. They used mostly algebraic solutions in paper-and-pencil environment and v geometric ones in technology environment. It means that different environments contribute separately pre-service teachers&lsquo
mathematical problem solving abilities. Different from traditional environments, technology contributed students&lsquo
mathematical understanding by means of dynamic features. In addition, pre-service teachers saved time, developed alternative strategies, constructed the figures precisely, visualized them easily, and measured accurately and quickly. The participants faced some technical difficulties in using the software at the beginning of the study but they overcome most of them at the end of instructional period. The results of this study has useful implications for mathematics teachers to use technology during their problem solving activities as educational community encourages to use technology in teaching and learning of mathematics.
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Silva, Caroline Lopes Ciofi. "Recuperação de norovirus no piso e no ar após diferentes protocolos de descontaminação." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/7/7139/tde-18092018-113258/.
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Introdução: O enfermeiro é responsável em atuar no controle da contaminação do ambiente, visando a prevenção de transmissão de infecções relacionadas à assistência à saúde. Surtos de gastroenterite causados por norovirus (NoV) em locais fechados são caracterizados pela persistência do vírus no ambiente, aerolização das partículas virais e baixa dose infectante, mesmo em indivíduos saudáveis. Portanto, há necessidade de definição de um protocolo seguro para limpeza e desinfecção do piso contaminado com vômito e fezes, considerando a possibilidade de dispersão de aerossóis a partir do piso. Objetivo: Avaliar a presença residual de partículas de NoV-GII no ar e no piso quando implementados diferentes protocolos de descontaminação do piso, após contaminação intencional. Método: Trata-se de um estudo experimental laboratorial. Dois tipos de piso, vinil e granito (matérias primas frequentemente utilizadas nos pisos dos serviços de saúde), foram contaminados intencionalmente com fezes humanas positivas 10% para NoV-GII, dissolvidas em 500ml de solução tampão salino-fosfato. Os pisos foram submetidos a três tipos de tratamento: limpeza padronizada com fricção manual, água e detergente neutro; limpeza seguida de desinfecção com hipoclorito de sódio 1% por 10 minutos; limpeza seguida de desinfecção com dispositivo portátil de luz ultravioleta por cinco minutos (SURFACE-UV®). Amostras foram obtidas do piso, por meio do swab, e do ar, por meio de um coletador de ar (Coriolis® - Bertin Technologies, França), nos seguintes momentos: antes e após a contaminação intencional; após a limpeza e após os métodos de desinfecção. Para detecção de NoV-GII nas amostras, utilizou-se a técnica 4.6.2. Reação em Cadeia pela Polimerase quantitativa precedida de Transcrição Reversa (RT-qPCR), pelo método TaqMan®. Resultados: Não foram encontradas diferenças estatisticamente significantes entre os tipos de piso após os protocolos de descontaminação, tanto para o residual de NoV-GII no piso, quanto no ar. Os valores médios de Cycle Threshold (Ct) após limpeza seguida de desinfecção foram maiores (38,75 40,00) comparados aos de após limpeza (35,67 38,66), comprovando a maior eficácia desse protocolo (p<0,001). Em algumas amostras, a limpeza isolada foi capaz de reduzir a contaminação por NoV do piso até níveis indetectáveis. Quando houve residual de NoV-GII após a limpeza do piso, o protocolo cuja desinfecção foi realizada com hipoclorito de sódio foi mais eficaz do que a luz ultravioleta (p<0,001), sendo que os valores de Ct de todas as amostras foram acima de 40. Em 27 das 36 (75%) amostras de ar coletas após a limpeza do piso, foram detectadas partículas de NoV, com diferenças estatisticamente significantes entre as segundas e terceiras amostras, coletadas a 150cm do piso. Foram identificadas que, em média, 17 cópias de RNA viral/L estavam presentes no ar após a limpeza, com redução gradual após a desinfecção. Conclusões: Quando vômito e fezes com NoV-GII contaminam o piso, há aerolização desse vírus já no ato da limpeza. Essas partículas podem ser inaladas ou depositarem em superfícies frequentemente tocadas pelas mãos, estabelecendo o ciclo de transmissão oro-fecal. As partículas virais residuais no piso após a limpeza, indiscutivelmente devem ser eliminadas, evitando assim a reaerolização do NoV a partir dessa fonte. Nesse sentido, a limpeza seguida de desinfecção com hipoclorito de sódio a 1% por 10 minutos mostra superioridade como protocolo de descontaminação do piso, quando comparado ao protocolo com limpeza seguida de desinfecção com luz ultravioleta por 5 minutos de exposição.Introduction: Nurses are responsible for controlling contamination of the environment, working to prevent the transmission of health-care-associated infections. Gastroenteritis outbreaks caused by Norovirus (NoV) in closed settings are characterized as the result of persistence of the virus in the environment, aerosolization of viral particles, and small infectious dose, even in healthy individuals. Therefore, a safe protocol to decontaminate the floor after vomit or feces have spilled must be defined, considering that subsequent aerosol dispersal may occur. Objective: To assess the presence of residual NoV-GII particles in the air and on the floor after different decontamination protocols are conducted on a deliberately contaminated floor. Method: This is an experimental laboratory study. Two types of floor, vinyl and granite (materials which are often used in the flooring of healthcare facilities), were intentionally contaminated with 10% NoV-GII-positive human feces dissolved in 500ml of a saline-phosphate buffer solution. The floors received three types of treatment: standard cleaning, with manual friction, water, and neutral detergent; cleaning followed by a ten- minute disinfection procedure using 1% sodium hypochlorite; and cleaning followed by a five- minute disinfection procedure using a portable ultraviolet light device (SURFACE-UV®). Swab samples were taken from the floor, and air samples were obtained using an air sampler (Coriolis® - Bertin Technologies, France) at the following moments: before and after the intentional contamination, after cleaning, and after disinfection. The TaqMan® method for real-time Reverse Transcription-Polymerase Chain Reaction was used to detect NoV-GII in the samples. Results: No statistically significant difference between the two types of floor was found for residual NoV-GII, either in the air or on the floor, after the decontamination protocols. The average Cycle Threshold (Ct) values found after cleaning followed by disinfection were higher (38.75 - 40.00) than those recorded after cleaning (35.67 - 38.66), thus attesting to the greater effectiveness of the latter protocol (p<0.001). In some samples, cleaning alone was enough to reduce floor contamination by NoV to undetectable levels. When residual NoV-GII was found after cleaning the floor, the disinfection protocol that involved using sodium hypochlorite proved more effective than UV-light exposure (p<0.001), and Ct values were higher than 40 for all samples. NoV particles were detected in 27 of the 36 (75%) air samples obtained after cleaning the floor, and significant statistical differences were found between the second and third samples, collected 150cm from the floor. An average of 17 copies of viral RNA/L were identified in the air after cleaning, gradually decreasing after disinfection. Conclusions: When NoV-GII-infected vomit or feces contaminate the floor, the virus is aerosolized even during cleaning. These particles may then be inhaled or settle on frequently touched surfaces, establishing the fecal-oral transmission cycle. Residual viral particles on the floor must undoubtedly be eliminated, thereby preventing NoV aerosolization from this source. Along these lines, cleaning followed by disinfection by 1% sodium hypochlorite for ten minutes proved to be a superior floor decontamination protocol when compared with cleaning followed by disinfection by UV-light exposure for five minutes.
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Burchartz, Birgit. "Problemlöseverhalten von Schülern beim Bearbeiten unlösbarer Probleme /." Hildesheim [u.a.] : Franzbecker, 2003. http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&doc_number=010263298&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA.
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Maass, Katja. "Mathematisches Modellieren im Unterricht : Ergebnisse einer empirischen Studie /." Hildesheim [u.a.] : Franzbecker, 2004. http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&doc_number=010770215&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA.
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Covino, Adriana Machado. "O cotidiano nos espaços de morar e habitar em saúde mental." Universidade de São Paulo, 2007. http://www.teses.usp.br/teses/disponiveis/7/7134/tde-19122007-162841/.
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Como conseqüência dos processos de desinstitucionalização psiquiátrica, situam-se as moradias para pessoas com sofrimento psíquico com longo tempo de internação psiquiátrica, que retornam ao território. O presente estudo teve como objetivo narrar e refletir sobre o cotidiano de duas moradias para pessoas com transtornos mentais na cidade de Londres, Reino Unido, de 2002 a 2005. O caminho metodológico emergiu sob a abordagem qualitativa, com o uso da narrativa como recurso metodológico. Essas moradias abrigavam 11 pessoas de diferentes crenças e nacionalidades, tendo em comum o diagnóstico de doenças mentais crônicas e com diversos graus de dependência de cuidados em seu cotidiano, necessitando de atenção nas 24h. O acompanhamento dos moradores era realizado pelos profissionais, que não tinham necessariamente uma formação técnica na área da saúde. Estes recebiam treinamento específico para o acompanhamento e auxílio das atividades diárias dentro e fora da residência. Entre os cuidadores e os profissionais de saúde, que atuavam havia diferenças no olhar e no cuidar de cada morador. Nestas moradias, a convivência suscitou uma reflexão sobre o cotidiano das práticas de cuidado em saúde mental no ambiente de uma moradia e a noção de habitar. Destacaram-se como pontos que merecem atenção: as possibilidades de reconstrução de vidas dentro dessas moradias; as diferenças entre morar e habitar; a importância de se valorizar as ações diárias realizadas no cotidiano desses espaços como possibilidades de resgatar as subjetividades de todos seus habitantesAs a consequence of the deinstitutionalizationof psychiatric patients, housing for people who have suffered long term institutionalization and are now back in society comes to light. This research narrates and reflects about the daily life of two care homes for people with mental disorders in the city of London, England, between 2002 and 2005. A qualitative approach was followed, with the use of narrative as a methodological resource. Eleven people lived in these particular homes, having in common the diagnostic of chronic mental health problems with varied levels of dependency, needing care 24 hours a day. The patients were aided by workers who did not necessarily have a technical degree in health care. These workers received specific training for handling daily activities inside and out of the homes. Between the care workers and the health professionals involved in caring, there were differences in how they envisioned the patients care needs. In these homes, the daily routine suscitated reflexion about mental health practices in a care home and the notion of \"inhabiting\". The following points can be highlighted: possibility of reconstructing lives; difference between live and inhabit; the importance of valuing ordinary actions accomplished in these spaces as a way to redeem the subjectivity in all its inhabitants
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Kösling, Arletta-Marie. "Die private Schule gemäß Art. 7 Abs. 4,5 GG : eine Untersuchung zu den Ersatzschulen und Ergänzungsschulen unter besonderer Berücksichtigung eines verfassungsrechtlich determinierten Schulbegriffes im Sinne des Art. 7 GG /." Baden-Baden : Nomos, 2005. http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&doc_number=014612611&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA.
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Polar, Ruiz Fiorella Alessandra, and Mariño Yajaira Fabiola Tomas. "Niveles de calidad percibidos del servicio en restaurantes de comida rápida de usuarios entre 18 a 35 años de los NSE A, B y C que residen en la zona 7 de Lima Metropolitana en el año 2019." Bachelor's thesis, Universidad Peruana de Ciencias Aplicadas (UPC), 2020. http://hdl.handle.net/10757/652412.
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Esta investigación surge a raíz de considerar que el principal factor que el cliente evalúa en cuanto a su experiencia percibida y a la vez la valida, es la calidad de servicio en los autoservicios de comida rápida tales como KFC, Burger King, Mc Donald´s, Popeyes, Domino’s Pizza, entre otros.
Para poder realizar esta investigación empezamos nuestro proceso de búsqueda de papers relacionados al tema, encontrando una investigación realizada en Mérida, Venezuela que tiene como título: “Niveles de calidad del servicio de comida rápida según las características de los usuarios”, realizada por el Municipio Libertador del estado Mérida, Venezuela, la que se usó como guía para poder adaptar esta investigación a Lima Metropolitana.
El objetivo de esta investigación es comparar los niveles de calidad de servicio a través de cinco dimensiones que son: Tangibilidad, Fiabilidad, Capacidad de respuesta, Garantía o seguridad y Empatía en usuarios de comida rápida entre 18 a 35 años que residan en la zona 7 de Lima Metropolitana y pertenecen a los niveles socioeconómicos A, B y C, durante el año 2019. Para el desarrollo de la investigación, se ha dividido a los consumidores en diversos grupos de acuerdo a sus características.
Para la ejecución del trabajo fue necesario adaptar el tipo de encuesta que se estaba usando en el paper guía (DINESERV) a una encuesta en escala de Likert, el que será detallado a profundidad en los siguientes capítulos de este estudio, ya que se trata de un tipo de encuesta sencilla de responder por el usuario y, por lo tanto, de mayor practicidad en la interpretación de resultados.
Finalmente, afirmamos que este trabajo se consolida como un apoyo para que los autoservicios entiendan mejor las necesidades de sus consumidores, de acuerdo a sus características y a las cinco dimensiones mencionadas anteriormente (Tangibilidad, Fiabilidad, Capacidad de respuesta, Garantía o seguridad y Empatía).This investigation arises as a result of which we consider that the quality of service is the main factor by which the customers evaluate their perceived experience about fast food self-service. In order to carry out this research, we began our search process to look for papers similar to the topic, finding an investigation carried out in Mérida, Venezuela that has the title: "Behavior of the quality levels of the fast food service according to the characteristics of the users from Merida, Venezuela." which was used as a guide to adapt this investigation to Lima, Peru. The objective of this research is to compare levels of quality of service through five dimensions that are tangibility, reliability, responsiveness, guarantee or security and empathy in fast food users between 18 and 35 years residing in zone 7 of Metropolitan Lima and belong to socioeconomic levels A, B and C at 2019 year. For the development of this investigation, the consumers will be divided into different groups according to their characteristics. For the execution of this investigation, was necessary to adapt the type of survey that was used in the paper guide (DINESERV), which will be detailed later, by a type of survey that is easier to answer for the user and more practical in the interpretation of results. Finally, we think that this investigation could help to the fast food self-service to understand better the needing of their consumers according to their characteristics and the five dimensions worked.
Tesis
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Silva, Alessandra Carvalho dos Santos da. "Capacitação ativa para o atendimento de parada cardiorrespiratória: uma adaptação da metodologia OSCE." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/7/7144/tde-01112018-144132/.
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Esta pesquisa apresenta um modelo de capacitação para o atendimento de parada cardiorrespiratória a partir de uma abordagem qualitativa com foco na prática pedagógica envolvida nesse processo. Os objetivos específicos foram: aplicar o método Objective Structured Clinical Examination (OSCE)adaptado para o atendimento de parada cardiorrespiratória, elaborar uma metodologia para a capacitação dos profissionais para o atendimento de parada cardiorrespiratória e analisar os mediadores pedagógicos aplicados no processo capacitação. A pesquisa foi realizada em uma Assistência Médica Ambulatorial Integrada, localizada na Região Leste do Município de São Paulo. Estimou-se que a capacitação ocorreria no centro de treinamento e no espaço dos participantes, o que demandou o reconhecimento antecipado do campo e articulações junto à Supervisão Técnica de Saúde. A organização dos materiais didáticos envolveu a parceria com um instrutor credenciado pela American Heart Association, além da elaboração e aplicação da metodologia OSCE adaptada para o processo de aprendizagem. Os sujeitos da pesquisa foram oito participantes voluntários, do turno da manhã e da tarde, integrantes da equipe de enfermagem da unidade. Procedeu-se uma capacitação em três etapas: a primeira constitui-se uma aula teórico-prática em atendimento à parada cardiorrespiratória no centro de treinamento. A segunda foi uma simulação de um caso clínico de parada cardiorrespiratória na sala de classificação de risco, envolvendo uma atriz e os sujeitos da pesquisa, seguido de um atendimento na sala de emergência utilizando um manequim e aplicando todos os procedimentos recomendados. Na terceira etapa foi realizada uma entrevista semiestruturada norteado por perguntas disparadoras. As cenas foram captadas por meio de gravação de imagens e de áudio na segunda etapas, a fim de promover um feedback aos participantes. Ao término dessa construção, procedeu-se à entrevista com roteiro semiestruturado individualmente, de forma a conhecer as dificuldades e facilidades vivenciadas pelos participantes e, simultaneamente, analisar a aplicabilidade da metodologia proposta. Quanto aos dados da entrevista, realizou-se a escuta, transcrição e sistematização em categorias por meio da técnica de análise de conteúdo. Os fundamentos teóricos e pedagógicos propostos por Robert Harden (1975), Paulo Freire (2014) e Edgar Morin (2003), nortearam a discussão dos resultados em duas categorias analíticas: mediação pedagógica no processo de capacitação e aprendizado no ambiente de trabalho como forma de produção. O resultado foi uma associação de três fases operacionais. A primeira fase de fundamento teórico-prático foi caracterizada pela interação proativa. A segunda fase de simulação com uma paciente-atriz, os participantes foram ativos no atendimento, entretanto os sinais de agravo clínico provocaram comportamento de apreensão, rapidamente superado. Houve uma pequena disfunção no acesso aos materiais, porém a equipe demonstrou equilíbrio, fito às manobras de ressuscitação realizando os procedimentos com sucesso. A terceira etapa foi a entrevista semiestruturada, resultando em uma súmula de pertinência pedagógica e metodológica para a transformação da prática. Cabe ressaltar que o conjunto da metodologia favoreceu a co-construção do sentido da aprendizagem e da reflexão crítica como base da transformação. Em síntese, foi possível concretizar a elaboração de um modelo de capacitação e comprovar sua aplicabilidade na prática do atendimento à parada cardiorrespiratória.This research presents a training model for cardiorespiratory arrest care based on a qualitative approach focused on the pedagogical practice involved in this process. The specific goals were: to apply the Objective Structured Clinical Examination (OSCE) method - adapted for cardiorespiratory arrest attendance, to create a professionals\' qualification methodology for cardiorespiratory arrest attendance and to analyze the pedagogical mediators applied in the training process. The research was carried out in an Integrated Ambulatory Medical Assistance, located in Sao Paulo\'s eastern area. It was stipulated that the training would take place at the training center and the participants environment, which required field early recognition and articulation with the Technical Health Supervision. The teaching supplies organization involved the partnership with an American Heart Association accredited instructor, besides the use of OSCE - adapted methodology for the learning process. The research subjects were eight volunteers, from morning and afternoon shifts, members of the unit\'s nursing team. A training was carried out in three stages: the first one constituted of a theoretical / practical class in cardiorespiratory arrest attendance at the training center. The second stage was a simulation of a clinical case of cardiorespiratory arrest at the risk classification room, people involved were an actress and the subjects of the research, followed by emergency room care using a mannequin and following all recommended procedures. In the third stage a semi-structured interview was conducted guided by triggering questions. The scenes were captured through recording of images and audio in the second stage, in order to provide feedback to participants. At the end of the training an individual semi-structured interview was conducted, in order to understand the difficulties and facilities experienced by the participants and simultaneously analyze the applicability of the proposed methodology. Regarding to interview data, listening and transcription and systematization were performed in categories through the technique of content analysis. The theoretical and pedagogical foundations proposed by Robert Harden (1975), Paulo Freire (2014) and Edgar Morin (2003) guided the results discussion in two analytical categories: training process pedagogical mediation and learning at work environment as a way of production. The result was an association of three operational phases. The first phase of theoreticalpractical foundation was characterized by proactive interaction. The second fase de simulation with a patient-actress, the participants were active in the attendance however the signs of clinical injury caused apprehension behavior, quickly overcome. There was a small dysfunction in the access to the materials, however the team demonstrated balance, aiming at resuscitation maneuvers performing the procedures successfully. The third step was the semistructured interview, resulting in a summary of pedagogical and methodological relevance for the transformation of the practice. It should be emphasized that the whole methodology favored the co-construction of the meaning of learning and critical reflection as the basis of transformation. In summary, it was possible to accomplish the elaboration of a training model and to prove its applicability in the practice of cardiorespiratory arrest attendance.
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Bovet, Jana. "Sanierung und Entwicklung als raumordnerische Aufgabe : [section] 7 Abs. 2 Nr. 2c ROG /." Dresden : Leibniz-Inst. für Ökolog. Raumentwicklung, 2003. http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&doc_number=010684136&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA.
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Schüller, Valérie. "Die Auftragsdefinition für den öffentlich-rechtlichen Rundfunk nach dem 7. und 8. Rundfunkänderungsstaatsvertrag /." Frankfurt am Main [u.a.] : Lang, 2007. http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&doc_number=015696318&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA.
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Cordeiro, Ana Rita Teixeira da Costa. "Plano de Marketing para a empresa BodyConcept : rede de franchising de clínicas de estética." Master's thesis, Instituto Superior de Economia e Gestão, 2016. http://hdl.handle.net/10400.5/13148.
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Mestrado em MarketingO presente Trabalho Final de Mestrado tem como principal objetivo o desenvolvimento de um Plano de Marketing para a empresa BodyConcept, uma rede de franchising de clínicas de estética que atua no mercado há 11 anos. Este plano tem como unidade de análise o conjunto de clínicas BodyConcept existentes, onde a rede atua com uniformização de políticas e diretrizes definidas pelo Master franchisador. Através deste plano, foi feito um diagnóstico empresarial da empresa, aferindo a qualidade do serviço prestado às clientes, de modo a definir objetivos de marketing e, posteriormente estratégias e táticas ao nível do marketing mix - 7 P's.
The main purpose of this Master Thesis is the development of a marketing plan for BodyConcept Company, which is a chain of franchising aesthetic clinics operating in the market for eleven years. This plan analyses the set of existing BodyConcept clinics where the network operates according to a standardization of policies and guidelines defined by the franchising Master. The plan provides an analysis of the Company business, assessing the quality of the services provided to customers, in order to establish marketing goals and afterwards, define marketing mix strategies and tactics - 7P's.
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Arrué, García Olenka Mariela. "Las dimensiones de la calidad de servicio percibida, el producto y el precio en relación a la satisfacción de los clientes entre 18 y 35 años que asisten a los Fast Good ubicados en la Zona 7 de Lima Metropolitana." Bachelor's thesis, Universidad Peruana de Ciencias Aplicadas (UPC), 2020. http://hdl.handle.net/10757/651929.
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Actualmente, la industria de restaurantes, en el Perú, se ha visto en la necesidad de adaptarse a las nuevas tendencias de los consumidores correspondientes a la alimentación saludable y estilos de vida acelerados. Por ello, se observa la aparición y expansión progresiva de nuevos formatos en Lima, como los Fast Good, que atienden dichas necesidades de manera específica. Por lo tanto, el objetivo del presente estudio es evaluar, a través del modelo DINESERV, la percepción de los comensales sobre las dimensiones de la calidad del servicio, el producto y precio, que derivan en la satisfacción final de los clientes, lo cual puede ser favorable o no, dependiendo de la gestión de dichos atributos por parte de los administradores y fundadores del nuevo formato.Nowadays, Restaurant Industry in Peru has found it necessary to adapt to new consumers’ trends regarding healthier eating and faster lifestyles. Therefore, new business models such as Fast Good have progressively appeared and expanded in order to specially fulfill those needs. Therefore, the objective of this investigation is to evaluate, through the and DINESERV model, the perception of the dimensions of service quality, product and price, that result in customer satisfaction, which may be favorable or not, depending on how business creators implement those attributes in this new formats.
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Prates, José Gilberto. "A representação social dos enfermeiros de serviços de urgência e emergência acerca da assistência aos usuários de álcool e outras drogas." Universidade de São Paulo, 2011. http://www.teses.usp.br/teses/disponiveis/7/7141/tde-17082011-100855/.
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Este estudo objetivou identificar e analisar a representação social dos enfermeiros de serviços de urgência e emergência acerca da assistência aos usuários de álcool e outras drogas. Foram realizadas quatorze entrevistas e para a análise dos discursos utilizou-se a abordagem qualitativa hermenêutica dialética, norteada pelos pressupostos teóricos da Reforma Psiquiátrica brasileira. A análise dos dados possibilitou a construção de quatro categorias empíricas: Assistência de Enfermagem, Processo Saúde-Doença, Estigma e Educação Permanente. Os resultados apontam que assistir um paciente intoxicado ou em abstinência é algo que perturba a rotina de atendimento nos serviços de urgência/emergência, demonstrando a falta de preparo e o receio por parte dos profissionais para lidar com estas situações, fato que afeta não somente o atendimento a este público, como também a captação e o encaminhamento destes indivíduos, posteriormente, para serviços especializados como o Centro de Atenção Psicossocial em álcool e outras drogas. A concepção dos entrevistados acerca dos usuários de substâncias psicoativas encontra-se apoiada no modelo moral, que traz embutido o conceito de anormalidade, evidenciando o preconceito e o estigma relacionado a este público, sendo este um dos principais desafios a ser superado ao atender esta população, de forma que não se reproduza os cuidados relacionados à psiquiatria tradicional. Sobretudo, quando o uso abusivo de substâncias psicoativas é visto, pelos enfermeiros, como uma patologia que pressupõe o predomínio das estruturas biológicas sobre as psicológicas e sociais, baseado na teoria da multicausalidade. Portanto, qualificar os profissionais de saúde para o atendimento de situações tão prevalentes, como o uso de álcool e outras drogas, deve fazer parte de um conjunto de ações dos serviços de saúde, visando maior qualidade nos atendimentos a esta população na rede de atenção à saúde.This study aimed to identify and analyze the social representation of nurses from the emergency services and emergency assistance regarding the users of alcohol and other drugs. Fourteen interviews were conducted to examine the discourses, using a qualitative approach, the dialectical hermeneutics, guided by theoretical assumptions of the Brazilian Psychiatric Reform. The data analysis allowed the construction of four empirical categories: Nursing Care, Health-Disease Process, Stigma and Continuing Education. The results show that watching a patient intoxicated or in withdrawal is something that disturbs the routine care in emergency, demonstrating the lack of preparation and fear on the part of professionals to handle these situations, a fact that affects not only the care this individuals, but also their routing, subsequently, for specialized services such as the Center for Psychosocial Care in alcohol and other drugs. The conceptions of the interviewees about the users of psychoactive substances is supported by the moral model, which brings along the concept of abnormality, revealing the prejudice and stigma related to this population. This is one of the main challenges to be overcome to take care of this population, instead of reproducing the traditional psychiatry. Especially since the abuse of psychoactive substances is viewed by nurses as a condition which presupposes the predominance of biological structures over the psychological and social theory based on the multiple causes. Therefore, to train and qualify the health professionals to cope with situations as prevalent as alcohol and other drugs should be part of a set of actions of health services, seeking higher quality care for this population, basing the assistance on a network health care.
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Lança, Ellen de Fátima Caetano. "Serviço de Atendimento Móvel de Urgência Fluvial de Manaus: perfil dos atendimentos, usuários e fatores relacionados ao agravamento dos atendidos." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/7/7139/tde-18092018-131440/.
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Introdução: Manaus dispõe de um Serviço de Atendimento Móvel de Urgência (SAMU) fluvial que atende a população que reside em comunidades ribeirinhas dos rios Negro e Amazonas. Tem-se observado várias iniciativas de atendimento pré-hospitalar (APH) com uso desse tipo de transporte; no entanto, não foram encontradas na literatura informações sobre esses serviços, perfil dos usuários e fatores associados a desfechos indesejáveis do atendimento. Objetivo: Caracterizar o perfil dos usuários, aspectos do atendimento do SAMU fluvial de Manaus e identificar fatores relacionados ao agravamento no APH fluvial. Método: Estudo descritivo correlacional realizado em duas etapas. Na primeira etapa, a coleta de informações foi retrospectiva e teve como fonte os registros dos atendimentos realizados pelo SAMU fluvial de Manaus de 2009 a 2015. Na segunda etapa, a coleta de dados foi prospectiva; indivíduos com 15 anos ou mais, atendidos pelo SAMU fluvial no período de seis meses (janeiro a junho de 2016), tiveram informações coletadas desde a chamada na Central de Regulação até a chegada à base fluvial. Pacientes encaminhados para hospitais tiveram a coleta de informações estendida até a saída hospitalar. Testes de associação foram aplicados considerando as características do atendimento e usuário perante o agravamento do paciente, identificado por meio das mudanças do Rapid Emergency Medicine Score (REMS) entre o atendimento inicial e final do SAMU fluvial. Resultados: Entre 2009 e 2015, o SAMU fluvial de Manaus realizou 2.002 atendimentos, a maior parte em comunidades do Rio Negro e próximas da base fluvial. A grande maioria dos atendidos pelo SAMU fluvial foi removida para Manaus (92%), variando o tipo de embarcação mais frequentemente utilizada no transporte ao longo dos anos e com ajustes na tripulação da modalidade Unidade de Suporte Avançado (USA) após 2015. Foi baixa a frequência de procedimentos nos atendimentos (média 1,5 procedimento), porém o acesso venoso foi realizado em quase todos os usuários (97,8%). Houve grande variabilidade dos tempos de APH. As médias do tempo de resposta (84 minutos) e total de APH fluvial (172 minutos) foram bastante elevadas. A maioria dos pacientes removidos foi encaminhada para hospital (44,9%) ou serviço de pronto atendimento (37,1%). A frequência de homens e mulheres atendidos foi semelhante e os usuários com menos de 35 anos predominaram. As causas mais frequentes dos atendimentos foram as relacionadas a sintomas, sinais e achados anormais e causas externas de morbidade e mortalidade. Os parâmetros fisiológicos e o valor médio do REMS inicial, 2,7 (dp = 3,6), indicaram baixo risco de morte dos pacientes. No entanto, a mortalidade hospitalar dos internados foi de 8,7%. Dos pacientes transportados pelo SAMU fluvial, 68,5% mantiveram o quadro clínico, 18,0% pioraram e 13,5% melhoraram durante o atendimento. Houve associação entre piora e local de destino dos usuários (p=0,037), também com as ocorrências relacionadas a contato com serpentes venenosas (p= 0,039) e dor aguda (p= 0,005). Conclusão: No geral, os resultados mostraram peculiaridades do SAMU fluvial de Manaus em relação a serviços terrestres que necessitam ser consideradas no planejamento, implementação e avaliação do APH fluvial.Introduction: Manaus has a fluvial Mobile Emergency Care Service (SAMU) that serves the population who lives in riverside communities of Negro and Amazon rivers. Several prehospital care initiatives (APH) have been observed regarding this type of transportation. However, information on these services, users\' profiles and factors associated with undesirable outcomes were not found in the literature. Objective: To characterize the profile of the users and aspects of Manaus fluvial SAMU and to identify factors related to the worsening in fluvial APH. Method: Descriptive, correlational study carried out in two stages. In the first stage, the information collection was retrospective and was based on the records of the services performed by Manaus fluvial SAMU from 2009 to 2015. In the second stage, data collection was prospective. Individuals aged 15 years and older attended by fluvial SAMU in the six-month period (January to June 2016) had information collected from the call to the Regulation Center until arrival at the fluvial base. Patients referred to hospitals had information collection extended until hospital discharge. Association tests were applied considering the characteristics of care and user before the patient\'s worsening, identified through the changes of the Rapid Emergency Medicine Score (REMS) from the initial care until the final care by fluvial SAMU. Results: From 2009 to 2015, Manaus fluvial SAMU carried out 2,002 visits, mostly in communities of Rio Negro and near the fluvial base. The vast majority of people served by the fluvial SAMU were removed to Manaus (92%). The type of boat most frequently used has changed over the years. Additionally, there were adjustments to the Advanced Support Unit (USA) crew after 2015. The frequency of procedures occurred during management was low (mean 1.5 procedure), but venous access was performed in almost all patients (97.8%). There was great variability of APH times. The mean response time (84 minutes) and total fluvial APH (172 minutes) were quite high. The majority of patients removed were referred to hospital (44.9%) or emergency care (37.1%). The frequency of men and women attended was similar and users less than 35 years old predominated. The most frequent causes of the visits were related to \"symptoms, signs and abnormal findings\" and \"external causes of morbidity and mortality\". The physiological parameters and the mean value of the initial REMS, 2.7 (SD = 3.6), indicated a low risk of death related to the patients. However, in- hospital mortality was 8.7%. Considering the patients transported by fluvial SAMU, 68.5% maintained the clinical presentation, 18.0% worsened and 13.5% improved during the care. There was an association between worsening and destination of the users (p = 0.037), as well as occurrences related to contact with venomous snakes (p = 0.039) and acute pain (p = 0.005). Conclusion: In general, the results showed peculiarities of Manaus fluvial SAMU related to terrestrial services that need to be considered in the planning, implementation and evaluation of fluvial APH.
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Farias, Deborah Elaine Caristo Santiago de. "Conflitos éticos no gerenciamento em enfermagem: da percepção à tomada de decisão." Universidade de São Paulo, 2015. http://www.teses.usp.br/teses/disponiveis/7/7140/tde-06112015-155757/.
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Introdução: Os conflitos éticos na saúde, geralmente, ocorrem entre os atores envolvidos na ação assistencial. Essa ação, no entanto, é realizada em estruturas organizacionais, sofrendo implicações desse ambiente. Dependendo da organização do trabalho e das metas institucionais pode haver maior ou menor intensidade dessas interferências. Assim, não raro os enfermeiros atuantes no gerenciamento se deparam com situações que apresentam problemas éticos nessa área. Objetivos: Identificar conflitos éticos na percepção de enfermeiros com vivência no gerenciamento de Serviços de Enfermagem hospitalar e analisar como os enfermeiros com vivência no gerenciamento em enfermagem tomam decisões frente a conflitos éticos. Método: Trata-se de um estudo exploratório, descritivo de abordagem qualitativa. Para a coleta de dados do primeiro objetivo, após a aprovação do Comitê de Ética em Pesquisa, foram entrevistados 20 enfermeiros, com vivência profissional na área gerencial hospitalar, constituindo uma amostra intencional, através da técnica bola de neve\" (snow ball). As entrevistas gravadas foram realizadas através de uma pergunta norteadora: Conte-me a respeito de conflitos éticos que tenha vivido na sua atuação gerencial. A coleta de dados do segundo objetivo foi realizada através da técnica de grupo focal, sendo utilizado um caso fictício (caso-conflito), contendo uma situação gerencial hipotética para o debate sobre a decisão. No caso-conflito os dois valores éticos situaram-se nos cursos de ação extremos: prestar assistência de enfermagem segura e atender ordem institucional de redução de quadro de pessoal para viabilizar a sobrevivência financeira do hospital. Os discursos foram analisados segundo a análise de conteúdo proposta por Bardin, balizados pelo referencial metodológico-conceitual do procedimento da Teoria de Deliberação Moral de Diego Gracia. Resultados: Emergiram inicialmente três categorias: igualdade na distribuição da carga de trabalho; autonomia profissional nas decisões gerenciais e justiça e prudência nas decisões gerenciais. Evidenciou-se que os conflitos éticos no gerenciamento em enfermagem decorreram da percepção dos valores confrontados, presentes no problema ético. Os conflitos éticos materializam-se na gestão de recursos em saúde, nas relações de poder no ambiente de trabalho, nas relações interpessoais, na organização do trabalho e nas determinações da política institucional, como partes da conjuntura que constitui a assistência ao paciente, visando à proteção e manutenção de sua dignidade. Na decisão realizada coletivamente, em geral, os cursos de ação tendenciaram para o curso médio, considerados prudentes, indicando conciliar os valores em conflito do caso, ordem e cuidado. Entretanto, mesmo com tendência para o espaço da prudência, a maioria das argumentações dos cursos de ação, se situou privilegiando a preservação do cuidado de enfermagem. Conclusão: Os enfermeiros-gerentes, diante de fatos impositivos das determinações organizacionais, elegem a assistência de enfermagem como prioridade, mas tentam uma conciliação das partes. A prudência, como resultado do debate colegiado dos enfermeiros, revela a necessidade de investimentos em espaços grupais de discussão (bio)ética e na capacitação dos profissionais, expandido os diálogos éticos, inclusive interinstitucionalmente. Vislumbra-se um terreno fértil a ser explorado, que possibilite debates e deliberação sobre os problemas éticos que afligem os enfermeiros, contribuindo para amenizar momentos de angustia e, até, de sofrimento moral presentes nos conflitos de valores desses profissionaisIntroduction: The ethical conflicts in health, generally, occur between the actors involved in care action. This action, however, is performed in organizational structures, suffering implications of this environment. Depending on work organization and institutional goals there may be greater or lesser intensity of these interference. So often the nurses working in management are faced with situations that present ethical problems in this area. Objectives: Identifying ethical conflicts in the perception of nurses with experience in hospital Nursing Services management and analyzing how nurses with experience in nursing management take decisions before the ethical conflicts. Method: This is an exploratory, descriptive study of qualitative approach. For collecting the data of the first objective, after the Research Ethics Committee approval, 20 nurses, with professional experience in hospital management area were interviewed, constituting an intentional sample, through \"snowball\" technique. Recorded interviews were conducted by a guiding question: \"Tell me about ethical conflicts that you have lived in your managerial acting.\" The data collection of the second objective was performed through the focus group technique, and used a fictitious case (case-conflict), containing a hypothetical managerial situation to the debate on the decision. In the case-conflict both ethical values stood in extreme \"courses of action\": provide safe nursing care and meet institutional order for staff reduction to enable the financial survival of the hospital. The speeches were analyzed according to content analysis proposed by Bardin, marked by methodological and conceptual framework of the Moral Deliberation Theory procedure of Diego Gracia. Results: First emerged three categories: equal in the distribution of the workload; professional autonomy in management decisions and justice and prudence in management decisions. It was evident that the ethical conflicts in nursing management resulted from the perception of values confronted, present in ethical problem. Ethical conflicts materialize in health resource management, in power relations in the workplace, in interpersonal relationships, work organization and in the determinations of institutional policy, as part of the environment that is patient care, aimed at protecting and maintaining its dignity. In the collectively held decision, in general, courses of action lean toward the middle course, considered prudent, indicating reconcile the conflicting values of the case, order and care. However, even with a tendency for the space of prudence, most of the arguments of \"courses of action\", stood favoring the preservation of nursing care. Conclusion: Nurses-managers, before impositions facts of organizational determinations, elect nursing care as a priority, but try a reconciliation of the parties. Prudence, as a result of collegiate debate of nurses, reveals the need for investment in group spaces for (bio)ethics discussion and professional training, expanded the ethical dialogue, including inter-institutionally. It glimpses a \"breeding ground\" to be exploited, which allow debates and deliberation on the ethical problems that afflict nurses, contributing to soften moments of anguish and even of moral suffering present in value conflicts of these professionals
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Nishi, Fernanda Ayache. "Sensibilidade e especificidade do Sistema Manchester de Classificação de Risco na priorização de pacientes com infarto agudo do miocárdio que apresentam dor torácica." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/7/7139/tde-12112017-200544/.
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Introdução: O Sistema Manchester de Classificação de Risco tem como objetivo definir a prioridade clínica para atendimento médico de pacientes nos serviços de emergência. A avaliação de pacientes com suspeita de infarto agudo do miocárdio com sintomas típicos como a dor torácica realizada por meio do Sistema Manchester exige adequada sensibilidade e especificidade do sistema ao determinar a prioridade para atendimento médico. Objetivos: Os objetivos deste estudo foram integrar as melhores evidências disponíveis quanto a sensibilidade e especificidade do Sistema Manchester na classificação de pacientes com relação ao diagnóstico de síndrome coronariana aguda; estimar a sensibilidade e especificidade do Sistema Manchester na classificação de pacientes com dor torácica para a adequada priorização no que se refere ao diagnóstico de infarto agudo do miocárdio num hospital geral de ensino na cidade de São Paulo; e verificar associação entre o desempenho do Sistema Manchester na avaliação desses pacientes e variáveis selecionadas. Método: Este estudo foi desenvolvido em duas etapas, sendo a primeira uma revisão sistemática da literatura realizada segundo metodologia de revisões de acurácia de testes diagnósticos do Joanna Briggs Institute. Na segunda etapa do estudo foram estimadas a sensibilidade e a especificidade do Sistema Manchester na avaliação de pacientes com infarto agudo do miocárdio por meio de um estudo metodológico, transversal e retrospectivo. A sensibilidade e a especificidade do Sistema Manchester foram estimadas por meio da verificação da classificação estabelecida para pacientes com dor torácica que receberam ou não o diagnóstico médico de infarto agudo do miocárdio após a classificação. Resultados: Foram incluídos na revisão sistemática seis estudos com total de 54.176 participantes, todos de qualidade metodológica moderada, que apontaram valores de sensibilidade entre 70% e 80%. Dois estudos que apresentaram os dados necessários para o cálculo de especificidade, tiveram valores calculados de 59% e 97%. A amostra do estudo primário incluiu 10.087 episódios de classificação, sendo 52,3% de pacientes do sexo feminino com média de idade de 43,6 anos (DP=17,6). Do total de episódios, 139 tinham diagnóstico de infarto. A sensibilidade do Sistema Manchester foi de 44,6% e a especificidade foi de 91,3%. Houve associação estatisticamente significativa entre o desempenho do Sistema Manchester e a idade dos pacientes (p<0,001), com maior frequência de classificação incorreta nas faixas etárias mais altas. Não houve associação entre o sexo dos pacientes e o desempenho do Sistema Manchester. Conclusão: a recomendação para uso do Sistema Manchester na avaliação de pacientes no serviço de urgência em relação ao diagnóstico de síndrome coronariana aguda foi de grau B segundo graus de recomendação estabelecidos pelo Joanna Briggs Institute, o que remete a uma recomendação \"fraca\" para uma determinada estratégia de gestão da saúde. Essa conclusão decorre sobretudo da heterogeneidade dos critérios de inclusão e portanto das amostras dos estudos incluídos. Os resultados do estudo evidenciam a necessidade de se discutir formas de melhorar a sensibilidade desse sistema para a adequada priorização de pacientes com dor torácica.Introduction: The Manchester Triage System aims to define the clinical priority of patients for medical care in the emergency department. The evaluation of patients with suspected acute myocardial infarction presenting typical symptoms such as chest pain using the Manchester Triage System requires proper sensitivity and specificity of the system in order to determine medical care priority. Objectives: The objectives of this study were: to integrate the best available evidence regarding the sensitivity and specificity of the Manchester Triage System in the evaluation of patients with the diagnose of acute coronary syndrome; to estimate the sensitivity and specificity of the Manchester Triage System in the classification of patients with chest pain to adequate prioritization in relation to the diagnose of acute myocardial infarction in a general teaching hospital in the city of São Paulo; to verify the association between the performance of the Manchester Triage System in the evaluation of these patients and selected variables. Methods: This study was developed in two stages, the first one consisted in a systematic review performed according to the methodology of diagnostic test accuracy systematic reviews from Joanna Briggs Institute. In the second stage of the study the sensitivity and specificity of the Manchester Triage System in the evaluation of patients with acute myocardial infarction were estimated though a methodological retrospective cross-sectional study. The sensitivity and specificity of the Manchester Triage System were estimated by verifying the classification of patients with chest pain who received or not the medical diagnosis of acute myocardial infarction. Results: The systematic review included six studies with a total of 54,176 participants, all of the studies with moderate methodological quality. The studies pointed sensitivity values from 70% to 80%. The specificity values calculated from two studies containing the necessary data were 59% and 97%. The sample of the performed primary study included 10,087 episodes of classification, 52.3% of the patients were females with average age of 43.58 years (SD=17.6). Of the total episodes, 139 had the diagnosis of infarction. The sensitivity of the Manchester Triage System was 44.6% and the specificity was 91.3%. There was statistically significant association between the performance of the Manchester Triage System and the age of the patients (p<0.001), with a higher frequency of incorrect classification in the older age groups. There was no observed association between the sex of the patients and the performance of the Manchester Triage System. Conclusion: Recommendation for the utilization of the Manchester Triage System in the evaluation of patients in emergency services to correct prioritization related to the diagnose of acute coronary syndrome was graded B according to the Joanna Briggs Institute grades of recommendation, which refers to a weak recommendation to a certain strategy for healthcare management. This finding is due to the heterogeneity of the inclusion criteria and therefore the samples of the included studies. The results of this study highlight the necessity of discussion about ways to improve the sensitivity of this system, for the adequate prioritization of patients with chest pain.
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Mink, Matthew Ryan. "Evaluation of 72 h Cosynch and 5 or 7 d post-AI gonadotropin releasing hormone on first service pregnancy rate in lactating dairy cows." Thesis, Virginia Tech, 2006. http://hdl.handle.net/10919/42590.
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Two studies were conducted to evaluate the effects of 5 or 7 d post-AI GnRH on first service PR, plasma P4, and CL volume in lactating dairy cows synchronized using 72 h Cosynch. All cows were synchronized and randomly assigned to one of three treatment groups: Control â no additional GnRH; 5 d â GnRH 5 d after TAI; 7 d â GnRH 7 d after TAI. In the first study, P4 concentrations were evaluated in samples collected at five separate times and CL volume and number were recorded at 30 d pregnancy examination for Holstein (n = 77) and Jersey (n = 33) cows. GnRH treatment did not affect PR (Control - 47.2%, 5 d GnRH - 40.5%, 7 d GnRH â 44.7%) or P4, but increased TCLV compared to controls (Control â 7.33 cm3, 5 and 7 d GnRH â 10.77 cm3). Incidence of accessory CL increased PR (94.7 vs. 60.6%), P4 (6.95 vs. 5.88 ng/mL), and TCLV (15.51 vs. 6.78 cm3) compared to cows with a spontaneous CL. Cows classified as cycling based on P4 evaluation had significantly higher PR than acyclic cows (54.4 vs. 16.1%). In the second study, Holstein cows (n = 1055) were submitted to the same experimental protocol and evaluated for first service PR. Post-AI GnRH treatment did not significantly affect PR. Primiparous cows (32.8%) tended to have higher PR than multiparous cows (27.6%), but GnRH treatment had no influence on this relationship. In conclusion, GnRH post-AI did not affect PR. Further evaluation of accessory CL incidence is warranted as it significantly affected PR.
(Abbreviations: AI â artificial insemination, CL â corpus luteum, PR â conception rate, P4 â progesterone, TCLV â total corpus luteum volume)Master of Science
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Alhajri, Muna. "Le Contrat BOT (Build, Operate, Transfer) au Koweït : un modèle de partenariat public-privé." Thesis, Université de Lorraine, 2018. http://www.theses.fr/2018LORR0063.
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Les pouvoirs publics koweïtiens entendent créer un climat favorable aux investisseurs, en mettant l’accent notamment sur le partenariat entre public et privé. C’est ainsi qu’en 2008, le parlement koweitien a adopté la loi 7/2008 qui comporte une organisation générale des contrats de constructions, d’exploitation et de transfert (BOT). Le législateur a adopté par la suite la loi 116/2014 sur le partenariat qui reprend avec plus de détails les formes de coopération publique-privée. À cet effet, deux organes ont été créés : le Haut Comité et l’Autorité des projets, avec des compétences très étendues quant à la formation et à l’exécution du contrat BOT (appel d’offres, négociations, conclusion du contrat, sa durée, son financement, etc.). L’objectif de cette étude est de traiter, à partir de cette législation, la notion de contrat BOT que les spécialistes assimilent volontiers au terme de concession, ou à celui de délégation de service public. Dans cette perspective, il est nécessaire d’aborder le montage financier et la nature juridique du contrat BOT. La mise en œuvre du contrat BOT fait intervenir une diversité des parties contractantes (administration, partenaires privés, créditeurs, sociétés de construction, fournisseurs de matériels, investisseurs de capitaux, consommateurs utilisateurs des produits, etc.), cela rend la réalisation de ce type de contrat assez complexe. Cette complexité peut se poser de manière aiguë au Koweït, dans la mesure où le pays vient juste d’inaugurer cette procédure de passation de marché impliquant directement le public et le privéLe montage financier des contrats BOT, connu sous le nom de « projet de financement » repose presque totalement sur des acteurs privés. Dès lors, la question qui se pose est celle de la répartition des risques. À ce sujet, l’analyse cherche à comprendre pourquoi les risques liés au financement sont assumés essentiellement par l’opérateur privé, indirectement par la société de projet, et directement par le prêteur, en l’occurrence les banques. Reste que pour couvrir ces risques, le contrat BOT prévoit, au bénéfice des pourvoyeurs de fonds, un certain nombre de garanties portant aussi bien sur les actifs composant le projet (équipements, outillages, stocks, transmission de créances), que sur le projet lui-même (nantissement et hypothèques des actions de la société de projet, cession de revenus, substitution des banques au promoteur privé défaillant).La nature juridique du contrat BOT soulève deux interrogations majeures : la première est de savoir si ce type de contrat relève de droit administratif ou de droit civil. La seconde porte sur les litiges qui peuvent naître de ce type de contrat comportant un large éventail d’éléments d’extranéité (investissements extérieurs, transfert de technologie, etc.) et soumis à l’arbitrage international. À ce niveau, il convient de connaître le droit applicable : s’agit-il du droit interne ou droit international ? C’est à cet ensemble de questions que cette recherche tente d’apporter un début de réponse en prenant comme cadre de réflexion le contexte koweïtienThe Public Authorities (Government) of Kuwait aim to create a favorable investor climate, with particular emphasis on public-private partnerships. Thus, in 2008, the Kuwaiti Parliament passed Law 7/2008, which includes a general organization of contracts of construction, exploitation and transfer (BOT) “Build, Operate and Transfer”. The legislator subsequently adopted the law 116/2014 on the partnership which repeats in more detail the forms of public-private cooperation. To this end, two bodies have been created: the High Committee and the Projects Authority, with extensive expertise in the training and execution of the BOT contract (call for tenders, negotiations, conclusion of the contract, its duration, financing, etc.). The objective of this study is to deal, from this legislation, with the concept of BOT contract that specialists readily assimilate to the term of concession, or that of public service delegation. In this perspective, it is necessary to address the financial arrangement and the legal nature of the BOT contract.The implementation of the BOT contract involves a diversity of contracting parties (administration, private partners, creditors, construction companies, equipment suppliers, capital investors, consumer users of products, etc.), which makes the implementation of this type of contract rather complex. This complexity can be seriously arisen in Kuwait, as the country has just inaugurated this procurement procedure directly involving the public and the private sector.The financial set-up of the BOT contracts, known as the "financing project", relies almost entirely on private actors. Therefore, the question that arises is that of the distribution of risks. In this regard, the analysis seeks to understand why financing risks are borne mainly by the private operator, indirectly by the project company, and directly by the lender, in this case the banks. However, to cover these risks, the BOT contract provides, for the benefit of fund providers, a number of guarantees covering both the project assets (equipment, tools, inventory, transfer of receivables) and the project itself (pledging and hypothecation of shares in the project company, transfer of income, substitution banks to the defaulting private promoter).The legal nature of the BOT contract raises two major questions: the first is whether this type of contract falls under administrative law or civil law. The second deals with disputes that may arise from this type of contract, which includes a wide range of foreign elements (outside investment, technology transfer, etc.) and is subject to international arbitration. At this level, one must know the applicable law: is it domestic law or international law? It is to this set of questions that this research tries to bring a beginning of answer by taking as a framework of reflection the Kuwaiti context
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Reuter, Kara. ""Children selecting books in a library" : extending models of information behavior to recreational setting /." Saarbrücken : VDM Verlag Dr. Müller, 2008. http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&doc_number=020218480&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA.
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Rumann, Stefan. "Kooperatives Experimentieren im Chemieunterricht : Entwicklung und Evaluation einer Interventionsstudie zur Säure-Base-Thematik /." Berlin : Logos, 2005. http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&doc_number=013834274&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA.
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Lezama, Morales Ruth. "Modélisation et programmation d’un robot anthropomorphe à 7 degrés de liberté actionné par muscles artificiels pneumatiques." Toulouse, INSA, 2008. http://eprint.insa-toulouse.fr/archive/00000218/.
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Un robot de service est un système robotique complexe qui accomplit des tâches de service, interagit avec son environnement et garantit une interaction sûre et fiable avec les êtres humains. Dans ce contexte, les travaux de cette thèse portent sur un bras de robot qui conserve des propriétés inhérentes au bras humain comme sa légèreté, sa flexibilité, sa souplesse articulaire, mais surtout sa capacité naturelle de contact. D'un point de vue général, l'objectif de cette thèse est la mise en service d'un bras de robot anthropomorphe à 7 degrés de liberté, actionné par des muscles artificiels pneumatiques. Plus précisément, nous examinons les modèles géométriques direct et inverse du bras de robot. L'établissement de ces modèles est précédé par le développement d'un outil graphique de simulation. La validation des modèles géométriques du robot est accomplie par l'exécution de tâches courantes, en mode de téléopération, comme par exemple, le suivi d'une trajectoire en maintenant un contact souple ou bien la manipulation d'objets fragiles. En résumé, les principales contributions de cette thèse portent sur la commande de l'actionneur à une paire de muscles artificiels pneumatiques. Le correcteur PID, PID avec un terme d'anticipation et la commande à structure variable sont étudiés sur deux des articulations du bras de robot. Les résultats expérimentaux obtenus permettent d'analyser les effets de la gravité et l'influence du couplage entre les articulations. Finalement, ce travail de thèse conclut par une discussion sur les aspects informatiques de la plateforme robotique ainsi qu'une réflexion sur les perspectives d'évolution du contrôleur de robotA service robot is a complex robotic system that accomplishes the tasks of service, interacts with its environment and guaranties an interaction sure and reliable with human beings. This thesis describes about an anthropomorphic robot arm of 7 degrees of freedom driven by pneumatic artificial muscles called McKibben. Robot actuation using pneumatic artificial muscles is suitable for service robot applications because they provide the robot with an articular flexibility, lightness and a natural compliance in close analogy with the human body. In general, the objective of this thesis is put in operation the anthropomorphic robot arm. More precisely, we examine the direct and inverse kinematic models of the robot. The implementation of these models is first analyzed by the development of a computerized graphic simulation tool. By applying the kinematic models, the execution of simple tasks in teleoperation mode such as, a trajectory tracking under soft contact and the manipulation of fragile objects is validated. However, the main contribution of this thesis is the automatic control of the pneumatic artificial muscle actuator. A PID, a feed-forward PID controller and a variable structure control system are studied. Corresponding experimental results show the effects of the gravity and the influence of the mechanical coupling between the articulations of the anthropomorphic robot arm. Finally, this work concludes with a discussion on the computer aspects of the platform as well as a consideration of the evolution of the robot control architecture
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Wüst, Sabine. "Exemplarische Untersuchung nicht-linearer Wechselwirkungen zwischen atmosphärischen Schwerewellen (Triade) anhand von raketengestützten Winddaten (Chaff) : 7 Tabellen /." Köln : DLR, Bibliotheks- und Informationswesen, 2005. http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&doc_number=014925663&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA.
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Dias, Cristiane Bergues. "Organização de uma rede de serviços públicos de saúde para a produção de ações de saúde mental no município de São Paulo." Universidade de São Paulo, 2008. http://www.teses.usp.br/teses/disponiveis/7/7134/tde-13062008-101441/.
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Trata-se de um Estudo de Caso - um instrumento para a produção de conhecimento científico que toma como objeto de estudo uma unidade dentro de um sistema mais amplo e tem por principal objetivo a compreensão de uma instância singular da realidade. O objeto de estudo é a organização da rede de serviços da Subprefeitura de Pinheiros, da Supervisão de Saúde Lapa/Pinheiros da Coordenadoria Regional de Saúde Centro-Oeste do Município de São Paulo, por ser a base operacional do Termo de Cooperação Técnica, Didática e Científica entre a Secretaria Municipal de Saúde e a Escola de Enfermagem da Universidade de São Paulo para a formação de Programa de Integração Ensino-Serviço. Os objetivos do estudo são: descrever a rede de serviços de saúde, com produção de ações de saúde mental, deste território; identificar como os serviços públicos se organizam para atender as necessidades de saúde mental da população adstrita ao território sob sua responsabilidade; verificar que fatores facilitam e quais fatores dificultam a articulação da rede e a produção de ações de saúde mental. A pesquisa respeitou todos os procedimentos éticos. São sujeitos do estudo um profissional e o gerente do serviço de saúde, para haver complementaridade das informações sobre a organização do serviço e atividades por eles executadas na unidade. O instrumento e o procedimento da coleta dos dados é a entrevista semi-estruturada. O tratamento dos dados empíricos para a elaboração do relatório final sustenta-se na visão de mundo que admite que a apreensão do real deve partir do fenômeno real, externo aos homens, e que são as conexões desse fenômeno com a totalidade que o torna concreto. As categorias empíricas construídas a partir da análise do material são: a) quem são os sujeitos do estudo; b) a dimensão estrutural: as diretrizes e os princípios para a organização dos sistemas de saúde; c) a dimensão particular: a rede de atenção e a função estratégica dos serviços; d) a dimensão singular: o processo de produção de ações de saúde mental nos serviços. A síntese das dificuldades e das facilidades para a construção da rede de serviços no território se formou pela voz de seus construtoresIt is a Case Study whose object is the organization of a network of public health services with regard to the mental health in the city of São Paulo. The objectives of the study are: to describe the network of health services with production on mental health; to identify the way which the public services are organized to provide medical assistance in mental health; To discover the facilities and the difficulties in the articulation between the services and in the production of actions on mental health. This research respected all the ethical procedures. The subjects of this study are workers of the health team and managers of the health services. The instrument for collection of data is a semi-structured interview. The treatment of this empirical material is based on the categories: a) who are the subject of the study, b) the structural dimension: the guidelines and principles for the organization of health systems, c) the particular dimension: the network of attention and the strategic role of services, d) a unique dimension: the production of actions of mental health services
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Silva, Cristiane Pavanello Rodrigues. "Proposta de avaliação de programas de controle de infecção hospitalar: validação das propriedades de medidas e diagnóstico parcial de conformidade em serviços de saúde do município de São Paulo." Universidade de São Paulo, 2010. http://www.teses.usp.br/teses/disponiveis/7/7139/tde-29042010-112347/.
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Estudo de desenvolvimento metodológico que teve por finalidade disponibilizar um sistema de avaliação de Programas de Prevenção e Controle de Infecção Hospitalar (PCIH), após validação das propriedades de medidas, que possibilite aplicação prática para diagnósticos situacionais, cujos resultados subsidiem tanto melhorias na área quanto informações concretas à sociedade sobre a qualidade desses PCIH em cada instituição de saúde. Para tal, previamente, foram construídos e realizada validação de conteúdo de quatro indicadores: 1- (PCET) Estrutura Técnico-operacional do PCIH; 2- (PCDO) Diretrizes Operacionais de Controle e Prevenção de IH; 3- (PCVE) Sistema de Vigilância Epidemiológica de IH; 4- (PCCP) Atividades de Controle e Prevenção de IH. Os objetivos específicos foram: realizar validação (construto e discriminante) e testar confiabilidade (consistência interna); realizar diagnóstico parcial de conformidade dos PCIH em serviços de saúde do Município de São Paulo. Os indicadores de PCIH foram aplicados em 50 instituições de saúde, que aceitaram voluntariamente participar do estudo. As características referentes ao perfil do hospital e os escores dos indicadores foram descritos por meio de estatística descritiva. A consistência interna foi analisada usando o coeficiente de Cronbach. A análise da validade discriminante foi realizada comparando-se os escores dos indicadores entre dois grupos de hospitais, (possuem algum tipo de certificação versus não possuem certificação em qualidade). E para a análise da validade de construto foi utilizada a Análise Fatorial Exploratória com matriz de correlação tetracórica. Os indicadores 1-PCET e 3-PCVE variaram pouco, com quase 100% de conformidade em toda a amostra, já os indicadores 2-PCDO e 4- PCCP apresentaram boa consistência interna com variação de 0,67 a 0,80. A validade discriminante desses indicadores indicou médias dos escores de conformidade superiores e com significância estatística no grupo de instituições com processos de qualificação ou acreditação em saúde. Na validação de construto foi possível diferenciar e identificar 2 dimensões para PCDO (fator 1- recomendações para prevenção de IH e fator 2 recomendações para padronização de procedimentos de profilaxia), com boa correlação dos itens que o compõe, o mesmo ocorrendo para PCCP (fator 1 interface com unidades de tratamento e fator 2 interface com unidades de apoio). N avaliação parcial de conformidade do PCIH todos os indicadores, com exceção do 4 PCCP, que variou de 9,5% a 100%, apresentaram escores > 90%,o que mostra que os hospitais participantes possuem um bom nível de qualidade dos PCIH instituídos, com médias superiores nas instituições com processos de qualificação da assistência. Com esse estudo foi possível validar as propriedades de medidas dos indicadores de PCIH e disponibilizar um instrumento factível como ferramenta de avaliação de PCIH de forma ética e científica para diagnóstico de qualidade na área.The objective of this study was to develop methodology that could ultimately be made available as a system for assessing Hospital Infection Control and Prevention Programs (HICPP), after validation of its measurement properties, which enable practical application in situational diagnoses, whose results provide both improvements in the area and reliable information about the quality of these HICPPs in each healthcare institution. To do so, the content of four indicators was constructed and validated beforehand: 1- (PCET) Technical-operational structure of the HICPP; 2- (PCDO) Operating Guidelines for Control and Prevention of HI; 3- (PCVE) Epidemiological Surveillance System for HI; 4- (PCCP) HI Prevention and Control Activities. The specific objectives were: fully validate (construct and discriminant) and test the reliability (internal consistency) of measurement properties; carry out a partial diagnosis of conformity of the HICPPs in São Paulo Municipal Healthcare Facilities. The HICPP indicators were applied in 50 healthcare institutions, which participated voluntarily in the study. The hospital profile characteristics and the scores of the indicators were described using descriptive statistics. Internal consistency was analyzed using the Cronbach coeficient; the analysis of discriminant validity was carried out by comparing the scores of the indicators between the two groups of hospitals, (those which had some type of quality certification versus those which did not) and exploratory factor analysis with a tetrachoric correlation matrix was used to analyze the validity of the construct. The indicators 1-PCET and 3-PCVE varied little, with almost 100% conformity throughout the sample, whereas the indicators 2-PCDO and 4- PCCP presented good internal consistency with a variation of 0.67 to 0.80; discriminant validity of these indicators showed higher average scores of conformity and were statistically significant in the group of institutions with certification or accreditation; in the validation of the construct it was possible to differentiate and determine 2 dimensions for PCDO (factor 1- recommendations for prevention of HI and factor 2 recommendations for the standardization of prophylaxis procedures), with good correlation of the units of analysis that composed it. The same occurred for PCCP (factor 1 interface with treatment units and factor 2 interface with support units). All of the indicators, with the exception of 4- PCCP, which ranged from 9.5% to 100%, presented scores of > 90%, which show that the HICPPs of participating hospitals have a good standard of quality, with higher average scores in the institutions with certification or accreditation. This study enabled the validation of the measurement properties of the HICPP indicators and produced a practicable HICPP assessment tool in an ethical and scientific manner for diagnosis of quality in this area.
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Silva, Cristiane Pavanello Rodrigues. "Indicadores para avaliação de programas de controle de infecção hospitalar: construção e validação." Universidade de São Paulo, 2005. http://www.teses.usp.br/teses/disponiveis/7/7139/tde-13082007-150704/.
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Estudo de desenvolvimento metodológico de elaboração e validação de medidas de avaliação em saúde. Teve como objetivo geral contribuir para o desenvolvimento de Indicadores de Avaliação de Programas de Controle de Infecção Hospitalar (PCIH) e específicos construir e validar o conteúdo dos indicadores construídos. Os procedimentos teóricos para validação dos indicadores de PCIH foram: a-seleção e construção dos indicadores; b-fundamentação do conteúdo científica dos indicadores; c-validação dos indicadores construídos. Foram construídos cinco indicadores: 1- (PCET) Estrutura Técnico-operacional do PCIH; 2- (PCDO) Diretrizes Operacionais de Controle e Prevenção de IH; 3- (PCVE) Sistema de Vigilância Epidemiológica de IH; 4- (PCCP) Atividades de Controle e Prevenção de IH; 5- (PCAE) Atividades Educacionais e Capacitação Técnica em controle de IH. A validação de conteúdo dos indicadores foi realizada por oito profissionais especialistas na área de controle de IH, a partir de um instrumento previamente elaborado e referiu-se a: 1º - manual operacional; 2º - atributos do conjunto dos indicadores; 3º - atributos individuais dos componentes de cada indicador; 4º - valoração da relevância dos componentes de cada indicador. Com exceção do indicador 5- PCAE, os demais foram todos validadosThis aim of this study is to create methodology for the development and validation of evaluation measurements in healthcare. The overall objective was to contribute to the development of Performance Indicators for Hospital Infection Control (HIC) programs and more specifically to create and validate the content of the indicators developed. The theoretical procedures for the validation of the indicators for HIC programs were: a-the selection and creation of the indicators; b-determination of the scientific basis for indicator content; c-validation of created indicators. In all, five indicators were created: 1- (PCET) Technical/operational structure of HIC program; 2- (PCDO) Operational Guidelines for the Control and Prevention of HI; 3- (PCVE) Epidemiological Surveillance System; 4- (PCCP) Activities for the Control and Prevention of HI; 5- (PCAE) Educational Activities and Technical Education in the control of HI. The validation of the content of the indicators was conducted by eight specialists in the area of HIC using a previously developed instrument and addressed: 1º - operational manual; 2º - indicator set attributes; 3º - individual attributes of the components of each indicator; 4º - assessment of the relevance of the components of each indicator. With the exception of indicator 5-PCAE, all of the indicators were validated
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Michel, Valérie. "Effets indésirables et interactions médicamenteuses des inhibiteurs de l'enzyme de conversion : a propos de 7 cas dans le service de cardiologie de l'hôpital Beaujon à Clichy." Paris 5, 1992. http://www.theses.fr/1992PA05P104.
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Figueiredo, Juliana Arantes. "Práticas e processos de trabalho no Centro de Atenção Psicossocial III: a perspectiva do campo psicossocial." Universidade de São Paulo, 2007. http://www.teses.usp.br/teses/disponiveis/7/7134/tde-12062007-114829/.
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O objeto de estudo desta pesquisa qualitativa são as práticas dos trabalhadores de um Centro de Atenção Picossocial III - CAPS III. A finalidade é contribuir para a compreensão das práticas em saúde mental produzidas no CAPS III, por meio da perspectiva crítica e colaborar com a consolidação da Reforma Psiquiátrica brasileira. Tem como objetivos: descrever as práticas de saúde mental dos trabalhadores do CAPS III; verificar se as práticas se articulam às diretrizes da Reforma Psiquiátrica brasileira e analisar os processos de trabalho desenvolvidos pelos trabalhadores nos seus elementos constitutivos, da perspectiva do campo psicossocial. O cenário de estudo é Núcleo de Atenção Psicossocial I da Secretaria Municipal de Saúde de Santo André. Participaram deste estudo 11 (onze) trabalhadores, um de cada categoria profissional, de nível médio e superior. Os dados empíricos foram obtidos por meio de entrevista individual semi-estruturada e para a caracterização do cenário de estudo, o Instrumento de Captação da Realidade Objetiva, método proposto pela Teoria de Intervenção Práxica em Enfermagem em Saúde Coletiva. O material empírico foi analisado de acordo com a orientação de Minayo, baseada na hermenêutica-dialética. A análise dos dados deu origem às categorias: a) o CAPS III e a rede de atenção à saúde mental; b) Organização interna do CAPS III; c) as práticas em saúde mental no CAPS III e as diretrizes da Reforma Psiquiátrica brasileira; d) os processos de trabalho no CAPS III. Os resultados indicam que, no plano descritivo, as práticas de saúde mental dos trabalhadores do CAPS III articulam-se às diretrizes da Reforma Psiquiátrica. A análise dos elementos constitutivos dos processos de trabalho evidencia contradições. Pode-se constatar atitudes coerentes com o quadro teórico de referência adotado, o campo psicossocial, embora estas não se articulem a um projeto coletivo institucional, revelando práxis espontâneas e reiterativas. A consolidação da Reforma Psiquiátrica requer processos de trabalho que se traduzam em práxis criativas, capazes de produzir transformações concretas na vida dos usuários dos serviços. Identifica-se a necessidade de formação dos trabalhadores com relação ao projeto coletivo institucional, visando qualificar a força de trabalho dos Centros de Atenção Psicossocial, dada a função social destes equipamentos, considerados estratégicos na reorientação do modelo de atenção à saúde mental. O material empírico evidencia uma crise na organização do serviço, revelando o sofrimento dos trabalhadores e a precarização da assistência prestada aos usuários do serviço. É necessário que o serviço possa colocar-se em crise para que esta necessidade possa ser tomada pelo poder local, visando transformar essa realidadeThe object of study of this qualitative research are practices of the workers of a Pshychosocial Attention Center III (CAPS III). The purpose of this study is to contribute to the understanding of the mental heath practices produced in the Pshychosocial Attention Center III, through a critical perspective, to cooperate with the consolidation of the Brazilian Psychiatric Reform. Objectives are: describe the mental heath practices of the workers of a CAPS III; verify if the mental health practices are related to the references of the Brazilian Psychiatric Reform and; analyze the processes of work developed by the workers of the CAPS III, in its constitutive elements, form a the perspective of the Pshychosocial Field. The scenery of this study is the Núcleo de Atenção Psicossocial I of the Health Department of Santo André. 11 (eleven) workers participated in the study; one form each professional category, medium level and higher education level workers. The empirical data were gathered through individual interviews with the workers and the characterization of the scenery of the study, according to the Method of Praxis Intervention of Nursing in Collective Heath. The empirical data are analyzed according to Minayo´s propose, based in dialectical-hermeneutic. The data provided the categories: a) CAPS III and the mental health care net; b) Internal organization of CAPS III; c) mental heath practices in CAPS III and the references of the Brazilian Psychiatric Reform; d) processes of work in CAPS III. The results indicate that, in a descriptive view, the mental health practices of the workers of CAPS III, correspond to the Brazilian Psychiatric Reform´s references. The analyzes of processes of work demonstrate contradictions. It is possible to recognize attitudes according to the theoretical references, the Pshychosocial Field, even though these attitudes are not related to a collective project, revealing spontaneous and reiterative praxis. The consolidation of the Brazilian Psychiatric Reform requires processes of work that constitutes creative praxis, capable to produce concrete transformation in users life. It is identified the need to develop the formation of the workers related to the collective project, aiming to qualify the work strength of the Pshychosocial Attention Center, considering the social function of this equipment, considered strategic in reorientation of the Mental Heath care model. The empirical data indicate crises in the internal organization of the service, revealing workers\' suffer and the loss on the quality of the assistance, which makes it necessary to the service to put its self in crises to be assumed by the local government instances
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Norberg, Brorsson Birgitta. "Man liksom bara skriver : skrivande och skrivkontexter i grundskolans år 7 och 8." Doctoral thesis, Örebro University, Department of Humanities, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-946.
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Birgitta Norberg Brorsson. 2007. Man liksom bara skriver. Skrivande och skrivkontexter i grundskolans år 7 och 8. (You just kind of write. Writing and writing contexts in the years 7 and 8 of the compulsory school).
This thesis deals with writing and writing contexts in the latter part of the Swedish compulsory school and with the interrelationship between the individual and the context, between the pupil, the teacher, the instruction of writing in the short and long perspective and the school as organization and institution. The general aim of the study is to deepen the understanding of school writing and its conditions by describing, analysing and interpreting the writing instruction from the teachers’, the pupils’ and my own perspectives. Fieldwork for my ethnographic study was conducted in two parallel classes, 36 pupils in all, over three terms in which all texts written during Swedish lessons were gathered. The theoretical framework is the sociocultural approach based on research by Vygotsky and Bachtin. Six texts written by three pupils regarding structure, style and teacher’s written response and the instruction in connection with the writing are analysed. The instruction in the long perspective is analysed with regard to what extent it offered the pupils coherence in their studies. To analyse the instruction in an organizational and institutional view concepts from Berg’s studies on school cultures and Langer’s research on effective American schools are used.
One major result is that the task, the receiver, the teacher’s response and the non-dialogic classrooms are factors with great impact on the pupils’ texts. Most tasks require that the pupil’s private, personal life and experiences are focused, e.g. in the many narrative texts, whereas discursive texts are not represented at all in the material. The instruction in the long perspective can in the main be characterised as catalogues, i.e. it does not lead to knowledge-in-action and is similar to Swedish as a proficiency subject. As to teacher response it is not possible to see any progression during the three terms but the same aspects are commented on in most texts in both classes and do not improve the texts. The culture and traditions of the school are important influencing factors in the teaching. One reason for this is the lack of in-service training of the teachers when the new steering system of the Swedish school was introduced in the middle of the 1990’s. When organizations undergo fundamental changes traditions seem to exercise greater influence on actors than otherwise. Time has great impact on school activities and three conflicting concepts of time are present at school: the pupil’s activity time, the teacher’s linear time and the institutional time. The work teams play a vital role for the teachers but the care of the pupils take most of their time. Pedagogic and didactic discussions are rare and subject matters have no forum at all. Many of the factors in the writing contexts are institutionally influenced and hence difficult to change but teachers and pupils are actors in school as organization and institution. This means that they can reproduce or transform the structures. In this there are developmental potentials.
Key words: compulsory school, writing contexts, school genres, structure, style, response, knowledge-out-of-context, individual, narrative, in-service training, subject didactics, time, work teams, institution
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Moiseenko, Sergej A. "Sibir· v period Graždanskoj vojny : materialy meždunarodnoj naučno-praktičeskoj konferencii (6-7 fevralja 2007 goda, G. Kemerovo) /." Kemerovo : Omskaja Akad. MVD Rossii, Kemerovskij Filial Zaočnogo Obučenija, 2007. http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&doc_number=016544412&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA.
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Börner, Andreas. "Das Eberswalder Urstromtal - Untersuchungen zur pleistozänen Landschaftsgenese zwischen Niederem Oderbruch und Werbellinseerinne (Nordost-Brandenburg) ; mit 7 Tabellen /." Usedom : Störr, 2007. http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&doc_number=016512767&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA.
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Okada, Marcia Massumi. "Violência doméstica contra a mulher: estudo com puérperas atendidas em uma maternidade filantrópica." Universidade de São Paulo, 2007. http://www.teses.usp.br/teses/disponiveis/7/7132/tde-13072007-100232/.
Full textAbstract:
A problemática da violência doméstica contra a mulher está disseminada ao redor do mundo, inclusive no Brasil, porém suas características variam de acordo com as circunstâncias pessoais, familiares, de relação conjugal, do contexto social e cultural envolvidas. Esta pesquisa teve o objetivo de identificar a ocorrência da violência doméstica contra a mulher e analisar a sua relação com algumas características da estrutura familiar e de vínculo com o parceiro. Trata-se de pesquisa transversal, de base hospitalar. A coleta de dados foi feita por meio de um formulário estruturado, baseado nos itens constantes no Abuse Assessment Screen-AAS, junto a 385 (N) mulheres atendidas em uma maternidade social filantrópica localizada na Cidade de São Paulo. Os dados, introduzidos em um banco de dados do Programa R para LINUX versão 2.1.1., foram submetidos à análise multivariada. O Teste Qui-Quadrado de Pearson e o Teste Exato de Fisher foram utilizados para a análise estatística dos dados. A freqüência da violência doméstica em algum momento da vida foi de 36,8% e, dentre estas, foram referidas a violência psicológica (97,2%), a física (28,9%) e a sexual (4,9%). A freqüência da violência doméstica na gravidez foi de 34,5% e, dentre estas, foram referidas a violência psicológica (95,9%), a física (34,7%) e a sexual (6,1%). Houve associação estatisticamente significante (p=0,00223; 0,001767) entre religião e o planejamento da gravidez e entre a violência doméstica e o hábito do etilismo do companheiro (p=0,0002533; 0,0002981). A violência doméstica foi uma problemática enfrentada por quase todas as mulheres desta pesquisa, em algum momento da vida, inclusive na gravidez. Os itens religião, planejamento da gravidez e etilismo devem ser incluídos na anamnese em saúde da mulher. Assim como os já constantes nesta anamnese, os itens mencionados devem ser sobretudo considerados no planejamento e desenvolvimento da assistência e abordados, de forma sistemática, pelos profissionais da área de saúdeDomestic violence against woman is spread worldwide. However its characteristics vary according to personal, family, marital, social and cultural aspects involved. This transversal, hospital-based study aimed at determining the occurrence of domestic violence against women and at analyzing its relation with some aspects of familial environment and relationship with the women´s partners. Data collection was carried out using a structured interview form, based on the content of the \"Abuse Assessment Screen\" (AAS) applied to 385 women assisted at a philanthropic maternity in the city of São Paulo. Study data analysis was performed using the \"R\" Software version 2.1.1 for Linux, and the statistical multi-variate analysis was performed by Pearson´s Qui-square and Fisher´s Exact tests. As many as 36,8% of the participants reported being subject to domestic violence, whether psychological, physical or sexual, sometime in her lifetime- 97.2%, 28.9% and 4.9%, respectively. As many as 34.5% of women comprising the study group reported being charged psychologically (95.9%), physically (34.7%) and sexually (6.1%) during pregnancy. There was a statistically significant association between religious belief and non-planned pregnancy, and between domestic violence and alcohol drinking on the part of the partner (p=0.00223/0.001767 and p=0.0002533/0.0002981, respectively). Reports on, religious belief, pregnancy planning and alcohol consumption should be included in the records of a woman during pre-natal and delivery care and need to be approached in a systematic way by health professionals