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Sample records for ajustados ajusted clinical

  1. Los adjusted clinicals groups: Un sistema de clasificación de pacientes por ajuste de riesgos

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    Antonio Sicras-Mainar

    2013-06-01

    Full Text Available Los Adjusted Clinical Groups (ACG son un sistema de ajuste de riesgos que clasifica a las personas según su edad y sexo y las condiciones médicas que presentan, y estas personas tienen un consumo similar de recursos sanitarios durante un periodo. Fueron desarrollados por Starfield y Weiner (Universidad Johns Hopkins, EE. UU. 1991, y su objetivo es medir el grado de enfermedad en poblaciones de pacientes basándose en sus niveles de comorbilidad. Entre sus principales aplicaciones destacan: a evaluar la eficiencia en la utilización de los servicios sanitarios, b medir la comorbilidad de la población, y c programar la financiación o pago capitativo para grupos de proveedores. Entre las ventajas del sistema ACG destaca la necesidad de un número limitado de variables para cada paciente (edad, sexo y diagnósticos y que la unidad de medida es el paciente. Se comentan algunas características de este sistema de ajuste de riesgos poblacionales.

  2. Ajuste escolar, rechazo y violencia en adolescentes.

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    Martínez Ferrer, Belén

    2009-01-01

    RESUMEN El objetivo general de esta tesis doctoral es analizar las relaciones existentes entre el contexto familiar, el escolar y la autoestima, en la predicción de tres indicadores de ajuste adolescente (ajuste escolar, rechazo escolar entre iguales y violencia/victimización escolar). Las variables consideradas en la investigación son: 1. Variables escolares: violencia escolar, victimización, rechazo entre iguales, actitud hacia la autoridad, actitud hacia la transgresión, actitud haci...

  3. Estilos relacionales parentales y ajuste adolescente

    OpenAIRE

    Oliva Delgado, Alfredo; Parra Jiménez, Agueda; Arranz Freijo, Enrique

    2008-01-01

    En este artículo se presentan los resultados de un estudio realizado sobre una muestra de 848 adolescentes de edades comprendidas entre los 12 y los 17 años, que cumplimentaron un cuestionario que incluía una escala con 6 dimensiones sobre su percepción del estilo parental o relacional materno y paterno y otros instrumentos para evaluar el ajuste adolescente. La realización de un análisis de conglomerados a partir de las puntuaciones en las 6 dimensiones que componían la escala re...

  4. Ajuste estructural e informalidad en Guatemala

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    María José Paz Antolín

    2008-01-01

    Full Text Available Debido a la relevancia de las reformas económicas aplicadas para el desempeño económico de las últimas dos décadas son necesarios estudios que analicen estos vínculos. Éste es el objetivo del presente trabajo que se centra en la economía guatemalteca y en la evolución de sus condiciones laborales. El análisis tiene presente los rasgos comunes de las políticas de reforma llevadas a cabo pero se centra en lo distintivo del caso guatemalteco. En este sentido, destacan el contexto político y social y la particular forma de inserción en la economía mundial. Los distintos indicadores estudiados muestran cómo se ha producido un deterioro de las condiciones laborales, sobre todo por el crecimiento de la informalidad. Aunque éste ha sido un fenómeno típico en Guatemala su evolución presenta elementos novedosos vinculados precisamente con las políticas de ajuste.

  5. Comparación entre Factores de Ajuste Multiplicativos y Aditivos para Producción por Lactancia en un Hato Holstein

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    Arboleda Zapata Elkin Mauricio

    1995-09-01

    Full Text Available La presente investigación se efectuó a partir de 558 registros de lactancia tomados del hato Holstein Paysandú el cual está situado en el corregimiento Santa Elena de Medellín en una zona ecológica de bosque húmedo montano bajo (bh-MB y pertenece a la Facultad de Ciencias Agropecuarias de la Universidad Nacional de Colombia, Sede Medellín. El objetivo propuesto fué determinar las ventajas comparativas entre factores de ajuste multiplicativos y aditivos para producción por lactancia. Para ello se trabajó con datos ajustados a 305 días, en vista de la muy alta significancia observada para el efecto duración de la lactancia. Después de confirmar por medio del programa de mínimos cuadrados de Harvey, 1988, que los factores medio-ambientales más influyentes sobre la producción ajustada a 305 días son el año de parto, los días abiertos previos y el número de partos (P£0.01, así como la edad y la época de parto (P£0.05, se procedió a ajustar por estos efectos mediante factores de corrección multiplicativos y aditivos. Inicialmente se utilizó como base la subclase de máxima producción para cada efecto y a ellas fueron llevados los demás registros; luego se obtuvieron factores aditivos mediante el uso de constantes estimadas por el programa Harvey y multiplicativos a partir de la media de mínimos cuadrados. Una vez ajustados los datos se corrió nuevamente el modelo inicial, con el fin de cuantificar la varianza residual presente tanto para factores de ajuste multiplicativos como aditivos, a los dos niveles propuestos. La comparación se realizó mirando las relaciones de la tabla F y las varianzas residuales entre grupos y dentro de ellos. Aunque no se presentaron diferencias marcadas, se observa que, en general los factores de ajuste aditivos tuvieron un mejor comportamiento que los multiplicativos, pues con el empleo de estos últimos queda una pequeña variación sin remover; en tanto que con factores de ajuste

  6. Controladores auto-ajustables para una clase de sistemas bilineales

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    Anna Patete

    2011-06-01

    Full Text Available En este trabajo, se propone un algoritmo auto-ajustable implícito basado en el criterio de varianza mínima generalizada para la estabilización de una clase de sistemas bilineales. La estabilidad del algoritmo propuesto es demostrada usando una función de Lyapunov y la estrategia de control por superficie deslizante. El algoritmo auto-ajustable propuesto es aplicado a una planta piloto térmica para evaluar su desempeño. / In this paper, a self-tuning algorithm based on the generalized minimum variance criterion is proposed for the stabilization of a class of bilinear systems. Using a Lyapunov function and the sliding mode control approach, the stability of the proposed algorithm is proven. The proposed self-tuning algorithm is applied to a simulated example to evaluate its performance.

  7. Ajustes Conversacionales para el Aprendizaje de Contenidos en L2

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    Berta de Dios

    2010-07-01

    Full Text Available Este trabajo pretende describir las interacciones conversacionales entre el alumnado en las aulas AICLE. Nos preguntamos si hay un vínculo entre las características de las interacciones y el aprendizaje de contenidos no lingüísticos y, si es así, qué tipo de ajustes fomentan dicho aprendizaje. Las aulas AICLE son los entornos ideales para estudiar el vínculo entre ajustes conversacionales y aprendizaje de contenidos porque, al no ser en la lengua materna del alumnado, se dan más ajustes conversacionales que en las clases en lengua materna.---------------------------------------------This article pursues to describe conversational adjustments among students in CLIL classes. We wonder if there is a link between the characteristics of the interactions and the learning of non-linguistic contents and, if there is, what kind of adjustments promote such learning. CLIL classes are the ideal environments to study the link between conversational adjustments and the learning of contents because, since they are not in the students’ mother tongue, conversational adjustments occur more frequently than in classes in mother tongue.

  8. Revocatoria del mandato: experiencias, dificultades y ajustes necesarios

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    William W. Jimu00E9nez

    2001-01-01

    Full Text Available En 1994 se introdujo en Colombia la figura de la Revocatoria del Mandato a los alcaldes y gobernadores como mecanismo tendiente al fortalecimiento de la democracia local. El presente artículo realiza un análisis de los 10 casos de revocatorias realizados hasta el 2.000. Con base en datos electorales registrados, la opinión de algunos expertos y el testimonio directo de actores involucrados; se presentan las dificultades, logros y limitaciones encontrados. En general, se observa la inoperancia, poco uso, alta abstención electoral e ineficacia política de la revocatoria. Finalmente, se realizan algunas recomendaciones con miras a realizar ajustes necesarios y urgentes.

  9. Estudo comparativo de diferentes prescrições de braquetes pré-ajustados em modelos virtuais pelo Método de Elementos Finitos Comparative study of different pre-adjusted brackets prescriptions on virtual models, by Finite Elements Method

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    Murilo Fernando Neuppmann Feres

    2009-08-01

    Full Text Available OBJETIVOS: comparar os efeitos de diferentes prescrições de braquetes pré-ajustados na movimentação dentária dos dentes anterossuperiores, por meio da utilização do Método de Elementos Finitos (MEF. MÉTODOS: foi utilizado um modelo tridimensional composto por um incisivo central, um incisivo lateral e um canino, todos do hemiarco superior esquerdo. Esses elementos foram submetidos à atuação de vetores de força que simularam a ação dos pré-ajustes de angulação e torque dos braquetes das prescrições de Alexander, Andrews, Capelozza, MBT, Ricketts e Roth. Após a simulação, os dados referentes ao deslocamento espacial dos pontos incisais e apicais foram registrados de forma que o novo posicionamento admitido pelos longos eixos dentários e seus pontos constituintes fossem determinados. RESULTADOS: a maioria das prescrições se comportou similarmente em relação aos parâmetros avaliados. As diferenças significativas encontradas no estudo se referem ao incisivo lateral superior que continha o braquete com a prescrição de Ricketts, que apresentou uma menor inclinação vestibular de seu longo eixo. Além disso, o canino superior da mesma prescrição apresentou uma maior inclinação de seu longo eixo para mesial e uma maior inclinação vestibular de seu longo eixo em relação às outras. A avaliação qualitativa da movimentação do incisivo central superior indicou um maior deslocamento distal dos ápices radiculares para as prescrições cujos autores estipularam maiores valores de angulação (Andrews, Capelozza, Roth e Alexander, e um maior deslocamento vestibular da coroa para as prescrições que estipularam os maiores valores de torque para os incisivos centrais (Ricketts, MBT, Alexander e Roth.AIM: The aim of the present study was to compare the effects of different prescriptions on anterior superior tooth movement simulation through a Finite Element Method (FEM. METHODS: It was utilized a 3D model, which was

  10. Ajustes ambientais nos modelos DEA e a agricultura irrigada

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    Yony Sampaio

    2012-09-01

    Full Text Available Modelos DEA têm sido extensivamente utilizados para medir eficiência e definir políticas. O modelo original não considera o caráter dinâmico e estocástico do ambiente agrícola. Em consequência, um produtor pode tomar decisões corretas mas obter um resultado menos satisfatório que outro devido a mudanças de preço ou de produtividade, decorrentes, por exemplo, do excesso de chuva. Para corrigir este problema é proposto um modelo em dois estágios que incorpora distribuições de preço e produtividade. Resultados de eficiência de produtores da fruticultura irrigada apontaram distribuição dos escores de eficiência do DEA-ajustado mais concentrada, suavizando os efeitos da aleatoriedade característica da produção agrícola.DEA models are frequently used to measure efficiency and propose policies. The original model does not consider the dynamic and stochastic set of agricultural production. As a consequence, a producer can make the correct decisions but obtain less satisfactory results due to price or productivity changes, resulting, for example, from excessive rain. To correct this problem a two-stage model that consider price and productivity distributions is proposed. Results comparing the efficiency of irrigated agriculture producers show that the distribution of efficiency scores are more centered, reducing the stochastic effects typical of agricultural production.

  11. Comparação de alguns modelos matemáticos para o ajuste às curvas de lactação individuais de vacas da raça Caracu

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    Faro L.E.

    2002-01-01

    Full Text Available Foram ajustadas 7239 curvas de lactação de vacas Caracu, controladas semanalmente entre os anos de 1978 a 1988, pertencentes à Fazenda Chiqueirão, Poços de Caldas, MG. As funções utilizadas foram a linear hiperbólica (FLH, a quadrática logarítmica (FQL, a gama incompleta (FGI e a polinomial inversa (FPI. Os parâmetros foram estimados por meio de regressões não lineares, usando-se processos iterativos. A verificação da qualidade do ajuste baseou-se no coeficiente de determinação ajustado (R²A, no teste de Durbin-Watson (DW e nas médias e desvios-padrão estimados para os parâmetros e funções dos parâmetros dos modelos. Para a curva média, os R²A foram superiores a 0,90 para todas as funções. Bons ajustes, baseados nos R²A>0,80 foram obtidos, respectivamente, por 25,2%, 39,1%, 31,1% e 28,4% das lactações ajustadas pelas funções FLH, FQL, FGI e FPI. De acordo com o teste de DW, bons ajustes foram proporcionados para 29,4% das lactações ajustadas pela FLH, 54,9% pela FQL, 34,9% pela FGI e 29,6% pela FPI. Para ambos os critérios, a FQL foi superior às demais funções, indicando grande variação nas formas das curvas de lactação geradas pelos ajustes individuais. Curvas atípicas foram estimadas pelas funções, com picos ocorrendo antes do parto e algumas vezes após o término da lactação. Todas as funções apresentaram problemas quando ajustaram dados individuais.

  12. Capacidade máxima de adsorção de fósforo e constante de energia em Latossolo Bruno em razão de diferentes ajustes do modelo Langmuir

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    Clovisson Menotti Boeira de Oliveira

    2014-12-01

    Full Text Available A capacidade máxima de adsorção de fósforo (CMAP é um parâmetro bastante útil para caracterizar a capacidade de adsorção de fósforo (P do solo e, por isso, o modelo de Langmuir, que possibilita essa estimativa, é bastante difundido. Porém, se o ajuste da equação for realizado por modelos não lineares ou linearizados, ou se forem escolhidos modelos de região única ou múltiplas, nem sempre os valores estimados da CMAP e da constante de energia de ligação (k são semelhantes. O objetivo deste trabalho foi avaliar o efeito do uso de diferentes métodos de ajuste do modelo de Langmuir sobre os valores estimados de CMAP e k. Para isso, utilizouse um único solo de alta capacidade de adsorção de P, o qual foi misturado a quantidades crescentes de areia lavada, construindo-se sistemas com capacidades de sorção crescentes, mas com a fase sólida constituída da mesma mineralogia. Foi utilizado solo do horizonte B de um Latossolo Bruno com 800 g kg-1 de argila, o qual foi misturado com areia em quantidades para obterem-se solos artificiais com 0, 200, 400, 600 e 800 g kg-1 de argila. Esses solos artificiais foram incubados por 30 dias com calcário para elevar o pH(H2O até 6,0 e, após, foram secos em estufa e peneirados. Foram realizadas as isotermas de adsorção e os dados ajustados pelo modelo de Langmuir, usando os seguintes métodos: NLin - não linear com região única; L-1R - linearização com região única; L-2RG - linearização com duas regiões, ajuste gráfico; L-3RG - linearização com três regiões, ajuste gráfico; L-2RE linerização com duas regiões, ajuste estatístico. Os resultados evidenciaram que todos os métodos utilizados estimaram valores de CMAP proporcionais ao teor de argila dos solos e poderiam ser usados para caracterizar os solos. Contudo, quando utilizados ajustes com mais de uma região de adsorção, os valores da CMAP para a última região foram sensivelmente superiores

  13. O aparelho pré-ajustado: sua evolução e suas prescrições The pre-adjusted appliance: evolution and prescriptions

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    Vicente de Sousa Brito Júnior

    2006-06-01

    Full Text Available Este trabalho revisou as prescrições de braquetes pré-ajustados existentes no mercado, abordando as variações dos valores de inclinação, angulação e rotação dentária. A revisão reporta desde a origem do conceito de uso de arcos retangulares em acessórios com secções retangulares até os atuais modelos de braquetes autoligados e outros braquetes com formatos diferenciados.This research intended to review all the available prescriptions of pre-adjusted orthodontic appliances in the market and to discuss the justification of the authors as to the prescribed angulation, inclination and rotation suggested. The review encompassed the rectangular wire application in Edgewise brackets, until the implementation of self ligation, and many other kinds of brackets with distinct shapes according to the utilized technique. It was clear the great variety of many orthodontic mechanotherapy and brackets prescriptions, demonstrating that Orthodontics is a science with many possible alternatives.

  14. AJUSTE PSICOSOCIAL, BIENESTAR SUBJETIVO Y OCIO EN ADULTOS MAYORES JUBILADOS MEXICANOS

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    Christian Oswaldo Acosta Quiroz

    2015-01-01

    Full Text Available El objetivo de este estudio fue establecer la relación entre ajuste psicosocial en la jubilación,bienestar subjetivo, actividades de ocio y variables sociodemográficas en adultos mayores ju-bilados mexicanos. Participaron 181 adultos mayores con una edad media de 69.12 años y untiempo medio de jubilación de 11.21 años. Los resultados indican que el ajuste psicosocial enla jubilación y el bienestar subjetivo se relacionan significativamente entre sí y con las variablessociodemográficas de sexo, nivel de estudios, estatus de salud y estado civil. A su vez, se re-lacionan con la frecuencia de actividades de ocio (con diferencias entre hombres y mujeres.Estas variables deben tenerse en cuenta para fomentar un mayor ajuste psicosocial y bienestarsubjetivo en adultos mayores jubilados.

  15. Variabilidade do risco do tempo de permanência ajustado para lactentes de muito baixo peso ao nascer entre centros da Neocosur South American Network

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    Guillermo Marshall

    2012-12-01

    Full Text Available OBJETIVOS: Desenvolver um modelo de predição para o tempo de permanência hospitalar (TPH em lactentes de muito baixo peso ao nascer (MBPN e comparar esse resultado entre 20 centros de uma rede neonatal, visto que o TPH é utilizado como uma medida da qualidade da assistência em lactentes de MBPN. MÉTODOS: Utilizamos dados coletados prospectivamente de 7.599 lactentes com peso ao nascer entre 500 e 1.500 g no período entre os anos de 2001 a 2008. O modelo de regressão de Cox foi empregado para desenvolver dois modelos de predição: um modelo prévio com dados do nascimento e outro posterior, que acrescenta morbidades relevantes dos primeiros 30 dias de vida. RESULTADOS: A mediana do TPH estimado e ajustado a partir do nascimento foi de 59 dias; 28 dias depois do tempo de sobrevida de 30 dias. Houve uma alta correlação entre os modelos (r = 0,92. O TPH esperado e o TPH observado variaram bastante entre os centros, mesmo depois de correção para as morbidades relevantes após 30 dias. O TPH mediano (variação: 45-70 dias e a idade concepcional na alta hospitalar (variação: 36,4-39,9 semanas refletem uma variabilidade alta entre centros. CONCLUSÃO: Um modelo simples, com fatores apresentados no nascimento, pode predizer o TPH de um lactente de MBPN em uma rede neonatal. Observou-se uma variabilidade nos TPHs considerável entre unidades de terapia intensiva neonatal. Especulamos que os resultados sejam provenientes das diferenças entre as práticas dos centros.

  16. EL FACTOR DE SOSTENIBILIDAD DEL SISTEMA PÚBLICO DE PENSIONES Y SU ENTRADA EN VIGOR. EL FACTOR DE EQUIDAD INTERGENERACIONAL “AJUSTADO A LA EDAD DE ACCESO A LA JUBILACIÓN”

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    Augusto Hoyo Lao

    2014-05-01

    Full Text Available La introducción del factor de sostenibilidad en el sistema de pensiones de la Seguridad Social y la elección del año base de aplicación constituyen decisiones de gran trascendencia debido a sus efectos reductores (acumulativos en el cálculo de las pensiones iniciales y en la revalorización de todas las pensiones. Este trabajo analiza los efectos de la aplicación anticipada del Factor de Equidad Intergeneracional (FEI, como propone el comité de expertos designado por el Gobierno de España, en concurrencia con la reforma paramétrica de la Ley 27/2011, cuantificando la reducción en las pensiones de jubilación que se causen en 2027 en torno al 26%.Se señala que la anticipación de la aplicación del FEI al periodo de transición de la reforma de 2011 supondría una redundancia de medidas orientadas a compensar el incremento en el número de años de percepción de la pensión debido al progresivo aumento de la esperanza de vida a la edad de jubilación. Además, técnicamente, el FEI es un factor inadecuado para tal objetivo cuando las condiciones de acceso y de cálculo de la pensión de jubilación van cambiando, como ocurre durante el periodo transitorio de la Ley 27/2011, en el que se dificultan estas condiciones para las cohortes que alcancen la edad legal de retiro. Como aportación de este trabajo se sugiere la aplicación de un nuevo FEI “ajustado a la edad de acceso a la jubilación” que, cumpliendo el objetivo de poner límite a la mayor longevidad, se adapta a distintos periodos (transitorio o plena vigencia de la reforma de 2011 y situaciones (como la anticipación o demora en el acceso a la jubilación y, además, es menos sensible al año de referencia que se elija para vincular la prestación a la evolución de la esperanza de vida. Se incluyen también propuestas de ajuste de los parámetros de cálculo de la pensión de jubilación para el periodo posterior a 2027. The introduction of sustainability factor in the

  17. Ajuste de modelos estocásticos lineares e não-lineares para a descrição do perfil longitudinal de árvores Fitting linear and nonlinear stochastic models to describe longitudinal tree profile

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    Leonardo Machado Pires

    2007-10-01

    Full Text Available Os modelos polinomiais são mais difundidos no meio florestal brasileiro na descrição do perfil de árvores devido à sua facilidade de ajuste e precisão. O mesmo não ocorre com os modelos não-lineares, os quais possuem maior dificuldade de ajuste. Dentre os modelos não-lineares clássicos, na descrição do perfil, podem-se citar o de Gompertz, o Logístico e o de Weibull. Portanto, este estudo visou comparar os modelos lineares e não lineares para a descrição do perfil de árvores. As medidas de comparação foram o coeficiente de determinação (R², o erro-padrão residual (s yx, o coeficiente de determinação corrigido (R²ajustado, o gráfico dos resíduos e a facilidade de ajuste. Os resultados ressaltaram que, dentre os modelos não-lineares, o que obteve melhor desempenho, de forma geral, foi o modelo Logístico, apesar de o modelo de Gompertz ser melhor em termos de erro-padrão residual. Nos modelos lineares, o polinômio proposto por Pires & Calegario foi superior aos demais. Ao comparar os modelos não-lineares com os lineares, o modelo Logístico foi melhor em razão, principalmente, do fato de o comportamento dos dados ser não-linear, à baixa correlação entre os parâmetros e à fácil interpretação deles, facilitando a convergência e o ajuste.Polynomial models are most commonly used in Brazilian forestry for taper modeling due to its straightforwardly fitting and precision. The use of nonlinear regression classic models, like Gompertz, Logistic and Weibull, is not very common in Brazil. Therefore, this study aimed to verify the best nonlinear and linear models, and among these the best model to describe the longitudinal tree profile. The comparison measures were: R², syx, R²adjusted, residual graphics and fitting convergence. The results pointed out that among the non-linear models the best behavior, in general, was given by the Logistic model, although the Gompertz model was superior compared with the Weibull

  18. Desempenho dos ajustes do Trauma and Injury Severity Score (TRISS: revisão integrativa

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    Cristiane de Alencar Domingues

    2015-12-01

    Full Text Available RESUMO Objetivo identificar estudos que realizaram ajustes na equação do Trauma and InjurySeverity Score (TRISS e compararam a capacidade discriminatória da equação modificada com a original. Método Revisão integrativa de pesquisas publicadas entre 1990 e 2014 nas bases de dados LILACS, MEDLINE, PubMed e SciELO utilizando-se a palavra TRISS. Resultados foram incluídos 32 estudos na revisão. Dos 67 ajustes de equações do TRISS identificados, 35 (52,2% resultaram em melhora na acurácia do índice para predizer a probabilidade de sobrevida de vítimas de trauma. Ajustes dos coeficientes do TRISS à população de estudo foram frequentes, mas nem sempre melhoraram a capacidade preditiva dos modelos analisados. A substituição de variáveis fisiológicas do Revised Trauma Score (RTS e modificações do Injury Severity Score (ISS na equação original tiveram desempenho variado. A mudança na forma de inclusão da idade na equação, assim como a inserção do gênero, comorbidades e mecanismo do trauma apresentaram tendência de melhora do desempenho do TRISS. Conclusão Diferentes propostas de ajustes no TRISS foram identificadas nesta revisão e indicaram, principalmente, fragilidades do RTS no modelo original e necessidade de alteração da forma de inclusão da idade na equação para melhora da capacidade preditiva do índice.

  19. Impacto del ajuste por inflación financiero en la gestión empresarial

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    Oda Hilda Gómez de Angulo

    2009-01-01

    Full Text Available La inflación es un fenómeno económico que afecta la situación financiera de las organizaciones, por lo que existe la Declaración de Principios de Contabilidad No. 10 (DPC-10 que establece las normas para efectuar el ajuste por inflación a los estados financieros. Con el propósito de conocer el impacto de este ajuste, se seleccionaron dos empresas que realizan actividades diferentes. Se efectuó una revisión bibliográfica y documental de la DPC-10 y, con base a los informes al cierre de cada ejercicio económico de las empresas objeto de estudio, se recopilaron y prepararon los datos en una misma unidad de medida para efectos de comparación, análisis e interpretación. Los resultados obtenidos indican que en la empresa regida por la Comisión Nacional de Valores se justifica el ajuste por inflación financiero debido a la naturaleza de la estructura financiera y a que la toma de decisiones administrativas y legales se realiza con base a esta información; mientras que en la institución regida por la Superintendencia de Cajas de Ahorro no se justifica la presentación del ajuste por inflación financiero, ya que no aporta ningún valor agregado a la organización y la toma de decisiones se realiza con base a los estados financieros históricos.

  20. Estratégia de corrida em média e longa distância: como ocorrem os ajustes de velocidade ao longo da prova? La estratégia de la carrera del media y larga distancia: como se producen los ajustes de velocidad a lo largo de la carrera? Pacing strategy in middle and long distance running: how are velocities adjusted during the race?

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    Everton Crivoi do Carmo

    2012-06-01

    Full Text Available A estratégia de corrida tem sido apontada como um fator decisivo para o sucesso do atleta. Durante corridas de média e longa duração, a melhor estratégia será aquela capaz de poupar as "reservas fisiológicas", permitindo ao atleta terminar a prova no menor tempo possível. O controle da estratégia de corrida parece ser influenciado por fatores fisiológicos e psicológicos, que são ajustados constantemente durante a corrida, permitindo ao atleta determinar a intensidade do esforço. Diversas variáveis fisiológicas têm sido relacionadas aos ajustes da estratégia de corrida, no entanto, os resultados observados são controversos e foco de grandes discussões. Assim, a presente revisão tem como objetivo propiciar aos profissionais do esporte um melhor entendimento de questões como: 1 quais as melhores estratégias adotadas para determinado tipo de prova?; 2 como os ajustes da estratégia de corrida são realizados?; e 3 quais variáveis fisiológicas influenciam no controle da estratégia de corrida?La estrategia de la carrera ha sido identificada como un factor decisivo para el éxito del atleta. Durante las carreras de médio y largo plazo, la mejor estrategia es aquella que puede salvar a la "reserva fisiológica" que permite al atleta terminar la carrera en el menor tiempo posible. El control de la estrategia de carrera parece estar influenciada por algunos factores fisiológicos y psicológicos, que se ajustan com frecuencia durante la carrera, lo que permite al atleta determinar la intensidad del esfuerzo. Muchas de las variables fisiológicas se han relacionadas con los ajustes de la estrategia de carrera, sin embargo, los resultados observados son controvertidos y foco de muchos debates. Por lo tanto, esta revisión tiene como objetivo proporcionar a los profesionales del deporte una mejor comprensión de temas tales como: 1 cuáles son las mejores estrategias adoptadas para un tipo particular de prubea?; 2 cómo los ajustes

  1. Representación de la Enfermedad, Afrontamiento y Ajuste en los Trastornos Alimentarios

    Directory of Open Access Journals (Sweden)

    Yolanda Quiles Marcos

    2009-01-01

    Full Text Available El objetivo de esta investigación es evaluar la representación de la enfermedad en pacientes con un trastorno alimentario (TA, así como su relación con el afrontamiento y el ajuste, utilizando como marco teórico el Modelo del Sentido Común de Leventhal. Método: Participaron 98 mujeres diagnosticadas de un TA. La media de edad fue 20.8 años (dt=5.61. Para evaluar la representación de la enfermedad se administró la adaptación española para los TA del Cuestionario de Percepción de la Enfermedad Revisado (IPQ-R. Resultados: Respecto a la identidad, los síntomas más señalados fueron la "pérdida de peso" (89.8% y las "alteraciones en la menstruación" (81.6%. Consideran que su enfermedad tiene una larga duración y serias consecuencias, así como que tienen control y siguiendo un tratamiento es posible su curación. El 21% de la varianza de las estrategias evitativas fue explicado por diferentes dimensiones de la representación de la enfermedad. Se confirman los efectos directos de la representación de la enfermedad sobre el ajuste, pero no los del afrontamiento. Conclusiones: Los resultados apoyan la necesidad de intervenir sobre las creencias que tienen estas pacientes sobre su enfermedad con el fin de mejorar su ajuste psicosocial.

  2. Relaciones con padres e iguales como predictoras del ajuste emocional y conductual durante la adolescencia

    OpenAIRE

    Oliva Delgado, Alfredo; Parra Jiménez, Agueda; Sánchez Queija, María Inmaculada

    2002-01-01

    El objetivo de esta investigación fue estudiar el papel que juegan las relaciones con padres e iguales en el ajuste emocional y conductual de los adolescentes. Concretamentte, pretendíamos analizar tanto la contribución independiente de padres e iguales como los posibles efectos de interacción entre ambos contextos. Una muestra de 221 chicos y 292 chicas de edades comprendidas entre los 13 y los 19 años cumplimentaron un cuestionario que incluía medidas sobre las relaciones familiares, las re...

  3. Ajuste del Índice de Pont para mujeres y hombres

    OpenAIRE

    Paula María Nava–Salcedo; Jaime Fabián Gutiérrez–Rojo; Alma Rosa Rojas–García

    2014-01-01

    La forma de arco dental de mujeres y hombres es diferente, en los hombres es amplio y en mujeres de forma parabólica. En ortodoncia existen índices y métodos para la predicción del ancho y forma del arco ideal, uno de estos índices es el de Pont que no toma en cuenta las diferencias entre sexos. Objetivos: determinar la efectividad del índice de Pont al emplearlo en hombres y mujeres, realizar el ajuste si fuera necesario a las formulas del índice de Pont para poder aplicarlo en hombres y muj...

  4. EFECTOS DE ENTRENAR PARA CUMPLIR CRITERIOS DE CONGRUENCIA EN TAREAS DE AJUSTE LECTOR

    OpenAIRE

    Germán Morales-Chávez; Manuel Hernández-Reyes; Alejandro León; Nadia Cruz-Alcalá; Claudio Carpio

    2010-01-01

    La presente investigación evaluó los efectos de entrenar estudiantes universitarios para satisfacer criterios de congruencia en tareas de ajuste lector con base en parámetros de congruencia y de coherencia. El grupo experimental fue entrenado para satisfacer criterios de congruencia y fue expuesto a dos pruebas de evaluación en satisfacción de criterios de congruencia y coherencia. El grupo control solo fue sometido a las pruebas de evaluación. Los resultados revelan que el entrenamiento favo...

  5. Ajuste del Índice de Pont para mujeres y hombres

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    Paula María Nava–Salcedo

    2014-07-01

    Full Text Available La forma de arco dental de mujeres y hombres es diferente, en los hombres es amplio y en mujeres de forma parabólica. En ortodoncia existen índices y métodos para la predicción del ancho y forma del arco ideal, uno de estos índices es el de Pont que no toma en cuenta las diferencias entre sexos. Objetivos: determinar la efectividad del índice de Pont al emplearlo en hombres y mujeres, realizar el ajuste si fuera necesario a las formulas del índice de Pont para poder aplicarlo en hombres y mujeres. Materiales y métodos: investigación descriptiva, no experimental y transversal. La muestra fue de 139 modelos de estudio, 94 de pacientes femeninos y 45 de pacientes masculinos, por lo que se seleccionaron 45 modelos de pacientes femeninos de forma aleatoria para igualar las muestras. Se compararon mediante una t de Student los valores reales de la muestra de hombres con los de las mujeres y el resultado del análisis de Pont en hombres y mujeres. Se realizó el ajuste de las constantes del índice de Pont para mujeres y  hombres, se aplicó a ambas poblaciones, el resultado se  comparó con los valores reales interpremolar e intermolar en maxilar y mandíbula. Resultados: el análisis de Pont no es efectivo para utilizarse en mujeres y hombres de Nayarit, se encontraron diferencias transversales entre ambas poblaciones, los ajustes realizados para la población femenina y masculinafue efectiva para utilizase en la población de Nayarit. Conclusiones: El índice de Pont no es aplicable debido a que sobreestima los valores de la población femenina y masculinade la población de Nayarit. Los ajustes realizados fueron efectivos y se recomienda evaluarlo en otras poblaciones.

  6. O ajuste gerencial e seus limites: a falha seqüencial em perspectiva comparada

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    Flávio da Cunha Rezende

    2008-08-01

    Full Text Available O artigo focaliza a explicação da falha seqüencial nas reformas gerenciais. Ele trata do problema dos limites do ajuste gerencial, em uma abordagem que tenta conectar teoria e dados empíricos, articulando três níveis de análise. O primeiro nível apresenta evidências comparativas da falha seqüencial das reformas nos governos nacionais a partir de um conjunto de indicadores voltados para compreender transformações no papel dos estados. O segundo nível analítico identifica, à luz da análise de um conjunto representativo de estudos comparativos da implementação de reformas, quatro mecanismos típicos presentes na explicação das falhas do ajuste gerencial. Busca-se configurar uma matriz explicativa de teorias sobre a falha seqüencial. Em seguida discute-se a experiência da reforma gerencial no contexto brasileiro, conferindo especial atenção para um dos mecanismos geradores da falha: o dilema do controle. As principais hipóteses são que guiam o artigo são que as reformas falham sequencialmente e existem pelo menos quatro mecanismos causais que produzem as reformas: a custos de transação envolvidos na produção das reformas; b legados de desempenho; c preponderância do ajuste fiscal e d o dilema do controle. Esses mecanismos atuam isolada ou combinadamente, reduzindo consideravelmente as chances de transformações do papel do Estado nos moldes gerenciais. As principais evidências analisadas no artigo permitem tornar consistente o argumento geral de que as reformas falharam nas tentativas de reduzir os gastos públicos, alterar padrões de alocação de recursos, reduzir a força de trabalho e transformar o papel do Estado. A principal conclusão é que as reformas falharam seqüencialmente e o ajuste gerencial exibe consideráveis limites, especialmente de natureza política.

  7. Le village camerounais à l'heure de l'ajustement

    OpenAIRE

    Courade, Georges

    1994-01-01

    1987 : L'État camerounais se déclare en cessasion de paiement et la crise latente, est révélée au grand jour. De proche en proche et à des degrés divers, l'ensemble des secteurs économiques et des catégories sociales est touché. L'Etat est contraint de faire appel aux institutions financières internationales pour tenter de redresser la situation. Plusieurs programmes successifs d'ajustement structurel sont mis en oeuvre pour s'achever provisoirement ? sur la dévaluation de janvier 1994. Les é...

  8. Proceso de ajuste emocional de padres cuyos hijos presentan algún tipo de discapacidad

    OpenAIRE

    Alcíbar Sánchez, B; Amador Velázquez, R

    2014-01-01

    La discapacidad se vive desde diferentes perspectivas ya sea padre, hijo, hermano, etc., y cada uno trata de sobreponerse a esta situación dependiendo de los recursos con los que cuente cada persona ya que tiene un impacto social, familiar y psicológico. En cuanto a lo psicológico, se enfrentan un sin fin de emociones contradictorias necesitando ayuda de profesionales para un adecuado manejo de la situación. El estudio tuvo como objetivo la aplicación de la Escala de ajustes para padres con h...

  9. Ajustes entre pais e filhos adultos coabitantes: limite e transgressão

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    Celia Regina Henriques

    2011-12-01

    Full Text Available O objetivo deste trabalho é investigar a relação entre pais e filhos adultos coabitantes no ambiente doméstico familiar e sublinhar os aspectos transformadores dessa dimensão interativa. Empreendemos uma discussão teórica interdisciplinar, incluindo autores como Singly, Giddens, Berger e Luckman. Pesquisamos esse universo por meio de um estudo de campo, realizando entrevistas semiestruturadas com oito famílias cariocas de classe média. Foram entrevistadas, separadamente e depois em conjunto, quatro díades mãe-filho, três díades mãe-filha e uma díade pai-filha. Entre os temas que emergiram da análise dos dados, destacamos os ajustes cotidianos nas instâncias relacionais. Verificamos que, na dinâmica interativa, diferentes ajustes cotidianos são estabelecidos. Pais e filhos se autorizam a romper ou esticar as regras de convivência, revelando o aspecto poroso da relação e estabelecendo um contexto propício para se jogar com as regras. Evidencia-se um jogo de reconstrução constante em um movimento ilimitado de avanços e recuos na esfera relacional.

  10. Apport d'un outil d'optimisation globale à l'ajustement des modèles statistiques

    OpenAIRE

    Cabarbaye, André; Faure, Julien

    2009-01-01

    Les modèles paramétriques ne peuvent représenter la réalité que si leurs paramètres ont été correctement ajustés à partir de données de retour d'expérience. La méthode d'ajustement la plus utilisée est la méthode du maximum de vraisemblance qui ne peut se suffire d'une simple technique d'optimisation locale quand les optima sont multiples. C'est la raison pour laquelle les outils existants donnent parfois des résultats erronés. Aussi avons-nous tenté d'ajuster différents modèles utilisés en f...

  11. Correlatos perceptivos e acústicos dos ajustes supraglóticos na disfonia Perceptive and acoustic correlates of supraglottis adjustments in dysfonia

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    Aline Magri

    2007-12-01

    Full Text Available OBJETIVO: avaliar os correlatos perceptivo-auditivos (ajustes supraglóticos e acústicos (formantes da qualidade vocal de indivíduos disfônicos com alterações glóticas, atendidos em ambulatório de fonoaudiologia de uma instituição hospitalar da cidade de São Paulo. MÉTODOS: o grupo estudado foi representado por amostras de voz de 20 indivíduos disfônicos com idades variadas entre 30 e 65 anos do sexo feminino (atendidos em um hospital da cidade de São Paulo e julgamentos perceptivo-auditivos da qualidade vocal por amostras avaliadas previamente por um grupo de juízes em atividade clínica. As amostras foram exploradas quanto à freqüência dos três primeiros formantes (F1, F2 e F3. Os valores foram considerados de forma qualitativa (comparados aos dados da análise perceptivo-auditiva e quantitativa (teste Qui-quadrado. RESULTADOS: os ajustes de qualidade vocal mais freqüentes foram laringe baixa, mandíbula fechada, lábios arredondados, corpo de língua abaixado, corpo de língua retraído, labiodentalização. Diferenças estatisticamente significantes foram encontradas para os valores de freqüência de F1 para os vocábulos "cata" (864 Hz e "gata" (814 Hz, p=0 e F3 para os vocábulos "cata" (2598 Hz e "gata" (2660 Hz, p=0,17 dos indivíduos do grupo estudado em relação aos valores de referência para o Português-Brasileiro. CONCLUSÃO: os ajustes de qualidade vocal identificados encontraram correspondência com a diminuição dos valores de F1 e F3 indicando tendências de ajustes do trato vocal.PURPOSE: to evaluate auditory perception (supraglottic adjustments and acoustic (formants of vocal quality in dysphonic individuals with glotic disorders, attended in a clinic a hospital in the city of São Paulo. METHODS: the studied was represented by voice samples taken form from 20 dysphonic people aged between 30 and 65 of the female gender (attended in a hospital in the city of Sao Paulo and the auditory perception

  12. Ajustamento psicológico e perspectiva de velhice pessoal em adultos com deficiência física Ajuste psicológico e la perspectiva percibida del envejecimiento personal en adulto y adultos moyores con discapacidad física Psychological adjustment and personal aging perspective in adults and older adults with physical disability

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    Marineia Crosara de Resende

    2009-12-01

    Full Text Available Foram investigadas relações entre senso de ajustamento psicológico e perspectiva de velhice em adultos e idosos com deficiência física. Participaram 90 pessoas, de ambos os sexos, com idade entre 25 e 84 anos, que responderam aos instrumentos: questionários sociodemografico e sobre a deficiência física; Inventário Sheppard de Atitudes em Relação à Velhice Pessoal; Escala de Desenvolvimento Pessoal (ajustamento psicológico. Os índices de ajustamento pessoal foram de moderados a altos, mas as mulheres pontuaram mais baixo. Para toda a amostra, quanto maior o senso de ajustamento, mais positiva a perspectiva de velhice pessoal. Os com deficiência congênita e os mais ajustados psicologicamente mostraram perspectivas mais positivas de velhice pessoal. Concluiu-se que envelhecer com uma deficiência física é um processo que exige competência adaptativa e resiliência aos eventos de vida e aos desafios acarretados pela deficiência.Realizamos una investigación para analizar las relaciones entre el ajuste psicológico y la perspectiva percibida del envejecimiento personal en adulto y adultos mayores con discapacidad física. Materiales y método: 90 participantes, ambos géneros, adultos con 25 a 84 respondieron a cuestionarios contestados pidiendo la información sobre características socio demográficas y discapacidad; el inventario de Sheppard de actitudes acerca del propio envejecimiento; y una escala que determina el ajuste psicológico percibido. Resultados: Los índices del ajuste personal eran moderados y altos. Las mujeres tenían las cuentas más bajas. Había correlaciones positivas observadas entre el ajuste psicológico positivo y las actitudes positivas acerca del propio envejecimiento. Los que tenían discapacidad congénita y el ajuste psicológico más alto divulgado demostraron perspectivas más positivas del envejecimiento personal. Conclusión: El envejecer con discapacidad física es un proceso complejo que

  13. EFECTOS DE ENTRENAR PARA CUMPLIR CRITERIOS DE CONGRUENCIA EN TAREAS DE AJUSTE LECTOR

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    Germán Morales-Chávez

    2010-01-01

    Full Text Available La presente investigación evaluó los efectos de entrenar estudiantes universitarios para satisfacer criterios de congruenciaen tareas de ajuste lector con base en parámetros de congruenciay de coherencia. El grupo experimental fue entrenadopara satisfacer criterios de congruencia y fue expuestoa dos pruebas de evaluación en satisfacción de criterios decongruencia y coherencia. El grupo control solo fue sometidoa las pruebas de evaluación. Los resultados revelan que elentrenamiento favoreció la satisfacción de criterios tanto decongruencia como de coherencia. Se discute la relevancia deldesempeño efectivo en una situación lectora con criterios decongruencia como condición para el desarrollo de conductaslectoras funcionalmente más complejas.

  14. Efectos de entrenar para cumplir criterios de congruencia en tareas de ajuste lector

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    Germán Morales-Chávez

    2010-01-01

    Full Text Available La presente investigación evaluó los efectos de entrenar estudiantes universitarios para satisfacer criterios de congruencia en tareas de ajuste lector con base en parámetros de congruencia y de coherencia. El grupo experimental fue entrenado para satisfacer criterios de congruencia y fue expuesto a dos pruebas de evaluación en satisfacción de criterios de congruencia y coherencia. El grupo control solo fue sometido a las pruebas de evaluación. Los resultados revelan que el entrenamiento favoreció la satisfacción de criterios tanto de congruencia como de coherencia. Se discute la relevancia del desempeño efectivo en una situación lectora con criterios de congruencia como condición para el desarrollo de conductas lectoras funcionalmente más complejas.

  15. Ajustement de faisceaux du SLAM revisité en utilisant un capteur RGB-D

    OpenAIRE

    Melbouci, kathia; Naudet Collette, Sylvie; Gay-Bellile, Vincent; Ait Aider, Omar; Carrier, Mathieu; Dhome, Michel

    2015-01-01

    International audience Nous présentons dans ce papier une méthode qui intègre l'information de profondeur fournie par un capteurRGB-D, pour la cartographie et la localisation simultanée ou (Simultanuous Localization And Mapping, SLAM) afind'améliorer la précision de la localisation. Nous présentons un nouvel ajustement de faisceaux local qui permet de combiner des données ayant une information de profondeur et des données visuelles dans une même fonction de coût totalement exprimée en pixe...

  16. Instituições, política e ajuste fiscal: o Brasil em perspectiva comparada

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    Loureiro Maria Rita

    2001-01-01

    Full Text Available Neste texto examinam-se as condições institucionais e políticas do ajuste fiscal. Mesmo considerando que as instituições afetam as estratégias dos atores e os resultados das políticas, supõe-se que o cumprimento das regras relativas ao controle fiscal dependem igualmente de certas condições políticas contingentes, como a coesão governamental. Embora a análise seja centrada no Brasil recente, são também confrontados casos de outros países - Estados Unidos, Holanda e Suécia - que também enfrentaram sérios problemas fiscais nos anos 80.

  17. La inteligencia emocional y el ajuste psicológico: un estudio transcultural

    OpenAIRE

    Fulquez Castro, Sandra Carina

    2011-01-01

    La intel·ligència emocional (IE) és una competència de l'ésser humà. Així mateix, elements psicològics com l'autoestima, l-autoconfiança, les relacions amb els iguals i les relacions amb els pares -en el cas dels adolescents- constitueixen eines que guien la salut mental i l'adaptació social de l'individu. L'estudi que es presenta demostra l'associació existent entre la IE (atenció emocional -AE- claredat emocional -CE- i reparació emocional -RE) i les variables d'ajust psicològic, així com d...

  18. El papel de la concertación social ante la política de ajuste

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    Juan Raso Delgue

    2015-10-01

    Full Text Available Contenido: Introducción. Ajuste. Modos de producción y concertación. Nuevos actores y nuevas dimensiones del conflictos. Las dimensiones de la nueva concertación. Contenidos de la nueva concertación. Conclusiones

  19. Comparación entre varias poblaciones estándar para el ajuste por edades

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    Llorca Díaz Javier

    2000-01-01

    Full Text Available FUNDAMENTO: Analizar el efecto que tiene la elección de una población de referencia sobre diferentes indicadores derivados de las tasas de mortalidad ajustadas por edad. MÉTODOS: Las tasas de mortalidad por diferentes causas de muerte en España de 1971 a 1992 son ajustadas empleando cuatro poblaciones de referencia: poblaciones españolas de 1971 y 1992, población estándar europea y población estándar mundial. Los resultados obtenidos con las cuatro poblaciones se comparan empleando tres indicadores: diferencia entre las tasas de 1992 y 1971, razón entre las tasas de 1992 y 1971y cambio anual porcentual entre 1971 y 1992. RESULTADOS: En la mayor parte de las causas de muerte estudiadas incluyendo el total de causas, la cardiopatía isquémica y casi todos los tumores, la razón de tasas y el porcentaje de cambio anual son similares con independencia de cuál sea la población estándar empleada. En cambio, la diferencia de tasas es muy diferente en función de la población de referencia. En las enfermedades infecciosas y el cáncer de testículo se produce la situación contraria: la diferencia de tasas es robusta mientras que la razón de tasas varía con la población estándar. Finalmente, la mortalidad por neumonía, enfermedad de Parkinson y cáncer de encéfalo muestra cambios en los tres indicadores utilizados. CONCLUSIONES: Es necesario realizar un análisis de las tasas específicas por edad antes de proceder a su ajuste. Este análisis permite averiguar si el ajuste por edades es correcto y qué indicador (diferencia, razón o cambio porcentual será adecuado para realizar comparaciones.

  20. Ajuste al rol de género en mujeres con y sin trastornos de la conducta alimentaria

    OpenAIRE

    González Alcántara, Karla Edith; Universidad Nacional Autónoma de México; Silva, Cecilia; Universidad Nacional Autónoma de México

    2014-01-01

    Los trastornos de la conducta alimentaria podrían estar relacionados con el ajuste al rol de género de quienes los padecen, es decir, con la distancia percibida entre las características que se acepta poseer y aquellas que conforman el ideal personal. Por tal motivo, con el fin de indagar si el ajuste al rol de género guarda relación con aquéllos, se evaluaron la autopercepción y el ideal del rol de género en una muestra de 154 mujeres con edades de entre 14 y 30 años, de las cuales 49 padecí...

  1. Teoría de las Contingencias Múltiples Dinámicamente Entrelazadas (Abriendo la caja negra del ajuste contingente

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    Lic. Jorge Washington Barrientos

    2013-12-01

    Full Text Available La teoría de las contingencias ha ocupado un rol destacado en el estudio del diseño de las estructuras organizacionales en los últimos cincuenta años. Sus contribuciones se han dirigido en distintas direcciones, una de ellas ha sido enumeración de factores de contingencia y la posterior identificación de relaciones entre estos y los elementos estructurales.Refinamientos posteriores han conceptualizado la respuesta sistémica que permite el ajuste (“fit” de la organización a los cambios en los factores de contingencia.Este trabajo se propone repasar críticamente las principales conceptualizaciones del ajuste estructural, y a la vez proponer una nueva variable interviniente en el marco de una teoría de contingencias múltiples dinámicamente entrelazadas.

  2. La influencia de las diferencias entre el padre y la madre sobre el ajuste adolescente

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    Antonia Jiménez-Iglesias

    2015-01-01

    Full Text Available Este trabajo se centra en analizar cómo influyen en el consumo de sustancias (tabaco, alcohol y cannabis y el bienestar psicológico adolescente (calidad de vida relacionada con la salud y satisfacción vital las diferencias entre el padre y la madre en afecto, promoción de la autonomía, revelación, interés y conocimiento. La muestra estuvo compuesta por 10170 chicos y chicas españoles de 13 a 18 años de familias biparentales que participaron en la edición 2006 del estudio Health Behaviour in School-aged Children (HBSC. Los resultados mostraron que los adolescentes que indicaron que su padre y madre coincidían en presentar altos niveles en las dimensiones familiares analizadas consumieron menos sustancias y tuvieron mejor bienestar psicológico. Por el contrario, el ajuste de los adolescentes cuyos progenitores (padre y madre tenían bajos niveles en esas dimensiones familiares fue peor. Concretamente, la dimensión más importante para el consumo de sustancias fue el conocimiento parental y para el bienestar psicológico lo fue el afecto parental; la revelación adolescente solo fue relevante para el consumo de alcohol y la calidad de vida, mientras que la promoción parental de la autonomía lo fue para la calidad de vida.

  3. Elementos para el análisis de los programas de ajuste

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    Villamizar Helena

    1991-12-01

    Full Text Available

    La aplicación de las políticas generales, preconizadas por los programas de ajuste en América Latina, en la mayoría de los casos no dieron los resultados deseados. Su éxito necesariamente requería del cumplimiento de ciertos supuestos y condiciones que permitieran que las políticas de "gestión de demanda no generaran efectos negativos sobre el crecimiento en el largo plazo. Al no cumplirse algunos de 105 supuestos teóricos básicos, y al no contar los países con flujos de capitales adecuados y con un entorno externo abierto, la aplicación de estos programas se tradujo en grandes sacrificios en el crecimiento y muchas veces en la perpetuación de situaciones recesivas. Puesto que la región aun no ha encontrado una verdadera vía de solución, se hace imperioso abordar la construcción de una nueva perspectiva teórica, basada en supuestos realistas, que permita abordar los apremiantes problemas del desarrollo latinoamericano.

  4. Consumo de sustancias durante la adolescencia: Trayectorias evolutivas y consecuencias para el ajuste psicológico

    OpenAIRE

    Alfredo Oliva; Águeda Parra; Inmaculada Sánchez-Queija

    2008-01-01

    Este estudio ha perseguido dos objetivos fundamentales: encontrar diferentes trayectorias en el consumo de sustancias a lo largo de la adolescencia y analizar las consecuencias que este consumo en la adolescencia temprana y media tiene para el ajuste emocional y comportamental al final de la adolescencia. El estudio, con un diseño descriptivo longitudinal mediante cuestionarios, se llevó a cabo sobre una muestra de 101 adolescentes (63 varones y 38 mujeres) que fueron estudiado...

  5. Inteligência emocional percebida (IEP) ajuste emocional e actividade física na terceira idade

    OpenAIRE

    Maria Manuela Lima de Figueiredo Queirós

    2007-01-01

    O interesse deste estudo está centrado na forma como interage a inteligência emocional percebida (IEP) com a prática da actividade física e que peso específi co tem cada uma das variáveis estudadas sobre o ajuste emocional das pessoas nesta faixa etária e, consequentemente, na sua qualidade de vida.

  6. Les réinventions du social dans le Maroc “ajusté”

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    Myriam Catusse

    2012-01-01

    Full Text Available Le Maroc de l’ajustement structurel et de la libéralisation économique est le théâtre d’une prise de conscience politique de l’exacerbation des risques sociaux – et de leurs éventuelles conséquences politiques. En l’espace de peu de temps a été adopté un vaste train de lois sociales, au premier chef desquelles un nouveau code du travail en 2003, remplaçant un dispositif vétuste hérité de la période coloniale. Parallèlement, sont créées des institutions para-publiques pour organiser une prise en charge associative et privée de l’aide aux “démunis”. Cet article se propose d’examiner les logiques présidant d’une part à une activité législative directement tournée vers une amélioration de la protection des salariés protégés et d’autre part à des actions d’assistanat ad hoc encouragées tant par les pouvoirs publics que par de grandes institutions internationales. Si cette accélération des réformes sociales se fonde sur l’idée de l’échec de l’intégration par le travail, elle participe d’une redéfinition des rôles de l’État marocain et d’une transformation des configurations d’acteurs et institutions participant à la prise en charge du social, dans un processus de dépolitisation de la question sociale.

  7. Análisis de los parámetros nutricionales y ajuste de requerimientos de la nutrición parenteral de inicio en el paciente crítico postquirúrgico

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    Mª Carmen Herrero Domínguez-Berrneta

    2014-02-01

    Full Text Available Objetivos: Analizar los parámetros nutricionales en pacientes críticos postquirúrgicos en situación de estrés, su evolución y evaluar el grado de ajuste de la Nutrición Parenteral (NP de inicio a los requerimientos de las recomendaciones recientemente publicadas. Material y métodos: Estudio observacional, retrospectivo incluyendo pacientes críticos postquirúrgicos ingresados en una unidad de reanimación postquirúrgica en 2011 con prescripción de NP. Se recogieron datos demográficos, antropométricos, diagnóstico, parámetros nutricionales, mortalidad, estancia total y en Reanimación (REA, y complicaciones. Se comparó el tipo de NP pautada, con la individualización de los requerimientos por kg según las últimas recomendaciones publicadas de nutrición en el paciente crítico (ASPEN, ESPEN, SENPE: 18-30 kcal/kg, 0,8-1,5 g/kg/proteínas, 4 mg/kg/min/glucosa y 2-3 mg/kg/min/glucosa en pacientes con hiperglucemia de estrés, y 0,5-1 g/kg/día lípidos. Las variables analizadas fueron ajuste calórico, proteico y de glucosa en la NP de inicio, recuperación de la albúmina > 3 g/dl a día 10º y la posible asociación clínica con el número de complicaciones, mortalidad y estancia. Resultados: Se analizaron 60 pacientes. El 23,3% (14/60 presentaban al ingreso desnutrición con una pérdida significativa de peso previa a la intervención. La albúmina, reactante de fase aguda negativo, fue significativamente baja al inicio, media 1,9 g/dl (IC95% 1,83-2,12 indicando un alto grado de estrés metabólico de los pacientes postquirúrgicos. Las NP pautadas se ajustaron a las recomendaciones en kcal, proteínas y lípidos en un 68,3%, 71,7%, 80,4% respectivamente. El 57,1% estaban ajustados en glucosa aunque no se tuvo en cuenta el posible aporte en sueroterapia. En pacientes con IMC < 22 kg/m² (16/60 se observó que el 81,8% de las NP pautadas presentaban exceso calórico, 60% exceso proteico y 43,8% exceso de lípidos (p < 0,05. Un 34

  8. Nova bandagem ajustável das artérias pulmonares na Síndrome de Hipoplasia de Câmaras Esquerdas A novel adjustable pulmonary artery banding system for hypoplastic left heart syndrome

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    Renato Samy Assadi

    2007-03-01

    Full Text Available OBJETIVO: A Síndrome de Hipoplasia de Câmaras Esquerdas representa um grande desafio para cirurgiões do mundo inteiro. Atualmente, tem sido proposto procedimento paliativo alternativo, por meio da bandagem bilateral das artérias pulmonares associada à colocação de stent no canal arterial e atrioseptostomia. No entanto, as bandagens utilizadas são fixas, podendo tornar-se inadequadas após o fechamento do esterno ou com o rápido crescimento somático do paciente. Descrevemos a primeira aplicação clínica do novo dispositivo miniaturizado de bandagem ajustável das artérias pulmonares em neonato portador da síndrome de hipoplasia de câmaras esquerdas, o qual permitiu ajustes percutâneos precisos do fluxo sangüíneo pulmonar. MÉTODO: Através de esternotomia mediana, neonato de 5 dias de vida foi submetido à bandagem pulmonar bilateral, usando este novo dispositivo, combinada com interposição de tubo de PTFE entre o tronco pulmonar e o tronco braquiocefálico. RESULTADOS: O paciente apresentou boa evolução pós-operatória. Três ajustes percutâneos das bandagens foram necessários para manter a saturação arterial de oxigênio entre 75-85%. No 48º dia de vida, o paciente foi submetido a atrioseptostomia com colocação de stent (6 mm para tratamento de comunicação interatrial restritiva. No 106º dia de vida, realizou-se operação de Norwood associada à anastomose cavopulmonar bilateral. As bandagens foram removidas, sem distorção das artérias pulmonares. CONCLUSÕES: O uso clínico deste sistema inovador de bandagem ajustável das artérias pulmonares mostrou-se factível, seguro e eficaz. Permitiu o ajuste fino do fluxo pulmonar de acordo com as necessidades clínicas, proporcionando um equilíbrio preciso entre as circulações pulmonar e sistêmica.OBJECTIVE: Hypoplastic left heart syndrome remains a challenge for worldwide surgeons. Initial palliation employing bilateral pulmonary artery banding along with

  9. Ajuste de distribuciones diamétricas por los métodos empíricos de Johnson.

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    Lema T Álvaro

    2002-06-01

    Full Text Available Se revisa la posibilidad de uso de los métodos empíricos de Johnson para el ajuste de las distribuciones diamétricas en silvicultura, ante la falta de indicios acerca del tipo de modelo a utilizar. Se presentan las cartas gráficas necesarias para la toma de decisiones acerca del modelo y se concluye acerca de la bondad del proceso. Con ello se pretende ganar objetividad frente al uso de la presentación de histogramas únicamente ante la falta de modelos.

  10. Ajuste do modelo de Schumacher e Hall e aplicação de redes neurais artificiais para estimar volume de árvores de eucalipto Adjustment of the Schumacher and Hall model and application of artificial neural networks to estimate volume of eucalypt trees

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    Mayra Luiza Marques da Silva

    2009-12-01

    Full Text Available Objetivou-se, neste trabalho, avaliar o ajuste do modelo volumétrico de Schumacher e Hall por diferentes algoritmos, bem como a aplicação de redes neurais artificiais para estimação do volume de madeira de eucalipto em função do diâmetro a 1,30 m do solo (DAP, da altura total (Ht e do clone. Foram utilizadas 21 cubagens de povoamentos de clones de eucalipto com DAP variando de 4,5 a 28,3 cm e altura total de 6,6 a 33,8 m, num total de 862 árvores. O modelo volumétrico de Schumacher e Hall foi ajustado nas formas linear e não linear, com os seguintes algoritmos: Gauss-Newton, Quasi-Newton, Levenberg-Marquardt, Simplex, Hooke-Jeeves Pattern, Rosenbrock Pattern, Simplex, Hooke-Jeeves e Rosenbrock, utilizado simultaneamente com o método Quasi-Newton e com o princípio da Máxima Verossimilhança. Diferentes arquiteturas e modelos (Multilayer Perceptron MLP e Radial Basis Function RBF de redes neurais artificiais foram testados, sendo selecionadas as redes que melhor representaram os dados. As estimativas dos volumes foram avaliadas por gráficos de volume estimado em função do volume observado e pelo teste estatístico L&O. Assim, conclui-se que o ajuste do modelo de Schumacher e Hall pode ser usado na sua forma linear, com boa representatividade e sem apresentar tendenciosidade; os algoritmos Gauss-Newton, Quasi-Newton e Levenberg-Marquardt mostraram-se eficientes para o ajuste do modelo volumétrico de Schumacher e Hall, e as redes neurais artificiais apresentaram boa adequação ao problema, sendo elas altamente recomendadas para realizar prognose da produção de florestas plantadas.This research aimed at evaluating the adjustment of Schumacher and Hall volumetric model by different algorithms and the application of artificial neural networks to estimate the volume of wood of eucalyptus according to the diameter at breast height (DBH, total height (Ht of the clone. For such, 21 scalings of stands of eucalyptus clones were used with

  11. Consumo de sustancias durante la adolescencia:trayectorias evolutivas y consecuencias para el ajuste psicológico

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    Alfredo Oliva

    2008-01-01

    Full Text Available Este estudio ha perseguido dos objetivos fundamentales: encontrar diferentes trayectorias en el consumo de sustancias a lo largo de la adolescencia y analizar las consecuencias que este consumo en la adolescencia temprana y media tiene para el ajuste emocional y comportamental al final de la adolescencia. El estudio, con un diseño descriptivo longitudinal mediante cuestionarios, se llevó a cabo sobre una muestra de 101 adolescentes (63 varones y 38 mujeres que fueron estudiados en 3 ocasiones: a los 13, 15 y 18 años de edad. Los resultados mostraron tres grupos de adolescentes en función de las trayectorias seguidas por su consumo de sustancias: consumo bajo, consumo ascendente y experimentación precoz. La comparación entre estos tres grupos indicó un mejor ajuste psicológico en la adolescencia tardía entre los varones y mujeres del grupo de experimentadores, mientras que los problemas de conducta fueron más frecuentes entre los incluidos en el grupo de consumo ascendente. Por otra parte, los análisis de regresión señalaron que el consumo moderado de sustancias en la adolescencia temprana estaba relacionado con una autoestima más alta y con menos problemas emocionales al final de la adolescencia, pero no con más problemas externos.

  12. Consensos, participación ciudadana y ajuste estructural de las finanzas públicas en Colombia 1998 - 2002

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    Carlos Ariel Sanchez-Torres

    2010-03-01

    Full Text Available Este ensayo estudia el proceso de ajuste estructural de las finanzas públicas que ha tenido lugar en Colombia a partir de 1998, con el propósito de examinar desde un punto de vista jurídico-político, en qué medida dicho proceso es resultado de un consenso en la sociedad colombiana y cuáles son las consecuencias de su existencia o de su ausencia, teniendo en cuenta la importancia de la legitimación democrática y el concepto pacto fiscal. Para el efecto, parte de la noción de participación ciudadana, de la importancia que esta institución tiene en Colombia a partir de 1991, así como de sus limitaciones. Luego se remonta al origen de la situación económica y fiscal que hizo necesario el ajuste y, luego, al acuerdo extendido con el Fondo Monetario Internacional, suscrito en 1999.

  13. Historia Funcional de Morfologías Lingüísticas y su Efecto en un Ajuste Convencional

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    Nataly Yáñez Ramírez

    2011-01-01

    Full Text Available Se observó si diferentes historias funcionales construidas durante la adquisición de un conjunto de morfologías lingüísticas facilitaban un ajuste convencional. Participaron 24 estudiantes universitarios distribuidos en tres grupos, expuestos a entrenamientos construidos bajo la lógica de diferentes niveles de interacción: contextual, suplementario o selector (Ribes y López, 1985; y posteriormente se evaluó su ejecución en una tarea convencional. El entrenamiento cuyo criterio de ajuste era de tipo selector fue la que más facilitó tanto la adquisición de las morfologías lingüísticas como su uso en la tarea, efecto que pareció más evidente en los hablantes que en los escuchas. No se encontraron diferencias entre los entrenamientos contextual y suplementario. Los resultados se discuten en términos de sus implicaciones teóricas y metodológicas.

  14. Ajustes Contábeis para o Cálculo do EVA: estudo sobre os procedimentos adotatos em empresas brasileiras

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    Eduardo Kazuo Kayo

    2008-06-01

    Full Text Available A geração de valor para o acionista está se tornando uma preocupação cada vez mais presente em resposta à pressão dos investidores e de conselhos de administração. Várias abordagens estão disponíveis, entre estas, uma linha de pensamento ligada ao Lucro Residual, o Valor Econômico Agregado (EVA, metodologia desenvolvida pela Stern Stewart & Co. Para cor-rigir as impropriedades percebidas na prática das demonstrações financeiras, alguns usuários da técnica do EVA ajustam os dados contábeis de acordo com os Princípios Contábeis Geralmente Aceitos, na expectativa de que tais ajustes produzam valores mais confiáveis e possam gerar ambiente propício aos comportamentos administrativos mais próximos ao ótimo esperado. A lógica e a mecânica por trás desses ajustes são tratadas ao longo do trabalho, investigando a possível correlação entre a percepção de entendimento do controller e a utilização dos métodos adotados pela organização.

  15. Au risque de rester "dedans" : Le double travail ajustement des usagers de drogues incarcérés

    OpenAIRE

    Fernandez, Fabrice

    2008-01-01

    L'articulation de l'expérience carcérale et de l'expérience toxicomaniaque est indissociable des types de double ajustement à la prison et à la réalité extérieure (la bifurcation, la coordination, la confrontation et la conjonction ). Selon la participation ou le refus des détenus à la logique carcérale, et leur capacité ou non à maintenir des liens avec le monde extérieur, les modes de consommation de drogues vont prendre des formes différenciées. Si l'expérience carcérale peut permettre de ...

  16. Les particules illocutoires, variable d’ajustement de la traduction sous-titrante au cinéma

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    Ève Vayssière

    2010-12-01

    Full Text Available Die illokutiven Partikel fungieren als Anpassungsvariable, die beim Übersetzungsakt zur Untertitelung von Filmen entweder weggelassen werden oder erscheinen. Wenn sie einfach gelöscht werden, ergeben sich weder grammatikalische Störungen noch Informationsverlust. Das Auftauchen dieser Partikel in den deutschen Untertiteln zeigt jedoch, wie wichtig sie sind: Als Partikel der Oralität tragen sie zur Idiomatizität bei.Les particules illocutoires sont des variables d’ajustement lors de l’acte de traduction sous-titrante au cinéma, elles peuvent être supprimées sans que cela occasionne de dysfonctionnement grammatical et elles disparaissent lors de la traduction en français sans que cela occasionne une perte d’informations. Leur apparition dans les sous-titres allemands montre néanmoins leur importance : particules de l’oralité, elles sont vecteur d’« idiomaticité ».

  17. Razões da crise de implementação do Estado gerencial: desempenho versus ajuste fiscal

    OpenAIRE

    Rezende Flávio da Cunha

    2002-01-01

    O artigo tem três diferentes propósitos. Em primeiro lugar, apresenta e discute a questão da crise de implementação das políticas de reforma administrativa. Na seqüência, apresenta uma revisão seletiva das principais teorias contemporâneas que tratam dessa questão. Em seguida, sugere uma teoria adicional, que relaciona a crise de implementação das reformas ao problema dos limites de obtenção da cooperação simultânea com os objetivos programáticos de ajuste fiscal e mudança institucional. A te...

  18. Razões da crise de implementação do Estado gerencial: desempenho versus ajuste fiscal

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    Rezende Flávio da Cunha

    2002-01-01

    Full Text Available O artigo tem três diferentes propósitos. Em primeiro lugar, apresenta e discute a questão da crise de implementação das políticas de reforma administrativa. Na seqüência, apresenta uma revisão seletiva das principais teorias contemporâneas que tratam dessa questão. Em seguida, sugere uma teoria adicional, que relaciona a crise de implementação das reformas ao problema dos limites de obtenção da cooperação simultânea com os objetivos programáticos de ajuste fiscal e mudança institucional. A teoria proposta argumenta que a tensão entre maior flexibilidade burocrática, por um lado, e a demanda por maior rigor nos sistemas internos de controles burocráticos, por outro, é um poderoso mecanismo causal que tende a gerar crises sucessivas de implementação de tais políticas. Por tal razão, as reformas tendem a gerar resistência organizada à mudança, problemas de coordenação, problemas de ação coletiva e outros problemas relacionados. O artigo desenvolve o argumento de que, embora tal explicação adquira validade geral para o caso das reformas administrativas, pode ser muito mais crítico para as reformas gerenciais onde a contradição entre os objetivos de ajuste fiscal e mudança institucional é muito mais intensa.

  19. Cirurgia de estrabismo ajustável no peroperatório com anestesia tópica em pacientes com orbitopatia de Graves Intraoperative adjustable strabismus surgery under drop anesthesia in patients with Graves' orbitopathy

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    Patrícia Grativol Costa

    2008-06-01

    Full Text Available OBJETIVO: Descrever as características clínicas pré-operatórias dos pacientes com estrabismo secundário à orbitopatia de Graves e os resultados da cirurgia com anestesia tópica e sutura ajustável. MÉTODOS: Estudo retrospectivo realizado no Hospital das Clínicas da Universidade de São Paulo. Foram pesquisados os prontuários de todos os pacientes atendidos no ambulatório de estrabismo no período de março de 1994 a maio de 2004. Destes, foram separados aqueles com estrabismo associado à orbitopatia de Graves submetidos à cirurgia ajustável com anestesia tópica. As características clínicas pré-operatórias e os resultados cirúrgicos foram levantados a partir desta análise. RESULTADOS: Foram incluídos 13 pacientes. O tipo de desvio mais freqüentemente encontrado foi esotropia com hipotropia. Em 9 pacientes modificou-se o retrocesso programado no pré-operatório. Três casos necessitaram de uma segunda cirurgia. Após 6 meses de seguimento, 8 dos 13 pacientes estavam ortotrópicos ou com foria pequena e com algum grau de estereopsia. CONCLUSÃO: Neste estudo observou-se que 62% (8/13 dos pacientes apresentavam hipotropia com esotropia, provavelmente por causa do comprometimento associado do reto inferior e reto medial. Nove dos 13 pacientes necessitaram de ajuste no peroperatório e apenas 3 foram reoperados, indicando a importância da técnica ajustável para melhor alinhamento ocular no pós-operatório, possibilitando obter resultados mais satisfatórios.PURPOSE: To report the clinical features of strabismus associated with Graves' orbitopathy, and the results of surgery with adjustable suture under drop anesthesia. METHODS: The charts of 13 patients who had surgical treatment for strabismus related to Graves' orbitopathy at Hospital das Clínicas of University of São Paulo were retrospectively reviewed. Ocular motility, sensorial examination and the follow-up after strabismus correction were studied. RESULTS

  20. Uso de modelos não-lineares para o ajuste de curvas de crescimento de cavalos pantaneiros

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    Sandra Aparecida Santos

    1999-07-01

    Full Text Available Dados de altura da cernelha e idade de 26 cavalos Pantaneiros, obtidos, na maioria, do nascimento até 36 meses, foram ajustados aos modelos de respostas não-lineares de Brody, Richards, Gompertz, Logístico, Weibull e Morgan-Mercer-Flodin. Estes seis modelos matemáticos foram comparados com o uso de uma medida de curvatura média e do erro médio quadrático combinado. O modelo de Weibull foi escolhido. A assíntota desta curva representa a altura esperada na maturidade. Os machos apresentaram um valor maior desta quantidade do que as fêmeas. O índice de maturidade, contudo, é maior para as fêmeas. Observou-se uma indicação de associação negativa entre altura na maturidade e índice de maturidade somente nas fêmeas. Tais resultados indicam que as fêmeas amadurecem mais cedo. Após testes de normalidade e homogeneidade de variância, as diferenças entre sexos foram analisadas com o uso do teste-t. Somente a altura da cernelha ao nascimento apresentou diferença significativa.

  1. Cronograma de amostragem de plantas de alface hidropônica para ajuste de curvas de crescimento Hydroponic lettuce sampling chronogram for fitting growth curves

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    Paula Machado dos Santos

    2007-12-01

    Full Text Available O ajuste de curvas de crescimento de plantas de alface durante seu ciclo necessita de amostragens no tempo, o que restringe o número de efeitos de tratamentos estudados. Com o objetivo de determinar o cronograma de amostragem de plantas de alface em hidroponia para o ajuste de curvas de crescimento até a fase de maturação das sementes, foram realizados dois cultivos em casa de vegetação durante a primavera e o outono, em área pertencente ao Departamento de Fitotecnia, na UFSM, Santa Maria, RS. A partir do ajuste de um modelo de crescimento com amostragem diária, simularam-se diferentes cronogramas de amostragem para o ajuste do mesmo modelo. Para encontrar o cronograma de maior intervalo entre amostragens, ou seja, menor número de coletas, foi comparado o ajuste do modelo de amostragem diária com os ajustes dos modelos dos diferentes intervalos de amostragens simulados, dois a dois, pelo teste F. Foram realizadas simulações considerando desde a data de transplante até a produção de sementes, para variáveis de fitomassa seca da planta e de partes da planta e área foliar. Em experimentos realizados com alface hidropônica na primavera, para o ciclo completo, recomendam-se amostragens a cada 3, 8, 20 e 9 dias para fitomassa seca relativa total da planta de alface, de folhas, de raiz e área foliar, respectivamente; enquanto que, para experimentos realizados no outono, é recomendável utilizar intervalos de amostragens a cada 2, 11, 12 e 11 dias, respectivamente.The fitting of growth curves for lettuce plants requires many samplings within o time interval, while can restrict the number of studied treatments. With the aim o determine sampling chronogram hidroponic lettuce for the fitting of growth curves until maturation of seeds. Two greenhouse trials were carried out in spring an autumn, at UFSM experimental area, Santa Maria, RS. Different sampling interval were simulated using the fitting of a daily model. The optimum sampling

  2. Cronograma de amostragem de alface cultivada em hidroponia para ajuste de curvas de crescimento vegetativo Sampling chronology of hydroponics lettuce plants for adjusting vegetative growth curves

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    Sidinei José Lopes

    2007-10-01

    Full Text Available O objetivo deste trabalho foi determinar o cronograma de amostragem de plantas de alface hidropônica, para ajuste de curvas de crescimento durante o período vegetativo. Foram realizados dois cultivos de alface, variedade Regina, de 8/9/2004 a 19/11/2004 (primavera/verão e 22/2/2005 a 24/5/2005 (verão/outono, em estufas de plástico do Dep. de Fitotecnia, da UFSM, Santa Maria, RS. A partir do ajuste do modelo co-seno com amostragem diária, registrada como padrão, diferentes intervalos entre as amostragens foram simulados para o ajuste do mesmo modelo. A fim de se encontrar o intervalo adequado, foi comparada a variância de falta de ajuste do modelo de amostragem diária com as variâncias de falta de ajuste dos modelos com diferentes intervalos de amostragens pelo teste F. Os cronogramas de amostragens para ajuste de curvas de crescimento de plantas de alface sob hidroponia, para experimentos de primavera/verão e verão/outono, possuem intervalos iguais a dois dias, para fitomassa seca total da planta e da folha; intervalos de quatro dias, para fitomassa de raiz; e, diariamente, para área foliar.The objective of this work was to determinate a sampling chronology to adjust lettuce hidroponic growth curves during its vegetative development. The variety Regina was grown from September 8, 2004 until November 19, 2004 (spring/summer and February 22, 2005 until May 24, 2005 (summer/fall. Plants were placed inside a plastic covered greenhouse in Santa Maria, RS, Brazil. Based on the adjusted cosine model, daily samples were taken as standard and different sampling intervals were simulated in order to better adjust the same model. To estimate de adequate sampling interval a comparison was conducted between the variance of lack of adjustment of the daily sampling with the variance of lack of adjustment of different samplings intervals using an F test. Sampling chronograms for adjusting crop growth curves of hydroponics lettuce plants for both

  3. Ajuste oclusal na Ortodontia: por que, quando e como? Occlusal adjustment in Orthodontics: why, when and how?

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    Roberto Carlos Bodart Brandão

    2008-06-01

    Full Text Available INTRODUÇÃO: o conhecimento sobre oclusão dentária deve ser considerado condição fundamental para a prática de uma Ortodontia de qualidade. O diagnóstico feito sem a manipulação do paciente em Relação Cêntrica pode levar à surpresa desagradável de se planejar o tratamento de uma má oclusão e se deparar com outra, depois dos primeiros arcos de nivelamento. Ao usar arcos retangulares, é importante a checagem dos contatos oclusais para se definir o tipo de movimento dentário necessário para o alcance do equilíbrio oclusal e, principalmente, verificar se este movimento é exeqüível. Durante o tratamento ortodôntico, devido à complexidade das superfícies oclusais, o ajuste oclusal por desgaste deve ser realizado para viabilizar movimentos dentários verticais, reduzindo o tempo de tratamento. Interferências oclusais são responsáveis tanto por efeitos adversos na biomecânica, quanto por aplicação de forças excessivas, que podem causar reabsorções radiculares. Após a Ortodontia, o ajuste oclusal é um dos determinantes da estabilização dentária, devendo-se obter, para cada dente posterior, contatos oclusais "A" e "B", ou "B" e "C" no sentido vestibulolingual, além dos contatos de "parada" e "equilíbrio" no sentido mesiodistal. Os dentes anteriores passam a funcionar em movimentos mandibulares, desocluindo de imediato os dentes posteriores, o que é denominado de guia anterior, visando equilíbrio muscular e proteção do sistema estomatognático. O desgaste seletivo não deve ser utilizado como substituto da movimentação ortodôntica. OBJETIVO: apresentar os princípios relacionados ao ajuste oclusal em Ortodontia.INTRODUCTION: The knowledge of dental occlusion should be considered the basic foundation to an excellent orthodontic practice. The patient’s diagnose without the centric relation assessment can take the orthodontist to an unpleasant surprises. The use of rectangular archwires requires occlusal

  4. Comparação de alguns modelos matemáticos para ajuste à curva de lactação média de um rebanho da raça Caracu Comparison of some mathematical models for the adjustment of the average milking curve of caracu breed herd

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    Lenira El Faro

    1999-01-01

    Full Text Available No presente estudo foi estimada a curva de lactação média de 7239 lactações de vacas da raça Caracu, com base em 299.949 controles semanais. As funções ajustadas aos dados médios da curva de lactação foram Linear Hiperbólica e Quadrática Logarítmica, como lineares, e Gama Incompleta e Polinomial Inversa, como não-lineares. Os parâmetros foram estimados por meio de processos iterativos, método de Gauss-Newton. O Coeficiente de Determinação ajustado (R²A, o Teste de Durbin-Watson (DW e os desvios (% entre as produções totais (PTL observadas e estimadas foram usados como medida da qualidade do ajuste. Os resíduos estimados, apesar de pequenos, apresentaram correlação serial positiva, pois o teste DW foi significativo para as quatro funções estudadas, indicando violação da pressuposição de independência entre estes resíduos. Os R²A foram superiores a 97% e os desvios entre as PTL observadas e estimadas, mínimos, indicando que, de acordo com estes critérios, qualquer função poderia ser usada para ajustar a curva de lactação média desse rebanho. Quanto aos componentes da curva, a melhor aproximação foi obtida pela função Polinomial Inversa, para produção inicial, tempo e produção no pico. As funções Gama Incompleta e Quadrática Logarítmica apresentaram ajustes semelhantes, porém a primeira apresentou melhor definição dos parâmetros e componentes da curva de lactação.The present study was carried out to estimate the average lactation curve of 7239 lactations of Caracu cows based on 299,949 weekly records. The functions fitted to the mean data of the lactation curve were: Linear Hyperbolic and Logarithmic Quadratic as linear and Incomplete Gamma and Inverse Polynomial function as non-linear. The parameters were estimated by iterative methods, Gauss-Newton method. The adjusted Coefficient of Determination (R²A, the Durbin-Watson test (DW and the deviations (% from actual and predicted total milk

  5. Estableciendo nexos entre Políticas de Ajuste Estructural y su impacto ambiental: una discusión metodológica

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    Rosalba Ortiz

    2011-09-01

    Full Text Available Las políticas de Ajuste Estructural han sido la base de la política económica costarricense en los últimos 10 años, por lo cual, han tenido gran incidencia en el análisis de los procesos y relaciones de cualquier sector productivo. En este contexto, los efectos ambientales de los últimos años, están decididamente influenciados por estas políticas, pues aunque, los programas de Ajuste no tienen como propósito direccionar aspectos ambientales, al modificar algunos precios relativos, pueden propiciar un cambio en el patrón de uso de un recurso, y es así como, tienen un efecto directo o indirecto sobre el ambiente

  6. La norma L1 como alternativa a la norma L2 en el ajuste de la regresión

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    Carlos N. Bouza

    2002-01-01

    Full Text Available En este trabajo analizamos el desarrollo y los conceptos de las normas L1 y L2 y se comparan con algunos ejemplos. Por una parte la norma L1 es óptima bajo los supuestos de que los errores tienen la distribución de Laplace. Esta fue propuesta mucho antes que el MC, pero las facilidades de cómputo de éstos últimos le dieron primacía. Actualmente va adquiriendo gran importancia para las aplicaciones económicas, dado que en general los problemas de finanzas y de series temporales incumplen con las hipótesis usadas en el teorema de Gauss-Markoff. El uso de la norma L2, es el método de universal aceptación en el ajuste de la regresión. Sin embargo su optimalidad solo es válida bajo una serie de supuestos que no se cumplen en general (Teorema de Gaus- Markoff. Por lo tanto, norma L1 aparece como una alternativa mejor que la L2 en muchas aplicaciones dada su robustez ante las observaciones atípicas.

  7. Velocidad de ajuste del precio de las acciones por sector económico en la Bolsa Mexicana de Valores

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    Verónica Patricia Rodríguez Vázquez

    2009-01-01

    Full Text Available Este estudio analiza la velocidad de ajuste del precio de las acciones de la Bolsa Mexicana de Valores de enero de 1998 a diciembre de 2007; para ello, se agruparon las acciones por sectores económicos y se compararon con el Índice de Precios y Cotizaciones (IPC. Asimismo, se clasificó a los sectores económicos en fuertes y débiles, dependiendo del porcentaje de influencia dentro de la muestra del IPC. Entre los sectores fuertes se ubicó a comunicaciones y transportes, comercio, construcción e industria extractiva; mientras que en los débiles a transformación, servicios y varios. El modelo de regresión utilizado fue el propuesto por Marshall y Walker (2002, con el que se buscó comprobar que los sectores fuertes ajustaban más rápidamente sus precios que los sectores débiles con respecto a la rentabilidad del mercado. Se encontró que existe evidencia de que los retornos de los sectores fuertes se adelantan a los retornos de los sectores débiles, principalmente porque los primeros ajustan más rápidamente sus precios a los movimientos del mercado.

  8. COMPARACIÓN DE HABILIDADES SOCIALES Y AJUSTE PSICOLÓGICO EN NIÑOS MEXICANOS DE TRES CONDICIONES

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    Claudia González Fragoso

    2014-01-01

    Full Text Available Las habilidades sociales en la infancia guardan una estrech a relación con aspectos como autoestima, ansiedad y depresión. Tales variables son indicadoras del ajuste psicológico, que puede alterarse en los niños que son víctimas de violencia o que viven en institucion es. Para contar con datos sobre niños mexicanos, el presente estudio exploratorio evaluó y comparó los niveles mostrados en habilidades sociales, autoestima, ansiedad y depresión en tres grupos de niños que se hallaban en condiciones de vida distintas: viviendo institucionalizados, en un albergue tempor al por ser víctimas de maltrato o en familia. A cada grupo de niños se les aplicaron cuatro instrumentos validados. Los resultados indican que los niños institucionalizados difirieron significativamente en todas las variables evaluadas en el estudio respecto a los niños que vivían en familia, y compartieron niveles similares de autoestima, ansiedad y depresión con los niños víctimas de maltrato. Estos, a su vez, difirieron de los niños que vivían en familia en esas variables y mostraron mayores índices de a gresión.

  9. Nuevos métodos para el ajuste flexible de estructuras macromoleculares a distintas resoluciones empleando modos normales de vibración en coordenadas internas

    OpenAIRE

    López Blanco, José Ramón

    2012-01-01

    Los objetivos principales de esta tesis son el desarrollo e implementación de una nueva metodología bioinformática para el análisis de los modos normales de vibración (NMA) en coordenadas internas (CI) y su aplicación en el ajuste flexible de estructuras atómicas macromoleculares en mapas de densidad a media/baja resolución.

  10. Apego y Ajuste Socio Emocional: Un Estudio en Embarazadas Primigestas Attachment and Socio-Emotional Adjustment: A Study in First Pregnant Women

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    Chamarrita Farkas

    2008-05-01

    Full Text Available Este artículo se centra en el estudio del apego adulto y su relación con el ajuste socioemocional durante el primer embarazo. Se utiliza una investigación descriptiva correlacional de carácter transversal. La muestra se compone de 139 embarazadas primigestas de 19 a 40 años y nivel socio-económico medio, medio bajo y bajo. El estilo de apego fue evaluado con el Cuestionario de Apego en Adultos, CaMir, y el ajuste socioemocional con el Cuestionario de Salud Mental, OQ-45.2. Se realizan análisis descriptivos de la muestra y correlaciones entre estilos de apego y las dimensiones del Cuestionario de Ajuste Socioemocional con el Coeficiente Producto Momento de Pearson. Los resultados muestran una relación significativa entre los estilos de apego y los indicadores de ajuste.This article focuses on the study of adult attachment and its relationship with socio-emotional adjustment during the first pregnacy. A correlational descriptive study using a cross-sectional design was conducted. The sample included 139 primípara females between 19 and 40 years of age, from medium, medium-low and low socioeconomic status. The attachment style was evaluated using the Attachment Questionnaire for Adults, CaMir, and the socio-emotional adjustment with the Mental Health Questionnaire, OQ-45.2. Descriptive analyses of the sample were conducted, and the bivariate correlations between attachment styles and adjustment was estimated. The results show a significant relation between attachment styles and adjustment indexes.

  11. Acontecimientos vitales estresantes, estilo de afrontamiento y ajuste adolescente: un análisis longitudinal de los efectos de moderación

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    Rosa María Estévez Campos

    2012-01-01

    Full Text Available El objetivo principal de este estudio fue analizar la relación entre la vivencia de los acontecimientos vitales estresantes y los problemas de ajuste emocional y comportamental durante la adolescencia, prestando atención al posible efecto moderador del estilo de afrontamiento. La muestra estuvo compuesta por 90 adolescentes que fueron seguidos durante seis años, desde su adolescencia media (15-16 años hasta la adultez emergente (21-22 años. Completaron cuestionarios sobre su vivencia de acontecimientos vitales estresantes, su estilo de afrontamiento y sus problemas de ajuste tanto emocionales como comportamentales. En un diseño longitudinal se analizó la evolución de cada estilo de afrontamiento según el sexo y se efectuaron análisis de moderación de las distintas estrategias de afrontamiento en la relación entre estresores vitales y el ajuste adolescente. Los resultados mostraron que las estrategias más aproximativas (búsqueda de ayuda y resolución de problemas aumentaron con la edad, mientras que las estrategias de evitación (cognitiva y conductual disminuyeron, aunque sólo algunas trayectorias fueron estadísticamente significativas. Respecto al sexo, las chicas utilizaron con mayor frecuencia estrategias de búsqueda de ayuda. Por otro lado, los análisis de moderación revelaron que solamente los estilos de afrontamiento de evitación moderaron la relación entre la presencia de estresores y el ajuste, aunque el efecto moderador fue diferente en función del tipo de estrategia de evitación empleada. Estos resultados contribuyen a esclarecer el posible efecto de las estrategias de evitación en la adaptación del adolescente a los acontecimientos vitales estresantes y la importancia de seguir profundizando en su estudio.

  12. P ET CO2 e SpO2 permitem ajuste ventilatório adequado em pacientes obesos mórbidos P ET CO2 y SpO2 permiten ajuste de ventilación adecuada en pacientes obesos mórbidos P ET CO2 and SpO2 allow adequate ventilatory adjustment in morbidly obese patients

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    Fábio Ely Martins Benseñor

    2004-08-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Apesar das diversas propostas ventilatórias para anestesia em pacientes obesos mórbidos, um consenso não foi estabelecido. Este estudo avaliou o ajuste ventilatório nestes pacientes durante anestesia baseado na oximetria e capnografia. MÉTODO: O consentimento prévio foi obtido da Comissão de Ética e dos pacientes. Excluíram-se tabagistas e portadores de doença cardíaca ou pulmonar. Foram estudados 11 pacientes com índice de massa corpórea (IMC de 59,2 ± 8,3 submetidos à gastroplastia sob anestesia geral (Grupo O. Oito não-obesos (IMC 20,2 ± 3,9 submetidos à gastrectomia formaram o grupo controle (NO. Ajustou-se a ventilação visando dióxido de carbono expiratório final (P ET CO2 menor que 40 mmHg e saturação periférica de oxigênio (SpO2 maior que 95%. Não se utilizou PEEP. Através de monitor respiratório CO2SMO Plus, mediu-se espaços mortos fisiológico, alveolar e de vias aéreas (VD phy, VD alv e VD aw e o volume corrente alveolar (VT alv. Amostras de sangue arterial e venoso central permitiram calcular PaO2/FIO2 e VD phy/VT. Os dados foram comparados e analisados por ANOVA (p JUSTIFICATIVA Y OBJETIVOS: A pesar de las diversas propuestas de ventilación para anestesia en pacientes obesos mórbidos, un consenso no fue establecido. Este estudio evaluó el ajuste de ventilación en estos pacientes durante anestesia fundamentado en la oximetria y capnografia. MÉTODO: El consentimiento previo fue obtenido de la Comisión de Ética y de los pacientes. Fueron excluidos fumantes y portadores de enfermedad cardíaca o pulmonar. Fueron estudiados once pacientes con índice de masa corpórea (IMC de 59,2 ± 8,3 sometidos a gastroplastia bajo anestesia general (Grupo O. Ocho no obesos (IMC 20,2 ± 3,9 sometidos a gastrectomia formaron el grupo control (NO. Se ajustó la ventilación visando el dióxido de carbono expiratorio final (P ET CO2 menor que 40 mmHg y saturación periférica de oxígeno (Sp

  13. Ajuste social em pacientes com transtorno afetivo bipolar, unipolar, distimia e depressão dupla Social disability in patients with bipolar and unipolar affective disorders, dysthymia and double depression

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    Adriana M Tucci

    2001-06-01

    Full Text Available OBJETIVOS: Dados internacionais mostram que os transtornos afetivos têm uma prevalência de, aproximadamente, 11,3% da população. Além disso, são uma das doenças que mais geram perdas sociais e nos relacionamentos familiares. O objetivo deste trabalho foi avaliar o ajuste social e familiar de pacientes com transtornos afetivos (bipolar, unipolar, distimia e com depressão dupla, comparando o resultado entre as categorias diagnósticas, além de verificar quais variáveis estão associadas e conduzem ao pior ajuste. MÉTODOS: Foram feitos a caracterização socioeconômica e demográfica e um levantamento dos dados de evolução e de história da doença por meio de um questionário elaborado para essa finalidade. Para a avaliação de ajuste social, utilizou-se a Escala de Avaliação da Incapacitação Psiquiátrica (DAS/OMS, 1998. O relacionamento familiar foi avaliado pelo Global Assessment of Relational Functioning Scale (GARF/APA, 1994. Foram estudados 100 pacientes em tratamento, por pelo menos seis meses, no Ambulatório de Psiquiatria da Faculdade de Medicina Unesp, Botucatu, SP. RESULTADOS/CONCLUSÕES: Com predomínio de mulheres, a maioria dos pacientes tinha no mínimo dois anos de seguimento, idade acima de 50 anos, baixa escolaridade e nível socioeconômico baixo. Não houve diferença estatística significativa quanto aos dados socioeconômicos e demográficos. Na análise de regressão logística, o diagnóstico e o relacionamento familiar tiveram papel significativo no resultado de ajustamento social. Os pacientes unipolares e os distímicos tiveram melhores resultados no ajustamento social e no relacionamento familiar do que os bipolares e aqueles com depressão dupla.OBJECTIVES: International data show that affective disorders have a prevalence of 11.3% in the general population. Besides that, they are responsible for social dysfunctioning and family relationship distress. The aim of this study was to assess social and

  14. La industria manufacturera en Centroamérica: Perspectivas del Ajuste a la nueva política comercial regional

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    Fernando RUEDA-JUNQUERA

    2009-11-01

    Full Text Available RESUMEN: La nueva política comercial del Mercado Común Centroamericano está dando lugar a cambios en los flujos comerciales, que inducirán un ajuste inter-/intraindustrial en el sector manufacturero regional. Este artículo presenta y analiza los principales resultados de un estudio empírico que evaluó el impacto del nuevo programa de integración regional en el patrón de especialización y comercio de manufacturas de cada país miembro. El enfoque empírico empleado conllevó la construcción de hojas de balance que integraron en una base comparable los datos de producción y comercio para el sector manufacturero de cada país. Asimismo, se obtuvieron dos grupos de ratios que midieron respectivamente, la importancia relativa de los mercados regional y mundial para los subsectores manufactureros de cada país, y el potencial de éstos para una especialización inter-/intraindustrial en los dos mercados.ABSTRACT: The new trade policy in the Central American Common Market is given rise to changes in trade flows that will induce an inter-/intraindustry adjustment in the regional manufacturing sector. This article presents and analyses the main results of an empirical study which assessed the impact of the new integration scheme on each member country's pattern of trade and specialisation in manufactures. The empirical approach used in the study involved the construction of balance sheets integrating production and trade data on a comparable basis for each country's manufacturing sector. Likewise, two groups of ratios were obtained. They measured respectively, the relative importance of the regional and world market for the manufacturing subsectors of each country and the subsectoral potential for an inter-/intraindustry specialisation in the two markets.

  15. Los Programas de Desarrollo Rural en la Argentina (en el contexto del ajuste macroeconómico neoliberal

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    Mabel Manzanal

    2000-09-01

    Full Text Available Este trabajo expone las estrategias de los principales programas de desarrollo rural en la Argentina, y sus alcances y posibilidades en el contexto del ajuste macroeconómico neoliberal. Discute si se están dando, o no, los cursos de acción adecuados, y si es viable la asistencia a los pobres rurales, promovida por los organismos internacionales de financiamiento, frente al impacto negativo de las políticas neoliberales sobre los pequeños y medianos productores agropecuarios.El desarrollo rural se inicia en la Argentina junto con la recuperación democrática de la década del 80, pero las primeras acciones recién comienzan a ejecutarse a principios de los 90. Desde entonces se sucedieron y se superpusieron diferentes programas, que son el objeto de este artículoThis paper discusses the strategies of Argentina’s main rural development programs, and their accomplishments and possibilities in the context of neoliberal macroeconomic adjustment. It analyzes whether the actions being carried out are suitable and whether assistance to the rural poor (promoted by international financing organizations is feasible in the face of the neoliberal policies’ negative impact on small and intermediate farmers and ranchers. Although rural development programs began in Argentina with the restoration of democracy in the 1980s, the first significant actions were not taken until the 1990s. The different programs that have followed, often overlapping, are the object of our study

  16. Acontecimientos vitales estresantes, estilo de afrontamiento y ajuste adolescente: un análisis longitudinal de los efectos de moderación

    OpenAIRE

    Rosa María Estévez Campos; Alfredo Oliva Delgado; Águeda Parra Jiménez

    2012-01-01

    El objetivo principal de este estudio fue analizar la relación entre la vivencia de los acontecimientos vitales estresantes y los problemas de ajuste emocional y comportamental durante la adolescencia, prestando atención al posible efecto moderador del estilo de afrontamiento. La muestra estuvo compuesta por 90 adolescentes que fueron seguidos durante seis años, desde su adolescencia media (15-16 años) hasta la adultez emergente (21-22 años). Completaron cuestionarios sobre su vivencia de aco...

  17. Predictores del ajuste psicosocial en divorciados de Monterrey, México: un análisis de género

    OpenAIRE

    Rogelio Rodríguez Hernández; Manuel Ribeiro Ferreira

    2013-01-01

    Las tasas de divorcio han crecido en México sostenidamente en las últimas décadas. Sin embargo, la investigación respectiva es escasa, por lo que se conoce poco la experiencia del divorcio en este país. Por ello, el objetivo de este estudio es explorar los factores que predicen el ajuste psicosocial en una muestra de adultos divorciados y en proceso de divorcio en Monterrey, México. Específicamente, se pretende conocer las diferencias de género en las variables que facilitan la adaptación a l...

  18. EL AJUSTE EN LA INVESTIGACIÓN SOBRE CONFIGURACIONES ESTRATÉGICAS Y DESEMPEÑO ORGANIZA TIVO: UNA RESEÑA /

    OpenAIRE

    Roca Puig, V.; Bou Llusar, J C.

    2004-01-01

    Este trabajo revisa la literatura sobre las configuraciones estratégicas, identificando tres diferentes aproximaciones a la formación de las configuraciones -los grupos estratégicos, los tipos estratégicos reales y los tipos estratégicos ideales-, Se describen sus características distintivas, el método empleado habitualmente para explicar su efecto sobre el desempeño organizativo y sus limitaciones. De especial relevancia es la ausencia del ajuste en la delimitación del concepto de configurac...

  19. Efectos de entrenar para cumplir criterios de congruencia en tareas de ajuste lector / effects of training for the satisfaction of congruence criteria on reading adjustment tasks

    OpenAIRE

    Hernández Reyes, Manuel; Morales Chávez, Germán,; Cruz Alcalá, Nadia; Carpio, Claudio

    2010-01-01

    La presente investigación evaluó los efectos de entrenar estudiantes universitarios para satisfacer criterios de congruencia en tareas de ajuste lector con base en parámetros de congruencia y de coherencia. El grupo experimental fue entrenado para satisfacer criterios de congruencia y fue expuesto a dos pruebas de evaluación en satisfacción de criterios de congruencia y coherencia. El grupo control solo fue sometido a las pruebas de evaluación. Los resultados revelan que el entrenamiento fav...

  20. Comparación entre factores de ajuste multiplicativos y aditivos para producción por lactancia en un hato holstein

    OpenAIRE

    Arboleda Zapata Elkin Mauricio; Valencia Restrepo Cesar Tulio; Montoya Serna Camilo

    2012-01-01

    La presente investigación se efectuó a partir de 558 registros de lactancia tomados del hato Holstein Paysandú el cual está situado en el corregimiento Santa Elena de Medellín en una zona ecológica de bosque húmedo montano bajo (bh-MB) y pertenece a la Facultad de Ciencias Agropecuarias de la Universidad Nacional de Colombia, Sede Medellín. El objetivo propuesto fué determinar las ventajas comparativas entre factores de ajuste multiplicativos y aditivos para producción por lactancia. Pa...

  1. Ajuste fiscal nos estados: uma análise do período 1998-2006 Fiscal adjustment in brazilian states

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    Sérgio Wulff Gobetti

    2010-01-01

    Full Text Available O objetivo deste artigo é analisar a forma de enquadramento dos estados ao Programa de Ajuste Fiscal (PAF e à Lei de Responsabilidade Fiscal (LRF, destacando seus impactos nas escolhas de alocação dos recursos públicos e na taxa de investimento. Os resultados obtidos após minucioso trabalho de depuração das bases de dados confirmam a melhoria da situação financeira de estados no período posterior à LRF, mas sugerem que existe um trade-off entre os indicadores fiscais, de um lado, e os investimentos e gastos em infraestrutura, de outro, exigindo uma reflexão sobre a qualidade e sustentabilidade do ajuste fiscal. Os dados orçamentários analisados também apontam evidências de contabilidade criativa.The objective of this article is to offer an analysis of the accommodation by Brazilian states with Fiscal Adjustment Program and with Fiscal Responsibility Act (FRA, showing their impacts on the choices of public resources allocation and on the investment rate. The results obtained after detailed work of data depuration confirm the improvement of financial situation of the states in the period post FRA, but also suggest the existence of a trade-off between fiscal indicators and infrastructure investment, demanding a reflection about the quality and the sustainability of the fiscal adjustment. The budget data analyzed also indicate evidences of creative accountability.

  2. UNA APROXIMACIÓN TEÓRICA A LA VALORACIÓN DEL DOBLE AJUSTE EN EL DISEÑO DE LA ESTRATEGIA DE RECURSOS HUMANOS

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    García Carbonell, Natalia

    2013-05-01

    Full Text Available Tradicionalmente la literatura ha considerado la necesidad del doble ajuste, vertical y horizontal, de la estrategia de recursos humanos en las organizaciones. Su importancia estratégica ha sido demostrada en buena parte de los estudios empíricos planteados. Sin embargo, la complejidad de este proceso requiere de un análisis más profundo que permita identificar los elementos que lo hacen posible. En el presente trabajo, partiendo de la revisión de la literatura de las perspectivas de investigación en dirección estratégica de recursos humanos y del concepto «fortaleza del sistema de recursos humanos» propuesto por Bowen y Ostroff (2004, discutimos los 3 factores que integran dicho concepto y su relación con el ajuste del sistema. Como consecuencia de ello, definimos 3 proposiciones teóricas que explican la vinculación entre ambas dimensiones y la fortaleza del sistema.

  3. Afectividad inducida e impacto en la creatividad, crecimiento personal después del cambio y ajuste percibido al narrar una experiencia emocional intensa

    Directory of Open Access Journals (Sweden)

    Silvia da Costa

    2015-05-01

    Full Text Available Se examinan en un estudio experimental los efectos de la inducción de afectividad positiva en la creatividad y la importancia de las emociones como variables mediadoras. Se indujo alta y baja afectividad positiva pidiendo a las personas participantes que redactaran tres poemas haikus sobre dos estímulos de connotación positiva, alta (N = 28 y baja (N = 28. Las personas escribieron sobre su experiencia de enamoramiento más intenso y contestaron una escala sobre las emociones sentidas al redactar el texto, una medida de crecimiento personal y una tercera referida a la obtención de metas adaptativas después del episodio. En la condición de alta afectividad positiva se informó de más emociones positivas y menos negativas al narrar la experiencia, un mayor crecimiento personal y un mayor ajuste. Jueces independientes evaluaron como más originales el último poema y la narración de la experiencia en la condición de alta afectividad positiva. Un análisis mediacional mostró que las emociones positivas explicaban la influencia de la manipulación sobre el crecimiento personal y el ajuste percibido.

  4. El ajuste estructural neoliberal en el sector agrario latinoamericano en la era de la globalización

    Directory of Open Access Journals (Sweden)

    Francisco García Pascual

    2003-10-01

    productividad,  balanza comercial, precios implícitos en la producción y en la exportación o nivel de ingresos de  los agricultores – podemos comprobar fehacientemente que la brecha que ha separado históricamente a la agricultura latinoamericana de  los sectores agrarios de los Estados Unidos o de la  Unión Europea es cada vez mayor. Es más, los  grandes problemas que atenazaban al mundo  agrario en América Latina a principios de los  ochenta (baja productividad, distribución desigual  de los recursos productivos, exclusión social, desequilibrios territoriales, amén de la dependencia tecnológica y de la dependencia financiera del  sector siguen siendo la realidad mayoritaria  después de dos décadas de ajuste estructural.

  5. Influencia de los cementos y de los diseños protésicos en el ajuste interno de estructuras de zirconia confeccionadas mediante tecnología Cad-Cam para prótesis fija

    OpenAIRE

    Sánchez Monescillo, Andrés

    2015-01-01

    1. INTRODUCCIÓN Y JUSTIFICACIÓN Aún quedan gran cantidad de elementos y variables que pueden influir en el ajuste interno de las restauraciones y cuyo desconocimiento obliga a seguir investigando. Este estudio permite conocer si existe una influencia real en el ajuste interno de estructuras de zirconia fabricadas mediante tecnología CAD-CAM en función del tipo de cemento utilizado y del tipo de convergencia oclusal de la preparación realizada. 2. OBJETIVOS - Evaluar la influencia de disti...

  6. Estilos parentales de socialización y ajuste psicosocial de los adolescentes: un análisis de las influencias contextuales en el proceso de socialización

    OpenAIRE

    Alarcón Cebrián, Antonio

    2012-01-01

    Estilos parentales de socialización y ajuste psicosocial de los adolescentes: un análisis de las influencias contextuales en el proceso de socialización. El objetivo de esta tesis doctoral ha sido el análisis de las relaciones entre los estilos parentales de socialización y el ajuste psicosocial de los hijos, y si esa relación se encuentra moderada por los niveles de riesgo de los vecindarios en los que las familias viven. Utilizando un modelo teórico de la socialización parental basado e...

  7. Propuesta de un método de ordenador para resolver el ajuste a la ecuación de Zener-Hollomon (Garofalo

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    Rieiro, I.

    1996-10-01

    Full Text Available An integrated computational method to solve the Zener-Hollomon equation has been developed by the authors. This method solves the fitting problem of the equation of Zener-Hollomon for wide ranges of applied stress, strain rate and work temperature by means of the progressive application of three kinds of algorithms. In the first place a program, by means of a reiterated linear regression by planes, allows to get some values that will be later the initial values of a second block of algorithms. It permits also to purify the experimental data set. The second block of algorithms carries out a fitting by nonlinear least squares using a variation of the modified Gauss-Newton method. In the third place a group of programs is chained that permit iterate starting by the solution of the previous program approaching (if it is necessary line by line in R2 until the optimum value is reached. All this with a support of statistical analysis for they determine the accuracy of each step, of the data, of the residuals and of the last fitting reached.

    Se presenta un método de ordenador integrado, desarrollado por los autores, para resolver la ecuación de Zener-Hollomon. Este método resuelve el problema del ajuste de la ecuación de Zener-Hollomon para amplios rangos de tensión aplicada, velocidad de deformación y temperatura de trabajo, mediante la aplicación progresiva de tres tipos de algoritmos. En primer lugar, una regresión reiterada multivariante por planos, para obtener unos valores que serán considerados como iniciales para un segundo bloque de algoritmos, además de depurar la base experimental de datos. El segundo bloque de algoritmos realiza un ajuste por mínimos cuadrados no lineales usando una modificación del método de Gauss-Newton modificado. En tercer lugar se encadena un grupo de programas que permiten iterar a partir de la solución del programa no lineal acercándose (si es preciso por líneas en R2

  8. Abuso infantil y ajuste psicológico en la edad adulta: Aportaciones del estudio con pacientes con y sin psicopatología alimentaria

    OpenAIRE

    Vilanova i Salichs, Sílvia

    2016-01-01

    El presente estudio tiene como objetivo examinar la relación entre el abuso infantil [sexual (ASI) y físico (AFI)] y el ajuste psicológico en la edad adulta: sintomatología alimentaria, insatisfacción corporal, psicopatología general, autoestima y personalidad. La muestra se compone de 796 mujeres jóvenes adultas de entre 18,05 y 30,98 años (M = 22,37 años; DE = 3,32) y está dividida en tres grupos en función de la condición diagnóstica: a) grupo comunitario de estudiantes universitarias de d...

  9. Reseña: Cuba ¿Ajuste o transición? Impacto de la reforma en el contexto del restablecimiento de las relaciones con Estados Unidos, de Velia Cecilia Bobes (coord., México, Flacso, 2015, 165 pp.

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    Katya Rodríguez Gómez

    2015-12-01

    Full Text Available Reseña:Cuba ¿Ajuste o transición? Impacto de la reforma en el contexto del restablecimiento de las relaciones con Estados Unidos, de Velia Cecilia Bobes (coord., México, Flacso, 2015, 165 pp.

  10. P ET CO2 e SpO2 permitem ajuste ventilatório adequado em pacientes obesos mórbidos P ET CO2 y SpO2 permiten ajuste de ventilación adecuada en pacientes obesos mórbidos P ET CO2 and SpO2 allow adequate ventilatory adjustment in morbidly obese patients

    OpenAIRE

    Fábio Ely Martins Benseñor; José Otávio Costa Auler Júnior

    2004-01-01

    JUSTIFICATIVA E OBJETIVOS: Apesar das diversas propostas ventilatórias para anestesia em pacientes obesos mórbidos, um consenso não foi estabelecido. Este estudo avaliou o ajuste ventilatório nestes pacientes durante anestesia baseado na oximetria e capnografia. MÉTODO: O consentimento prévio foi obtido da Comissão de Ética e dos pacientes. Excluíram-se tabagistas e portadores de doença cardíaca ou pulmonar. Foram estudados 11 pacientes com índice de massa corpórea (IMC) de 59,2 ± 8,3 submeti...

  11. Ajuste rápido de dosis de tapentadol en el tratamiento del dolor mal controlado Fast titration of tapentadol for the treatment of badly controlled pain

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    M. J. Sánchez del Águila

    2012-02-01

    Full Text Available Introducción: el tapentadol es un nuevo fármaco de acción dual MOR/NRI, que actúa a nivel central, efectivo en el tratamiento del dolor moderado e intenso, que presenta un perfil de tolerabilidad mas favorable que otros opiáceos. Esto podría permitir una titulación rápida que permita un control precoz del dolor. Material y métodos: presentamos dos casos clínicos en los que se realiza una titulación rápida de la dosis de tapentadol en pacientes hospitalizados con dolor mal controlado. Este ajuste rápido, permitió controlar el dolor, en ausencia de efectos secundarios, acortando el tiempo de estancia hospitalaria de estos pacientes. Conclusiones: el perfil favorable de efectos secundarios mostrado por el tapentadol, permite un ajuste rápido de la dosis, que consigue un control eficaz del dolor en un menor lapso de tiempo.Background: tapentadol is a new drug with a centrally acting, dual action mechanism on MOR/NRI. It is effective on moderate to severe pain and shows a favourable side effects profile in comparison to other major opiates. This could allow a fast dose titration to achieve an earlier pain control. Material and methods: we present two cases on which we have performed a fast dose titration in hospitalised patients with bad pain control. This fast titration allowed an early control of the pain, in absence of side effects, achieving a shortening in their hospital stay. Conclusions: the favourable side effects profile of tapentadol, allows a fast dose titration, achieving an efficacious pain control in a shorter time lapse.

  12. RÉGIMEN HÍDRICO Y AJUSTE OSMÓTICO EN VARIEDADES CUBANAS DE TRIGO (Triticum aestivum Y T. durum CULTIVADAS EN CONDICIONES DE SALINIDAD

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    Leandris Argentel

    2013-01-01

    Full Text Available Los potenciales hídrico y osmótico y el ajuste osmótico en 12 variedades cubanas de trigo pertenecientes a las especies Triticum aestivum y Triticum durum cultivadas en condiciones de salinidad fueron evaluados, siguiendo las metodologías para tales fines. Las plantas se establecieron en un invernadero en condiciones de hidroponía a un nivel de salinidad de 8 dS.m -1 , como control se montó un tratamiento con una conductividad eléctrica de 0,36 dS.m -1 . Las evaluaciones se realizaron a los 25 días posteriores a la germinación. Como resultado se obtuvo una significativa disminución de los valores del potencial hídrico en la mayoría de las variedades en todos los órganos medidos y se observó una significativa disminución de sus valores desde las raíces hasta las hojas para asegurar el gradiente hídrico. Las variedades que no disminuyeron significativamente su potencial hídrico mostraron comportamiento similar en los tres órganos evaluados aunque el gradiente de potenciales se mantuvo. El potencial osmótico disminuyó significativamente en todas las variedades y sus valores fueron inferiores a -0,6 MPa. Todas las variedades realizaron el ajuste osmótico, siendo el valor más significativo AO= 0,3 MPa en las variedades INIFAT RM-36, INIFAT RM-32, INIFAT RM-37. Se observó variabilidad en la respuesta al estrés salino entre variedades y especies para las tres variables evaluadas.

  13. HISTORIA FUNCIONAL DE MORFOLOGÍAS LINGÜÍSTICAS Y SU EFECTO EN UN AJUSTE CONVENCIONAL/ FUNCTIONAL HISTORY OF LINGUISTIC MORPHOLOGIES AND THEIR EFFECT ON A CONVENTIONAL ADJUSTMENT/ HISTÓRIA FUNCIONAL DE MORFOLOGIAS LINGÜÍSTICAS E SEU EFEITO EM UM AJUSTE CONVENCIONAL

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    Nataly Yáñez Ramírez

    2011-12-01

    Full Text Available Se observó si diferentes historias funcionales construidas durante la adquisición de un conjunto de morfologías lingüísticas facilitaban un ajuste convencional. Participaron 24 estudiantes universitarios distribuidos en tres grupos, expuestos a entrenamientos construidos bajo la lógica de diferentes niveles de interacción: contextual, suplementario o selector (Ribes y López, 1985; y posteriormente se evaluó su ejecución en una tarea convencional. El entrenamiento cuyo criterio de ajuste era de tipo selector fue la que más facilitó tanto la adquisición de las morfologías lingüísticas como su uso en la tarea, efecto que pareció más evidente en los hablantes que en los escuchas. No se encontraron diferencias entre los entrenamientos contextual y suplementario. Los resultados se discuten en términos de sus implicaciones teóricas y metodológicas.

  14. Linear study and bundle adjustment data fusion; Application to vision localization; Recherche lineaire et fusion de donnees par ajustement de faisceaux; Application a la localisation par vision

    Energy Technology Data Exchange (ETDEWEB)

    Michot, J.

    2010-12-09

    integrate this additional information directly into an extended bundle adjustment, by adding a constraint term in the weighted cost function. We evaluate three methods (based on machine learning or regularization) that dynamically select the weight associated to the constraint and show that these methods can be used in a real time multi-sensor SLAM, and validate them with different types of constraint on the orientation or on the scale. Experiments conducted on real video sequences show that this technique of constrained bundle adjustment reduces the drifts observed with the classical vision algorithms and improves the global accuracy of the positioning system. (author) [French] Les travaux presentes dans ce manuscrit concernent le domaine de la localisation et la reconstruction 3D par vision artificielle. Dans ce contexte, la trajectoire d'une camera et la structure 3D de la scene filmee sont initialement estimees par des algorithmes lineaires puis optimisees par un algorithme non-lineaire, l'ajustement de faisceaux. Cette these presente tout d'abord une technique de recherche de l'amplitude de deplacement (recherche lineaire), ou line search pour les algorithmes de minimisation iterative. La technique proposee est non iterative et peut etre rapidement implantee dans un ajustement de faisceaux traditionnel. Cette technique appelee recherche lineaire algebrique globale (G-ALS), ainsi que sa variante a deux dimensions (Two way-ALS), accelerent la convergence de l'algorithme d'ajustement de faisceaux. L'approximation de l'erreur de reprojection par une distance algebrique rend possible le calcul analytique d'une amplitude de deplacement efficace (ou de deux pour la variante Two way-ALS), par la resolution d'un polynome de degre 3 (G-ALS) ou 5 (Two way-ALS). Nos experimentations sur des donnees simulees et reelles montrent que cette amplitude, optimale en distance algebrique, est performante en distance euclidienne, et permet

  15. Ajuste de modelos de platô de resposta via regressão isotônica Response plateau models fitting via isotonic regression

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    Renata Pires Gonçalves

    2012-02-01

    Full Text Available Dentro do contexto nutricional, a suplementação de microminerais em rações para aves frequentemente é feita em quantidades superiores às exigidas na tentativa de assegurar o bom desempenho dos animais. Os experimentos do tipo dose resposta são muito comuns na determinação de níveis ótimos dos nutrientes na ração e contemplam a utilização de modelos de regressão para atingir tal objetivo. Porém, na análise de regressão usual, geralmente, não se usa uma informação a priori sobre uma possível relação de ordem na variável resposta. A regressão isotônica é um método de estimação por mínimos quadrados que gera estimativas que satisfazem a mesma ordenação dos dados. Na teoria da regressão isotônica, essa informação é utilizada de forma essencial e espera-se que a eficiência do ajuste seja aumentada quando se faz uso dela. Diante do exposto, o presente trabalho tem como objetivo utilizar uma metodologia de regressão isotônica, como uma forma alternativa para analisar dados de deposição de zinco (Zn na tíbia de aves machos da linhagem Hubbard. No estudo, foram considerados os modelos de platô de resposta polinomial quadrático e não linear exponencial. Além desses modelos, também foi proposto o ajuste de um modelo logarítmico para os dados e a eficiência da metodologia foi avaliada por meio de um estudo de simulação Monte Carlo, considerando diferentes cenários para os valores paramétricos. A isotonização dos dados propiciou uma melhora em todos os avaliadores de qualidade de ajuste considerados no trabalho. Dentre os modelos utilizados, o logarítmico apresentou estimativas dos parâmetros mais coerentes com os valores relatados na literatura, para os dados de deposição de Zn na tíbia de aves machos.Within the nutritional context, the supplementation of microminerals in bird food is often made in quantities exceeding those required in the attempt to ensure the proper performance of the animals

  16. Series de días hábiles en Colombia: una aplicación al ajuste del crecimiento industrial

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    Álvaro Montenegro García

    2014-06-01

    Full Text Available Si bien muchos economistas son conscientes del efecto de los días hábiles sobre la medición de la producción, aún es frecuente encontrar que estas cifras se analizan sin el correspondiente ajuste. En general, el número de días hábiles en un mes cambia de un año a otro, lo cual es cierto para todos los meses, no solo para los que contienen la Semana Santa. Este trabajo recopila la serie de días hábiles mensuales tomando en cuenta los festivos actuales y anteriores a la Ley Emiliani, y la utiliza para ajustar la serie de producción manufacturera del DANE. Para algunos meses, la diferencia entre la cifra de crecimiento industrial reportada por el DANE y la cifra ajustada por días hábiles puede acercarse a los 12 puntos porcentuales, en cualquier dirección

  17. Ajuste produtivo e medidas de flexibilização da legislação trabalhista Productive adjustment and flexibilization in the labor laws

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    Rosana Ribeiro

    2007-05-01

    Full Text Available A partir da década de 90, a introdução de inovações tecnológicas e organizacionais na indústria brasileira se intensificou significativamente. Um dos objetivos deste artigo é analisar os principais obstáculos à negociação de cláusulas referentes a essas inovações entre o sindicato dos trabalhadores da indústria de calçados, da indústria siderúrgica e da indústria têxtil e os respectivos empresários. Outro objetivo é investigar o grau de difusão das recentes medidas de flexibilização da legislação trabalhista e a estratégia desses sindicatos. Palavras-chave: Ajuste produtivo. Negociação coletiva. Flexibilização. Legislação trabalhista. During the 90’s, many new technologies and innovations in organizational structure were introduced to the Brazilian industry. One of the purposes of this article is to analyze the main obstacles to the negotiation of new labor laws in relation to theses changes between labor unions (footwear, metal and textile industry workers and the owners of the factories. The other purpose is to investigate the level of diffusion of the recent flexibilization measures of the labor legislation and the strategy of these unions. Keywords: Productive adjustment. Collective negotiation. Flexibilization. Labor laws.

  18. Cálculo, mediante la aplicación del algoritmo de ajuste por mínimos cuadrados, de los componentes de velocidad para estaciones GNSS continuas

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    Jorge Moya Zamora

    2014-07-01

    Full Text Available El cálculo de la velocidad de una estación de observación continua GNSS representa un insumo fundamental en la geodesia moderna. El hecho de determinar la posición de las estaciones GNSS de forma diaria implica que se puedan establecer las series temporales de las estaciones, con base en las cuales se puede obtener información de la influencia de fenómenos que afecten el comportamiento de estas. En este artículo se plantea una descripción del algoritmo de ajuste por mínimos cuadrados adaptado y aplicado a la determinación de los componentes de velocidad de estaciones de observación continua. Además, se aplica este algoritmo para la calcular la velocidad de la estación ETCG, perteneciente al Sistema Geocéntrico para las Américas (SIRGAS.

  19. El papel de la categorización social y las diferencias sociodemográficas en la autoestima, el ajuste y el bienestar psicológicos de una muestra de inmigrantes

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    José Andrés Peña-Pinzón

    2014-05-01

    Full Text Available Se explora el efecto de la saliencia de la categorización social inmigrante y su interacción con diferencias sociodemográficas (nivel de estudios, situación laboral, sexo de los sujetos, en ajuste psicológico, bienestar psicológico y autoestima. 210 inmigrantes de origen sudamericano, residentes en las provincias de Granada y Almería, fueron distribuidos en dos condiciones experimentales: "saliencia baja/alta de la categorización social inmigrante". Encontramos efecto de la manipulación sobre las medidas de pertenencia e identidad (autoestima colectiva, autoestima individual, ansiedad (SA-45 y bienestar laboral. Cuando la saliencia de la categorización social es baja (vs. alta, los sujetos presentan mejor autoestima, menos ansiedad y menos bienestar laboral. El sexo se asocia con la manipulación experimental en las escalas privada y pública (autoestima colectiva y en somatización, depresión y ansiedad (SA45. Los hombres para los que es menos saliente su condición de inmigrante presentan resultados más óptimos. El nivel de estudios y la situación laboral se asocian con ajuste psicológico: los sujetos sin trabajo (vs. los que están trabajando y los de estudios básicos o sin estudios (vs. los de estudios medios o superiores presentan peor ajuste.

  20. Determinação de rotina do crômio em fezes, como marcador biológico, pelo método espectrofotométrico ajustado da 1,5-difenilcarbazida The spectrophotometric method on the routine of 1,5-diphenylcarbazide was adjusted on chromium determination in feces, after its utilization as a biological marker as chromium (III oxide

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    Hermann Bremer Neto

    2005-06-01

    Full Text Available O objetivo deste estudo foi ajustar o método espectrofotométrico da 1,5-difenilcarbazida à determinação do crômio em fezes, como marcador biológico, adequando-o à rotina laboratorial. Fatores que poderiam exercer interferência na transformação do crômio (III à crômio (VI foram testados, como a recuperação do metal, quantidade de amostra, quantidade e ordem de emprego dos ácidos oxidantes da digestão úmida, temperatura e tempo de digestão e perda por volatilização do crômio como cloreto de cromila, porém não se determinou estatisticamente interferência destes fatores. No método ajustado, a amostra é digerida pela clássica mistura ácida nítrica/perclórica, levando a oxidação do crômio (III a crômio (VI, e alíquota do extrato diluído é usado para reação com 1,5-difenilcarbazida; as absorbâncias são medidas a 550nm, utilizando-se de cubetas de um centímetro de caminho óptico, contra prova em branco conduzida simultaneamente. Dicromato de potássio foi empregado como substância de referência para obtenção da curva padrão na faixa de 0,25 - 2,5mg.mL-1 de Cr2O3 (1mg Cr2O3 º 1,9355mg K2Cr2O7.This work aims at adjusting the spectrophotometric method of 1,5-diphenylcarbazide for the determination of chromium in feces, as a biological marker. Factors that could interfere with the transformation of chromium (III into chromium (VI were tested, as the metal recovery, the sample amount, the amount and the order of use of the oxidant acids of the wet digestion, digestion temperature and digestion time, loss of chromium by volatilization as chromyl chlorid. However the interference of these factors were not statistically determined. In the adjusted method, the sample is classically digested by nitric/perchloric acid mixture leading to the oxidation of chromium (III to chromium (VI, and an aliquot of the diluted extract is used for reaction with 1,5-diphenylcarbazide; absorbance was measured at 550nm, using 1cm

  1. Variabilidade do risco do tempo de permanência ajustado para lactentes de muito baixo peso ao nascer entre centros da Neocosur South American Network Center variability in risk of adjusted length of stay for very low birth weight infants in the Neocosur South American Network

    Directory of Open Access Journals (Sweden)

    Guillermo Marshall

    2012-12-01

    Full Text Available OBJETIVOS: Desenvolver um modelo de predição para o tempo de permanência hospitalar (TPH em lactentes de muito baixo peso ao nascer (MBPN e comparar esse resultado entre 20 centros de uma rede neonatal, visto que o TPH é utilizado como uma medida da qualidade da assistência em lactentes de MBPN. MÉTODOS: Utilizamos dados coletados prospectivamente de 7.599 lactentes com peso ao nascer entre 500 e 1.500 g no período entre os anos de 2001 a 2008. O modelo de regressão de Cox foi empregado para desenvolver dois modelos de predição: um modelo prévio com dados do nascimento e outro posterior, que acrescenta morbidades relevantes dos primeiros 30 dias de vida. RESULTADOS: A mediana do TPH estimado e ajustado a partir do nascimento foi de 59 dias; 28 dias depois do tempo de sobrevida de 30 dias. Houve uma alta correlação entre os modelos (r = 0,92. O TPH esperado e o TPH observado variaram bastante entre os centros, mesmo depois de correção para as morbidades relevantes após 30 dias. O TPH mediano (variação: 45-70 dias e a idade concepcional na alta hospitalar (variação: 36,4-39,9 semanas refletem uma variabilidade alta entre centros. CONCLUSÃO: Um modelo simples, com fatores apresentados no nascimento, pode predizer o TPH de um lactente de MBPN em uma rede neonatal. Observou-se uma variabilidade nos TPHs considerável entre unidades de terapia intensiva neonatal. Especulamos que os resultados sejam provenientes das diferenças entre as práticas dos centros.OBJECTIVES: To develop a prediction model for hospital length of stay (LOS in very low birth weight (VLBW infants and to compare this outcome among 20 centers within a neonatal network. METHODS: Data from 7,599 infants with birth weights of 500-1,500 g born between the years 2001-2008 were prospectively collected. The Cox regression model was employed to develop two prediction models: an early model based upon variables present at birth, and a late one that adds relevant

  2. Caracterização dos perfis glicêmicos domiciliares como estratégia para os ajustes insulinoterápicos em pacientes com diabetes mellitus do tipo 1 Caracterización de los perfiles glicémicos domiciliares como estrategia para los ajustes insulino-terápicos en pacientes con diabetes mellitus tipo 1 Glycemic profiles in insulin adjustments in patients with type 1 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Sonia Aurora Alves Grossi

    2003-03-01

    Full Text Available O artigo tem como objetivo principal caracterizar os perfis glicêmicos domiciliares de pacientes com diabetes mellitus tipo1, a partir de um esquema de monitorização proposto, e adotá-los como estratégia de ajuste nas doses de insulina. Foram realizados 3259 testes, 781 antes do café, 752 antes do almoço, 765 antes do jantar, 740 antes de deitar e 221 pela madrugada. A média das glicemias nestes períodos ultrapassaram os limites superiores satisfatórios em 6,87%, 3,83%, 11,37%, 30,50% e 19,28% respectivamente. Estes dados forneceram subsídios para ajustes nos esquemas insulinoterápicos. Os níveis HbA1c não mudaram de forma significante com os ajustes realizados porém, foram mantidos em 10%.El objetivo principal de este artículo consiste en caracterizar los perfiles glicémicos domiciliares de los pacientes con diabetes mellitus tipo 1, a partir de un esquema propuesto de monitorización, para aplicarlo como estrategia, en los ajustes de las dosis de insulina. Fueron realizados 3.259 tests, de los cuales 781se hicieron antes del desayuno, 752 se realizaron antes del almuerzo, 765 antes de la merienda, 740 se hicieron antes de dormir y los 221 se hicieron en la madarugada. La media de las glicemias en estos períodos ultrapasaron los límites superiores satisfactorios em 6,8%, 3,83%, 11,37%, 30,50% y 19,28% respectivamente. Estos datos ofrecieron subsidios para poder ajustar los esquemas insulinoterápicos. Los niveles de HbA1c no variaron de forma significativa com los ajustes realizados y se mantuvieron em 10%.The goal of this paper is to characterize the glycemic profiles of patients with type 1 diabetes mellitus like a strategy in insulin adjustments. A total of 3259 tests were realized being 781 before breakfast, 752 before lunch, 765 before dinner and 740 before bed and 221 in the dawn. The average of the blood glucose tests in these periods oversteped the superior limits in 6,87%, 3,83%, 11,37%, 30,50% e 19,28% respectively

  3. Modelo experimental de bandagem ajustável do tronco pulmonar para preparo rápido do ventrículo

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    DIAS Carlos A.

    2000-01-01

    Full Text Available OBJETIVO: Um dispositivo de bandagem do tronco pulmonar (TP com ajuste percutâneo foi desenvolvido com o objetivo de induzir a hipertrofia rápida do ventrículo subpulmonar. MATERIAL E MÉTODOS: Consiste de um manguito de silicone insuflável percutaneamente, através de um botão de silicone auto-selante. Os corações de 7 cabritos jovens (peso médio: 8,7 kg foram submetidos à sobrecarga sistólica imposta pelo dispositivo e avaliados sob os aspectos hemodinâmicos, ecocardiográficos e morfológicos. Foram extraídas biópsias basais do miocárdio do ventrículo direito (VD para análise microscópica (perímetro e área do miócito. O dispositivo foi implantado no TP. As pressões do VD, TP e aorta foram monitorizadas. Após convalescença, foi iniciado o protocolo de insuflação do dispositivo de bandagem do TP. Foi injetada água destilada no botão auto-selante (via percutânea, até que a pressão sistólica do VD atingisse 70% da pressão sistólica do VE. As avaliações ecocardiográfica e hemodinâmica foram realizadas a cada 24 horas. A sobrecarga sistólica do VD foi mantida por um período de 96 horas, com insuflações progressivas no limite máximo tolerado, a cada 24 horas. Após esse período, os animais foram sacrificados para análise morfológica dos corações. Outros 9 cabritos (peso médio: 7,7 kg foram utilizados como grupo controle, para análise do peso do VD. RESULTADOS: Após 96 horas de sobrecarga sistólica do VD, foi observado um aumento do gradiente sistólico VD/TP de 10,1±4,3 mmHg para 60,0±11,0 mmHg e da pressão sistólica no VD de 22,4±4,1 mmHg para 71,0±10,0 mmHg (p<0,0001. O ecocardiograma revelou aumento da espessura muscular do VD, de 4,4±0,5 mm para 7,3±1,7 mm (p=0,001. Quando comparado ao grupo controle, houve um ganho de peso de 74% do VD submetido à sobrecarga sistólica (p<0,0001. À microscopia óptica, foi observado aumento de 27% no perímetro e de 69% na área dos miócitos (p=0

  4. Ajuste psicosocial en agresores, víctimas puras y víctimas agresivas en la escuela. Psychosocial adjustment in aggressors, pure victims and aggressive

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    Estefanía Estévez

    2008-07-01

    Full Text Available

    En el presente estudio se examinan las diferencias entre cuatro categorías de adolescentes –agresores, víctimas puras, víctimas agresivas y estudiantes no implicados en problemas comportamentales o de victimización en la escuela– en relación con la autoestima, la sintomatología depresiva, el estrés percibido, el sentimiento de soledad, y una medida general de satisfacción con la vida. Los participantes fueron 1.319 adolescentes con edades comprendidas entre los 11 y los 16 años (47% chicos y escolarizados en siete centros públicos de enseñanza secundaria ubicados en Valencia (España. Los análisis de varianza indicaron la existencia de diferencias significativas entre las cuatro categorías de estudiantes. Así, los adolescentes no implicados mostraron un mejor ajuste psicosocial general: niveles más elevados de autoestima y satisfacción con la vida y niveles inferiores de sintomatología depresiva, estrés percibido y sentimiento de soledad. Las puntuaciones en este grupo fueron equivalentes a aquellas obtenidas por los agresores con respecto a la autoestima, la sintomatología depresiva y la soledad. Sin embargo, los agresores percibieron más estrés y expresaron menor satisfacción con sus vidas, como así también hicieron los otros dos grupos, a saber: víctimas puras y víctimas agresivas. Las víctimas mostraron los niveles más elevados de sentimiento de soledad.

    Palabras clave: Agresor, víctima, víctima agresiva, violencia escolar, ajuste psicosocial.

    The present study examined differences among four categories of adolescents –aggressors, pure victims, aggressive victims, and students not involved in behavioural or victimization problems at school– with respect to self-esteem, depressive symptomatology, perceived stress, feeling of loneliness, and a general measure of satisfaction with life. Participants were 1,319 adolescents aged from 11 to 16 years old (47% male and drawn from seven state

  5. Modelos para ajuste da produção de gases em silagens de girassol e milho Models for fit of gas production in sunflower and corn silages

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    Renius Mello

    2008-02-01

    Full Text Available O objetivo deste trabalho foi identificar entre os modelos Brody, Von Bertalanffy, Gompertz, France, Logístico, Logístico modificado e Logístico bicompartimental, aquele que apresenta maior qualidade de ajuste à curva de produção cumulativa de gases em silagens de girassol e milho. Os critérios adotados foram: coeficiente de determinação, quadrado médio do resíduo, análise gráfica das curvas observadas e estimadas, análise gráfica de dispersão dos resíduos estudentizados, erro percentual médio, eficiência relativa e número de iterações para atingir a convergência. Os modelos Brody, France e Logístico bicompartimental apresentaram os maiores valores de coeficiente de determinação em ambos os substratos, e a diferença entre eles pode ser considerada desprezível. Estes modelos apresentaram, também, os menores valores de quadrado médio do resíduo em silagens de girassol, e a diferença entre eles foi considerada desprezível. Os modelos Brody e France apresentaram menor quadrado médio do resíduo em silagens de milho. Todos os modelos apresentaram dispersão positiva dos resíduos em ambos os substratos após 144 horas de incubação. O modelo Brody apresentou menor erro percentual médio e número de iterações em ambos os substratos. Os modelos Logístico bicompartimental e France apresentaram maior eficiência relativa, respectivamente, em silagens de girassol e milho. Assim, o modelo Logístico bicompartimental apresenta maior qualidade de ajuste à curva de produção de gases em silagens de girassol e milho.The aim of this work was to identify among the Brody, Von Bertalanffy, Gompertz, France, Logistic, Modified logistic and Dual-pool logistic models, the one that presents the highest quality of fit for cumulative gas production curve in sunflower and corn silages. The quality of fit was evaluated by coefficient of determination, residual mean square, graphic analysis of the observed and estimated curves

  6. Estudio del consumo de ácidos en el ajuste de pH en diferentes medios de fermentación alcohólica

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    Lixis Rojas-Sariol

    2011-01-01

    Full Text Available Se estudia la influencia de diferentes ácidos y nutrientes en el ajuste del pH de medios de fermentación alcohólica a partir de melaza de caña de azúcar. El objetivo es evaluar de manera preliminar la sustitución de compuestos azufrados por otros que no aporten azufre a los medios de fermentación, debido a que el contenido de sulfatos (SO2 presentes en las vinzas depende en gran medida del azufre que se incorpore a la fermentación alcohólica, mediante la adición de los nutrientes y ácidos que se empleen. Es importante que la vinaza tratada mediante digestión anaeróbia presente bajas concentraciones de sulfatos para minimizar en el biogás producido el contenido de H2S, evitar la corrosión del equipamiento empleado en el uso del biogás y disminuir los costos de desulfuración. Sin embargo, los resultados muestran que no es recomendable sustituir el ácido sulfúrico y el sulfato de amonio empleados industrialmente en los medios de fermentación alcohólica, ya que para alcanzar el valor de pH deseado se adicionan menores cantidades de ácido cuando se usa ácido sulfúrico en un medio de fermentación compuesto por fosfato de amonio y sulfato de amonio, además económicamente también es aconsejable usar este ácido, porque es más barato con respecto a los ácidos estudiados.

  7. Ajuste social y escolar de jóvenes víctimas de maltrato infantil en situación de acogimiento residencial

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    Alexander Muela

    2013-01-01

    Full Text Available El objetivo del presente trabajo consistió en examinar el ajuste social y escolar de jóvenes que habían sufrido maltrato en la infancia y se encontraban en situación de acogimiento residencial. Además, pretendíamos comprobar si existían diferencias entre los sujetos sometidos a distintas situaciones de desprotección infantil. En el estudio participaron 318 jóvenes residentes en la Comunidad Autónoma del País Vasco de edades comprendidas entre los 13 y los 18 años (M = 15.35, DT = 1.68 pertenecientes a tres colectivos. El primero de ellos estaba constituido por 69 jóvenes (31 mujeres y 38 varones víctimas de maltrato infantil que se hallaban bajo una medida de protección de acogimiento residencial. El segundo grupo estaba formado por 75 jóvenes (29 mujeres y 46 varones víctimas de maltrato infantil que se encontraban en situación de riesgo de desamparo. Por último, el tercer grupo estaba constituido por 174 jóvenes (95 mujeres y 79 varones que no habían sufrido maltrato. Los resultados pusieron de manifiesto que, independientemente de la situación de desprotección infantil en la que se encontrasen, los jóvenes víctimas de maltrato infantil mostraban mayores dificultades de adaptación social y escolar que los jóvenes que no habían sufrido maltrato en la infancia.

  8. Ajustes nos movimentos de alcançar e apreender objetos: impacto da Síndrome de Down Adjustments in the movements of reaching for and grasping objects: the impact of Down Syndrome

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    Mariana Martins dos Santos

    2012-06-01

    Full Text Available OBJETIVOS: verificar a influência das propriedades dos objetos nos ajustes realizados por lactentes típicos e com Síndrome de Down (SD dos quatro aos oito meses de idade ao alcançar e apreender objetos. MÉTODOS: 16 lactentes, avaliados uma vez ao mês dos 4 aos 8 meses, sendo oito típicos e oito com SD. Quatro objetos esféricos (maleável grande, maleável pequeno, rígido grande e rígido pequeno foram apresentados, e os cinco primeiros movimentos válidos foram registrados para análise das variáveis: ajuste proximal (uni e bimanual, ajuste distal (orientação da palma, abertura da mão e apreensão do objeto. RESULTADOS: os lactentes típicos apresentaram mais ajuste bimanual para objetos grandes aos seis e oito meses e os com SD aos sete meses. Quanto aos ajustes distais, os lactentes típicos variaram seu comportamento enquanto os com SD apresentaram uso predominante da posição oblíqua. Em geral, o grupo típico apresentou maior sucesso na apreensão dos objetos rígidos e maleável pequeno quando comparados aos lactentes com SD. CONCLUSÕES: Os lactentes com SD apresentaram menor variedade de ajustes o que levou a um menor sucesso na apreensão, possivelmente devido a restrições intrínsecas da SD.OBJECTIVES: to verify the influence that properties of objects have on the reaching and grasping adjustments made by infants with and without Down syndrome (DS between four to eight months of age. METHODS: 16 infants, eight typical and eight with DS, were evaluated once a month from months 4 to 8. Four spherical objects (large soft, small soft, large hard and small hard were offered and the first five valid movements were recorded for analysis of the variables: proximal adjustment (uni- and bimanual, distal adjustments (palm orientation, hand opening and grasping of the object. RESULTS: the typical infants displayed greater bimanual adjustment for large objects at six and eight months and those with DS at seven months. As for distal

  9. Ajuste de modelos autorregressivos, na forma de modelos lineares dinâmicos, via inferência Bayesiana Autorregresive models fitting with a dynamic linear models approach via Bayesian inference

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    Marcelo Costa Souza

    2004-10-01

    Full Text Available Os modelos autorregressivos têm sido utilizados para as mais diversas aplicações, a maioria pela análise clássica, na qual os parâmetros são quantidades fixas, não podendo assumir variações ao longo do tempo. Com este trabalho objetivou-se a compreensão de modelos autorregressivos de ordem 2, AR(2, representados na forma de modelos lineares dinâmicos, utilizando como processo de estimação a inferência Bayesiana. O método de Cadeias de Markov Monte Carlo (MCMC foi utilizado para o cálculo das estimativas a partir da implementação dos algoritmos amostrador de Gibbs e "Forward Filtering, Backward Sampling - FFBS". Com base nos modelos AR(2, apresentaram-se o cálculo e a obtenção das distribuições condicionais completas para todos os parâmetros do modelo. Para avaliar o comportamento e a qualidade do ajuste, utilizaram-se duas cadeias de valores, cada uma com 8000 iterações, para três diferentes tamanhos de séries geradas, com 200, 500 e 800 observações. Como parte da aplicação, ajustou-se a série Canadian Lynx (NICHOLLS e QUIN, 1982 para diferentes fatores de desconto (0,90, 0,95 e 0,99, sendo o erro quadrático médio resultante utilizado para a comparação com o ajuste da mesma série, via inferência clássica. Um melhor ajuste para o modelo com fator de desconto igual a 0,99 foi observado. Considerando-se as estimativas obtidas tanto no caso simulado quanto para dados reais, obtiveram-se as previsões um passo à frente para as séries atualizada e "amostrada para trás", e para essa última, o ajuste e o erro quadrático médio comportaram-se bem melhor. Com base nos resultados obtidos, observou-se um bom ajuste dos modelos AR(2 na forma de modelos dinâmicos, via inferência Bayesiana, além de se obter uma melhor compreensão em relação à qualidade do ajuste em diferentes situações, simuladas e reais.The autoregressive models have been widely used in applications, mostly through a classical viewpoint

  10. Bandagem ajustável do tronco pulmonar: IX: atividade da G6PD do miocárdio de cabras adultas submetido ao treinamento ventricular

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    Renato Samy Assad

    2013-12-01

    Full Text Available OBJETIVO: O aumento da atividade miocárdica da Glicose 6-Fosfato Desidrogenase tem sido demonstrado na insuficiência cardíaca. Este estudo avalia a atividade miocárdica da Glicose 6-Fosfato Desidrogenase no treinamento do ventrículo subpulmonar de cabras adultas. MÉTODOS: Foram utilizadas 18 cabras adultas, divididas em três grupos: convencional (bandagem fixa, sham e intermitente (bandagem ajustável; 12 horas diárias de sobrecarga. A sobrecarga sistólica (70% da pressão sistêmica foi mantida durante quatro semanas. As avaliações hemodinâmica e ecocardiográfica foram realizadas durante todo o estudo. Depois de cumprido o protocolo, os animais foram mortos para avaliação morfológica e da atividade da Glicose 6-Fosfato Desidrogenase dos ventrículos. RESULTADOS: Apesar de haver sobrecarga sistólica proporcionalmente menor no ventrículo subpulmonar do grupo intermitente (P=0,001, ambos os grupos de estudo apresentaram aumento da massa muscular de magnitude similar. Os grupos intermitente e convencional apresentaram aumento da massa de 55,7% e 36,7% (P<0,05, respectivamente, em comparação ao grupo sham. O conteúdo de água do miocárdio não variou entre os grupos estudados (P=0,27. O ecocardiograma demonstrou maior aumento (37,2% na espessura do ventrículo subpulmonar do grupo intermitente, em relação aos grupos sham e convencional (P<0,05. Foi observada maior atividade da Glicose 6-Fosfato Desidrogenase na hipertrofia miocárdica do ventrículo subpulmonar do grupo convencional, comparada aos grupos sham e intermitente (P=0,05. CONCLUSÃO: Ambos os grupos de treinamento ventricular desenvolveram hipertrofia ventricular, a despeito do menor tempo de sobrecarga sistólica no grupo intermitente. A maior atividade de Glicose 6-Fosfato Desidrogenase observada no grupo convencional pode refletir um desequilíbrio redox, com maior produção de fosfato de dinucleotídeo de nicotinamida e adenina e glutationa reduzida, um

  11. Estudio de las primeras consultas en un Centro de Salud Mental (II. Características clínicas, sucesos vitales, ajuste y apoyo social, motivación y expectativas.

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    Oscar Martínez Azumendi

    1997-01-01

    Full Text Available Proyecto de evaluación de 749 consultas consecutivas durante año y medio en un Centro de Salud Mental Comunitario. Se presentan las características y diferencias por sexos en relación con la sintomatolog��a diagnóstico, valoración global de la gravedad del caso, ajuste social, autoestima y apoyo social percibido. Además se describe el número y tipo de sucesos vitales referidos en los 6 meses anteriores, así como motivación y expectativas que traen al servicio.

  12. Drogodependientes vs. usuarios de salud mental con trastornos de personalidad: su relación con la calidad de vida, la psicopatología en Eje I, el ajuste psicológico y dinámica familiar

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    José Miguel Martínez-González; Pilar Munera-Ramos; Elisardo Becoña-Iglesias

    2013-01-01

    El objetivo de este estudio ha sido analizar algunas variables de gran relevancia en el tratamiento de los trastornos de la personalidad como son la calidad de vida, el nivel de gravedad de ajuste psicológico, la concomitancia con psicopatología del Eje I y la percepción de dinámica familiar de estos pacientes. La muestra la componente 68 pacientes que presentan un trastorno de la personalidad de los que el 57.4 % son drogodependientes en tratamiento en un centro ambulatorio de atención a ...

  13. El papel de la categorizaci??n social y las diferencias sociodemogr??ficas en la autoestima, el ajuste y el bienestar psicol??gicos de una muestra de inmigrantes

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    Pe??a-Pinz??n, Jos?? Andr??s; G??mez-Berrocal, Carmen; Fern??ndez-Parra, Antonio

    2014-01-01

    El objetivo general de esta investigaci??n es explorar en qu?? medida el ajuste y el bienestar psicol??gicos de las personas inmigrantes est??n relacionados de forma diferente con la valoraci??n de las identidades (personal/social) que componen el autoconcepto. Un total de 210 personas inmigrantes residentes en las provincias de Granada y Almer??a, fueron distribuidas en tres grupos que se establecieron en funci??n de dos criterios: saliencia (baja/alta) de la identidad social inmigrante y si...

  14. Ajuste e balanceamento do portfólio de projetos: o caso de uma empresa do setor químico Project portfolio adjustment and balance: a case study in the chemical sector

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    Marisa Padovani; Marly Monteiro de Carvalho; Antonio Rafael Namur Muscat

    2012-01-01

    O objetivo deste trabalho é compreender a etapa de ajuste no contexto da gestão do portfólio de projetos, destacando sua relação com os processos de categorização e balanceamento. A pesquisa realizada tem caráter qualitativo, sendo a abordagem adotada o estudo de caso longitudinal. A pesquisa foi desenvolvida em uma empresa do setor químico brasileiro. As evidências, de várias fontes, foram coletadas através de entrevistas, documentos e dados dos sistemas corporativos. Para a compreensão do p...

  15. Avaliação estrutural da escala de ajustamento diádico Evaluacíon de la escala de ajuste conyugal Structural assessment of the dyadic adjustment scale

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    José Augusto Evangelho Hernandez

    2008-09-01

    Full Text Available O objetivo deste estudo foi avaliar a Escala de Ajustamento Diádico respondida por uma amostra não-probabilística de homens e mulheres brasileiros que estavam em relacionamento amoroso de diversos tipos. Os 542 sujeitos foram recrutados em diversos locais de Porto Alegre/RS e região metropolitana. Através da técnica estatística Análise Fatorial, este estudo realizou um exame da estrutura da escala. Os resultados obtidos foram comparados com o estudo original de construção do instrumento e outras confirmações subseqüentes. Através da comparação dos escores médios dos diferentes tipos de casais da amostra atual se pôde verificar o poder discriminativo do instrumento e, além disso, foi examinada sua fidedignidade. Apareceram evidências que dão razoável suporte à versão brasileira do instrumento para sua utilização na pesquisa e na clínica psicológica.El propósito del estudio presente fue evaluar la Escala de Ajuste Conyugal contestada por una muestra non-probabilistic de hombres y mujeres brasileños que estuvieron implicados con relaciones de amor de varias clases. Los 542 sujetos fueron reclutados en varios sitios en Porto Alegre/RS y su área metropolitana. Con la técnica de estadística del análisis factorial, este estudio examinó la estructura de la escala. Los resultados fueron comparados a la construcción original del instrumento y de otras confirmaciones subsecuentes. Comparando las puntuaciones promedio de las clases diferentes de parejas de la muestra presente, podemos verificar el poder discriminatorio del instrumento, además de esto, su fiabilidad fue examinada también. Pruebas mostradas, del apoyo razonable a la versión brasileña del instrumento para su uso en la investigación y en clínica de psicología.The Dyadic Adjustment Scale answered by a non-probabilistic sample of Brazilian males and females involved in different types of love relationships is assessed. The 542 subjects were recruited in

  16. Ajuste de modelos não-lineares em estudos de associação entre polimorfismos genéticos e crescimento em bovinos de corte Adjustment of nonlinear models in study of association between genetic polymorphisms and growth in beef cattle

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    Claudia Cristina Paro de Paz

    2004-12-01

    Full Text Available Foram utilizados dados de peso ao nascimento, ao desmame e mensais dos 8 aos 19 meses de idade de 11 classes de genótipos, formadas pela concatenação dos polimorfismos genéticos da kappa-caseína-HinfI (CSN3: AA e AB, do hormônio do crescimento-AluI (GH: LL e LV e da beta-lactoglobulina-HaeIII (LGB: AA, AB e BB (G1=AALLAA, G2=AALLAB, G3=AALLBB, G4=AALVAB, G5=AALVBB, G6=ABLLAA, G7=ABLLAB, G8=ABLLBB, G9=ABLVAA, G10=ABLVAB e G11=ABLVBB. As informações foram obtidas de animais de três grupos genéticos: ½Canchim-Nelore (CN, ½Angus-Nelore (AN e ½Simental-Nelore (SN, nascidos em 1998 e 1999 e pertencentes à Embrapa Pecuária Sudeste, São Carlos, SP. Dos cinco modelos estudados: Brody, Von Bertalanffy, Richards, Gompertz e Logístico, o último apresentou melhor qualidade de ajuste. As estimativas dos parâmetros A (valor assintótico, k (taxa de maturação e m (ponto de inflexão obtidas do modelo Logístico, ajustado para descrever o crescimento de cada animal, foram analisadas pelo método dos quadrados mínimos, por meio de um modelo linear, que incluiu, além da média geral, o efeito do genótipo, o ano de nascimento, o sexo e o manejo alimentar. Para os animais do grupo genético CN, os genótipos influenciaram significativamente as estimativas dos parâmetros A e k da curva de crescimento. O genótipo G3 apresentou valor inferior de A e superior de k em relação aos genótipos G7 e G8. Quanto aos grupos genéticos AN e SN, não foi observado efeito significativo do genótipo sobre nenhum dos três parâmetros. A aplicação da técnica de modelos não-lineares em estudos de associação entre polimorfismos genéticos e crescimento animal proporcionou uma análise detalhada do desenvolvimento dos animais de diferentes genótipos (genes: CSN3, GH e LGB.Weights at birth, at weaning and monthly from 8 to 19 months of age of the 11 genotype identified by combination of polymorphic RFLP's of the genes kappa-casein-HinfI (CSN3: AA and

  17. Teorías e hipótesis de régimen aplicadas al estudio de ajuste dinámico de los cauces aluviales

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    Conesa García, Carmelo

    2003-06-01

    Full Text Available Geomorphic approaches to describe and explain the equilibrium alluvial river channel form, and another approache porpuses to stable «regime» channel design, have relied on simple equations relating channel dimensions to sediment grain-size, gradient and discharge. These equations are either empirical «hydraulic geometry» equations, obtained from regression analysis of the main variables sampled in natural rivers, or «rational» regime equations derived from physical theory of hydraulics and sediment transport. In this work several theories and hypothesis on the river regime are shown in order to explain the dynamic adjustments of channels in connection with environmental changes: i theory of unit stream power, ii minimum energy dissipation rate , iii dispersive-force model, iv concepts of boundary shear stress and critical bank shear, v other regime relationships. Finally, the last part is devoted to the application of the regime theories in arid and semi-arid environments, by considering it a complex aspect, of great interest in the hydro-morphologic context and until the moment little studied.

    Las aproximaciones geomórficas para describir y explicar la forma de equilibrio de un cauce fluvial y los métodos propuestos para el diseño de cauces de «régimen » estable han contado siempre con ecuaciones simples que relacionan las dimensiones del cauce con el tipo de sedimento, pendiente y caudal. Estas ecuaciones son ecuaciones empíricas de «geometría hidráulica», obtenidas a partir del análisis de regresión de variables relevantes muestreadas en cursos de agua naturales o ecuaciones «racionales » de régimen derivadas a partir de la teoría física sobre hidráulica y transporte de sedimentos. En este trabajo se muestran diferentes teorías e hipótesis de régimen para explicar el ajuste dinámico de los cauces aluviales en relación con los cambios ambientales: i teoría de energía por unidad de corriente, ii tasa m

  18. Adjustment of the infiltration curve by different empirical models Ajuste de la curva de infiltración por medio del uso de modelos empíricos diferentes Ajuste da curva de infiltração por meio de diferentes modelos empíricos

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    Carlos A. V. de Azevedo

    2009-12-01

    . Los modelos propuestos por Horton Kostiakov y Kostiakov-Lewis fueron ajustados a los datos obtenidos a campo con el infiltrómetro de anillo. Entre todos los modelos testados el de Horton presentó los mejores resultados. Entretanto, los pronósticos de los modelos Horton Kostiakov y Kostiakov – Lewis se mostraron muy similares.
    A estimativa de algumas propriedades físico-hídricas do solo, por meio do uso de modelos empíricos, constitui uma excelente alternativa para a redução do tempo e do custo das análises laboratoriais, especialmente para aplicação rápida e precisa desses valores em projetos agrícolas. O objetivo do presente trabalho é estimar a velocidade de infiltração de água no solo por meio de modelos empíricos propostos por Horton, Kostiakov e Kostiakov-Lewis e comparar os resultados com os dados obtidos em campo por meio do infiltrômetro de anel. A pesquisa foi conduzida em solo de textura arenosa da área experimental da Empresa Estadual de Pesquisas Agropecuárias – EMEPA, localizada no município de Lagoa Seca (PB. Foram realizados, ao longo da área experimental, um total de 65 testes de infiltração, por meio do infiltrômetro de anel. Os modelos de Horton, Kostiakov e Kostiakov-Lewis foram ajustados aos dados obtidos em campo com o infiltrômetro de anel. Dentre os modelos testados, o proposto por Horton foi o que apresentou o melhor desempenho. Entretanto, os prognósticos dos modelos de Horton, Kostiakov e Kostiakov-Lewis foram praticamente similares.

  19. Fluidos no período pós-operatório: efeitos da falta de ajuste ao peso corpóreo Líquidos en el período postoperatorio: efectos de la falta de ajuste al peso corporal Fluids in the postoperative period: effects of lack of adjustment to body weight

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    Alejandro Risso Vazquez

    2011-06-01

    Full Text Available OBJETIVO: Comparar as diferenças no equilíbrio hídrico e eletrolítico em pacientes com baixo e alto peso corpóreo no primeiro dia pós-operatório. MÉTODOS: Em um período de 18 meses avaliamos prospectivamente 150 pacientes durante as primeiras 24 horas após cirurgia, na unidade de terapia intensiva de um hospital universitário. Pacientes com baixo (90 kg foram comparados em termos de fornecimento e eliminação de fluidos. RESULTADOS: Não foram observadas diferenças significantes em termos de volume (4,334 ± 1,097 em versus 4,644 ± 1,957 mL/24 horas e composição dos fluidos administrados (481 ± 187 versus 586 ± 288 mEq [Na+]administrados em 24 horas. O débito urinário em 24 horas foi similar (2,474 ± 1,597 versus 2,208 ± 678 mL/24 horas, porém o grupo com baixo peso teve uma maior eliminação de eletrólitos (296 ± 195 versus 192 ± 117 mEq [Na+]urina/24 horas, p=0.0246. Quando os fluidos administrados foram ajustados ao peso corpóreo, o volume e quantidade de eletrólitos dos fluidos administrados foram maiores no grupo com baixo peso (79 ± 21 versus 47 ± 22 mL/ kg/24 horas, pOBJETIVO: Comparar las diferencias en el equilibrio de líquidos y electrolitos en los pacientes con bajo y alto peso en el primer día postoperatorio. MÉTODOS: Durante un período de 18 meses, evaluamos prospectivamente 150 pacientes, en las primeras 24 horas después de la cirugía, en una unidad de cuidados intensivos de un hospital escuela afiliado auna universidad. Se compararon pacientes con bajo ( 90 Kg en términos de ingesta y excreción urinariade agua y electrolitos. RESULTADOS: No se observaron diferencias significativas en el volumen (4,334 ± 1,097 vs. 4,644 ± 1,957 ml/24 hs. y la composición de los líquidos administrados (481 ± 187 vs. 586 ± 288 mEq [Na +]administrado/24 hs. El volumen de La diuresis en24 horas fue similar (2,474 ± 1,597 vs 2208 ± 678 ml/24 hs., pero el grupo de bajo peso mostró una mayor eliminación de

  20. Ajuste de un Modelo Hidrodinámico para una Columna con Empaques Estructurados usando Valores Experimentales Fit of an Hydrodynamic Model for a Structured Packing Column using Experimental Data

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    R.H. Chávez

    2004-01-01

    Full Text Available El objetivo del presente trabajo es ajustar un modelo hidrodinámico para columna empacada con empaque estructurado, partiendo de valores experimentales. Se comparan dos empaques, uno construido en el Instituto Nacional de Investigaciones Nucleares (ININ, de gasa de alambre de latón, y otro de la empresa Sulzer Ltda., de gasa de alambre de acero inoxidable. El modelo hidrodinámico se ajustó mediante la técnica de mínimos cuadrados con el método Levenberg-Marquardt para ecuaciones no lineales. Se obtuvieron las caídas de presión experimentales y teóricas determinadas por el modelo, así como los parámetros de ajuste del modelo tanto para el empaque ININ, como para el Sulzer BX. El empaque ININ mostró mayor caída de presión que el empaque Sulzer BX, debido a sus características geométricas. Se concluye que con la determinación de los parámetros de ajuste del modelo, se puede definir los regímenes del flujo de columnas que empleen empaque estructurado ININ y Sulzer BX.The objective of the present study is to fit a hydrodynamic model for a packed column with structured packing, based on experimental values. Two packing materials were used, one was made by the Instituto Nacional de Investigaciones Nucleares (ININ of the gauze type made of brass and the other by Sulzer Ltda., also of the gauze type but made of stainless steel. The hydrodynamic model was fit using the method of least squares using the Levenberg and Marquardt methodology for non-linear equations. Experimental and theoretical pressure drops were determined using the model, as well as the fitted parameters of the model both for ININ and Sulzer BX packings. The ININ packing has a higher pressure drop than the Sulzer BX, due to its geometric characteristics. It is concluded that by using the fitted parameters of the model, flow regimes in the column may be defined when using ININ or Sulzer BX structured packing

  1. Ajuste do modelo Chistiansen-Hargreaves para estimativa da evapotranspiração do feijão no cerrado Chistiansen-Hargreaves model adjustment for estimating evapotranspiration of bean crop in the Cerrado region

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    Omar C. Rocha

    2003-08-01

    Full Text Available Os produtores de feijão da região do Cerrado contam com apenas uma tecnologia, já estabelecida, para o manejo das irrigações: a tensiometria. Muito embora essa metodologia tenha alto potencial de uso não tem sido amplamente adotada pelos produtores, razão pela qual a utilização de modelos de estimativa de evapotranspiração tem se mostrado bastante aplicável à realidade da região. Assim, este trabalho tem o objetivo de avaliar o desempenho do modelo Chistiansen-Hargreaves na estimativa da evapotranspiração da cultura do Feijão Preto, no período seco do Cerrado brasileiro, almejando colocar à disposição dos produtores um modelo ajustado, que permita um manejo eficiente da irrigação no sistema produtivo da região. A evapotranspiração do feijoeiro foi medida com um lisímetro de pesagem. O experimento foi conduzido na Embrapa Cerrados, localizada em Planaltina, DF, Brasil. Quando calculado com coeficientes de cultura determinados na pesquisa e testado com o termo energético ajustado (S0 = 0,5 o modelo apresentou ótimo desempenho podendo, nesta condição, ser empregado com segurança no manejo de irrigação.Bean producers from the Brazilian Cerrado region have only one technology for the irrigation management: the measurement of the water tension in the soil through the use of tensiometers. Although this methodology has high potential, it has not been widely adopted by the producers. Thus, the utilization of models to estimate evapotranspiration estimate has shown to be applicable to the Cerrado region. So, this paper aims to evaluate the performance of the Chistiansen-Hargreaves model to estimate evapotranspiration of black bean crop in the dry season of the Brazilian Cerrado region. It also aims to provide producers an the adjusted model to estimate evapotranspiration which permit an efficient management for the agricultural irrigated system of the Cerrado region. The evapotranspiration of the black bean crop was

  2. Comparação de métodos para ajuste de modelos de semivariograma da precipitação pluvial anual Comparison of methods for adjusting semivariogram model of annual rainfall

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    José R. P. de Carvalho; Sidney R. Vieira; Célia R. Grego

    2009-01-01

    Comumente dados de precipitação pluvial apresentam variação e a obtenção da estimativa de sua distribuição espacial é primordial no planejamento agrícola e ambiental. O objetivo neste trabalho foi comparar o método de estimação dos mínimos quadrados ponderados para ajuste de modelos ao semivariograma com o método de tentativa e erro, através da técnica de auto-validação "jack-knifing", para dados de precipitação pluvial média anual do Estado de São Paulo. Observações de precipitação correspon...

  3. Influência do tamanho e da rigidez dos objetos nos ajustes proximais e distais do alcance de lactentes Influence of object size and rigidity on proximal and distal adjustments to infant reaching

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    NACF Rocha

    2006-09-01

    Full Text Available CONTEXTUALIZAÇÃO: Estudos têm identificado que as propriedades dos objetos induzem os ajustes no alcance; no entanto, poucos investigaram a influência específica do tamanho e rigidez dos objetos em lactentes jovens. OBJETIVO: Verificar se lactentes de 4 a 6 meses realizam ajustes proximais e distais ao alcançarem objetos de diferentes tamanhos e rigidez. MÉTODOS: Nove lactentes saudáveis foram posicionados em uma cadeira inclinada a 50º. Quatro objetos foram apresentados, um rígido grande (RG, um rígido pequeno (RP, um maleável grande (MG e um maleável pequeno (MP, por um período de 1 minuto cada. Em um total de 384 alcances, foram analisados os ajustes proximais (alcance uni e bimanual e distais (orientação da mão horizontal, vertical e oblíqua; mão aberta, fechada e semi-aberta e o sucesso do alcance dos objetos. RESULTADOS: Constatou-se ajuste bimanual para o objeto RG e unimanual para os demais. A orientação da mão oblíqua foi predominante no toque dos objetos, enquanto para a preensão dos mesmos, a predominância foi a vertical, principalmente para o objeto RG. A orientação horizontal não foi observada na preensão do objeto RG. A mão semi-aberta foi mais freqüente no início do alcance para todos os objetos, enquanto no toque do objeto RG a mão aberta foi predominante. O sucesso do alcance foi maior para os objetos maleáveis (MG, MP do que para os rígidos (RG e RP. CONCLUSÃO: Lactentes jovens estudados são capazes de planejar e ajustar seus movimentos baseados na percepção das propriedades físicas dos objetos, o que sugere interação percepção-ação.BACKGROUND: Studies have identified that object properties lead to adjustments to reaching. However, few have investigated the specific influence of object size and rigidity among young infants. OBJECTIVE: To verify whether four to six-month-old infants make proximal and distal adjustments when reaching for objects of different sizes and rigidity. METHOD

  4. Ajuste osmótico em milho cultivado em diferentes sistemas de manejo de solo e disponibilidade hídrica Osmotic adjustment in maize cultivated in different soil tillage systems and water availability

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    Cleusa Adriane Menegassi Bianchi

    2005-07-01

    Full Text Available A cultura do milho é sensível ao déficit hídrico, e esta é uma causa freqüente de redução na produção de grãos. O objetivo deste trabalho foi verificar a ocorrência de ajuste osmótico em milho, cultivado em dois sistemas de manejo do solo, com diferentes disponibilidades hídricas. Os tratamentos consistiram do cultivo do milho em semeadura direta (SD e convencional (SC, com irrigação de forma a manter a umidade do solo próxima à capacidade de campo, e sem irrigação. O ajuste osmótico foi obtido pela diferença do potencial osmótico hidratado entre as plantas irrigadas e sem irrigação. Os maiores valores de potencial mínimo de água na folha ocorreram em plantas cultivadas sob SD, em razão do maior potencial matricial da água no solo nesse sistema. O potencial de pressão e o osmótico hidratado diminuíram em conseqüência do déficit hídrico, o que determinou a ocorrência de ajuste osmótico em ambos os sistemas, que foi mais intenso em manejo convencional. Portanto, o potencial mínimo de água na folha demonstra ser um indicador adequado da condição hídrica das plantas de milho. A cultura apresenta tolerância ao déficit hídrico por meio do mecanismo de ajuste osmótico.Maize is a very sensible crop to water deficit, which is a frequent cause of reduction in its grain yield. The objective of this work was to verify the occurrence of osmotic adjustment in maize cultivated in different soil management systems and water availability. The maize was cropped in no-tillage (NT and conventional tillage (CT, with irrigation and no-irrigation. For measurements of minimum leaf water potential, a pressure chamber was utilized. Osmotic adjustment was calculated as the difference between osmotic potentials at full turgor, in irrigated and non-irrigated plants. Highest values of minimum leaf water potential were found in plants cropped in NT, as a response to the highest soil potential on this cropping system. Pressure

  5. Desarrollo de un modelo de ajuste por el riesgo para el infarto agudo de miocardio en España: comparación con el modelo de Charlson y el modelo ices. Aplicaciones para medir resultados asistenciales

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    Juan Manuel Sendra Gutiérrez

    2006-01-01

    Full Text Available Fundamento: El infarto agudo de miocardio representa una importante carga de morbimortalidad en los países desarrollados. El objetivo de este trabajo es desarrollar un modelo de ajuste por el riesgo para evaluar los resultados del manejo de esta patología y comparar su desempeño con otros modelos. Métodos: Se desarrolla un modelo de ajuste de riesgo para el infarto agudo de miocardio mediante regresión logística con la información de una base de datos administrativa de hospitales españoles, considerando la mortalidad intrahospitalaria como variable respuesta y variables propias del paciente como predictoras. Se compara su capacidad predictiva con la del modelo de Charlson y el modelo ICES. Los modelos se aplican para evaluar la mortalidad intrahospitalaria. Resultados: La edad (OR: 1,07; la localización anterolateral (OR: 2,32 e inferoposterior (OR:1,91; el shock cardiogénico (OR:39,99, las arritmias (OR: 94,43, la enfermedad cerebrovascular (OR:2,15 y la insuficiencia renal (OR:1,87 aparecen asociados con un mayor riesgo de mortalidad. El modelo desarrollado ofrece mejor capacidad predictiva (-2LL: 2240 que el modelo de Charlson (-2LL: 3073 y el modelo ICES (-2LL: 2366. No hay diferencias significativas en la mortalidad ajustada por el riesgo de los 23 hospitales estudiados, ni diferencias entre centros públicos y privados, ni por volumen de atención o nivel tecnológico. La coronariografía (RMAR: 0,66 y las intervenciones coronarias percutáneas (RMAR: 0,69 son procedimientos con efecto protector. Conclusiones: El modelo desarrollado puede constituir una herramienta útil para evaluar la práctica asistencial del infarto en centros hospitalarios.

  6. O formante do cantor e os ajustes laríngeos utilizados para realizá-lo: uma revisão descritiva The singer's formant and the laryngeal adjustments used to realize it: a descriptive review

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    Cristina de Souza Gusmão

    2010-01-01

    Full Text Available Este estudo descreve, através da literatura da Fonoaudiologia e da Física Acústica, alguns aspectos relacionados à produção da voz, tais como o espectro do som como a frequência fundamental, os harmônicos, os formantes e também os ajustes laríngeos. A revisão de literatura inclui a descrição anátomo-fisiológica do aparelho vocal, suas funções e mecanismo para produção vocal. Descreve também os aspectos relacionados à espectografia do som, da localização dos formantes e de ajustes anatômicos e musculares para se obter o formante do cantor. Este estudo visa esclarecer conceitos e levantar questionamentos sobre o que ocorre na fisiologia vocal e o que é dito e aceito pelo senso comum sobre o formante do cantor.This study describes some voice production aspects, like sound spectrum as the fundamental frequency, harmonics, the formants and also the laryngeal adjustments through the phonoaudiology and acoustics literature. The literature review includes the anatomical and physiological description of the vocal apparatus, its functions and the mechanism for the vocal production. It also describes related aspects of the sound spectrographs, to the formants location and to the anatomical muscle adjustments to realize the singer's formant. This study aims at clarifying concepts and raising questions about what happens in vocal physiology and what is said and accepted by the common sense about the singer's formant.

  7. EFECTOS DE LA SALINIDAD EN LAS VARIABLES HÍDRICAS POTENCIALES HÍDRICO Y OSMÓTICO Y AJUSTE OSMÓTICO EN CULTIVARES CUBANOS DE TRIGO (Triticum aestivum L. Y T. durum L.

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    Leandris Argentel

    2013-01-01

    Full Text Available El experimento se desarrolló con el objetivo de evaluar el efecto de la salinidad en los potenciales hídrico y osmótico y el ajuste osmótico en 12 cultivares de trigo pertenecientes a las especies Triticum aestivum L. y Triticum durum L., en etapas iniciales del desarrollo, siguiendo las metodologías para su determinación. Las plantas se establecieron en un invernadero en condiciones de hidroponía aplicando, como primer tratamiento, una solución nutritiva salinizada a base de NaCl a una conductividad eléctrica de 8 dS.m-1. El tratamiento control consistió en la solución nutritiva sin salinidad significativa (0,36 dS.m-1. Las evaluaciones se realizaron a los 25 días posteriores a la germinación. Los resultados mostraron una significativa disminución de los valores del potencial hídrico en la mayoría de los cultivares en todos los órganos medidos y se observó una significativa disminución de sus valores desde las raíces hasta las hojas para asegurar el gradiente hídrico. Los cultivares que no disminuyeron significativamente su potencial hídrico mostraron comportamiento similar en los tres órganos evaluados aunque el gradiente de potenciales se mantuvo. El potencial osmótico disminuyó significativamente en todos los cultivares y sus valores fueron inferiores a -0,6 MPa. Todos los cultivares realizaron el ajuste osmótico, siendo el valor más significativo AO= 0,3 MPa en los cultivares INIFAT RM-36, INIFAT RM-32, INIFAT RM-37. Se observó variabilidad en la respuesta al estrés salino entre los cultivares y especies para las tres variables evaluadas.

  8. RETIRO LABORAL Y AJUSTE A LA JUBILACIÓN DE HOMBRES Y MUJERES EN LA MEDIANA EDAD (WORK RETIREMENT AND ADJUSTMENT TO RETIREMENT OF MEN AND WOMEN IN THE MIDDLE-AGED

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    Cruz Meléndez Roxana

    2011-04-01

    Full Text Available Resumen:En este artículo se presentan los resultados de una investigación aplicada cuyo objeto de estudio fue un grupo de hombres exfuncionarios y mujeres exfuncionarias del área administrativa de la Universidad de Costa Rica (UCR que se encuentran en la etapa de vida denominada “la mediana edad” y que enfrentan el proceso trabajo-retiro laboral. El estudio consistió en identificar los principales factores que inciden en el retiro laboral a una edad más temprana; la viviencia del proceso, el ajuste a la jubilación y sus implicaciones a nivel personal y social. La información recopilada se obtuvo a partir de la técnica “la entrevista fenomenológica” concebida como una exploración profunda que proporciona datos de gran valor conceptual y humana; en ella, tanto la persona que entrevista como la entrevistada mantienen un compromiso para que la búsqueda de la información sea dentro de una relación empática. Partiendo de lo subjetivo por su historia de vida al mandato social por lo roles asignados y asumidos por la población en estudio. Los resultados obtenidos indican que pareciera que la valoración que cada uno de los participantes hace de su rol laboral y el significado del trabajo en sus vidas es determinante en el proceso de retiro laboral y su ajuste al rol de persona jubilada.Abstract: This article presents the results of applied research study that was aimed at a group of men and women, former administrative staff of the University of Costa Rica that are in the stage of life called middle age and facing work-retirement process work. The study consist in identify the main factors affecting the removal from work at a younger age, the experiencing process, adjustment to retirement and its implications for personal and social level. Information collected was obtained from the technique "the phenomenological interview “conceived as a deep exploration that provides valuable data conceptual and human, in her interview both

  9. Programa de ajuste multiparamétrico de curvas de titulação potenciométricas de ácidos húmicos Multiparametric adjustment program of potentiometric titration curves of humic acids

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    Clausius Duque Gonçalves Reis

    2010-04-01

    Full Text Available Tendo em vista a dificuldade de determinação dos pontos de inflexão na curva de titulação potenciométrica de ácidos húmicos, por metodologias tradicionais, foi desenvolvido foi desenvolvido um programa na linguagem Delphi para ajuste multiparamétrico de dados de titulação potenciométrica. Para isso um processo iterativo para estimar as raízes de um polinômio, com base no método de Newton-Raphson, foi utilizado. Os dados das titulações potenciométricas de ácidos húmicos usados nas regressões foram obtidos em um sistema automatizado de titulação potenciométrica. O programa desenvolvido na linguagem Delphi permite maior versatilidade e facilidade de operação, com uma interação mais amigável com o usuário. As curvas de titulação potenciométricas ajustadas sobrepuseram-se quase que totalmente às curvas experimentais. Os valores de pKa e as percentagens de grupos tituláveis dos ácidos húmicos, parâmetros ajustáveis na regressão multiparamétrica, apresentaram valores comparáveis com dados da literatura.Regarding the difficulty of determining the inflection points in the potentiometric titration curve of humic acids by means of traditional methodologies, a Delphi program a Delphi program was developed for the multiparametric data adjustment in potentiometric titration. For this purpose, an iterative process was used, based on the Newton-Raphson method to estimate the roots of a polynomial. The humic acid potentiometric titration data, used in regressions, were obtained in an automated system of potentiometric titration. The program developed in Delphi language features greater versatility, ease of operation and better interaction with the user. The adjusted potentiometric titration curves overlap the experimental curves almost entirely. The pKa values and percentages of titrable groups of humic acids extracted from soil, adjustable parameters in the multiparametric regression, were comparable with those reported

  10. Las reformas de 2009 al Reglamento de la Corte Interamericana de Derechos Humanos: una regulación de prácticas existentes y un ajuste del Reglamento de noviembre de 2000

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    María Clara Galvis Patiño

    2009-12-01

    Full Text Available Durante su octogésimo segundo período ordinario de sesiones, celebrado en su sede en San José de Costa Rica, del 19 al 31 de enero de 2009, la Corte Interamericana de Derechos Humanos —en adelante también «la Corte Interamericana», «la Corte», «la Corte IDH» o «el Tribunal»— aprobó una serie de reformas puntuales del Reglamento de la Corte Interamericana de Derechos Humanos —en adelante, el «Reglamento1—, que entraron en vigencia el 24 de marzo de 20092. En este artículo, se referirá, en primer lugar, a los antecedentes y al contexto en el que tuvo lugar la reciente reforma del Reglamento de la Corte. Luego mencionaré algunos de sus temas y aspectos más destacados, los cuales tienen que ver, por una parte, con la reglamentación de prácticas que el alto Tribunal interamericano ha venido adoptando en los últimos años y, por otra, con el ajuste de aspectos puntuales del trámite de los casos contenidos en el reglamento adoptado en noviembre de 2000, que entró en vigencia el 1 de junio de 20013. Finalmente, me referiré a los temas pendientes que deben ser abordados en futuras reformas del reglamento de la Corte.

  11. A tecnologia da informação como suporte ao ajuste da previsão da demanda: um estudo de caso em uma empresa de bebidas carbonatadas

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    Alexandre Pereira Salgado Junior

    2010-08-01

    Full Text Available A gestão da cadeia de suprimentos é um problema que sempre instigou gestores por todo o mundo, ademais os modelos de previsão da demanda tradicionais não mais satisfazem os novos desafios da gestão dos estoques e da ruptura. Assim, novas soluções foram desenvolvidas, buscando-se melhorar os níveis de serviço prestados ao consumidor final. Dentre elas, destaca-se a utilização da TI que, por disponibilizar a informação em tempo real, pode contribuir para o ajuste dos modelos tradicionais de previsão da demanda. Desta forma, o objetivo desta pesquisa é analisar como a TI pode ajudar o segmento de bebidas a ajustar sua previsão de demanda. O método de pesquisa utilizado foi o estudo de caso, analisando uma empresa de bebidas carbonatadas, escolhida por conveniência. Para análise dos dados, utilizou-se a técnica de análise de conteúdo. Como principais resultados destacam-se melhorias no nível dos estoques, na ruptura e no nível de serviço.

  12. Sistemas homogéneos de ecuaciones diofánticas. Resolución y aplicación al ajuste automático de reacciones químicas

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    Recuero, Alfonso

    1984-06-01

    Full Text Available An algorithm to solve systems of linear homogeneous diophantine equations is given here. Subsequently, as an example of application, a method of heuristic search for the best solution is described; this fulfils certain conditions within an infinite space of solutions of various dimensions. Finally, an application of the algorithm and of the process of heuristic search for the best solution in adjusting chemical reactions is described. The listing in BASIC of the program of application mentioned is included, for the HP-75 portable computer.

    Se presenta un algoritmo de resolución de sistemas de ecuaciones diofánticas lineales y homogéneas. Seguidamente y como ejemplo de aplicación se describe un método de búsqueda heurística de una solución óptima que cumpla unas ciertas condiciones dentro de un espacio infinito de soluciones de varias dimensiones. Por último se describe la aplicación del algoritmo y del procedimiento de búsqueda heurística para el caso de ajuste de reacciones químicas. Se incluye el listado en BASIC del programa para el ordenador HP-75.

  13. Uso de modelos não-lineares para o ajuste de curvas de crescimento de cavalos pantaneiros Using nonlinear models to describe height growth curves in pantaneiro horses

    Directory of Open Access Journals (Sweden)

    Sandra Aparecida Santos

    1999-07-01

    Full Text Available Dados de altura da cernelha e idade de 26 cavalos Pantaneiros, obtidos, na maioria, do nascimento até 36 meses, foram ajustados aos modelos de respostas não-lineares de Brody, Richards, Gompertz, Logístico, Weibull e Morgan-Mercer-Flodin. Estes seis modelos matemáticos foram comparados com o uso de uma medida de curvatura média e do erro médio quadrático combinado. O modelo de Weibull foi escolhido. A assíntota desta curva representa a altura esperada na maturidade. Os machos apresentaram um valor maior desta quantidade do que as fêmeas. O índice de maturidade, contudo, é maior para as fêmeas. Observou-se uma indicação de associação negativa entre altura na maturidade e índice de maturidade somente nas fêmeas. Tais resultados indicam que as fêmeas amadurecem mais cedo. Após testes de normalidade e homogeneidade de variância, as diferenças entre sexos foram analisadas com o uso do teste-t. Somente a altura da cernelha ao nascimento apresentou diferença significativa.Height at withers data mostly from birth to 36 months of age of 26 Pantaneiro horses were used to fit Brody, Richards, Gompertz, Logistic, Weibull and Morgan-Mercer-Flodin nonlinear response functions. Based on measures of average curvature and combined mean square error, the Weibull model was chosen. The asymptote of this curve, representing the average height at maturity, was higher for males than females. The maturity index, however, was more elevated for females than males. There was indication of a negative association between the maturity index and height at maturity only for females. These results indicate that females mature earlier. After checking for normality and homogeneity of variances within groups (sex the analysis investigated sex differences via t-tests. A significant difference was detected only for height at birth.

  14. Ajuste do modelo fototérmico de estimativa do desenvolvimento e do índice de área foliar de soja Adjustment of the photothermic model to estimate soybean development and leaf area index

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    Neila T. Toledo

    2010-03-01

    Full Text Available Visou-se neste estudo, realizar o ajuste do modelo de estimativa do desenvolvimento de populações de soja e da variação do índice de área foliar para a variedade IAS 5. Como fonte de variação na velocidade de desenvolvimento, diferentes épocas de plantio foram utilizadas em experimentos nos anos agrícolas de 2004/2005 (três datas e 2005/2006 (quatro datas no IRDeR (Instituto Regional de Desenvolvimento Rural localizado em Augusto Pestana, RS (28º 27' 17" S e 53º 54' 50" W, nos quais foram identificadas as datas em que ocorreram as principais fases do desenvolvimento da cultura da soja, seguindo a Escala Fenológica de Fehr & Caviness e estimados o índice de área foliar em quatro momentos: no final do período de instalação da população vegetal (V6; no início do florescimento (R1; início do enchimento de grãos (R5; e no início da maturação (R7. As variáveis meteorológicas temperaturas mínima e máxima diárias foram coletadas. Após o ajuste dos coeficientes genéticos, o modelo foi formatado no programa Stella 5.0. O modelo de estimativa do desenvolvimento da soja teve desempenho satisfatório, apresentando estimativas precisas para os dados que o determinaram. O modelo de estimativa do índice de área foliar apresentou estimativas satisfatórias.The present study was carried out to adjust the soy population development model and the leaf area index model for the IAS 5 cultivar. Different sowing dates were used in two experiments as source of development variation during 2004/2005 (three dates and 2005/2006 (four dates in the IRDeR (Instituto Regional de Desenvolvimento Rural located in Augusto Pestana, in the State of Rio Grande do Sul (28º 27' 17" S and 53º 54' 50" W. The main crop development phases were identified according to the Feher & Caviness phenological scale, and the leaf area index was determined in four occasions: at the final period of plant population installation (V6; at the beginning of flowering

  15. Observador Asintótico Ajustable para Reactores Bioquímicos: Aplicación a la Digestión Anaerobia A Tunable Asymptotic Observer for Biochemical Reactors: Application to Anaerobic Digestion

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    V. Alcaraz

    2004-01-01

    Full Text Available En este trabajo se propone un observador asintótico ajustable para sistemas dinámicos no lineales que pueden ser descritos por un conjunto de ecuaciones diferenciales ordinarias. A diferencia de los observadores asintóticos clásicos, este observador está provisto de ganancias variables que pueden ser ajustadas por el usuario. En la etapa inicial de la estimación, este observador es robusto frente a perturbaciones inducidas por un conocimiento parcial de los términos no lineales. Eventualmente, este observador es totalmente independiente de los términos no lineales, lo que le confiere una robustez total frente a cualquier perturbación inducida por estos términos. El observador es probado mediante simulaciones rigurosas y es aplicado a un modelo dinámico de digestión anaerobia para el tratamiento de aguas residuales, mostrando propiedades excelentes de convergencia, estabilidad y desempeño. La respuesta del observador propuesto es más rápida que la obtenida con los observadores asintóticos clásicosIn this paper a tunable asymptotic observer for non-linear dynamic systems that can be described by a set of ordinary differential equations, is proposed. In contrast with classical asymptotic observers, this one is provided with variable gains that can be tuned by the user. At the first stage of the estimation, the observer is robust against disturbances induced by poorly known non-linear terms. Eventually, the observer becomes fully independent of the nonlinear terms and thus robust against any disturbance induced by the nonlinear terms. The performance of the observer is tested through rigorous simulations in a dynamic anaerobic digestion model for wastewater treatment, showing excellent convergence and stability properties. Finally, it is shown that the proposed observer yields faster estimates than those obtained by using the classical asymptotic observers

  16. Abordagem multidisciplinar de pacientes obesos mórbidos submetidos a tratamento cirúrgico pelo método da banda gástrica ajustável Multidisciplinary approach to morbidly obese patients undergoing surgical treatment by adjustable gastric banding

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    Denis Pajecki

    2010-10-01

    Full Text Available OBJETIVO: Avaliar o resultado do tratamento cirúrgico de pacientes obesos mórbidos pelo método da BGA, acompanhados em ambulatório multidisciplinar. MÉTODOS: Foram estudados 20 pacientes com IMC que variou de 36,6 a 72 kg/m2 (X=47,51 +/- 6,1 e idade entre 36 a 60 anos, submetidos à colocação de BGA. As comorbidades encontradas no pré-operatório foram hipertensão arterial (nove, diabetes tipo II (quatro, apneia do sono grave (um, hipertrigliceridemia (quatro e problemas ortopédicos graves (três. No seguimento pós-operatório os pacientes foram atendidos em ambulatório multidisciplinar (cirurgião, endocrinologista, psiquiatra e nutricionista. Nos primeiros seis meses, a orientação foi de visitas mensais para ajustes da banda e orientação nutricional. Após, as visitas ocorreram a cada dois ou três meses, conforme a necessidade. RESULTADOS: O tempo cirúrgico variou de 40 a 180 minutos; o de internação de 1 a 10 dias (X = 36 horas. Duas pacientes necessitaram reintervenção cirúrgica por complicações tardias: uma rotação do portal e um deslizamento superior da banda . O tempo de seguimento variou de 28 a 36 meses. A perda de peso média foi de 29,26 kg +/- 8,8, ou 24,37% +/- 6,1 do peso inicial e 49,16% +/- 11,3 do excesso de peso. O IMC médio variou de 47,51 para 34,88. Houve melhora global das comorbidades, mais acentuada nos pacientes com maior perda de peso. CONCLUSÃO: Os resultados obtidos foram satisfatórios para a maioria dos pacientes nos quesitos perda de peso e melhora das comorbidades.OBJECTIVE: To evaluate the outcome of the surgical treatment of morbidly obese patients by Adjustable Gastric Banding (ABG followed in a multidisciplinary clinic. METHODS: We studied 20 patients with BMI ranging from 36.6 to 72 kg/m2 (X = 47.51 + / - 6.1 and aged between 36 to 60 years, undergoing placement of AGB. Preoperative comorbidities were hypertension (nine, type II diabetes (four, severe sleep apnea (one

  17. Disputas, ajustes e acomodações na produção da agenda eleitoral: a cobertura jornalística ao Programa Bolsa Família e as eleições de 2006

    Directory of Open Access Journals (Sweden)

    Flávia Biroli

    2010-06-01

    Full Text Available Resumo: Este artigo apresenta uma análise da cobertura jornalística ao Programa Bolsa Família durante as eleições presidenciais de 2006. A pesquisa abrange um total de 166 textos que mencionaram o Programa, publicados pelos jornais O Globo, O Estado de São Paulo, Folha de São Paulo e Valor Econômico entre os dias 1º de setembro e 31 de outubro de 2006. Discutimos a dinâmica de produção da agenda eleitoral, observando as disputas, ajustes e acomodações que constituem a cobertura. A análise conjunta das vozes e dos enquadramentos presentes no material permite observar aspectos relevantes das interações entre os campos da mídia e da política no contexto em que a cobertura foi realizada. As conclusões ressaltam a baixa pluralidade do noticiário, associada a representações das eleições de 2006 e da democracia brasileira que têm como aspectos centrais a estigmatização dos eleitores de baixa renda e dos beneficiários de programas sociais.Abstract: This article presents an analysis of the news about an important social program maintained by the federal government, Programa Bolsa Família, in the period of brazilian major elections of 2006. The study is based in 166 texts published in the newspapers O Globo, O Estado de São Paulo, Folha de São Paulo e Valor Econômico between September 1st and October 31st. We discuss the production of electoral agenda, observing disputes, adjustments and acommodations that constitute news coverage. The analysis of voices and framings in the texts leads to the observation of relevant aspects of the relations between media and politics at that moment. Conclusions underline the low plurality in press coverage, connected to representations of the elections of 2006 and Brazilian democracy that include stigmatization of low income voters and beneficiaries of social programs.

  18. Evaluación del grado de ajuste de las revistas científicas españolas de ciencias de la salud a las normas internacionales de presentación de publicaciones periódicas

    Directory of Open Access Journals (Sweden)

    López-Cózar Emilio Delgado

    1997-01-01

    Full Text Available FUNDAMENTO: Se evalúa el cumplimiento, por parte de 205 revistas científicas españolas de ciencias de la salud, de las normas internacionales de presentación de publicaciones periódicas, con el fin de mejorar su calidad informativa, puesto que la normalización constituye un elemento importante en el éxito del proceso de transferencia de la información científica. MÉTODOS: Las revistas se identificaron a través de cinco bibliografías impresas y cuatro bases de datos bibliográficas. Se controlaron 136 preceptos extraídos de las normas internacionales de presentación de publicaciones periódicas emitidas por la International Standardization Organization (86% y de recomendaciones generadas por la UNESCO, el International Committee of Medical Journal Editors, el Council of Biology Editors y EJ Huth (14%. Para cada parámetro se valoraron tres niveles de evaluación (Inclusión, Presentación y Ubicación, por lo que el número total de ítemes evaluados fue de 342. RESULTADOS: El grado de normalización de las revistas biomédicas españolas estudiadas fue del 33,5% ± 8,5. Destacan por su buen ajuste los parámetros referidos a la identificación de la revista en las páginas del texto y al sumario del fascículo. Los aspectos más descuidados se concentran en el volumen y sumario analítico. Las revistas peor normalizadas son las auspiciadas por empresas y organismos de gestión. Las revistas anuales son las mejor estandarizadas. CONCLUSIONES: El bajo nivel de normalización que resulta no se debe a un deficiente cumplimiento generalizado de todos los parámetros sino más bien al incumplimiento completo de algunos de los mismos, en concreto: las normas que regulan el sumario analítico y la cubierta, sumario e índices de volumen. Para conseguir una mayor normalización de las revistas se propone un cambio en la política de difusión de las normas, la elaboración de guías y manuales para la confección de publicaciones cient

  19. LA REFORMA ECONÓMICA Y SU IMPACTO SOCIAL EN COSTA RICA DURANTE EL PERÍODO DE AJUSTE ESTRUCTURAL: apuntes críticos para el análisis

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    Rafael Arias Ramírez

    2007-12-01

    Full Text Available Resumen El objetivo de este artículo es analizar la reforma económica implementada en Costa Rica en los últimos veinticinco años como resultado de la aplicación de los programas y políticas de ajuste estructural. Para tal efecto se analiza el debate que acompañó el proceso de aprobación e implementación de los mencionados programas, el discurso de los mismos, su desempeño y algunos de sus principales efectos sociales. Esta reforma económica representó un cambio importante en el estilo de desarrollo y en las funciones del estado social vigentes desde la década de los 1950s. De ahí que resulte de gran interés analizar cuál fue el nuevo enfoque de desarrollo que se implementó a partir de la década de los años ochenta y los resultados del mismo en materia de crecimiento económico y equidad social. Esta publicación pretende servir de insumo para promover la tarea académica de repensar la política de desarrollo que la sociedad costarricense debe definir dentro del nuevo contexto de la globalización.   Abstract The objective of this article is to analyze the economic reform implemented in Costa Rica in the last twenty-five years as result of the application of the structural adjustment programs and policies. For such effect we analyze the debate that accompanied the process of approval and implementation of the mentioned programs, the speech of such, its performance and some of its main social effects. This economic reform represented an important change in the style of development and in the current functions of the social state from the decade of 1950s. Hence it results of big interest to analyze which was the new approach of development that was implemented from the decade of the eighties and the results of the same one on the subject of economic growth and social equity.This publication tries to serve as input to promote the academic task of rethinking the politics of development that the Costa Rican society must define

  20. Reorganização dos ajustes posturais antecipatórios em indivíduos após AVE: influência de um programa de intervenção em fisioterapia no registo electromiográfico do tibial anterior e solear

    OpenAIRE

    Rodrigues, Sónia

    2010-01-01

    Introdução: As dificuldades encontradas em individuos após Acidente Vascular Encefálico, ao nível da marcha, influenciam significativamente o retorno ao trabalho, a participação na comunidade ou o desempenho nas actividades da vida diária. Objectivo: Neste trabalho, procurou-se verificar qual o efeito de um programa de intervenção em fisioterapia nos ajustes posturais antecipatórios que ocorrem previamente ao movimento voluntário e assim pré-determinar a sua contribuição para a...

  1. A mortalidade materna nas capitais brasileiras: algumas características e estimativa de um fator de ajuste Maternal mortality in Brazilian State Capitals: some characteristics and estimates for an adjustment factor

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    Ruy Laurenti

    2004-12-01

    Full Text Available A mortalidade materna pode ser considerada um excelente indicador de saúde, não só da mulher, mas da população geral; mostra, também, iniqüidades. A redução da mortalidade materna é uma das principais metas, estando também incluída nas Metas do Desenvolvimento do Milênio da ONU. OBJETIVO: Conhecer a qualidade da informação da mortalidade de mulheres de 10 a 49 anos, e estimar a razão de mortalidade materna (RMM e os fatores de ajuste para os dados oficiais, no conjunto das capitais de estados brasileiros e Distrito Federal. METODOLOGIA: Adotou-se a metodologia RAMOS (a partir da declaração de óbito, entrevista no domicílio da mulher falecida, com preenchimento de questionário, sobre variáveis demográficas, epidemiológicas, clínicas e de acesso a serviços; seguiam-se consultas a prontuários médicos hospitalares e a laudos de autópsia. Após o resgate da informação, pôde ser feita análise das reais causas básicas, terminais e associadas. A população de estudo foi estimada em 7.332 mortes de mulheres de 10 a 49 anos, ocorridas no primeiro semestre de 2002, sendo 239 óbitos por causas maternas. A RMM foi de 54,3 por cem mil nascidos vivos (n.v., no conjunto de capitais, variando entre 42 por cem mil n.v. no Sul, e 73,2 por cem mil n.v. no Nordeste. O fator de ajuste para o conjunto das capitais brasileiras foi igual a 1,4; para as regiões (considerando apenas as capitais, variaram entre 1,08 na Região Norte e 1,83 na Região Sul. As mortes obstétricas diretas corresponderam a 67,1%, mostrando que assistência ao pré-natal, ao parto e ao puerpério deve ser aprimorada.INTRODUCTION: There is criticism as to the heterogeneity and reliability of mortality data in Brazilian Regions. However, official mortality statistics of State Capitals are more accurate and have adequate coverage. Reduction of maternal mortality is one of the world's major goals and it is measured by the Maternal Mortality Ratio. International

  2. THE INFLUENCE OF MANAGERIAL WORK DETERMINANTS ON THE PERCEPTION OF FITNESS BETWEEN TECHNOLOGY AND TASK: AN EXPLORATORY STUDY A INFLUÊNCIA DOS DETERMINANTES DO TRABALHO GERENCIAL NA PERCEPÇÃO DO AJUSTE ENTRE A TECNOLOGIA E A TAREFA: UM ESTUDO EXPLORATÓRIO

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    Mauri Leodir Löbler

    2010-12-01

    Full Text Available This paper investigates if the managerial work nature modifies the manager's perception regarding the adjustment of Information Technology (IT to their task. The indicators of managerial work, as experience and frequency of IT use and manager decision-making roles, were based on studies of Vlahos and Ferrat (1998 and Vlahos, Ferratt and Knoepfle (2004 as well as the task technology fit, reasoned from the Task-Technology Fit model (TTF (Goodhue, 1995. This paper contributes to understanding the IS as a support tool for the tasks that composed the manager's role in the organization. Through an exploratory study conducted with 238 managers, we observed that more increases the experience of the individual with the Information System (IS, greater the adjustment perceived for it, between the technology and the task running; and higher the user access the IS, greater the fit between the technology and their tasks. As for the decision-making roles, we identified the roles of manager/entrepreneur and conflict manager are those who envisage a better adaptation of technology to their work, getting through the IS support for the work to proceed more efficiently. Este artigo investiga se a natureza do trabalho gerencial modifica a percepção do gestor quanto ao ajuste da Tecnologia da Informação (TI à sua tarefa. Os indicadores do trabalho gerencial, como a experiência e frequência de uso da TI e papéis decisórios do gestor, foram baseados nos estudos de Vlahos e Ferrat (1998 e Vlahos, Ferratt e Knoepfle (2004, além do ajuste da tecnologia à tarefa, fundamentado a partir do modelo de Ajuste Tecnologia-Tarefa (TTF (Goodhue, 1995. O trabalho contribui no entendimento dos SI como ferramenta de suporte para a execução das tarefas que compõem o papel do gestor na organização. Através de um estudo exploratório, realizado junto a 238 gestores, observou-se que quanto mais aumenta a experiência do individuo com os Sistemas de Informação (SI, maior

  3. L’exposition contrôlée à la lumière et à l’obscurité ajuste le rythme du cortisol salivaire chez les travailleurs de nuit

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    Anny Casademont

    2005-05-01

    Full Text Available Dans cette étude réalisée sur le terrain et en laboratoire, nous avons testé l’efficacité d’une intervention consistant à contrôler l’exposition à la lumière/obscurité de façon à favoriser l’adaptation circadienne au travail de nuit. Six travailleurs permanents de nuit (moyenne d’âge 37,1 ± σ : 8,1 ans avaient comme consigne de s’exposer de façon intermittente à une lumière blanche vive plein spectre (~2 000 lux au cours des 6 premières heures de leur quart de travail de 8 heures. Il leur était demandé de se protéger de la lumière solaire du matin avec des verres teintés (densité gris neutre, transmission visuelle de la lumière 15 % et de maintenir des épisodes réguliers de sommeil/obscurité dans une pièce très sombre. Ces épisodes devaient commencer 2 heures après la fin de chaque quart de travail de nuit. Cinq travailleurs du groupe contrôle (41,1 ± σ : 9,9 ans ont été étudiés alors qu’ils devaient uniquement maintenir un horaire régulier de sommeil/obscurité. Des procédures de routine constante, réalisées avant et après une série d’environ 12 quarts de travail de nuit s’échelonnant sur 3 semaines, ont montré chez les travailleurs du groupe traitement une variation significative dans l’heure d’apparition du pic de cortisol ainsi qu’un ajustement de ce rythme à un horaire de travail de nuit. Un plus petit changement de phase a été observé dans le groupe contrôle, ce qui suggère une adaptation partielle à l’horaire de travail de nuit. Nos résultats démontrent l’efficacité d’une exposition judicieuse à la lumière et à l’obscurité pour favoriser l’adaptation des rythmes physiologiques au travail de nuit.The efficacy of a light/darkness intervention designed to promote circadian adaptation to night shift work was tested in this combined field and laboratory study. Six permanent night shift workers (mean age: 37.1 / s: 8.1 years were instructed to

  4. CLINICAL BIOCHEMISTRY

    Science.gov (United States)

    Assessment of the health status of animals through measurement of cellular, biochemical, and macromolecular constituents in blood, secretions, and excretions has been variously referred to as clinical chemistry, clinical biochemistry, or clinical pathology. he genesis of this dis...

  5. Comparación de dos métodos para corregir el sesgo de no respuesta a una encuesta: sustitución muestral y ajuste según propensión a responder A comparison of two methods to adjust for non-response bias: field substitution and weighting non-response adjusments based on response propensity

    Directory of Open Access Journals (Sweden)

    Alejandra Vives

    2009-08-01

    Full Text Available La no respuesta es un problema creciente en encuestas poblacionales que puede ser causa de sesgo de no-respuesta cuando respondedores y no respondedores difieren sistemáticamente. Objetivo: Comparar los resultados obtenidos mediante dos técnicas de corrección para el sesgo de no-respuesta: sustitución muestral y pesos de no respuesta obtenidos mediante propensión a responder. Métodos: Se comparan los efectos de la sustitución muestral semicontrolada y el uso de pesos de ajuste obtenidos mediante la propensión a responder sobre seis resultados de una encuesta de salud. Resultados: A pesar de las diferencias significativas entre respondedores y no respondedores, mediante la corrección las prevalencias estimadas sólo cambian levemente, dando ambas técnicas de ajuste resultados similares. Sólo en el caso del tabaquismo, la sustitución muestral parece haber aumentado el sesgo de la estimación. Conclusiones: Nuestros resultados sugieren que tanto mediante un procedimiento de sustitución muestral semicontrolada, como a través del ajuste estadístico de la no respuesta mediante la propensión a responder, se obtienen estimaciones de prevalencias corregidas similares.Unit non-response is a growing problem in sample surveys that can bias survey estimates if respondents and non-respondents differ systematically. Objetives: To compare the results of two nonresponse adjustment methods: field substitution and weighting nonresponse adjustment based on response propensity. Methods: Field substitution and response propensity weights are used to adjust for non-response and their effect on the prevalence of six survey outcomes is compared. Results Although significant differences are found between respondents and non-respondents, only slight changes on prevalence estimates are observed after adjustment, with both techniques showing similar results. In the sole case of smoking, substitution seems to have further biased survey estimates. Conclusions

  6. Clinical biophysics

    Energy Technology Data Exchange (ETDEWEB)

    Anbar, M.; Spangler, R.A.; Scott, P.

    1985-01-01

    Chapters are included on clinical decision making, principles of biomedical engineering, computers and their medical uses, clinical radiobiology, diagnostic x-ray radiology, clinical applications of ultrasonics, nuclear medicine, NMR imaging, diagnostic imaging, bioelectric techniques in diagnosis and therapy, biophysical aspects of the clinical laboratory, and biophysical aspects of modern surgery.

  7. Clinical Trials

    Science.gov (United States)

    Clinical trials are research studies that test how well new medical approaches work in people. Each study answers ... prevent, screen for, diagnose, or treat a disease. Clinical trials may also compare a new treatment to a ...

  8. Clinical Research and Clinical Trials

    Science.gov (United States)

    ... Meetings, Conferences & Events Partnering & Donating to the NICHD Staff Directory ... Clinical Research Skip sharing on social media links Share this: Page Content Clinical research is research that directly involves a ...

  9. Métricas de calidad y un modelo costo : Beneficio ajustados a un caso real de la industria del software

    OpenAIRE

    Sanchez, Alejandro; Riesco, Daniel Eduardo; Montejano, Germán Antonio; Peralta, Mario

    2002-01-01

    Las inspecciones de documentos de software son uno de los métodos más efectivos para detectar defectos, evitando la espera hasta la etapa de pruebas y brindando a la gerencia del proyecto valiosa información en tiempo real. Para analizar la utilización de inspecciones es necesario considerar la evolución de la calidad de los documentos inspeccionados, y la conveniencia económica del proceso. La calidad de los documentos se mide y compara utilizando métricas significativas. La rentabilidad ...

  10. Ajuste dos simuladores de dados meteorológicos do modelo EPIC para diferentes locais do Estado de São Paulo Adjustment of the simulators of meteorological data of the EPIC model for different localities in the State of São Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    Angélica G. Picini

    2005-06-01

    Full Text Available O modelo EPIC (Erosion Productivity Impact Calculator foi desenvolvido para simular o efeito de estratégias de manejos agrícolas em recursos hídricos e produtividade de solos. No presente estudo, o desempenho dos simuladores de dados meteorológicos foi avaliado para localidades do Estado de São Paulo (Campinas, Jaú, Manduri, Mococa, Pindorama e Ubatuba, incluindo: a Cadeia de Markov para probabilidades de seqüências de dias úmidos e secos; a equação de temperatura máxima ajustada para dias úmidos e a equação de radiação solar, também ajustada para dias úmidos. A partir dos testes e ajustes dos modelos com os dados históricos, verificou-se o melhor desempenho para o modelo de probabilidade de seqüências de dias secos, considerando-se o dia anterior úmido - P(W|D em relação ao modelo de probabilidade de seqüências para dois dias úmidos consecutivos - P(W|W. Os modelos de temperatura máxima do ar e de radiação solar apresentaram bom desempenho nos testes. Para todos os modelos, os melhores resultados foram obtidos a partir dos ajustes para cada local, quando comparados às estimativas obtidas pelos valores originais propostos na concepção do EPIC. Ubatuba apresentou comportamento distinto.EPIC (Erosion Productivity Impact Calculator model has been developed to simulate the effect of agricultural management strategies of water resources and soil productivity. In this study, the performance of meteorological data simulators were evaluated for six (Campinas, Jaú, Manduri, Mococa, Pindorama and Ubatuba localities in the State of São Paulo, Brazil, which include the Markov chain probabilities for the sequences of wet and dry days; the maximum air temperature model adjusted for wet days; and the solar radiation model also adjusted for wet days. From tests and adjustments of the models using the historical data for each locality, the best performance for the model of probabilities for dry days sequence has been found

  11. Influência da função distribuição de quebra na modelagem e simulação do circuito de moagem de Carajás - Parte 1 - ajuste de modelos Influence of the distribution function on modeling and simulation of the Carajás grinding circuit - Part 1 - model fit

    Directory of Open Access Journals (Sweden)

    Bianca Foggiatto

    2010-06-01

    Full Text Available O modelo de misturador perfeito (PMM leva em conta, tanto as características do equipamento, como as do minério. As características do minério são representadas pela função distribuição de quebra. Tal função pode ser determinada através de um método laboratorial proposto pelo JKMRC ou de funções padronizadas. O presente trabalho descreve o processo de modelagem matemática do circuito de moagem de Carajás, utilizando o software JKSimMet. Como resultado, foi possível avaliar a qualidade do ajuste do modelo em dois cenários: 1 utilizando a função distribuição de quebra-padrão do programa; 2 utilizando a função distribuição de quebra determinada para a alimentação do circuito de moagem. A partir desta análise, determinou-se, no ajuste do PMM e, em particular, na função taxa de quebra ou cinética de fragmentação, a influencia da função distribuição.The perfect mixing model (PMM is based on parameters derived from the equipment characteristics as well as ore breakage characteristics. Ore characteristics are represented through the appearance function. This function may be determined using JKMRC laboratorial methods or by standard functions. This work describes the model fitting process of the Carajas grinding circuit, using the JKSimMet simulator. Two scenarios were used in model fitting exercises: 1 standard appearance function; and 2 appearance function based on testing carried out on samples taken at circuit feed. From this assessment, the appearance function's influence in the PMM fit and it's relation with the breakage rate were determined. The influence of the appearance function on the respective breakage rate distribution was assessed.

  12. Clinical Research

    DEFF Research Database (Denmark)

    Christensen, Irene

    2016-01-01

    for years to come. This paper seeks to provide insights into ramp-up management studies through providing an agenda for conducting collaborative clinical research and extend this area by proposing how clinical research could be designed and executed in the Ramp- up management setting.......This paper is about the logic of problem solving and the production of scientific knowledge through the utilisation of clinical research perspective. Ramp-up effectiveness, productivity, efficiency and organizational excellence are topics that continue to engage research and will continue doing so...

  13. Clinical photography.

    Science.gov (United States)

    Jakowenko, Janelle

    2009-01-01

    Digital cameras, when used correctly, can provide the basis for telemedicine services. The increasing sophistication of digital cameras, combined with the improved speed and availability of the Internet, make them an instrument that every health-care professional should be familiar with. Taking satisfactory images of patients requires clinical photography skills. Photographing charts, monitors, X-ray films and specimens also requires expertise. Image capture using digital cameras is often done with insufficient attention, which can lead to inaccurate study results. The procedures in clinical photography should not vary from camera to camera, or from country to country. Taking a photograph should be a standardised process. There are seven main scenarios in clinical photography and health professionals who use cameras should be familiar with all of them. Obtaining informed consent prior to photography should be a normal part of the clinical photography routine.

  14. Clinical supervision.

    Science.gov (United States)

    Goorapah, D

    1997-05-01

    The introduction of clinical supervision to a wider sphere of nursing is being considered from a professional and organizational point of view. Positive views are being expressed about adopting this concept, although there are indications to suggest that there are also strong reservations. This paper examines the potential for its success amidst the scepticism that exists. One important question raised is whether clinical supervision will replace or run alongside other support systems.

  15. Clinical cases

    International Nuclear Information System (INIS)

    This presentation is about clinical cases and the contribution of the PET - CT Fag application in the diagnosis and treatment of different types of cancer. The cases presented were: neck diseases, epidermoid carcinoma, liver damage and metastasize, lymphoma, thrombosis, colonic cancer and lung disease

  16. [Clinical pathology].

    Science.gov (United States)

    Dimitrijević, Jovan

    2006-05-01

    This work describes the basic elements of pathology used in clinical practice. Pathology plays an important role in clinical and scientific work, but only a few areas of pathology will be covered. Although the contribution of oncological and surgical pathology to therapy is the most well known, the cases chosen here will involve infectious pathology, diseases of the kidney and the liver, autoimmune diseases, as well as organ transplantation. Especially important is the description of methods that enable more accurate morphological diagnoses, such as histochemistry, immunohistochemistry, immunofluorescence, and electronic microscopy. Previous experience and joint work with clinical doctors have enabled the definition of significant morphological elements as well as of essential methods of pathohistological diagnosis. Besides, as is often the case, although disease symptoms are difficult to discern and biochemical results do not show significant changes compared to normal values, the results of biopsy come as a surprise to clinical doctors. For example, in virus hepatitis B involving so-called asymptomatic HBsAg carriers, we discovered every morphological form of hepatitis, from minimal lesions to chronic, persistent, and active hepatitis. With hepatitis C, certain morphological lesions point to the etiopathogenesis of this disease and thus help to confirm the diagnosis and to instigate therapy on time. Another significant experience involves kidney biopsies in cases when clinical findings are asymptomatic. Often, in such cases, morphological findings point to glomerulonephritis and glomerulopathy at different stages. Timely and subtle morphological diagnostics offer a more precise explanation for the pathological injury of tissues than other diagnostic methods. In this way, by adopting new methods, the work of pathologists is included more and more in everyday clinical practice. The inclusion of pathologists in a transplantation team makes sure a proper selection of

  17. Os perfusionistas Brasileiros e o ajuste do rolete arterial: comparação entre a calibração estática e dinâmica Brazilian perfusionists and arterial roller pump adjustment: comparison between static and dynamic calibration method

    Directory of Open Access Journals (Sweden)

    Francisco Ubaldo Vieira Junior

    2011-06-01

    Full Text Available INTRODUÇÃO: Bombas de roletes desempenham um papel importante na circulação extracorpórea. No entanto, a oclusão dos roletes das bombas deve ser realizada de forma adequada e estas podem ser ajustadas, principalmente por dois métodos: estático e dinâmico. OBJETIVO: Investigar como os perfusionistas brasileiros ajustam as bombas de rolete arterial em seus serviços e testar o uso de um Dispositivo Auxiliar de Calibração que facilita o ajuste pelo método de calibração dinâmica. MÉTODOS: Foi instalada uma bomba de roletes com os acessórios necessários para a realização de sua calibração pelos métodos de velocidade de queda (calibração estática e calibração dinâmica durante o XXVIII Congresso Brasileiro de Circulação Extracorpórea. Foi solicitado aos perfusionistas que ajustassem uma bomba de roletes conforme procedimento normalmente utilizado em seu serviço. Após cada regulagem, foi medida a respectiva pressão pelo método de calibração dinâmica com o auxílio do dispositivo. O projeto foi aprovado pelo Comitê de Ética em Pesquisa da UNICAMP, sob Nº 1144/2010. RESULTADOS: Participaram da pesquisa 56 perfusionistas. A média das 56 medidas de pressão de calibração dinâmica foi 434 ± 214 mmHg; 76% das medidas realizadas ficaram no intervalo preconizado para o uso da técnica de calibração dinâmica (entre 150 e 500 mmHg. CONCLUSÃO: Os perfusionistas brasileiros tendem a calibrar bombas de roletes com ajustes menos oclusivos. As amplitudes das medidas de pressão de calibração dinâmica tendem a ser menores para perfusionistas mais experientes. O dispositivo pode ser utilizado por perfusionistas para ajustar bombas de roletes com maior precisão e, principalmente, repetitividade e em alguns minutos.INTRODUCTION: Roller pumps play an important role in extracorporeal circulation. However, occlusion of the rollers should be adequately performed and this can be adjusted mainly by two methods: static and

  18. Clinical biochemistry

    Science.gov (United States)

    Alexander, W. C.; Leach, C. S.; Fischer, C. L.

    1975-01-01

    The objectives of the biochemical studies conducted for the Apollo program were (1) to provide routine laboratory data for assessment of preflight crew physical status and for postflight comparisons; (2) to detect clinical or pathological abnormalities which might have required remedial action preflight; (3) to discover as early as possible any infectious disease process during the postflight quarantine periods following certain missions; and (4) to obtain fundamental medical knowledge relative to man's adjustment to and return from the space flight environment. The accumulated data presented suggest that these requirements were met by the program described. All changes ascribed to the space flight environment were subtle, whereas clinically significant changes were consistent with infrequent illnesses unrelated to the space flight exposure.

  19. Una Técnica de Inteligencia Artificial para el Ajuste de uno de los Elementos que Definen una B-Spline Racional No Uniforme (NURBS A Technique of Artificial Intelligence to Fit one of the Elements that Define a Non-Uniform Rational B-Spline (NURBS

    Directory of Open Access Journals (Sweden)

    Sandra P Mateus

    2010-01-01

    Full Text Available Dentro de las técnicas existentes de Inteligencia Artificial, se escogieron y adaptaron dos Redes Neuronales Artificiales (RNA para realizar el ajuste de uno de los elementos que definen una B-Spline Racional No Uniforme (NURBS y con ello obtener un modelado adecuado de la NURBS. Los elementos escogidos fueron los puntos de control. Las RNA utilizadas son las de Función de Base Radial y las de Kohonen o Mapas Auto-organizativos. Con base en el análisis de resultados y la caracterización de las RNA, la Función de Base Radial tuvo un desempeño más adecuado y óptimo para un número elevado de datos, lo cual es una desventaja de los Mapas Auto-organizativos. En este modelo se tiene que realizar procesos extras para determinar la neurona ganadora y realizar el reajuste de los pesos.In the existing techniques of Artificial Intelligence, two Artificial Neural Networks (ANN were selected and adapted to fit one of the elements that define a Non-Uniform Rational B-Spline (NURBS and thus obtaining an appropriate modeling of the NURBS. The selected elements were the checkpoints. The ANN used were the Radial Basis Function and the Kohonen model or Self-Organizing Maps. Based on the analysis of the results and characterization of the ANN the Radial Basis Function had a more appropriate and optimum performance for a large number of data, which is a disadvantage of the Self-Organizing Maps. In this model, additional processes must be done to determine the winning neuron and the weights must be refitted.

  20. Participating in Clinical Trials

    Science.gov (United States)

    ... this page please turn Javascript on. Participating in Clinical Trials About Clinical Trials A Research Study With Human Subjects A clinical ... to treat or cure a disease. Phases of Clinical Trials Clinical trials of drugs are usually described based ...

  1. Ajustes aos US-GAAPS: estudo empírico sobre sua relevância para empresas brasileiras com ADRs negociados na bolsa de Nova Iorque Adjustments to US-GAAPS: empirical study on their relevance for brazilian companies with ADR traded on the New York exchange

    Directory of Open Access Journals (Sweden)

    Fábio Moraes da Costa

    2007-06-01

    Full Text Available A relevância das informações disponibilizadas ao mercado por empresas brasileiras com American Depositary Recepts (ADRs negociados na Bolsa de Nova Iorque foi avaliada neste trabalho. Essas empresas devem atender à exigência da Securities and Exchange Commission e elaborar suas demonstrações contábeis de acordo com os United States Generally Accepted Accounting Principles (US-GAAP até 30 de junho, anualmente. Diante desse fato, dois conjuntos de informações estão disponíveis, promovendo a base de dados para o estudo da relevância das variáveis lucro líquido e patrimônio líquido para o período entre 1999 e 2003. Após a utilização do modelo desenvolvido por Ohlson (1995 e de seus desdobramentos posteriores, os resultados evidenciam que (1 as informações elaboradas segundo os princípios de contabilidade geralmente aceitos no Brasil são relevantes; (2 as informações em US-GAAP disponibilizadas em junho possuem menor ou igual relevância do que as divulgadas em abril e (3 os ajustes aos US-GAAP efetuados no patrimônio líquido são relevantes para o mercado de capitais brasileiro.This study evaluated the value-relevance of the information disclosed by Brazilian companies with American Depositary Receipts traded on the New York Stock Exchange. Those companies must comply with the requirement of the Securities and Exchange Commission and elaborate their financial statements according to the United States Generally Accepted Accounting Principles (US-GAAP until 30th of June, annually. Thus, two sets of information are available, providing data to evaluate the value-relevance of the variables net income and stockholders’ equity, from 1999 to 2003. After applying the model Ohlson developed in 1995 and its further developments, results indicate that (1 the information elaborated according to the generally accepted accounting principles in Brazil are value-relevant; (2 the relevance of the information in US-GAAP made available

  2. Análise da influência de diferentes tamanhos e composições de amostras no ajuste de uma relação hipsométrica para Eucalyptus grandis Evaluation of the influence of varying sample sizes and composition on the precision of a hypsometric relation for Eucalyptus grandis

    Directory of Open Access Journals (Sweden)

    Gilson Fernandes da Silva

    2007-08-01

    Full Text Available O ajuste de relações hipsométricas a partir de dados oriundos de inventário florestal com o objetivo de estimar o volume de árvores individuais é procedimento comum nas empresas florestais brasileiras. Assim, considerando um conjunto de 481 árvores de Eucalyptus grandis, obtido por meio de um procedimento de inventário florestal, foram simulados diversos tamanhos de amostra, variando de 6 a 204 árvores-amostra. Para cada tamanho de amostra foram feitas 10.000 simulações para cada tamanho de amostra obtidas aleatoriamente. Considerando o exposto, este trabalho teve como objetivo avaliar o efeito do tamanho e da composição das amostras simuladas sobre a precisão de um modelo hipsométrico previamente selecionado. O modelo selecionado teve como variáveis independentes o diâmetro à altura do peito (DAP e a idade, sendo avaliado também o efeito dessas variáveis sobre as estimativas de altura. Ao final, conclui-se que amostras com pelo menos 27 árvores proporcionaram estimativas mais precisas da altura das árvores quando comparadas com amostras menores que esse número. No entanto, amostras maiores que 27 árvores não implicaram ganhos significativos em termos de precisão. Conclui-se também que a variável DAP foi mais importante para estimar a altura do que a variável idade, considerando-se o modelo proposto, sendo a influência da variável idade na estimação da altura maior nas árvores de maior DAP.The adjustment of hypsometric relations using data from forest inventory aiming at the estimation of individual tree volumes is a common task in Brazilian forestry companies. This study used a data set of 481 trees of Eucalyptus grandis from a forest inventory. Simulation was carried out varying sample sizes from 6 to 204 sample-trees. For each sample size it was run 10,000 simulations for each size samples selected randomly. This study aimed at evaluating the effect of sample size and structure on the precision of a

  3. Modelos de ajuste e métodos para a determinação da curva de retenção de água de um Latossolo-vermelho-amarelo Adjustment models and methods for determining the soil water retention curve of a red-yellow Latosol

    Directory of Open Access Journals (Sweden)

    Wanderley Andrade Costa

    2008-04-01

    Full Text Available A caracterização da capacidade de retenção de água de um solo é fundamental para a descrição do fluxo de água através dele e para o adequado manejo da irrigação. São apresentadas comparações entre curvas de retenção de água do solo: ajustadas pelos modelos propostos por van Genuchten e por Hutson & Cass; obtidas pelo método do WP4 usando processo de umedecimento e de secagem; obtidas pelo método da centrífuga utilizando amostras deformadas e indeformadas; e obtidas pelo WP4 e centrífuga, usando um processo de secagem e amostra deformada. Amostras deformadas e indeformadas foram coletadas com trados específicos em um Latossolo Vermelho-Amarelo (LVA, textura argilosa. Foram determinadas as propriedades hídricas do solo necessárias à elaboração das curvas de retenção de água obtidas por análise de regressão. O modelo de van Genuchten possibilitou o melhor ajuste nas diversas situações estudadas. Considerando o processo de secagem, o teor de água útil obtido superou em 13 % o resultado do processo de umedecimento e evidenciou reduzido efeito de histerese. A amostra deformada apresentou-se com um teor de água útil superior 61,7 % ao valor obtido para a amostra indeformada. Entre os métodos estudados, verificou-se que aquele que usa o WP4 subestimou os dados obtidos pela centrífuga. Verificou-se que há diferenças entre amostra deformada e indeformada e os métodos utilizados na obtenção da curva de retenção.The characterization of the soil water retention capacity is fundamental for an adequate irrigation management and water flow description. We present comparisons of soil water retention curves adjusted in distinct ways: by the models proposed by van Genuchten and by Hutson & Cass; by the WP4 method in a wetting and drying process; by the centrifuge method using disturbed as well as undisturbed soil samples; and by the WP4 and centrifuge using a drying process and disturbed soil samples. Disturbed and

  4. Participating in Clinical Trials

    Medline Plus

    Full Text Available ... Participating in Clinical Trials: About Clinical Trials In This Topic About Clinical Trials Risks and Benefits Terms ... with Your Doctor Taking Medicines The information in this topic was provided by the National Library of ...

  5. Participating in Clinical Trials

    Medline Plus

    Full Text Available ... Participating in Clinical Trials About Clinical Trials A Research Study With Human Subjects A clinical trial is a research study that involves human subjects. The purpose of ...

  6. Participating in Clinical Trials

    Medline Plus

    Full Text Available ... Clinical Trials In This Topic About Clinical Trials Risks and Benefits Terms to Know Finding a Clinical ... researchers may gather information about experimental treatments, their risks, and how well they work compare existing therapies ...

  7. Participating in Clinical Trials

    Medline Plus

    Full Text Available Home > Health topics A-Z > Participating in Clinical Trials: About Clinical Trials In This Topic About Clinical Trials Risks ... centers across the country. The National Institutes of Health funds much of this basic research. Screening Trials ...

  8. Participating in Clinical Trials

    Medline Plus

    Full Text Available ... on. Participating in Clinical Trials About Clinical Trials A Research Study With Human Subjects A clinical trial is a research study that involves human subjects. The purpose ...

  9. Future requirements. Clinical investigations

    DEFF Research Database (Denmark)

    Qvist, V.

    2002-01-01

    Biocompatability, Cariology, Clinical trials, Dental materials, Helath services research, Human, Pedodontics......Biocompatability, Cariology, Clinical trials, Dental materials, Helath services research, Human, Pedodontics...

  10. Limites: a questão do manejo clínico hoje Limits: the issue of clinical management today

    Directory of Open Access Journals (Sweden)

    Walter Firmo de Oliveira Cruz

    2012-12-01

    Full Text Available Objetiva-se refletir sobre a necessidade de transformação na técnica psicanalítica, considerando o intrapsíquico e o intersubjetivo. A frequência de insucessos nos atendimentos indica a necessidade da discussão de novos parâmetros. A forma de abordar o tema buscou ultrapassar fronteiras entre as escolas psicanalíticas. Procurou-se caracterizar as manifestações subjetivas contemporâneas articulando-as às condições de oferta do trabalho analítico, visando eventuais ajustes no manejo clínico.This article offers a reflection on the need for change in psychoanalytical technique to account for intrapsychic and intersubjective processes. The failure rate in psychotherapeutic practice indicates that new criteria need to be discussed. Approaches to this topic sought to cross borders between different psychoanalytical schools of thought. Contemporary subjective manifestations were characterized and linked with the terms of offer of analytical work to suggest possible changes in clinical management.

  11. HISTIOCYTOSIS X: CLINICAL OBSERVATIONS

    Directory of Open Access Journals (Sweden)

    E. Y. Ponomareva

    2014-07-01

    Full Text Available Two clinical cases of pulmonary Langerhans cell histiocytosis X have been analyzed demonstrating lung and other inner organ pathology, common clinical and X-ray features but different life prognosis.

  12. HISTIOCYTOSIS X: CLINICAL OBSERVATIONS

    OpenAIRE

    E. Y. Ponomareva; A. P. Rebrov; E. E. Archangelskaja; A. A. Roshchina; R. N. Steshenko; A. S. Bukia; N. V. Dvornikova; N. N. Moskaleva

    2014-01-01

    Two clinical cases of pulmonary Langerhans cell histiocytosis X have been analyzed demonstrating lung and other inner organ pathology, common clinical and X-ray features but different life prognosis.

  13. Fertility Clinic Success Rates

    Science.gov (United States)

    ... and Autism 2013 Assisted Reproductive Technology Fertility Clinic Success Rates Report Recommend on Facebook Tweet Share Compartir 2013 ART Fertility Clinic Success Rates Report [PDF - 1MB] Bookmarks and thumbnails are ...

  14. Participating in Clinical Trials

    Medline Plus

    Full Text Available ... trial is to find out if an experimental drug, therapy, medical device, lifestyle change, or test will ... disease. Phases of Clinical Trials Clinical trials of drugs are usually described based on their phase. The ...

  15. Clinical Laboratory Fee Schedule

    Data.gov (United States)

    U.S. Department of Health & Human Services — Outpatient clinical laboratory services are paid based on a fee schedule in accordance with Section 1833(h) of the Social Security Act. The clinical laboratory fee...

  16. Research Areas - Clinical Trials

    Science.gov (United States)

    Information about NCI programs and initiatives that sponsor, conduct, develop, or support clinical trials, including NCI’s Clinical Trial Network (NCTN) and NCI Community Oncology Research Program (NCORP) initiatives.

  17. NIH Clinical Centers

    Data.gov (United States)

    Federal Laboratory Consortium — The NIH Clinical Center consists of two main facilities: The Mark O. Hatfield Clinical Research Center, which opened in 2005, houses inpatient units, day hospitals,...

  18. Spina Bifida Clinic Directory

    Science.gov (United States)

    ... Bifida Clinic Children’s Hospital New Orleans 200 Henry Clay Avenue (Pediatric-22) New Orleans, LA 70118 504- ... www.reach-clinic.org Back to top Oregon Child Development & Rehabilitation Center Oregon Health & Science University (pediatric ...

  19. Evolution of Clinical Enzymology

    OpenAIRE

    Büttner, J

    1981-01-01

    The evolution of clinical enzymology is discussed in relation to the history of general enzymology and clinical chemistry. The discussion is limited to the period from 1835 (definition of catalysis by Berzelius) to 1935 (description of the optical test by Warburg). In conclusion, a general account is given of the introduction of the concept of quantitative enzyme activity determination into clinical medicine.

  20. Participating in Clinical Trials

    Medline Plus

    Full Text Available ... was provided by the National Library of Medicine Topic last reviewed: December 2013 For an enhanced version of this page please turn Javascript on. Participating in Clinical Trials About Clinical Trials A Research Study With Human Subjects A clinical trial is ...

  1. Clinical document architecture.

    Science.gov (United States)

    Heitmann, Kai

    2003-01-01

    The Clinical Document Architecture (CDA), a standard developed by the Health Level Seven organisation (HL7), is an ANSI approved document architecture for exchange of clinical information using XML. A CDA document is comprised of a header with associated vocabularies and a body containing the structural clinical information. PMID:15061557

  2. University cardiology clinic.

    Science.gov (United States)

    Borozanov, V

    2013-01-01

    In distant 1972, within framework of the Internal Clinic, a cardiologic department was organized which was soon, on 29.XII.1974, transformed into the Cardiology Clinic, later the Institute for Heart Diseases, and in 2008 was renamed the University Cardiology Clinic. The greater part of its foundation was possible owing to Prof. Dimitar Arsov and Prof. Radovan Percinkovski, who was the clinic's first director in the period from 1974 to 1984. In 1985, the Clinic moved into its own new building, and in that way was physically detached from the Internal Clinics. Until its move to the new building, the Clinic functioned in the Internal Clinics building, organized as an outpatient polyclinic and inpatient infirmary department with clinical beds, a coronary intensive care unit and a haemodynamics laboratory equipped with the most modern equipment of that time. Today the Clinic functions through two integral divisions: an inpatient infirmary department which comprises an intensive coronary care unit and fourteen wards which altogether have 139 clinical beds, and the diagnostic centre which comprises an emergency clinic and day hospital, a communal and consultative outpatients' clinic functioning on a daily basis, through which some 300-350 patients pass every day, and diagnostic laboratories with a capacity of nearly 100 non-invasive and 20-30 invasive diagnostic procedures daily. The Clinic is a teaching base, and its doctors are educators of students at the Medical, Dental and Pharmacy Faculties, and also of students at the High School for Nurses and X-ray technicians, but also for those in Internal Medicine and especially Cardiology. The Clinic is also a base for scientific Masters' and post-doctoral studies, and such higher degrees are achieved not only by doctors who work here, but also by doctors from Medical Centres both in the country and abroad. Doctors working in this institution publish widely, not only a great number of books and monographs, but also original

  3. Clinical Process Intelligence

    DEFF Research Database (Denmark)

    Vilstrup Pedersen, Klaus

    2006-01-01

    knowledge to the point of care in a proactive manner. Attention has been on the translation of guidelines and the integration with the elec-tronic medical record (EMR). Less attention has been paid to the evaluation of clinical practice in relation to clinical guide-lines. I claim that single patient cases......, generalized processes de-ducted from many patient cases and clinical guidelines, are all guidelines that may be used in clinical reasoning. The differ-ence is the validity of the suggested actions and decisions. In the case of generalized processes deducted from EMRs, we have "what we usually do" practice i......Ideally, clinical guidelines are created from evidence based medicine. Translating the narrative semi-structured article for-mat of the clinical guidelines into a computable language makes it possible to utilize this information in IT-supported clinical reasoning, and thereby bring the relevant...

  4. Learning clinical reasoning.

    Science.gov (United States)

    Pinnock, Ralph; Welch, Paul

    2014-04-01

    Errors in clinical reasoning continue to account for significant morbidity and mortality, despite evidence-based guidelines and improved technology. Experts in clinical reasoning often use unconscious cognitive processes that they are not aware of unless they explain how they are thinking. Understanding the intuitive and analytical thinking processes provides a guide for instruction. How knowledge is stored is critical to expertise in clinical reasoning. Curricula should be designed so that trainees store knowledge in a way that is clinically relevant. Competence in clinical reasoning is acquired by supervised practice with effective feedback. Clinicians must recognise the common errors in clinical reasoning and how to avoid them. Trainees can learn clinical reasoning effectively in everyday practice if teachers provide guidance on the cognitive processes involved in making diagnostic decisions.

  5. Integrating clinical research into clinical decision making

    Directory of Open Access Journals (Sweden)

    Mark R Tonelli

    2011-01-01

    Full Text Available Evidence-based medicine has placed a general priority on knowledge gained from clinical research for clinical decision making. However, knowledge derived from empiric, population-based research, while valued for its ability to limit bias, is not directly applicable to the care of individual patients. The gap between clinical research and individual patient care centers on the fact that empiric research is not generally designed to answer questions of direct relevance to individual patients. Clinicians must utilize other forms of medical knowledge, including pathophysiologic rationale and clinical experience, in order to arrive at the best medical decision for a particular patient. In addition, clinicians must also elucidate and account for the goals and values of individual patients as well as barriers and facilitators of care inherent in the system in which they practice. Evidence-based guidelines and protocols, then, can never be prescriptive. Clinicians must continue to rely on clinical judgment, negotiating potentially conflicting warrants for action, in an effort to arrive at the best decision for a particular patient.

  6. Children and Clinical Studies: Why Clinical Studies Are Important

    Medline Plus

    Full Text Available ... NHLBI Trials Clinical Trial Websites Children and Clinical Studies Learn more about Children and Clinical Studies Importance of Children in Clinical Studies Children have often had to accept medicines and ...

  7. CME ON CLINICAL RESEARCH

    OpenAIRE

    Suneel. I. Majagi; S. S. Torgal; S. V. Hiremath

    2012-01-01

    Safety and efficacy are the two major concerns for any drug therapy. Globally clinical research plays an inevitable role in bringing a new molecule into the market after its synthesis by the pharmaceutical industries. Availability of large patient population, highly educated and skilled manpower, wide spectrum of diseases and favorable economic environment imply India’s potential as a global hub for clinical research. Pharmaceutical companies and Clinical Research Organization (CRO)s will req...

  8. Clinical research informatics

    CERN Document Server

    Richesson, Rachel L

    2012-01-01

    This book provides foundational coverage of key areas, concepts, constructs, and approaches of medical informatics as it applies to clinical research activities, in both current settings and in light of emerging policies. The field of clinical research is fully characterized (in terms of study design and overarching business processes), and there is emphasis on information management aspects and informatics implications (including needed activities) within various clinical research environments. The purpose of the book is to provide an overview of clinical research (types), activities, and are

  9. Participating in Clinical Trials

    Medline Plus

    Full Text Available ... In This Topic About Clinical Trials Risks and Benefits Terms to Know Finding a Clinical Trial Informed ... for more information Scientists usually do years of experiments in the laboratory and in animals before they even consider testing an experimental treatment ...

  10. Developing Clinical Competence

    NARCIS (Netherlands)

    P.F. Wimmers (Paul)

    2006-01-01

    textabstractThe development of clinical competence is the main purpose of medical education. The long road to become clinically competent starts on the first day of medical school, and every institution strives to select the best students. The responsibility of medical schools is to train th

  11. Clinical Supervision in Denmark

    DEFF Research Database (Denmark)

    Jacobsen, Claus Haugaard

    2011-01-01

    on giving and receiving clinical supervision as reported by therapists in Denmark. Method: Currently, the Danish sample consists of 350 clinical psychologist doing psychotherapy who completed DPCCQ. Data are currently being prepared for statistical analysis. Results: This paper will focus primarily...

  12. Participating in Clinical Trials

    Medline Plus

    Full Text Available ... In This Topic About Clinical Trials Risks and Benefits Terms to Know Finding a Clinical Trial Informed ... years of experiments in the laboratory and in animals before they even ... this early research occurs at universities and medical centers across the ...

  13. Gait analysis: clinical facts.

    Science.gov (United States)

    Baker, Richard; Esquenazi, Alberto; Benedetti, Maria G; Desloovere, Kaat

    2016-08-01

    Gait analysis is a well-established tool for the quantitative assessment of gait disturbances providing functional diagnosis, assessment for treatment planning, and monitoring of disease progress. There is a large volume of literature on the research use of gait analysis, but evidence on its clinical routine use supports a favorable cost-benefit ratio in a limited number of conditions. Initially gait analysis was introduced to clinical practice to improve the management of children with cerebral palsy. However, there is good evidence to extend its use to patients with various upper motor neuron diseases, and to lower limb amputation. Thereby, the methodology for properly conducting and interpreting the exam is of paramount relevance. Appropriateness of gait analysis prescription and reliability of data obtained are required in the clinical environment. This paper provides an overview on guidelines for managing a clinical gait analysis service and on the principal clinical domains of its application: cerebral palsy, stroke, traumatic brain injury and lower limb amputation.

  14. Clinical Pathway for Thyroidectomy.

    Science.gov (United States)

    Villar del Moral, Jesús María; Soria Aledo, Víctor; Colina Alonso, Alberto; Flores Pastor, Benito; Gutiérrez Rodríguez, María Teresa; Ortega Serrano, Joaquín; Parra Hidalgo, Pedro; Ros López, Susana

    2015-05-01

    Clinical pathways are care plans applicable to patient care procedures that present variations in practice and a predictable clinical course. They are designed not as a substitute for clinical judgment, but rather as a means to improve the effectiveness and efficiency of the procedures. This clinical pathway is the result of a collaborative work of the Sections of Endocrine Surgery and Quality Management of the Spanish Association of Surgeons. It attempts to provide a framework for standardizing the performance of thyroidectomy, the most frequently performed operation in endocrine surgery. Along with the usual documents of clinical pathways (temporary matrix, variance tracking and information sheets, assessment indicators and a satisfaction questionnaire) it includes a review of the scientific evidence around different aspects of pre, intra and postoperative management. Among others, antibiotic and antithrombotic prophylaxis, preoperative preparation in hyperthyroidism, intraoperative neuromonitoring and systems for obtaining hemostasis are included, along with management of postoperative hypocalcemia.

  15. Situated clinical cognition.

    Science.gov (United States)

    Timpka, T

    1995-10-01

    The features characterizing study of clinical cognition in situ are formulated as: Re-cognition of context, culture, history and affect. Socializing and phenomenalistic elements are again included in the research agenda. Interest for representations: an analysis level is reserved for the symbols, rules and images relevant to define in models of clinical cognition. De-emphasis on computer modeling: investigations focus on the 'functional systems' in which computers are involved. Rootedness in classical philosophical problems: issues concerning situated clinical cognition are connected to the width of available theoretical literature. Belief in interdisciplinary studies: productive interactions between the new and traditional disciplines is anticipated, implying that new shared methods have to be developed. When scientific perspectives are broadened, a new balance has to be found between the relevance of the subject of study and methodological rigor. The situated clinical cognition framework is to allow for moving between models, theories, and perspectives, as it does not presuppose a singular model of clinical thinking.

  16. Clinical PET application

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Sang-Moo; Hong, S. W.; Choi, C. W.; Yang, S. D.; Choi, J. S.; Kweon, O. J. et al. [Korea Cancer Center Hospital, Seoul (Korea)

    2000-12-01

    PET gives various metabolic images, and is very important, new diagnostic modality in clinical oncology. In Korea Cancer Center Hospital, PET is installed as a research tool of long-mid-term atomic research project. For the efficient use of PET for clinical and research projects, income from the patients should be managed to get the raw material, equipment, manpower, and also for the clinical PET research. 1. Support the clinical application of PET in oncology. 2. Budgetary management of income, costs for raw material, equipment, manpower, and the clinical PET research project. In this year, 1,327 cases of PET images were obtained, which resulted total income of 829,770,000won. Increased demand for {sup 18}FDG in and outside KCCH need more than 2 times production of {sup 18} in a day. Manpower should be added for the second PET operation and RI production. 10 figs., 4 tabs. (Author)

  17. Clinical Research Methodology 2: Observational Clinical Research.

    Science.gov (United States)

    Sessler, Daniel I; Imrey, Peter B

    2015-10-01

    Case-control and cohort studies are invaluable research tools and provide the strongest feasible research designs for addressing some questions. Case-control studies usually involve retrospective data collection. Cohort studies can involve retrospective, ambidirectional, or prospective data collection. Observational studies are subject to errors attributable to selection bias, confounding, measurement bias, and reverse causation-in addition to errors of chance. Confounding can be statistically controlled to the extent that potential factors are known and accurately measured, but, in practice, bias and unknown confounders usually remain additional potential sources of error, often of unknown magnitude and clinical impact. Causality-the most clinically useful relation between exposure and outcome-can rarely be definitively determined from observational studies because intentional, controlled manipulations of exposures are not involved. In this article, we review several types of observational clinical research: case series, comparative case-control and cohort studies, and hybrid designs in which case-control analyses are performed on selected members of cohorts. We also discuss the analytic issues that arise when groups to be compared in an observational study, such as patients receiving different therapies, are not comparable in other respects.

  18. Clinical PET application

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Sang Moo; Hong, Song W.; Choi, Chang W.; Yang, Seong Dae [Korea Cancer Center Hospital, Seoul (Korea)

    1997-12-01

    PET gives various methabolic images, and is very important, new diagnostic modality in clinical oncology. In Korea Cancer Center Hospital, PET is installed as a research tool of long-mid-term atomic research project. For the efficient use of PET for clinical and research projects, income from the patients should be managed to get the raw material, equipment, manpower, and also for the clinical PET research. 1. Support the clinical application of PET in oncology. 2. Budgetary management of income, costs for raw material, equipment, manpower, and the clinical PET research project. In this year, 250 cases of PET images were obtained, which resulted total income of 180,000,000 won. 50,000,000 won was deposited for the 1998 PET clinical research. Second year PET clinical research should be managed under unified project. Increased demand for {sup 18}FDG in and outside KCCH need more than 2 times production of {sup 18}FDG in a day purchase of HPLC pump and {sup 68}Ga pin source which was delayed due to economic crisis, should be done early in 1998. (author). 2 figs., 3 tabs.

  19. Clinical microbiology informatics.

    Science.gov (United States)

    Rhoads, Daniel D; Sintchenko, Vitali; Rauch, Carol A; Pantanowitz, Liron

    2014-10-01

    The clinical microbiology laboratory has responsibilities ranging from characterizing the causative agent in a patient's infection to helping detect global disease outbreaks. All of these processes are increasingly becoming partnered more intimately with informatics. Effective application of informatics tools can increase the accuracy, timeliness, and completeness of microbiology testing while decreasing the laboratory workload, which can lead to optimized laboratory workflow and decreased costs. Informatics is poised to be increasingly relevant in clinical microbiology, with the advent of total laboratory automation, complex instrument interfaces, electronic health records, clinical decision support tools, and the clinical implementation of microbial genome sequencing. This review discusses the diverse informatics aspects that are relevant to the clinical microbiology laboratory, including the following: the microbiology laboratory information system, decision support tools, expert systems, instrument interfaces, total laboratory automation, telemicrobiology, automated image analysis, nucleic acid sequence databases, electronic reporting of infectious agents to public health agencies, and disease outbreak surveillance. The breadth and utility of informatics tools used in clinical microbiology have made them indispensable to contemporary clinical and laboratory practice. Continued advances in technology and development of these informatics tools will further improve patient and public health care in the future.

  20. Marking out the clinical expert/clinical leader/clinical scholar: perspectives from nurses in the clinical arena

    OpenAIRE

    Mannix, Judy; Wilkes, Lesley; Jackson, Debra

    2013-01-01

    Background Clinical scholarship has been conceptualised and theorised in the nursing literature for over 30 years but no research has captured nurses’ clinicians’ views on how it differs or is the same as clinical expertise and clinical leadership. The aim of this study was to determine clinical nurses’ understanding of the differences and similarities between the clinical expert, clinical leader and clinical scholar. Methods A descriptive interpretative qualitative approach using semi-struct...

  1. Mindfulness and clinical psychology.

    Science.gov (United States)

    Childs, David

    2011-09-01

    Does mindfulness offer more to psychology than a useful therapeutic technique? This paper argues that it can also establish a state of presence which is understood in relation to the practice of phenomenology. Mindfulness is then both linked to a Western intellectual tradition and offers that tradition a systematic method. This is an opening for psychological investigation of the non-conceptual basis of everyday experience. The combination of this theoretical stance with the increasingly widespread practical training of clinical psychologists in mindfulness has broad implications for clinical practice; this is illustrated in relation to the descriptive approach to clinical problems, qualitative research, and reflective practice.

  2. [Midwifery clinical practicum education].

    Science.gov (United States)

    Kao, Chien-Huei; Gau, Meei-Ling

    2013-06-01

    Midwifery is a practical facet of the health sciences that emphasizes professional competence-oriented teaching and learning. Cognitive and practical processes integrate and build midwifery student professional knowledge, attitudes, and skills. Clinical education is a teaching method and strategy used to prepare midwifery students for professional practice. Midwifery clinical teaching plans are designed using literature review, expert opinions, and student comments and determine total required hours and caseloads. Midwifery clinical teaching activities and methods promote self-reflection, childbirth education fundamentals, learning by role model observation, and learning role function through overseas observership programs. This paper discusses midwifery education dilemmas and coping methods in Taiwan.

  3. CME ON CLINICAL RESEARCH

    Directory of Open Access Journals (Sweden)

    Suneel. I. Majagi

    2012-06-01

    Full Text Available Safety and efficacy are the two major concerns for any drug therapy. Globally clinical research plays an inevitable role in bringing a new molecule into the market after its synthesis by the pharmaceutical industries. Availability of large patient population, highly educated and skilled manpower, wide spectrum of diseases and favorable economic environment imply India’s potential as a global hub for clinical research. Pharmaceutical companies and Clinical Research Organization (CROs will require many trained personnel to carry out the clinical research. Keeping in mind these facts a CME with the theme of “Clinical research” had been jointly organized by the Dept of pharmacology, K.L.E University’s J.N.M.C, Belgaum and Indian Pharmacological Society (I.P.S, Belgaum branch on 20th February 2010. In the first scientific session, Dr.P.A.Patil (JNMC spoke on “Preclinical studies”. In vitro and in vivo experiments of various doses of ‘study drug’ can obtain preliminary efficacy, toxicity and pharmacokinetic information suggesting the scientific merit for further development as an investigational new drug (IND. Local or systemic toxicity studies can be conducted (ex: urine analysis, blood biochemical assay, gross and microscopic pathology etc. Dr. B.J. Mahendra Kumar (KLE University’s College of pharmacy talked on “Role of Drug Controller General of India (DCGI in Clinical Trials”. He explained about Drug and cosmetic acts/rules, requirements/guidelines for permission to import and/or to manufacture new drugs or to undertake clinical trials i.e. Schedule Y and its appendices. Dr.N.M.Patil (JNMC elaborated about “Ethical issues in clinical trials”. Ethics is required to: avoid exploitation of the subjects (maintain safety and wellbeing, protect vulnerable groups, children, disabled, elderly etc. Independent Ethics Committees (IEC and Institutional Review Boards (IRB are concerned with medical ethics. IECs review, regulate

  4. La sostenibilidad de la política fiscal en el Perú: 1970-2005

    OpenAIRE

    Luis A. Arias; Elmer Cuba; Raúl Salazar

    1997-01-01

    El presente estudio analiza la historia del déficit fiscal peruano en el período 1970-1996. El estudio tiene dos objetivos. El primero es construir un indicador de la situación fiscal libre de la influencia del ciclo económico; es decir, un déficit macroeconómicamente ajustado (DMA), que permita ver la posición fiscal subyacente. El segundo objetivo es construir indicadores de sostenibilidad fiscal, que puedan ser útiles para prevenir futuros ajustes. Estos ejercicios no solamente son útiles ...

  5. Cinética e modelagem da secagem de carambola (Averrhoa carambola L.) em secador de bandeja = Kinetics and modeling of star fruit (Averrhoa carambola L.) drying in a tray dryer

    OpenAIRE

    Paulo Bonomo; Modesto Antonio Chaves; Rafael da Costa Ilhéu Fontan; Calila Teixeira Santos; Renata Ferreira Bonomo

    2010-01-01

    No presente trabalho, objetivou-se obter curvas de secagem de carambola (Averrhoa carambola L.) em secador de bandejas. A partir dessas curvas foram obtidos dados de taxa de secagem e de difusividade, além do ajuste de modelos semiteóricos aos dados experimentais. As curvas de secagem foram obtidas, utilizando-se um secador de bandejas nas temperaturas de 50, 60 e 70°C e com fluxo de ar de 1,5 m s-1. Aos dados experimentais foram ajustados os modelos dePage, Henderson e Pabis e Exponencial, u...

  6. Fidelity in clinical simulation

    DEFF Research Database (Denmark)

    Jensen, Sanne; Nøhr, Christian; Rasmussen, Stine Loft

    2013-01-01

    Clinical simulation may be used to identify user needs for context sensitive functionalities in e-Health. The objective with this paper is to describe how user requirements and use cases in a large EHR-platform procurement may be validated by clinical simulation using a very low-fidelity prototype...... without any existing test data. Instead of using test scenarios and use cases, the healthcare professionals who are participating in the clinical simulation are generating both scenario and patient data themselves. We found that this approach allows for an imaginative discussion, not restricted by known...... functionalities and limitations, of the ideal EHR-platform. Subsequently, we discuss benefits and challenges of using an extremely low fidelity environment and discuss the degree of fidelity necessary for conducting clinical simulation....

  7. Participating in Clinical Trials

    Medline Plus

    Full Text Available ... experimental drug, therapy, medical device, lifestyle change, or test will help treat, find, or prevent a disease. A clinical trial may compare experimental products or tests to those already available or may compare existing ...

  8. Clinical Case Registries (CCR)

    Data.gov (United States)

    Department of Veterans Affairs — The Clinical Case Registries (CCR) replaced the former Immunology Case Registry and the Hepatitis C Case Registry with local and national databases. The CCR:HIV and...

  9. Clinical specular microscopy

    Energy Technology Data Exchange (ETDEWEB)

    Hirst, L.W.; Laing, R.A.

    1987-01-01

    This book provides the general ophthalmologist with a guide to the clinical applications of specular microscopy. Important material is included on laser injury, cataract surgery, corneal transplants, glaucoma, uveitis, and trauma.

  10. Participating in Clinical Trials

    Medline Plus

    Full Text Available ... Clinical Trials Videos quiz yourself MedlinePlus for More Information National Institute on Aging Related Topics Talking with Your Doctor Taking Medicines The information in this topic was provided by the National ...

  11. Health Clinic Cost Reports

    Data.gov (United States)

    U.S. Department of Health & Human Services — Healthcare Cost Report Information System (HCRIS) Dataset - Independent Rural Health Clinic and Freestanding Federally Qualified Health Center (HCLINIC).This data...

  12. Leprosy neuropathy: clinical presentations.

    Science.gov (United States)

    Nascimento, Osvaldo J M

    2013-09-01

    Leprosy is a chronic infectious peripheral neuropathy caused by Mycobacterium leprae. The different clinical presentations of the disease are determined by the quality of the host immune response. Early detection of leprosy and treatment by multidrug therapy are the most important steps in preventing deformity and disability. Thus the early recognition of the clinical leprosy presentation is essential. Mononeuritis, mononeuritis multiplex (MM), polyneuritis (MM summation) are the most frequent. The frequent anesthetic skin lesions are absent in the pure neuritic leprosy presentation form. Isolated peripheral nerve involvement is common, including the cranial ones. Arthritic presentation is occasionally seen, usually misdiagnosed as rheumatoid arthritis. Attention should be given to autonomic dysfunctions in leprosy. There are clinical presentations with severe neuropathic pain - painful small-fiber neuropathy. Leprous late-onset neuropathy (LLON) clinical presentation should be considered facing a patient who develop an inflammatory neuropathy many years after a previous skin leprosy treatment. PMID:24141500

  13. Understanding Clinical Alarm Safety.

    Science.gov (United States)

    Lukasewicz, Carol L; Mattox, Elizabeth Andersson

    2015-08-01

    Patient safety organizations and health care accreditation agencies recognize the significance of clinical alarm hazards. The Association for the Advancement of Medical Instrumentation, a nonprofit organization focused on development and use of safe and effective medical equipment, identifies alarm management as a major issue for health care organizations. ECRI Institute, a nonprofit organization that researches approaches for improving patient safety and quality of care, identifies alarm hazards as the most significant of the "Top Ten Health Technology Hazards" for 2014. A new Joint Commission National Patient Safety Goal focusing on clinical alarm safety contains new requirements for accredited hospitals to be fully implemented by 2016. Through a fictional unfolding case study, this article reviews selected contributing factors to clinical alarm hazards present in inpatient, high-acuity settings. Understanding these factors improves contributions by nurses to clinical alarm safety practice.

  14. Participating in Clinical Trials

    Medline Plus

    Full Text Available ... that could identify a disease in its early stages. Usually, trial participants must show signs of the ... Trials Clinical trials of drugs are usually described based on their phase. The U.S. Food and Drug ...

  15. Transgressive first clinical experiences

    DEFF Research Database (Denmark)

    Jensen, Carsten Juul; Jeppesen, Lise Kofoed; Drachmann, Merete

    2014-01-01

    . The nursing students’ learning seems to be oriented towards socialization in the clinic as a workplace. This means that the nursing students seek to deal with overwhelming experiences concerning the naked bodies of patients and death, useful application of theoretical knowledge, the path from novice...... to advanced beginner, and adjusting to the workplace community. The conclusion is that the learning of nursing students during their first clinical in-service placement appears informal and not founded on evident best practice.......This Study seeks to comprehend learning experiences of nursing students during their first clinical in-service placement. This Paper is part of a longitudinal development project interviewing the Student Nurse after each one of the five clinical in-service placements and then one year after...

  16. OARSI Clinical Trials Recommendations

    DEFF Research Database (Denmark)

    Kraus, V B; Blanco, F J; Englund, M;

    2015-01-01

    The objective of this work was to describe requirements for inclusion of soluble biomarkers in osteoarthritis (OA) clinical trials and progress toward OA-related biomarker qualification. The Guidelines for Biomarkers Working Group, representing experts in the field of OA biomarker research from...... both academia and industry, convened to discuss issues related to soluble biomarkers and to make recommendations for their use in OA clinical trials based on current knowledge and anticipated benefits. This document summarizes current guidance on use of biomarkers in OA clinical trials...... and their utility at five stages, including preclinical development and phase I to phase IV trials. As demonstrated by this summary, biomarkers can provide value at all stages of therapeutics development. When resources permit, we recommend collection of biospecimens in all OA clinical trials for a wide variety...

  17. ClinicalTrials.gov

    Data.gov (United States)

    U.S. Department of Health & Human Services — Provides patients, family members, health care professionals, and members of the public easy access to information on clinical trials for a wide range of diseases...

  18. Participating in Clinical Trials

    Medline Plus

    Full Text Available ... Learn More Participating in Clinical Trials Videos quiz yourself MedlinePlus for More Information National Institute on Aging Related Topics Talking with Your Doctor Taking Medicines The information in ...

  19. The clinical nanomedicine handbook

    CERN Document Server

    Brenner, Sara

    2013-01-01

    Designed to foster a stronger awareness and exploration of the subject by practicing clinicians, medical researchers and scientists, The Clinical Nanomedicine Handbook discusses the integration of nanotechnology, biology, and medicine from a clinical point of view. The book highlights relevant research and applications by specialty; it examines nanotechnology in depth, and the potential to solve medical problems. It also increases literacy in nanotechnology, and allows for more effective communication and collaboration between disciplines. Details worldwide developments in nanomedicine Provide

  20. Clinical careers film.

    Science.gov (United States)

    2015-09-01

    Those interested in developing clinical academic careers might be interested in a short animated film by Health Education England (HEE) and the National Institute for Health Research. The three-minute film, a frame from which is shown below, describes the sort of opportunities that are on offer to all professionals as part of the HEE's clinical academic careers framework. You can view the film on YouTube at tinyurl.com/pelb95c. PMID:26309005

  1. Clinical Applications for Estetrol

    OpenAIRE

    Visser M; Coelingh Bennink HJT

    2010-01-01

    In this paper the potential clinical applications for the human fetal estrogen estetrol (E4) are presented based on recently obtained data in preclinical and clinical studies. In the past E4 has been classified as a weak estrogen due to its rather low estrogen receptor affinity. However, recent research has demonstrated that due to its favorable pharmacokinetic properties, especially the slow elimination and long half-life, E4 is an effective orally bioavailable estrogen agonist with estro...

  2. Clinical toxinology specialty training.

    Science.gov (United States)

    White, Julian

    2013-07-01

    Clinical toxinology is the medical discipline dealing with the diagnosis, treatment and prevention of toxin diseases caused by exposure to venomous animals and poisonous animals, plants and mushrooms. Currently there is no national or international organisation accrediting or training doctors in this discipline, but the role of the IST in this area is the subject of a recently approved revised Constitution. A few courses covering some aspects of clinical toxinology exist, either with limited curricula, or with only a minor clinical focus, or with a very regional, non-global focus. The only comprehensive clinical toxinology course is the one provided in Adelaide, Australia, running regularly since 1997. This course may form the nucleus from which IST can develop a global accredited training scheme in clinical toxinology. Such a scheme will require input from diverse global regions and will be far more comprehensive and over a much longer time than the current Short Course, though may incorporate the Short Course in some way, or a derivative of it. Accreditation of medical expertise in clinical toxinology will be required at the national level and this might be accomplished by the IST working with existing national medical specialty organisations and governments, with the IST supervising the training and accreditation requirements and the national organisations providing the framework for registration of medical expertise at the local level. PMID:23524067

  3. Clinical Studies with Epothilones

    Science.gov (United States)

    Altmann, Karl-Heinz

    As indicated in previous chapters, epothilone research so far has delivered seven new chemical entities that have been advanced to clinical trials in humans (Fig. 1). However, the amount of clinical data publicly available at this time strongly varies between individual compounds, depending on their development stage, but also on the general publication policy of the developing company. The compound that has been most comprehensively characterized in the clinical literature is ixabepilone (BMS-247550), for which trial results have been described in a number of articles in peer-reviewed journals and which has been granted FDA approval for two clinical indications on Oct. 16, 2007. For all other compounds, most of the information on clinical trials is available only in abstract form. In all these cases it remains uncertain, whether the content of these abstracts fully reflects the content of the subsequent (poster or oral) presentations at the corresponding meeting; in fact, it seems likely that additional data will have been included in the actual meeting presentations that may not have been available at the time of abstract submission. As this is unknown to the author, such additional information cannot be considered in this chapter, which is solely based on information documented in accessible abstracts or journal publications. It should also be kept in mind that the interpretation of data from ongoing clinical trials or forward looking statements based on data from completed trials are always preliminary in character.

  4. Fundamentals of clinical trials

    CERN Document Server

    Friedman, Lawrence M; DeMets, David L; Reboussin, David M; Granger, Christopher B

    2015-01-01

    This is the fifth edition of a very successful textbook on clinical trials methodology, written by recognized leaders who have long and extensive experience in all areas of clinical trials. The three authors of the first four editions have been joined by two others who add great expertise.  Most chapters have been revised considerably from the fourth edition.  A chapter on regulatory issues has been included and the chapter on data monitoring has been split into two and expanded.  Many contemporary clinical trial examples have been added.  There is much new material on adverse events, adherence, issues in analysis, electronic data, data sharing, and international trials.  This book is intended for the clinical researcher who is interested in designing a clinical trial and developing a protocol. It is also of value to researchers and practitioners who must critically evaluate the literature of published clinical trials and assess the merits of each trial and the implications for the care and treatment of ...

  5. Children and Clinical Studies: Why Clinical Studies Are Important

    Medline Plus

    Full Text Available ... Systematic Evidence Reviews & Clinical Practice Guidelines Resources Continuing Education Researchers Funding Training & Career Development Division of Intramural Research Research Resources Research Meeting Summaries Technology Transfer Clinical Trials What Are Clinical Trials? Children & ...

  6. Clinical outcomes of the inclusion of the therapeutic drug monitoring report in the electronic clinical record.

    Science.gov (United States)

    Sáez Belló, Marina; Moya Gil, Ana; López Montenegro Soria, M Ángeles; Sánchez Sancho, Pablo; Frias Ruiz, Pau; Climente Martí, Mónica

    2016-09-01

    Objetivos: Valorar la integración del informe de monitorización farmacocinética (IMFC) en la historia clínica electrónica (HCE). Método: Estudio observacional ambispectivo de cohortes de 149 días de duración: PRE (retrospectiva, 49 días) con emisión del IMFC en papel y POST (prospectiva, 100 días) con emisión del IMFC integrado en HCE. Criterios de exclusión: Pacientes no ingresados, solicitudes de monitorización farmacocinética de unidades de críticos y neonatos, así como monitorizaciones cuyo objetivo no era el ajuste posológico.

  7. How Do Clinical Trials Work?

    Science.gov (United States)

    ... Trials Clinical Trial Websites How Do Clinical Trials Work? If you take part in a clinical trial, ... kol). This plan explains how the trial will work. The trial is led by a principal investigator ( ...

  8. Computerizing clinical practice guidelines

    DEFF Research Database (Denmark)

    Lyng, Karen Marie

    It is well described that hospitals have problems with sustaining high quality of care and expedient introduction of new medical knowledge. Clinical practice guidelines (CPGs) have been promoted as a remedy to deal with these problems. It is, however, also well described that application and comp......It is well described that hospitals have problems with sustaining high quality of care and expedient introduction of new medical knowledge. Clinical practice guidelines (CPGs) have been promoted as a remedy to deal with these problems. It is, however, also well described that application...... and compliance with CPGs in most areas of clinical practice are deficient. Computerization of CPGs has been brought forward as a method to disseminate and to support application of CPGs. Until now, CPG-computerization has focused on development of formal expressions of CPGs. The developed systems have, however......, not gained any extensive application in clinical practice. The basic assumption in this thesis is that the scanty penetration is due to an inappropriate design process when designing computerized CPGs for clinical work practice. This thesis examines the application of guidance within areas where CPG...

  9. Pediatric anthrax clinical management.

    Science.gov (United States)

    Bradley, John S; Peacock, Georgina; Krug, Steven E; Bower, William A; Cohn, Amanda C; Meaney-Delman, Dana; Pavia, Andrew T

    2014-05-01

    Anthrax is a zoonotic disease caused by Bacillus anthracis, which has multiple routes of infection in humans, manifesting in different initial presentations of disease. Because B anthracis has the potential to be used as a biological weapon and can rapidly progress to systemic anthrax with high mortality in those who are exposed and untreated, clinical guidance that can be quickly implemented must be in place before any intentional release of the agent. This document provides clinical guidance for the prophylaxis and treatment of neonates, infants, children, adolescents, and young adults up to the age of 21 (referred to as "children") in the event of a deliberate B anthracis release and offers guidance in areas where the unique characteristics of children dictate a different clinical recommendation from adults.

  10. OARSI Clinical Trials Recommendations

    DEFF Research Database (Denmark)

    McAlindon, T. E.; Driban, J. B.; Henrotin, Y.;

    2015-01-01

    The goal of this document is to update the original OARSI recommendations specifically for the design, conduct, and reporting of clinical trials that target symptom or structure modification among individuals with knee osteoarthritis (OA). To develop recommendations for the design, conduct......, and reporting of clinical trials for knee OA we initially drafted recommendations through an iterative process. Members of the working group included representatives from industry and academia. After the working group members reviewed a final draft, they scored the appropriateness for recommendations. After...... and index knee, describing interventions, patient-reported and physical performance measures, structural outcome measures, biochemical biomarkers, and reporting recommendations. In summary, the working group identified 25 recommendations that represent the current best practices regarding clinical trials...

  11. Toward transparent clinical policies.

    Science.gov (United States)

    Shiffman, Richard N; Marcuse, Edgar K; Moyer, Virginia A; Neuspiel, Daniel R; Hodgson, Elizabeth Susan; Glade, Gordon; Harbaugh, Norman; Miller, Marlene R; Sevilla, Xavier; Simpson, Lisa; Takata, Glenn

    2008-03-01

    Clinical policies of professional societies such as the American Academy of Pediatrics are valued highly, not only by clinicians who provide direct health care to children but also by many others who rely on the professional expertise of these organizations, including parents, employers, insurers, and legislators. The utility of a policy depends, in large part, on the degree to which its purpose and basis are clear to policy users, an attribute known as the policy's transparency. This statement describes the critical importance and special value of transparency in clinical policies, guidelines, and recommendations; helps identify obstacles to achieving transparency; and suggests several approaches to overcome these obstacles.

  12. Clinical reasoning of nursing students on clinical placement: Clinical educators' perceptions.

    Science.gov (United States)

    Hunter, Sharyn; Arthur, Carol

    2016-05-01

    Graduate nurses may have knowledge and adequate clinical psychomotor skills however they have been identified as lacking the clinical reasoning skills to deliver safe, effective care suggesting contemporary educational approaches do not always facilitate the development of nursing students' clinical reasoning. While nursing literature explicates the concept of clinical reasoning and develops models that demonstrate clinical reasoning, there is very little published about nursing students and clinical reasoning during clinical placements. Semi-structured interviews were conducted with ten clinical educators to gain an understanding of how they recognised, developed and appraised nursing students' clinical reasoning while on clinical placement. This study found variability in the clinical educators' conceptualisation, recognition, and facilitation of students' clinical reasoning. Although most of the clinical educators conceptualised clinical reasoning as a process those who did not demonstrated the greatest variability in the recognition and facilitation of students' clinical reasoning. The clinical educators in this study also described being unable to adequately appraise a student's clinical reasoning during clinical placement with the use of the current performance assessment tool. PMID:27235568

  13. ClinicalAccess: a clinical decision support tool.

    Science.gov (United States)

    Crowell, Karen; Vardell, Emily

    2015-01-01

    ClinicalAccess is a new clinical decision support tool that uses a question-and-answer format to mirror clinical decision-making strategies. The unique format of ClinicalAccess delivers concise, authoritative answers to more than 120,000 clinical questions. This column presents a review of the product, a sample search, and a comparison with other point-of-care search engines. PMID:25927513

  14. [Clinical examination of vertigo].

    Science.gov (United States)

    Topka, Helge Roland

    2016-07-01

    Acute vertigo may originate from peripheral or central vestibular disorders. As central vestibular symptoms may indicate severe brainstem or cerebellar ischemia, rapid clinical differentiation is required. To this end, evaluation of spontaneous or gaze-evoked nystagm, head-impulse test as well identification of skew deviation are most helpful. PMID:27464281

  15. Prolactinomas : clinical studies

    NARCIS (Netherlands)

    Kars, Marleen

    2008-01-01

    Prolactinoma are treated with dopamine agonists, which are effective in reducing prolactin and tumor size. Studies reporting clinical and radiological outcome are scarce. The study described in chapter 2, assesses long-term outcome in patients treated with dopamine agonists for macroprolactinoma. An

  16. Clinical Positioning Space

    DEFF Research Database (Denmark)

    Williams, Lars Peter Hedegaard; Christensen, Mette Krogh; Rytter, Carsten;

    2014-01-01

    In this article, we present a case study of residents’ clinical experiences and communication in outpatient oncology consultations. We apply positioning theory, a dynamic alternative to role theory, to investigate how oncology residents and patients situate themselves as persons with rights...

  17. Participating in Clinical Trials

    Medline Plus

    Full Text Available ... to find out if an experimental drug, therapy, medical device, lifestyle change, or test will help treat, find, or prevent a disease. A clinical trial may compare experimental products or ... universities and medical centers across the country. The National Institutes of ...

  18. Clinical Mastery of Hypnosis.

    Science.gov (United States)

    Horevitz, Richard P.

    Hypnosis is an increasingly popular clinical intervention. The number of training courses in hypnosis is growing each year. Research on hypnosis training appears to show that limited exposure to training, as is typical in the common 3 to 5 day format of mass training, produces limited results. Only when training is extended over time do the…

  19. The Unstructured Clinical Interview

    Science.gov (United States)

    Jones, Karyn Dayle

    2010-01-01

    In mental health, family, and community counseling settings, master's-level counselors engage in unstructured clinical interviewing to develop diagnoses based on the "Diagnostic and Statistical Manual of Mental Disorders" (4th ed., text rev.; "DSM-IV-TR"; American Psychiatric Association, 2000). Although counselors receive education about…

  20. Clinically isolated laryngeal sarcoidosis

    DEFF Research Database (Denmark)

    Plaschke, Christina Caroline; Owen, Hanne Hoejris; Rasmussen, Niels

    2011-01-01

    to a combination of CO(2)-laser excision of supraglottic tissue and closure of the incision with sutures. All serological tests were negative or normal, including angiotensin 1 converting enzyme. The clinical expression was uniform with pale, smooth swellings of the supraglottic structures. Surgery proved...

  1. Hepatitis C: Clinical Trials

    Science.gov (United States)

    ... Reports Clinician Tools Clinician Tools Home Guidelines and Best Practices Topic Reviews Algorithms, Screens, Toolkits Provider Education Provider ... about federally and privately supported clinical research in human volunteers. Site gives information about a trial's purpose, who may participate, locations, and phone ... Forms State and Local Resources Strat Plan FY 2014-2020 VA Plans, Budget, & ...

  2. Radioimmunoimaging in clinical oncology

    International Nuclear Information System (INIS)

    In the thesis radiolabeled antibodies were tested for screening of cancer in patients without previous knowledge of tumour histopathology. They were tested as well targeting known cancer, sometimes in unknown clinical stage. Methods for detection enhancement utilizing double-tracer techniques and alternative routes of administration were also investigated. (385 refs., 11 tabs.)

  3. Integrated clinical information system.

    Science.gov (United States)

    Brousseau, G

    1995-01-01

    SIDOCI (Système Informatisé de DOnnées Cliniques Intégrées) is a Canadian joint venture introducing newly-operating paradigms into hospitals. The main goal of SIDOCI is to maintain the quality of care in todayUs tightening economy. SIDOCI is a fully integrated paperless patient-care system which automates and links all information about a patient. Data is available on-line and instantaneously to doctors, nurses, and support staff in the format that best suits their specific requirements. SIDOCI provides a factual and chronological summary of the patient's progress by drawing together clinical information provided by all professionals working with the patient, regardless of their discipline, level of experience, or physical location. It also allows for direct entry of the patient's information at the bedside. Laboratory results, progress notes, patient history and graphs are available instantaneously on screen, eliminating the need for physical file transfers. The system, incorporating a sophisticated clinical information database, an intuitive graphical user interface, and customized screens for each medical discipline, guides the user through standard procedures. Unlike most information systems created for the health care industry, SIDOCI is longitudinal, covering all aspects of the health care process through its link to various vertical systems already in place. A multidisciplinary team has created a clinical dictionary that provides the user with most of the information she would normally use: symptoms, signs, diagnoses, allergies, medications, interventions, etc. This information is structured and displayed in such a manner that health care professionals can document the clinical situation at the touch of a finger. The data is then encoded into the patient's file. Once encoded, the structured data is accessible for research, statistics, education, and quality assurance. This dictionary complies with national and international nomenclatures. It also

  4. Computers and clinical arrhythmias.

    Science.gov (United States)

    Knoebel, S B; Lovelace, D E

    1983-02-01

    Cardiac arrhythmias are ubiquitous in normal and abnormal hearts. These disorders may be life-threatening or benign, symptomatic or unrecognized. Arrhythmias may be the precursor of sudden death, a cause or effect of cardiac failure, a clinical reflection of acute or chronic disorders, or a manifestation of extracardiac conditions. Progress is being made toward unraveling the diagnostic and therapeutic problems involved in arrhythmogenesis. Many of the advances would not be possible, however, without the availability of computer technology. To preserve the proper balance and purposeful progression of computer usage, engineers and physicians have been exhorted not to work independently in this field. Both should learn some of the other's trade. The two disciplines need to come together to solve important problems with computers in cardiology. The intent of this article was to acquaint the practicing cardiologist with some of the extant and envisioned computer applications and some of the problems with both. We conclude that computer-based database management systems are necessary for sorting out the clinical factors of relevance for arrhythmogenesis, but computer database management systems are beset with problems that will require sophisticated solutions. The technology for detecting arrhythmias on routine electrocardiograms is quite good but human over-reading is still required, and the rationale for computer application in this setting is questionable. Systems for qualitative, continuous monitoring and review of extended time ECG recordings are adequate with proper noise rejection algorithms and editing capabilities. The systems are limited presently for clinical application to the recognition of ectopic rhythms and significant pauses. Attention should now be turned to the clinical goals for detection and quantification of arrhythmias. We should be asking the following questions: How quantitative do systems need to be? Are computers required for the detection of

  5. [Clinical diagnosis of dyslexia].

    Science.gov (United States)

    Martínez Hermosillo, A; Balderas Gil, A

    1980-01-01

    In 5 years of experience at the Instituto Nacional de la Comunicacion Humana, 302 clinical histories showed the diagnosis of dyslexia. The following parameters were studied: age, sex, heredofamilial history, gestation, psychomotor development, clinical picture, examination of the language (type, reading, spontaneous writing, dictation, mathematic concepts), laterality, scholarship, scholar failures, psychological study. The following results were obtained: Dyslexia was more important or frequent between 5 to 8.9 years of age. Males predominated 3:1. The heredofamilial history was important. Dyslexia prevailed in products of the first gestations. A high disturbance was found in the psychomotor development of a large percent of dyslexic patients. Examination of language was also important. Dyslexia was more frequent in right-handed patients. Scholar failures in one or more instances were found. The psychological study must be done. If dyslexia is diagnosed on time, it may be prevented and all unwanted sequelae may be avoided.

  6. Clinical physiopathology of hypernatremia

    Directory of Open Access Journals (Sweden)

    F. Sgambato

    2013-05-01

    Full Text Available BACKGROUND The maintenance of sodium levels at normal ranges has to be considered one of the most important and crucial physiological balance in order to preserve life. The increase of natremia determines the leakage of H2O from the inside of cells and the consequent brain cells withering, that causes encephalopathy at different stages and in some cases it can even lead to death. AIM OF THE STUDY The fundamentals of general physiopathology are analysed together with systems of compensation and brain adaptation in the three different aetiopathogenetic forms: primary increase of sodium (hypervolemic and haedematose form; missed introduction of pure water (mainly euvolemic form, with no aedema; loss of hypotonic fluids (hypovolemic form with dehydration. The three different clinical entities with their relative clinical approaches have been described.

  7. Models for transition clinics.

    Science.gov (United States)

    Carrizosa, Jaime; An, Isabelle; Appleton, Richard; Camfield, Peter; Von Moers, Arpad

    2014-08-01

    Transition is a purposeful, planned process that addresses the medical, psychosocial, educational, and vocational needs of adolescents and young adults with chronic medical conditions, as they advance from a pediatric and family-centered to an adult, individual focused health care provider. This article describes some of the models for transition clinics or services for epilepsy in five countries (Canada, France, Colombia, Germany, and the United Kingdom). These models include joint adult and pediatric clinics, algorithm-driven service, and a check list system in the context of pediatric care. Evaluation of these models is limited, and it is not possible to choose an optimal program. The attitude and motivation of health care providers may be the most important elements. PMID:25209087

  8. Clinical Applications for Estetrol

    Directory of Open Access Journals (Sweden)

    Visser M

    2010-01-01

    Full Text Available In this paper the potential clinical applications for the human fetal estrogen estetrol (E4 are presented based on recently obtained data in preclinical and clinical studies. In the past E4 has been classified as a weak estrogen due to its rather low estrogen receptor affinity. However, recent research has demonstrated that due to its favorable pharmacokinetic properties, especially the slow elimination and long half-life, E4 is an effective orally bioavailable estrogen agonist with estrogen antagonistic effects on the breast in the presence of estradiol. Based on the pharmacokinetic properties, the pharmacological profile and the safety and efficacy results in human studies, E4 seems potentially suitable as a drug for human use in applications such as hormone replacement therapy (vaginal atrophy and vasomotor symptoms, contraception, osteoporosis and breast cancer.

  9. Clinical applications for estetrol.

    Science.gov (United States)

    Visser, Monique; Coelingh Bennink, Herjan J T

    2009-03-01

    In this paper the potential clinical applications for the human fetal estrogen estetrol (E(4)) are presented based on recently obtained data in preclinical and clinical studies. In the past E(4) has been classified as a weak estrogen due to its rather low estrogen receptor affinity. However, recent research has demonstrated that due to its favorable pharmacokinetic properties, especially the slow elimination and long half-life, E(4) is an effective orally bioavailable estrogen agonist with estrogen antagonistic effects on the breast in the presence of estradiol. Based on the pharmacokinetic properties, the pharmacological profile and the safety and efficacy results in human studies, E(4) seems potentially suitable as a drug for human use in applications such as hormone replacement therapy (vaginal atrophy and vasomotor symptoms), contraception, osteoporosis and breast cancer. PMID:19167495

  10. Horizons in clinical nanomedicine

    CERN Document Server

    Karagkiozaki, Varvara

    2014-01-01

    Nanomedicine-the application of nanotechnology to health sciences-has the potential to address many important medical problems by exploiting the advanced physicochemical characteristics of nanostructured materials and devices. It can revolutionize conventional medicine by offering cutting-edge developments in the processes of diagnosing, treating, and preventing diseases, injuries, or genetic disorders. Thus, clinical nanomedicine holds promise to preserve and improve human health.This book provides a comprehensive overview on the forefront developments of nanotechnology in various domains of

  11. Prolactinomas: clinical studies

    OpenAIRE

    Kars, Marleen

    2008-01-01

    Prolactinoma are treated with dopamine agonists, which are effective in reducing prolactin and tumor size. Studies reporting clinical and radiological outcome are scarce. The study described in chapter 2, assesses long-term outcome in patients treated with dopamine agonists for macroprolactinoma. An increased risk of cardiac valve disease has been reported in patients treated with cabergoline for Parkinson’s disease. Stimulation of serotonin receptors on cardiac valves by dopamine agonists re...

  12. Pharmacovigilance using Clinical Text.

    Science.gov (United States)

    Lependu, Paea; Iyer, Srinivasan V; Bauer-Mehren, Anna; Harpaz, Rave; Ghebremariam, Yohannes T; Cooke, John P; Shah, Nigam H

    2013-01-01

    The current state of the art in post-marketing drug surveillance utilizes voluntarily submitted reports of suspected adverse drug reactions. We present data mining methods that transform unstructured patient notes taken by doctors, nurses and other clinicians into a de-identified, temporally ordered, patient-feature matrix using standardized medical terminologies. We demonstrate how to use the resulting high-throughput data to monitor for adverse drug events based on the clinical notes in the EHR. PMID:24303315

  13. Rural health clinics infrastructure

    Energy Technology Data Exchange (ETDEWEB)

    Olson, K.

    1997-12-01

    The author discusses programs which were directed at the installation of photovoltaic power systems in rural health clinics. The objectives included: vaccine refrigeration; ice pack freezing; lighting; communications; medical appliances; sterilization; water purification; and income generation. The paper discusses two case histories, one in the Dominican Republic and one in Colombia. The author summarizes the results of the programs, both successes and failures, and offers an array of conclusions with regard to the implementation of future programs of this general nature.

  14. Clinical highlights from Amsterdam

    Directory of Open Access Journals (Sweden)

    Jouke T. Annema

    2016-07-01

    Full Text Available This article contains highlights and a selection of the scientific advances from the Clinical Assembly that were presented at the 2015 European Respiratory Society International Congress in Amsterdam, the Netherlands. The most relevant topics for clinicians will be discussed, covering a wide range of areas including interventional pulmonology, rehabilitation and chronic care, thoracic imaging, diffuse and parenchymal lung diseases, and general practice and primary care. In this comprehensive review, exciting novel data will be discussed and put into perspective.

  15. Clinical Applications of Capnography

    OpenAIRE

    NIKOLOVA-TODOROVA, ZORICA

    2008-01-01

    This article gives a short review of the basic definitions of capnography and its use. The introduction gives an overview of the historical development of this procedure. Technical features of the method are presented, followed by several definitions for understanding the basic terms needed to realize the applications of capnography. The last section is a descriptive part that explains the most important clinical applications of capnography, the strengths and limitations of this method. This ...

  16. Clinical multiphoton FLIM tomography

    Science.gov (United States)

    König, Karsten

    2012-03-01

    This paper gives an overview on current clinical high resolution multiphoton fluorescence lifetime imaging in volunteers and patients. Fluorescence lifetime imaging (FLIM) in Life Sciences was introduced in Jena/Germany in 1988/89 based on a ZEISS confocal picosecond dye laser scanning microscope equipped with a single photon counting unit. The porphyrin distribution in living cells and living tumor-bearing mice was studied with high spatial, temporal, and spectral resolution. Ten years later, time-gated cameras were employed to detect dental caries in volunteers based on one-photon excitation of autofluorescent bacteria with long fluorescence lifetimes. Nowadays, one-photon FLIM based on picosecond VIS laser diodes are used to study ocular diseases in humans. Already one decade ago, first clinical twophoton FLIM images in humans were taken with the certified clinical multiphoton femtosecond laser tomograph DermaInspectTM. Multiphoton tomographs with FLIM modules are now operating in hospitals at Brisbane, Tokyo, Berlin, Paris, London, Modena and other European cities. Multiple FLIM detectors allow spectral FLIM with a temporal resolution down to 20 ps (MCP) / 250 ps (PMT) and a spectral resolution of 10 nm. Major FLIM applications include the detection of intradermal sunscreen and tattoo nanoparticles, the detection of different melanin types, the early diagnosis of dermatitis and malignant melanoma, as well as the measurement of therapeutic effects in pateints suffering from dermatitis. So far, more than 1,000 patients and volunteers have been investigated with the clinical multiphoton FLIM tomographs DermaInspectTM and MPTflexTM.

  17. Clinical vaccine development

    OpenAIRE

    Han, Seunghoon

    2015-01-01

    Vaccination is regarded as one of the biggest triumphs in the history of medicine. We are living in the most successful period of vaccine development. The accumulation of multidisciplinary knowledge and the investment of massive funding have enabled the development of vaccines against many infectious diseases as well as other diseases including malignant tumors. The paradigm of clinical vaccine evaluation and licensure has also been modernized based on scientific improvements and historical e...

  18. Psychiatrists and clinical psychologists

    Directory of Open Access Journals (Sweden)

    Ajai R. Singh

    2006-03-01

    Full Text Available Psychiatrists and clinical psychologists share an inevitable, if rather uneasy, relationship. So very much like a modern marriage. Can't do without it, can't get out of it. Both sides contemplate divorce often. Think of separation by mutual consent. Even keep threatening as they rave and rant. Have secret, and not so secret, flings on the side. But, like the proverbial homing bird, or the conservative Indian arranged marriage, have no option but to stick it out with each other. Psychiatrists are otherwise good people. But that does not make them immune to handling clinical psychologists with the condescending tolerance and patronizing acceptance that teachers, for example, have towards rambling students. Or the rich have towards the poor. This does not take long to get converted into exasperation and smirky asides in the less charitable amongst the psychiatrists. Not that clinical psychologists are very helpful in motivating the psychiatrists to change for the better. For they, like most people in their position, over react and get aggressive when confronted with this attitude. And understandably so. However, it is time both realized their attitudes were not helpful either for mutual interaction, or growth of the Mental Health Movement at large. We can understand why psychiatrists behave the way they do. They are exposed to this same condescending-patronising attitude from their own peers in the medical profession. Their medical colleagues have yet to develop a feeling of healthy respect for psychiatry. Psychiatrists, no doubt, feel this is unjustified, but their peers are still in a position to deny them the respect and acceptance they seek. What they get from their medical colleagues, they unwittingly pass on to their clinical psychologist colleagues. But understanding why it occurs does not absolve them of their responsibility to behave more rationally, rather than emotionally, with the latter. [No abstract available.

  19. Randomised clinical trial

    DEFF Research Database (Denmark)

    Meineche-Schmidt, V.; Christensen, E.; Bytzer, P.

    2011-01-01

    Background: Response to proton pump inhibitor (PPI) treatment in dyspepsia is unpredictable. Aim: To identify symptoms associated with response to esomeprazole in order to target patients for empirical treatment. Methods: Eight hundred and five uninvestigated, primary care patients with upper GI ....... Conclusions In patients with uninvestigated dyspepsia, PPI responders can be reliably identified by a simple pocket chart using symptoms and patient characteristics (ClinicalTrials.gov NCT00318968). © 2010 Blackwell Publishing Ltd....

  20. Hyponatraemia in clinical practice

    OpenAIRE

    Biswas, M.; Davies, J S

    2007-01-01

    Hyponatraemia is defined as a serum sodium concentration below 135 mmol/l. It causes major diagnostic and management problems in practice. Hyponatraemic disorders are divided into euvolaemic, hypervolaemic and hypovolaemic. In the evaluation of the hyponatraemic patient, history taking should focus on identifying the potential cause, duration and symptomatology. Clinical examination should include assessment of volume status. Acute hyponatraemia of less than 48 h duration requires prompt corr...

  1. Ciliocytophthoria in clinical virology.

    Science.gov (United States)

    Hadziyannis, E; Yen-Lieberman, B; Hall, G; Procop, G W

    2000-08-01

    Direct immunofluorescence assays (DFAs) are used in the clinical virology laboratory for the rapid detection of viruses. An assessment of the cellularity of specimens submitted for DFA is necessary for the most effective use of this assay. This assessment ensures that an adequate number of the appropriate cells are present for examination. During this assessment, clinical virologists may encounter unfamiliar cellular elements or cellular fragments. One of these elements, ciliocytophthoria, has been misinterpreted as a parasite in specimens submitted for cytologic testing. We describe a similar case in which a technologist thought that ciliocytophthoria possibly represented a ciliated parasite in a nasopharyngeal specimen sent for respiratory syncytial virus DFA. After a thorough morphologic examination, the staff dismissed the possibility of a ciliated parasite. We confirmed this entity as ciliocytophthoria using morphologic criteria and the Diff-Quik stain. This near misidentification of ciliocytophthoria as a ciliated parasite affords us the opportunity to raise the awareness of clinical virologists about ciliocytophthoria. Additionally, we briefly review useful features for differentiating ciliocytophthoria from the only ciliate parasitic for humans, Balantidium coli. Finally, we present the utility of a commonly used cytologic stain, the Diff-Quik stain, for the confirmation of ciliocytophthoria. PMID:10923088

  2. The IMPACT clinic

    Science.gov (United States)

    Tracy, C. Shawn; Bell, Stephanie H.; Nickell, Leslie A.; Charles, Jocelyn; Upshur, Ross E.G.

    2013-01-01

    Abstract Problem addressed The growing number of elderly patients with multiple chronic conditions presents an urgent challenge in primary care. Current practice models are not well suited to addressing the complex health care needs of this patient population. Objective of program The primary objective of the IMPACT (Interprofessional Model of Practice for Aging and Complex Treatments) clinic was to design and evaluate a new interprofessional model of care for community-dwelling seniors with complex health care needs. A secondary objective was to explore the potential of this new model as an interprofessional training opportunity. Program description The IMPACT clinic is an innovative new model of interprofessional primary care for elderly patients with complex health care needs. The comprehensive team comprises family physicians, a community nurse, a pharmacist, a physiotherapist, an occupational therapist, a dietitian, and a community social worker. The model is designed to accommodate trainees from each discipline. Patient appointments are 1.5 to 2 hours in length, during which time a diverse range of medical, functional, and psychosocial issues are investigated by the full interprofessional team. Conclusion The IMPACT model is congruent with ongoing policy initiatives in primary care reform and enhanced community-based care for seniors. The clinic has been pilot-tested in 1 family practice unit and modeled at 3 other sites with positive feedback from patients and families, clinicians, and trainees. Evaluation data indicate that interprofessional primary care models hold great promise for the growing challenge of managing complex chronic disease. PMID:23486816

  3. Basic and clinical immunology

    Science.gov (United States)

    Chinen, Javier; Shearer, William T.

    2003-01-01

    Progress in immunology continues to grow exponentially every year. New applications of this knowledge are being developed for a broad range of clinical conditions. Conversely, the study of primary and secondary immunodeficiencies is helping to elucidate the intricate mechanisms of the immune system. We have selected a few of the most significant contributions to the fields of basic and clinical immunology published between October 2001 and October 2002. Our choice of topics in basic immunology included the description of T-bet as a determinant factor for T(H)1 differentiation, the role of the activation-induced cytosine deaminase gene in B-cell development, the characterization of CD4(+)CD25(+) regulatory T cells, and the use of dynamic imaging to study MHC class II transport and T-cell and dendritic cell membrane interactions. Articles related to clinical immunology that were selected for review include the description of immunodeficiency caused by caspase 8 deficiency; a case series report on X-linked agammaglobulinemia; the mechanism of action, efficacy, and complications of intravenous immunoglobulin; mechanisms of autoimmunity diseases; and advances in HIV pathogenesis and vaccine development. We also reviewed two articles that explore the possible alterations of the immune system caused by spaceflights, a new field with increasing importance as human space expeditions become a reality in the 21st century.

  4. STRUCTURED CLINICAL EVALUATION

    Directory of Open Access Journals (Sweden)

    Arabela Maria Barbosa Sampaio

    2014-05-01

    Full Text Available In a world experiencing profound technological and socio-political changes in areas of knowledge and capacity, healthcare can not remain static. A new kind of professional is required, whose practice is based on ethics, scientific standards, integrity, citizenship, and health promotion, who develops skills beyond healthcare, such as decision making, communication,leadership, management, and continuing education. No single method can assess all of these elements (knowledge, skills, and attitudes, and only a combination of methods is able to produce a valid evaluation. An alternative method exists: structured clinical assessments based on observation of "to do, or how to do" that aim to complete this evaluation by focusing attention on the performance of specific skills. In order to broaden the scope of evaluation methods that have been used in health education, this article, a literature review, intends to offer readers an overview of the diverse types of structured clinical evaluation, emphasizing Objective Structured Clinical Examination, the most widely used in Brazil, with a goal of advancing opportunities for health professionals to make use of this evaluative tool.

  5. Gateways to clinical trials.

    Science.gov (United States)

    Bayes, M; Rabasseda, X; Prous, J R

    2002-01-01

    Gateways to Clinical Trials is a guide to the most recent clinical trials in current literature and congresses, which has been retrieved from the Clinical Studies knowledge area of Prous Science Integrity, the world's first drug discovery and development portal, providing information on study design, treatments, conclusions and references. This issue focuses on the following selection of drugs: Abacavir sulfate; abciximab; abetimus sodium; adalimumab; aldesleukin; almotriptan; alteplase; amisulpride; amitriptyline hydrochloride; amoxicillin trihydrate; atenolol; atorvastatin calcium; atrasentan; Beclometasone dipropionate; bosentan; Captopril; ceftriaxone sodium; cerivastatin sodium; cetirizine hydrochloride; cisplatin; citalopram hydrobromide; Dalteparin sodium; darusentan; desirudin; digoxin; Efalizumab; enoxaparin sodium; ertapenem sodium; esomeprazole magnesium; estradiol; ezetimibe; Famotidine; farglitazar; fluorouracil; fluticasone propionate; fosamprenavir sodium; Glibenclamide; glucosamine sulfate; Heparin sodium; HSPPC-96; hydrochlorothiazide; Imatinib mesilate; implitapide; Lamivudine; lansoprazole; lisinopril; losartan potassium; l-Propionylcarnitine; Melagatran; metformin hydrochloride; methotrexate; methylsulfinylwarfarin; Nateglinide; norethisterone; Olmesartan medoxomil; omalizumab; omapatrilat; omeprazole; oseltamivir phosphate; oxatomide; Pantoprazole; piperacillin sodium; pravastatin sodium; Quetiapine hydrochloride; Rabeprazole sodium; raloxifene hydrochloride; ramosetron hydrochloride; ranolazine; rasburicase; reboxetine mesilate; recombinant somatropin; repaglinide; reteplase; rosiglitazone; rosiglitazone maleate; rosuvastatin calcium; Sertraline; simvastatin; sumatriptan succinate; Tazobactam sodium; tenecteplase; tibolone; tinidazole; tolterodine tartrate; troglitazone; Uniprost; Warfarin sodium; Ximelagatran. PMID:11980386

  6. Myocarditis in Clinical Practice.

    Science.gov (United States)

    Sinagra, Gianfranco; Anzini, Marco; Pereira, Naveen L; Bussani, Rossana; Finocchiaro, Gherardo; Bartunek, Jozef; Merlo, Marco

    2016-09-01

    Myocarditis is a polymorphic disease characterized by great variability in clinical presentation and evolution. Patients presenting with severe left ventricular dysfunction and life-threatening arrhythmias represent a demanding challenge for the clinician. Modern techniques of cardiovascular imaging and the exhaustive molecular evaluation of the myocardium with endomyocardial biopsy have provided valuable insight into the pathophysiology of this disease, and several clinical registries have unraveled the disease's long-term evolution and prognosis. However, uncertainties persist in crucial practical issues in the management of patients. This article critically reviews current information for evidence-based management, offering a rational and practical approach to patients with myocarditis. For this review, we searched the PubMed and MEDLINE databases for articles published from January 1, 1980, through December 31, 2015, using the following terms: myocarditis, inflammatory cardiomyopathy, and endomyocardial biopsy. Articles were selected for inclusion if they represented primary data or were review articles published in high-impact journals. In particular, a risk-oriented approach is proposed. The different patterns of presentation of myocarditis are classified as low-, intermediate-, and high-risk syndromes according to the most recent evidence on prognosis, clinical findings, and both invasive and noninvasive testing, and appropriate management strategies are proposed for each risk class. PMID:27489051

  7. Clinical Assay Development Support - Office of Cancer Clinical Proteomics Research

    Science.gov (United States)

    The NCI’s Division of Cancer Treatment and Diagnosis and the Cancer Diagnosis Program announce a request for applications for the Clinical Assay Development Program (CADP) for investigators seeking clinical assay development and validation resources.

  8. Construction of ethics in clinical research: clinical trials registration

    Directory of Open Access Journals (Sweden)

    C. A. Caramori

    2007-01-01

    Full Text Available Scientific development that has been achieved through decades finds in clinical research a great possibility of translating findings to human health application. Evidence given by clinical trials allows everyone to have access to the best health services. However, the millionaire world of pharmaceutical industries has stained clinical research with doubt and improbability. Study results (fruits of controlled clinical trials and scientific publications (selective, manipulated and with wrong conclusions led to an inappropriate clinical practice, favoring the involved economic aspect. In 2005, the International Committee of Medical Journal Editors (ICMJE, supported by the World Association of Medical Editors, started demanding as a requisite for publication that all clinical trials be registered at the database ClinicalTrials.gov. In 2006, the World Health Organization (WHO created the International Clinical Trial Registry Platform (ICTRP, which gathers several registry centers from all over the world, and required that all researchers and pharmaceutical industries register clinical trials. Such obligatory registration has progressed and will extend to all scientific journals indexed in all worldwide databases. Registration of clinical trials means another step of clinical research towards transparency, ethics and impartiality, resulting in real evidence to the forthcoming changes in clinical practice as well as in the health situation.

  9. Gateways to clinical trials.

    Science.gov (United States)

    Bayés, M; Rabasseda, X; Prous, J R

    2005-04-01

    Gateways to Clinical Trials is a guide to the most recent clinical trials in current literature and congresses. The data in the following tables has been retrieved from the Clinical Trials Knowledge Area of Prous Science Integrity, the drug discovery and development portal, http://integrity. prous.com. This issue focuses on the following selection of drugs: ABX-IL-8, Acclaim, adalimumab, AGI-1067, alagebrium chloride, alemtuzumab, Alequel, Androgel, anti-IL-12 MAb, AOD-9604, aripiprazole, atomoxetine hydrochloride; Biphasic insulin aspart, bosentan, botulinum toxin type B, bovine lactoferrin, brivudine; Cantuzumab mertansine, CB-1954, CDB-4124, CEA-TRICOM, choriogonadotropin alfa, cilansetron, CpG-10101, CpG-7909, CTL-102, CTL-102/CB-1954; DAC:GRF, darbepoetin alfa, davanat-1, decitabine, del-1 Genemedicine, dexanabinol, dextofisopam, dnaJP1, dronedarone hydrochloride, dutasteride; Ecogramostim, eletriptan, emtricitabine, EPI-hNE-4, eplerenone, eplivanserin fumarate, erlotinib hydrochloride, ertapenem sodium, escitalopram oxalate, esomeprazole magnesium, etoricoxib, ezetimibe; Falecalcitriol, fingolimod hydrochloride; Gepirone hydrochloride; HBV-ISS, HSV-2 theracine, human insulin; Imatinib mesylate, Indiplon, insulin glargine, ISAtx-247; L612 HuMAb, levodopa/carbidopa/entacapone, lidocaine/prilocaine, LL-2113AD, lucinactant, LY-156735; Meclinertant, metelimumab, morphine hydrochloride, morphine-6-glucuronide; Natalizumab, nimotuzumab, NX-1207, NYVAC-HIV C; Omalizumab, onercept, osanetant; PABA, palosuran sulfate, parathyroid hormone (human recombinant), parecoxib sodium, PBI-1402, PCK-3145, peginterferon alfa-2a, peginterferon alfa-2b, peginterferon alfa-2b/ribavirin, pemetrexed disodium, pimecrolimus, PINC, pregabalin; Ramelteon, rasagiline mesilate, rasburicase, rimonabant hydrochloride, RO-0098557, rofecoxib, rosiglitazone maleate/metformin hydrochloride; Safinamide mesilate, SHL-749, sitaxsentan sodium, sparfosic acid, SprayGel, squalamine, St. John's Wort

  10. Gateways to clinical trials.

    Science.gov (United States)

    Tomillero, A; Moral, M A

    2009-09-01

    Gateways to Clinical Trials is a guide to the most recent clinical trials in current literature and congresses. The data in the following tables has been retrieved from the Clinical Trials Knowledge Area of Prous Science Integrity, the drug discovery and development portal, http://integrity.prous.com. This issue focuses on the following selection of drugs: AAV1/SERCA2a, Abacavir sulfate/lamivudine, Adalimumab, Aliskiren fumarate, Ambrisentan, Aripiprazole, AT-7519, Atazanavir sulfate, Atomoxetine hydrochloride, Azacitidine, Azelnidipine; Besifloxacin hydrochloride, Bevacizumab, Bioabsorbable everolimus-eluting coronary stent, Bortezomib, Bosentan, Budesonide/formoterol fumarate; CAIV-T, Carisbamate, Casopitant mesylate, Certolizumab pegol, Cetuximab, Ciclesonide, Ciprofloxacin/dexamethasone, CTCE-9908; Dalcetrapib, Darunavir, Deferasirox, Desloratadine, Disitertide, Drotrecogin alfa (activated), DTA-H19, Duloxetine hydrochloride, Dutasteride; Ecogramostim, Efalizumab, Emtricitabine, Eribulin mesilate, Escitalopram oxalate, Eszopiclone, EUR-1008, Everolimus-eluting coronary stent, Exenatide; Fampridine, Fluticasone furoate, Formoterol fumarate/fluticasone propionate, Fosamprenavir calcium, Fulvestrant; Gabapentin enacarbil, GS-7904L; HPV-6/11/16/18, Human Secretin, Hydralazine hydrochloride/isosorbide dinitrate; Imatinib mesylate, Imexon, Inalimarev/Falimarev, Indacaterol, Indacaterol maleate, Inhalable human insulin, Insulin detemir, Insulin glargine, Ixabepilone; L-Alanosine, Lapatinib ditosylate, Lenalidomide, Levocetirizine dihydrochloride, Liraglutide, Lisdexamfetamine mesilate, Lopinavir, Loratadine/montelukast sodium, Lutropin alfa; MeNZB, Mepolizumab, Micafungin sodium, Morphine hydrochloride; Nabiximols, Nikkomycin Z; Olmesartan medoxomil, Omalizumab; Paclitaxel-eluting stent, Pegfilgrastim, Peginterferon alfa-2a, Peginterferon alfa-2b, Perifosine, PF-489791, Plitidepsin, Posaconazole, Pregabalin; QAX-576; Raltegravir potassium, Ramelteon, Rasagiline

  11. Classification and clinical assessment

    Directory of Open Access Journals (Sweden)

    F. Cantini

    2012-06-01

    Full Text Available There are at least nine classification criteria for psoriatic arthritis (PsA that have been proposed and used in clinical studies. With the exception of the ESSG and Bennett rules, all of the other criteria sets have a good performance in identifying PsA patients. As the CASPAR criteria are based on a robust study methodology, they are considered the current reference standard. However, if there seems to be no doubt that they are very good to classify PsA patients (very high specificity, they might be not sensitive enough to diagnose patients with unknown early PsA. The vast clinical heterogeneity of PsA makes its assessment very challenging. Peripheral joint involvement is measured by 78/76 joint counts, spine involvement by the instruments used for ankylosing spondylitis (AS, dactylitis by involved digit count or by the Leeds dactylitis index, enthesitis by the number of affected entheses (several indices available and psoriasis by the Psoriasis Area and Severity Index (PASI. Peripheral joint damage can be assessed by a modified van der Heijde-Sharp scoring system and axial damage by the methods used for AS or by the Psoriatic Arthritis Spondylitis Radiology Index (PASRI. As in other arthritides, global evaluation of disease activity and severity by patient and physician and assessment of disability and quality of life are widely used. Finally, composite indices that capture several clinical manifestations of PsA have been proposed and a new instrument, the Psoriatic ARthritis Disease Activity Score (PASDAS, is currently being developed.

  12. Gateways to clinical trials.

    Science.gov (United States)

    Tomillero, A; Moral, M A

    2010-11-01

    Gateways to Clinical Trials is a guide to the most recent clinical trials in current literature and congresses. The data in the following tables has been retrieved from the Clinical Trials Knowledge Area of Thomson Reuters Integrity(SM), the drug discovery and development portal, http://www.thomsonreutersintegrity.com. This issue focuses on the following selection of drugs: Abatacept, Adalimumab, AdCD40L, Adefovir, Aleglitazar, Aliskiren fumarate, AM-103, Aminolevulinic acid methyl ester, Amlodipine, Anakinra, Aprepitant, Aripiprazole, Atazanavir sulfate, Axitinib; Belimumab, Bevacizumab, Bimatoprost, Bortezomib, Bupropion/naltrexone; Calcipotriol/betamethasone dipropionate, Certolizumab pegol, Ciclesonide, CYT-997; Darbepoetin alfa, Darunavir, Dasatinib, Desvenlafaxine succinate, Dexmethylphenidate hydrochloride cogramostim; Eltrombopag olamine, Emtricitabine, Escitalopram oxalate, Eslicarbazepine acetate, Eszopiclone, Etravirine, Everolimus-eluting coronary stent, Exenatide, Ezetimibe; Fenretinide, Filibuvir, Fludarabine; Golimumab; Hepatitis B hyperimmunoglobulin, HEV-239, HP-802-247, HPV-16/18 AS04, HPV-6/11/16/18, Human albumin, Human gammaglobulin; Imatinib mesylate, Inotuzumab ozogamicin, Invaplex 50 vaccine; Lapatinib ditosylate, Lenalidomide, Liposomal doxorubicin, Lopinavir, Lumiliximab, LY-686017; Maraviroc, Mecasermin rinfabate; Narlaprevir; Ocrelizumab, Oral insulin, Oritavancin, Oxycodone hydrochloride/naloxone; Paclitaxel-eluting stent, Palonosetron hydrochloride, PAN-811, Paroxetine, Pazopanib hydrochloride, Peginterferon alfa-2a, Peginterferon alfa-2b, Pemetrexed disodium, Pertuzumab, Pitavastatin calcium, Posaconazole, Pregabalin, Prucalopride succinate; Raltegravir potassium, Ranibizumab, RHAMM R3 peptide, Rosuvastatin calcium; Salclobuzic acid sodium salt, SCY-635, Selenate sodium, Semapimod hydrochloride, Silodosin, Siltuximab, Silybin, Sirolimus-eluting stent, SIR-Spheres, Sunitinib malate; Tapentadol hydrochloride, Tenofovir disoproxil

  13. Philosophy of clinical psychopharmacology.

    Science.gov (United States)

    Aragona, Massimiliano

    2013-03-01

    The renewal of the philosophical debate in psychiatry is one exciting news of recent years. However, its use in psychopharmacology may be problematic, ranging from self-confinement into the realm of values (which leaves the evidence-based domain unchallenged) to complete rejection of scientific evidence. In this paper philosophy is conceived as a conceptual audit of clinical psychopharmacology. Its function is to criticise the epistemological and methodological problems of current neopositivist, ingenuously realist and evidence-servant psychiatry from within the scientific stance and with the aim of aiding psychopharmacologists in practicing a more self-aware, critical and possibly useful clinical practice. Three examples are discussed to suggest that psychopharmacological practice needs conceptual clarification. At the diagnostic level it is shown that the crisis of the current diagnostic system and the problem of comorbidity strongly influence psychopharmacological results, new conceptualizations more respondent to the psychopharmacological requirements being needed. Heterogeneity of research samples, lack of specificity of psychotropic drugs, difficult generalizability of results, need of a phenomenological study of drug-induced psychopathological changes are discussed herein. At the methodological level the merits and limits of evidence-based practice are considered, arguing that clinicians should know the best available evidence but that guidelines should not be constrictive (due to several methodological biases and rhetorical tricks of which the clinician should be aware, sometimes respondent to extra-scientific, economical requests). At the epistemological level it is shown that the clinical stance is shaped by implicit philosophical beliefs about the mind/body problem (reductionism, dualism, interactionism, pragmatism), and that philosophy can aid physicians to be more aware of their beliefs in order to choose the most useful view and to practice coherently

  14. Shared clinical decision making

    Science.gov (United States)

    AlHaqwi, Ali I.; AlDrees, Turki M.; AlRumayyan, Ahmad; AlFarhan, Ali I.; Alotaibi, Sultan S.; AlKhashan, Hesham I.; Badri, Motasim

    2015-01-01

    Objectives: To determine preferences of patients regarding their involvement in the clinical decision making process and the related factors in Saudi Arabia. Methods: This cross-sectional study was conducted in a major family practice center in King Abdulaziz Medical City, Riyadh, Saudi Arabia, between March and May 2012. Multivariate multinomial regression models were fitted to identify factors associated with patients preferences. Results: The study included 236 participants. The most preferred decision-making style was shared decision-making (57%), followed by paternalistic (28%), and informed consumerism (14%). The preference for shared clinical decision making was significantly higher among male patients and those with higher level of education, whereas paternalism was significantly higher among older patients and those with chronic health conditions, and consumerism was significantly higher in younger age groups. In multivariate multinomial regression analysis, compared with the shared group, the consumerism group were more likely to be female [adjusted odds ratio (AOR) =2.87, 95% confidence interval [CI] 1.31-6.27, p=0.008] and non-dyslipidemic (AOR=2.90, 95% CI: 1.03-8.09, p=0.04), and the paternalism group were more likely to be older (AOR=1.03, 95% CI: 1.01-1.05, p=0.04), and female (AOR=2.47, 95% CI: 1.32-4.06, p=0.008). Conclusion: Preferences of patients for involvement in the clinical decision-making varied considerably. In our setting, underlying factors that influence these preferences identified in this study should be considered and tailored individually to achieve optimal treatment outcomes. PMID:26620990

  15. HIV/AIDS Clinical Trials

    Science.gov (United States)

    ... Home Apps APIs Widgets Order Publications Skip Nav HIV/AIDS Clinical Trials Home > Clinical Trials Español small ... Renal (Kidney) Complications/Damage Skin Diseases FDA-Approved HIV Drugs Abacavir Atazanavir Atripla Cobicistat Combivir Complera Darunavir ...

  16. Clinical Investigator Inspector List (CLIIL)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Clinical Investigator Inspection List (CLIIL) contains names, addresses, and other pertinent information gathered from inspections of clinical investigators who...

  17. Rare Diseases Clinical Research Network

    Science.gov (United States)

    ... RDCRN? Aims of the Rare Diseases Clinical Research Network Contact Us RDCRN Members Login Accessibility Disclaimer The Rare Diseases Clinical Research Network is an initiative of the Office of Rare ...

  18. Clinical review on RIT

    International Nuclear Information System (INIS)

    Full text of publication follows. Radioimmunotherapy (RIT) has been in use for more than 20 years and has progressed significantly with the discovery of new molecular targets, the development of new stable chelates, the humanization of monoclonal antibodies (MAbs), and the use of pre-targeting techniques. Today, 2 products targeting the CD20 antigen are approved in the treatment of B lymphoma: 131-tositumomab (Bexxar) and 90Y-ibritumomab tiuxetan (Zevalin). RIT can be applied in clinical practice for patients with relapsed or refractory follicular lymphoma (FL) or as consolidation after induction chemotherapy in front-line treatment in FL patients. Hematological toxicity is the major side effect of RIT and depends on bone marrow involvement and prior treatment. High-dose treatment, RIT as consolidation, RIT in first-line treatment, fractionated RIT and use of new humanized MAbs, in particular targeting CD22, showed promising results in B lymphoma. Targeting of antigens other than CD20 appears particularly interesting in the context of consolidation therapy after rituximab-based therapy. In other hemopathies, such as multiple myeloma (MM), RIT efficacy has been suggested in preclinical studies. Syndecan-1 is expressed in all MM and preclinical studies showed promising results using 213Bi-labeled anti-CD138. In solid tumors, more resistant to radiations and less accessible to large molecules such as MAbs, clinical efficacy remains limited. However, RIT used in minimal or small-size metastatic disease has shown promising clinical efficacy. Pre-targeting approaches have shown potential in increasing the therapeutic index of radiolabeled antibodies. Recently, a phase II clinical trial showed efficacy of anti-CEA pre targeted 131I-RIT in 42 progressive medullary thyroid carcinoma patients. Disease control according RECIST criteria (objective response + stabilization) was observed in 32 patients (76.2%), including one durable CR of at least 40 months and 31 durable

  19. [Rickettsiosis: a clinical approach].

    Science.gov (United States)

    Boillat, N; Greub, G

    2007-05-16

    Rickettsiosis are zoonotic diseases transmitted to humans by arthropods. Prevalence of imported disease increases in parallel to the frequency of international travel. Clinical presentation is characterised by fever, headache and rash. Delay in the initiation of an antibiotic treatment efficient on Rickettsia spp. may have fatal impact on evolution. Serology is the more widely used diagnostic test. However, it only provides retrospective diagnosis. Polymerase chain reaction (PCR) and immunohistochemistry may provide early diagnosis. Doxycyclin is the first-line treatment and should be given empirically as soon as a rickettsial disease is suspected. PMID:17585624

  20. Understanding Oracle Clinical

    CERN Document Server

    Johnson, Joan

    2007-01-01

    This Short Cut is written to assist you, an Oracle Clinical Developer, with many of the tasks and decisions you may encounter on an occasional basis. These tasks involve study setup and maintenance, account maintenance, handling discrepancies, preparing data sets for analysis, batch-loading data, altering system-level settings and defining standard processes. A working knowledge of screen setup and procedure coding is assumed. Remote Data Capture (RDC), which moves data entry from the CRO or pharmaceutical company to the sites, is fast becoming the preferred way to gather and clean data for

  1. Clinical management of agnosia.

    Science.gov (United States)

    Burns, Martha S

    2004-01-01

    Agnosia is a neurological recognition deficit that affects a single modality. Visual agnosias include pure object agnosia, prosopagnosia, akinetopsia, and pure alexia. Auditory agnosias include pure word deafness, phonagnosia, and pure sound agnosia. New neuroimaging tools have permitted scientists to better understand the loci of lesions that cause various agnosias and from that knowledge to develop theories about the processing networks that contribute to perception and recognition in each modality. These research data, in turn, inform the rehabilitation process. By utilizing current knowledge about neuroprocessing networks, clinical professionals can differentially diagnose agnosias from aphasia and other cognitive deficits. Practical approaches to treatment of agnosia will follow once the diagnosis is established.

  2. Marketing applications for dental clinic

    OpenAIRE

    Čevela, Josef

    2010-01-01

    The essay deals with the marketing strategy of the dental clinic, more specifically the dental clinic Sorriso DENTAL s.r.o. It also analyses and describes the marketing mix. Based on these things, it offers certain recommendations for the clinic and its marketing conception.

  3. Clinical sensitivity: the inseparability of ethical perceptiveness and clinical knowledge.

    Science.gov (United States)

    Nortvedt, P

    2001-01-01

    This article argues that there is an important connection between ethical sensitivity and clinical competency in nursing. This is more than a defense for ethical attitudes and virtues in clinical practice, however. I will show in what way ethical sensitivity is important not only to moral judgment, but to professional clinical knowledge and judgment as well. Drawing on central insights from continental philosophy, Husserl, Heidegger, Levinas and Foucault, as well as classical virtue theory, the article elucidates the inseparability of ethical sensitivity and clinical knowledge in nursing. Ethical sensitivity has bearing upon clinical knowledge and awareness in two important ways. First, what we consider relevant clinical knowledge and therapeutic measures frequently encounter the realities of clinical conditions, realities which embody certain moral qualities and appeal to moral values. In clinical nursing, it is important to understand how this encounter between professional knowledge and moral values informs clinical action, making it morally as well as professionally proper. Second, sensitivity to vulnerability qualifies clinical knowledge in the way that it alerts clinical sensitivity altogether. Perception of morally salient features informs the nurse about significant changes in the patient's pathological condition. The ability to be touched morally by the patient's condition, his or her vulnerability or vitality and positive experience is epistemologically and prognostically significant.

  4. Clinical Verification of Homeopathy

    Directory of Open Access Journals (Sweden)

    Michel Van Wassenhoven

    2011-07-01

    Full Text Available The world is changing! This is certainly true regarding the homeopathic practice and access to homeopathic medicine. Therefore our first priority at the ECH-LMHI [1] has been to produce a yearly report on the scientific framework of homeopathy. In the 2010 version a new chapter about epidemic diseases has been added including the Leptospirosis survey on the Cuban population. A second priority has been to review the definition of the homeopathic medicines respecting the new framework generated by the official registration procedure and the WHO report. We are working now on a documented (Materia Medica and provings list of homeopathic remedies to facilitate the registration of our remedies. The new challenges are: first of all more good research proposals and as such more funding (possible through ISCHI + Blackie Foundation as examples [2]; international acceptance of new guidelines for proving and clinical verification of homeopathic symptoms (Proposals are ready for discussion; total reconsideration of the homeopathic repertories including results of the clinical verification of the symptoms. The world is changing, we are part of the world and changes are needed also for homeopathy!

  5. Freud's early clinical work.

    Science.gov (United States)

    Vogel, L Z

    1994-01-01

    Freud became a medical practitioner because it was impossible for him to pursue the desired career of a microscopic researcher. His education and training had not prepared him for the task of being a practicing physician. In his private practice he began treating some very intelligent, chaotic, demanding, volatile and disturbed patients. Anna von Lieben was one of these patients whom Freud treated very intensively for a long period of time. Elise Gomperz was another talented and severely pained early patient of Freud. Over a number of years, Freud was her psychiatrist and provided her with attentive care using a variety of treatment methods that were available to him at that time. Emmy von N.'s condition was also fluctuating and very demanding. The dramatic sense and chronic clinical course of these patients is compatible with the contemporary diagnostic category of Borderline Personality Disorder. Freud provided these patients with long-term supportive care while he attempted to cure them. At the same time, Freud committed himself to the theory of radical cure and downplayed the supportive, draining and difficult clinical work that he was doing.

  6. Gateways to clinical trials.

    Science.gov (United States)

    Bayes, M; Rabasseda, X; Prous, J R

    2005-01-01

    Gateways to Clinical Trials are a guide to the most recent clinical trials in current literature and congresses. The data in the following tables have been retrieved from the Clinical Trials Knowledge Area of Prous Science Integrity, the drug discovery and development portal, http://integrity.prous.com. This issue focuses on the following selection of drugs: (-)-Epigallocatechin gallate; ACP-103, Ad.Egr.TNF.11 D, adalimumab, AF-IL 12, AIDSVAX gp120 B/B, alefacept, alemtuzumab, a-Galactosylceramide, ALVAC vCP 1452, alvimopan hydrate, alvocidib hydrochloride, aminolevulinic acid hydrochloride, aminolevulinic acid methyl ester, anakinra, anidulafungin, antarelix, aprepitant, aripiprazole, arsenic sulfide, asoprisnil, atazanavir sulfate, atomoxetine hydrochloride; Bevacizumab, bimatoprost, BMS-184476, bortezomib, bosentan, botulinum toxin type B, BrachySil, brivudine; Caffeine, calcipotriol/betamethasone dipropionate, cannabidiol, capsaicin for injection, caspofungin acetate, CC-4047, cetuximab, CGP-36742, clofazimine, CpG-7909, Cypher; Darbepoetin alfa, dextromethorphan/quinidine sulfate, dimethylfumarate, dronabinol/cannabidiol, drotrecogin alfa (activated), duloxetine hydrochloride, dutasteride; Ecogramostim, efalizumab, eletriptan, emtricitabine, enfuvirtide, eplerenone, esomeprazole magnesium, estradiol acetate, eszopiclone, etoricoxib, exenatide, ezetimibe, ezetimibe/simvastatin; Fampridine, fondaparinux sodium, fosamprenavir calcium; Gefitinib, GPI-0100; hA 20, HTU-PA, human insulin, HuOKT 3 gamma 1(Ala 234-Ala 235), hyaluronic acid; Icatibant, imatinib mesylate, Indiplon, INKP-100, INKP-102, iodine (I131) tositumomab, istradefylline, IV gamma-globulin, ivabradine hydrochloride, ixabepilone; Lacosamide, landiolol, lanthanum carbonate, lasofoxifene tartrate, LB-80380, lenalidomide, lidocaine/tetracaine, linezolid, liposomal doxorubicin, liposomal vincristine sulfate, lopinavir, lopinavir/ritonavir, lumiracoxib, lurtotecan; Maribavir, morphine glucuronide, MVA-5 T

  7. Gateways to clinical trials.

    Science.gov (United States)

    Tomillero, A; Moral, M A

    2008-09-01

    Gateways to Clinical Trials are a guide to the most recent clinical trials in current literature and congresses. The data in the following tables has been retrieved from the Clinical Trials Knowledge Area of Prous Science Integrity, the drug discovery and development portal, http://integrity.prous.com.This issue focuses on the following selection of drugs: ABT-263, AC-2307, Aclidinium bromide, Adefovir dipivoxil, ADH-1, Agatolimod sodium, Alefacept, Aliskiren fumarate, Aminolevulinic acid methyl ester, Anakinra, Apaziquone, Aprepitant, Aripiprazole, ASM-8, Atiprimod hydrochloride, AVE-0277, AVE-1642, AVE-8062, Axitinib, Azacitidine, AZD-0530; Bazedoxifene acetate, Bevacizumab, Bexarotene, BI-2536, Biphasic insulin aspart, BMS-387032, BMS-663513, Bortezomib, BQ-123, Brivanib alaninate, BSI-201; Caspofungin acetate, CDX-110, Cetuximab, Ciclesonide, CR-011, Cypher; Daptomycin, Darbepoetin alfa, Dasatinib, Decitabine, Deferasirox, Denosumab, Dexlansoprazole, Dexmethylphenidate hydrochloride, DNA-Hsp65 vaccine, Dovitinib, Drotrecogin alfa (activated), DTaP-HBV-IPV/Hibvaccine, DTaP-IPV-HB-PRP-T, Duloxetine hydrochloride, Dutasteride; Ecogramostim, Elacytarabine, Emtricitabine, Endothelin, Entecavir, Eplivanserin fumarate, Escitalopram oxalate, Everolimus, Ezetimibe, Ezetimibe/simvastatin; Farletuzumab, Fesoterodine fumarate, Fibrin sealant (human), Fulvestrant; Gefitinib, Gemtuzumab ozogamicin, Glufosfamide, GSK-1562902A; Hib-TT; Imatinib mesylate, IMC-11F8, Imidazoacridinone, IMP-321, INCB-18424, Indiplon, Indisulam, INNO-406, Irinotecan hydrochloride/Floxuridine, ITF-2357, Ixabepilone; KRN-951; Lasofoxifene tartrate; Lenalidomide, LGD-4665, Lonafarnib, Lubiprostone, Lumiliximab; MDX-1100, Melan-A/MART-1/gp100/IFN-alfa, Methyl-CDDO, Metreleptin, MLN-2704, Mycophenolic acid sodium salt; Na-ASP-2, Naproxcinod, Nilotinib hydrochloride monohydrate, NPI-2358; Oblimersen sodium, Odanacatib; Paclitaxel nanoparticles, PAN-811, Panobinostat, PBI-1402, PC-515, Peginterferon alfa

  8. CLINICAL, EPIDEMIOLOGICAL AND MYCOLOGICA

    Directory of Open Access Journals (Sweden)

    Ratheesh T

    2014-09-01

    Full Text Available BACKGROUND: Tinea versicolor is a chronic, mild, usually asymptomatic infection of the stratum corneum. The lesions are discrete or confluent and appear as discolored or hypo pigmented areas of the skin. The affected areas are located principally on the chest, abdomen, upper extremities and back. The etiologic agent is the lipophilic yeast Pityrosporum orbiculare, part of the normal flora of the human skin. This study is undertaken to know “clinical, patterns of the disease with respect to morphology and distribution, associated conditions and epidemiological factors like age, sex distribution and seasonal variation of the disease”. METHODS: Two hundred patients of tinea versicolor were selected. Patients belonging to the age group of above 10 years and below 60 years belonging to both sexes were selected and included in the study group after taking consent. A detailed history was taken with particular reference to onset, duration, symptoms and treatment taken and were recorded. Factors like – seasonal variation, family history and presence of any associated illnesses was also noted. A thorough clinical examination was done with reference to the location, the color, the extent of the lesions, the margins, the type of lesions and the details were recorded. Potassium hydroxide (KOH examination and Wood’s lamp examination were done in all the patients before therapy. RESULTS: Out of 200 patients, majority of them belong to 2nd and 3rd decade of life (72%. The Male: Female ratio was 1.5:1. There was a family history of 16%. The trunk was the most common site involved. Majority of the patients had exacerbation in summer. The most common associated dermatoses were acne vulgaris, immunosuppression and infections. INTERPRETATION AND CONCLUSION: Tinea versicolor is a disease of worldwide distribution, although it is significantly more common in humid and tropical climates. The true incidence cannot be estimated precisely because the disease is

  9. Clinical Reasoning Terms Included in Clinical Problem Solving Exercises?

    Science.gov (United States)

    Musgrove, John L; Morris, Jason; Estrada, Carlos A; Kraemer, Ryan R

    2016-05-01

    Background Published clinical problem solving exercises have emerged as a common tool to illustrate aspects of the clinical reasoning process. The specific clinical reasoning terms mentioned in such exercises is unknown. Objective We identified which clinical reasoning terms are mentioned in published clinical problem solving exercises and compared them to clinical reasoning terms given high priority by clinician educators. Methods A convenience sample of clinician educators prioritized a list of clinical reasoning terms (whether to include, weight percentage of top 20 terms). The authors then electronically searched the terms in the text of published reports of 4 internal medicine journals between January 2010 and May 2013. Results The top 5 clinical reasoning terms ranked by educators were dual-process thinking (weight percentage = 24%), problem representation (12%), illness scripts (9%), hypothesis generation (7%), and problem categorization (7%). The top clinical reasoning terms mentioned in the text of 79 published reports were context specificity (n = 20, 25%), bias (n = 13, 17%), dual-process thinking (n = 11, 14%), illness scripts (n = 11, 14%), and problem representation (n = 10, 13%). Context specificity and bias were not ranked highly by educators. Conclusions Some core concepts of modern clinical reasoning theory ranked highly by educators are mentioned explicitly in published clinical problem solving exercises. However, some highly ranked terms were not used, and some terms used were not ranked by the clinician educators. Effort to teach clinical reasoning to trainees may benefit from a common nomenclature of clinical reasoning terms.

  10. Clinical management of neurocysticercosis.

    Science.gov (United States)

    Del Brutto, Oscar H

    2014-04-01

    Neurocysticercosis is the most common helminthic disease of the nervous system and a leading cause of acquired epilepsy worldwide. Differences in the number and location of lesions as well as in the severity of the immune response against the parasites, makes neurocysticercosis a complex disease. Therefore, a single therapeutic approach is not expected to be useful in every patient. Introduction of cysticidal drugs - praziquantel and albendazole - have changed the prognosis of thousands of patients with neurocysticercosis. While pioneer trials of therapy were flawed by a poor design, recent studies have shown that cysticidal drugs results in disappearance of lesions and clinical improvement in most cases. Nevertheless, some patients with parenchymal neurocysticercosis may be left with remaining cysts and may develop recurrent seizures after therapy, and many patients with subarachnoid cysts may need repeated courses of therapy. In addition, not all forms of the disease benefit from cysticidal drugs.

  11. Clinical pharmacokinetics of melatonin

    DEFF Research Database (Denmark)

    Harpsøe, Nathja Groth; Andersen, Lars Peter Holst; Gögenur, Ismail;

    2015-01-01

    PURPOSE: The aim of the review was to provide an overview of studies investigating the pharmacokinetics of exogenous melatonin in humans and if possible, to provide recommendations for clinical use. METHODS: The review was conducted in accordance to PRISMA guidelines. A systematic literature search...... was performed in PubMed and Embase databases. The pharmacokinetic variables included maximal plasma/serum concentration (Cmax), time to maximal plasma/serum concentration (Tmax), elimination half-life (T1/2), area-under-the-curve plasma/serum concentrations (AUC), clearance (Cl), volume of distribution (VD......) and 1602 L (4 mg, oral). Bioavailability of oral melatonin ranged from 9 to 33%. Pharmacokinetics was affected by age, caffeine, smoking, oral contraceptives, feeding status, and fluvoxamine. Critically ill patients displayed accelerated absorption and compromised elimination. CONCLUSIONS: Despite...

  12. Dabigatran in clinical practice

    DEFF Research Database (Denmark)

    Ageno, Walter; Eikelboom, John; Lip, Gregory Y H

    2016-01-01

    confirmed, but VKA use is complicated by need for regular monitoring of the international normalized ratio and multiple drug and food interactions. Dabigatran is an oral direct thrombin inhibitor that can be used with fixed doses, without the need for routine anticoagulation laboratory monitoring...... and the advantage of few drug or diet interactions. Dabigatran is effective for stroke and systemic thromboembolism in AF and for the prophylaxis and treatment of VTE. The drug has a good safety profile and consistently shows a reduction in intracranial hemorrhage risk compared to warfarin. A specific reversal...... agent for dabigatran has been approved by FDA and EU. This review provides a summary of publications assessing clinical utility of dabigatran for different indications....

  13. Developing Effective Clinical Trainers

    Directory of Open Access Journals (Sweden)

    Kevin Khamarko

    2012-05-01

    Full Text Available Continuing education and training provides a means to improve performance among health care professionals (HCP. Research shows, however, that continuing professional education activities have inconsistent effects on HCP competence, performance, and patient health outcomes. Furthermore, the trainer’s role as a facilitator of knowledge translation (KT has been understudied. To understand how clinical trainers support their trainees in translating what they learned into practice, we conducted 16 in-depth interviews with expert trainers. These interviews yielded a variety of KT-enhancing strategies, including tailoring training activities to their trainees’ needs. In addition, participants recommended trainers familiarize themselves with their trainees’ work environments, be able to identify their knowledge deficits, and devote time to provide trainees with post-training support. Creating an effective training, one that leads to transfer, requires active planning, communication, and command of the training topic by skilled trainers.

  14. [Osteoporosis: a clinical perspective].

    Science.gov (United States)

    Matikainen, Niina

    2016-01-01

    Osteoporosis is defined by decreased bone density and microarchitectural deterioration that predispose to fragility fractures. The WHO diagnostic criteria of osteoporosis require bone densitometry but treatment is possible on the basis of high clinical fracture risk and can be assessed by the FRAX risk algorithm. All those subject to fracture risk should be advised about proper basic treatment of osteoporosis, including exercise, prevention of falls, smoking cessation, avoidance of alcohol intake, and dietary or supplemental abundance of calcium and vitamin D. Underlying diseases must be studied after diagnosis of osteoporosis even if treatment is initiated without densitometry. When indicated, specific osteoporosis therapy includes bisphosphonates, denosumab, teriparatide, strontium ranelate or SERMs. In hypogonadism, gonadal steroids may be indicated alone or in addition to a specific treatment. Treatment effect and continuation are assessed after 2 to 5 years. PMID:27400591

  15. Clinical aspects of melatonin.

    Science.gov (United States)

    Reiter, Russel J; Korkmaz, Ahmet

    2008-11-01

    Melatonin is produced in the human pineal gland, particularly at night, with the circadian rhythm of blood melatonin levels closely paralleling its production within the pineal gland. Light exposure at night, or rapid transmeridian travel severely compromises the circadian production of melatonin. The disturbed melatonin rhythm contributes to jet lag and sleep inefficiency, both of which are improved by melatonin administration. Melatonin is also a highly effective direct free radical scavenger and antioxidant. In this capacity, melatonin reduces experimental cataractogenesis, traumatic injury to the spinal cord and brain, and protects against oxidative damage to neurons and glia in models of stroke, Parkinsonism, and Alzheimer's disease. Additionally, melatonin and its metabolites are highly effective in protecting against ionizing radiation. Finally, melatonin may be a treatment for hypertension. Melatonin's high efficacy, its high safety profile, and its virtual lack of toxicity make it of interest in clinical medicine. PMID:18997997

  16. Clinical application of PET

    Energy Technology Data Exchange (ETDEWEB)

    Lomena, Francisco [Hospital Clinico Villarroel, Barcelona (Spain). Nuclear Medicine]. E-mail: flomena@clinic.ub.es; Soler, Marina [CETIR Grup Medic. Esplkugues de Llobregat, Barcelona (Spain). PET Unit

    2005-10-15

    Positron emission tomography (PET) is an imaging modality that gives information on tissue metabolism and functionalism, different from other imaging techniques like computed tomography (CT) and magnetic resonance imaging (MRI), which provide anatomical or structural information. PET has reached its development in biomedical research because of its capacity to use analogous compounds of many endogenous substance as tracers, and to measure, in vivo and in a non-invasive way, their consumption by the different organs and tissues of the mammalian body. Fluorodeoxyglucose-F 18 (FDG) PET has been proven to be a tracer adequate for clinical use in oncology and in many neurological diseases, with an excellent cost-efficiency ratio. The current PET-CT scanners can come to be the best tools for exploring patients who suffer from cancer.(author)

  17. Clinical pharmacokinetics of anticonvulsants.

    Science.gov (United States)

    Hvidberg, E F; Dam, M

    1976-01-01

    Anticonvulsant therapy was among the first areas to benefit from clinical pharmacokinetic studies. The most important advantage is that the frequent interindividual variation in the plasma level/dose ratio for these drugs can be circumvented by plasma level monitoring. For several anticonvulsants the brain concentration is shown to parallel the plasma concentration. Phenytoin (diphenylhydantoin) is stil the most important anticonvulsant and the one for which kinetics have been thoroughly investigated in man. These investigations have revealed several reasons for the wellknown difficulties in using this drug clinically. The absorption rate and fraction are very much dependent on the pharmaceutical preparation, and changes of brand may alter the plasma level of phenytoin in spite of unaltered dose. The elimination capacity is saturable causing dose dependent kinetics, which again means disproportional changes in plasma level with changes in dose. Great individual variations exist in the rate of metabolism, and several pharmacokinetic drug interactions are known. As an optimum therapeutic plasma concentration range has been established monitoring plasma levels must be strongly advocated. Interpretation of plasma levels in uraemic patients must take into account decreased protein binding of the drug. Carbamazepine is probably as effective as phenytoin. The elimination is a first order process, but the rate of metabolism increases after a few weeks' treatment. An active metabolite (epoxide) may be the cause of some side-effects. Combined treatment with other anticonvulsant drugs decreases the half-life and more frequent dosing may be necessary. An optimum therapeutic concentration range has been suggested and plasma monitoring is advocated, along with that of the active metabolite, the epoxide. Phenobarbitone is still much used but its kinetics have been investigated to a lesser extent. The main problem is the variability in the rate of elimination. In children the half

  18. Clinical limitations of Invisalign.

    Science.gov (United States)

    Phan, Xiem; Ling, Paul H

    2007-04-01

    Adult patients seeking orthodontic treatment are increasingly motivated by esthetic considerations. The majority of these patients reject wearing labial fixed appliances and are looking instead to more esthetic treatment options, including lingual orthodontics and Invisalign appliances. Since Align Technology introduced the Invisalign appliance in 1999 in an extensive public campaign, the appliance has gained tremendous attention from adult patients and dental professionals. The transparency of the Invisalign appliance enhances its esthetic appeal for those adult patients who are averse to wearing conventional labial fixed orthodontic appliances. Although guidelines about the types of malocclusions that this technique can treat exist, few clinical studies have assessed the effectiveness of the appliance. A few recent studies have outlined some of the limitations associated with this technique that clinicians should recognize early before choosing treatment options.

  19. Gateways to clinical trials.

    Science.gov (United States)

    Tomillero, A; Moral, M A

    2008-10-01

    Gateways to clinical trials is a guide to the most recent trials in current literature and congresses. The data in the following tables has been retrieved from the Clinical Trials Knowledge Area of Prous Science Integrity(R), the drug discovery and development portal, http://integrity.prous.com. This issue focuses on the following selection of drugs: (+)-Dapoxetine hydrochloride, (S)-Tenatoprazole sodium salt monohydrate 19-28z, Acotiamide hydrochloride hydrate, ADV-TK, AE-37, Aflibercept, Albinterferon alfa-2b, Aliskiren fumarate, Asenapine maleate, Axitinib; Bavituximab, Becatecarin, beta-1,3/1,6-Glucan, Bevacizumab, Bremelanotide; Calcipotriol/betamethasone dipropionate, Casopitant mesylate, Catumaxomab, CDX-110, Cediranib, CMD-193, Cositecan; Darinaparsin, Denosumab, DP-b99, Duloxetine hydrochloride; E75, Ecogramostim, Elacytarabine, EMD-273063, EndoTAG-1, Enzastaurin hydrochloride, Eplerenone, Eribulin mesilate, Esomeprazole magnesium, Etravirine, Everolimus, Ezetimibe; Faropenem daloxate, Febuxostat, Fenretinide; Ghrelin (human); I-131 ch-TNT-1/B, I-131-3F8, Iclaprim, Iguratimod, Iloperidone, Imatinib mesylate, Inalimarev/Falimarev, Indacaterol, Ipilimumab, Iratumumab, Ispinesib mesylate, Ixabepilone; Lapatinib ditosylate, Laquinimod sodium, Larotaxel dehydrate, Linezolid, LOR-2040; Mapatumumab, MKC-1, Motesanib diphosphate, Mycophenolic acid sodium salt; NK-012; Olanzapine pamoate, Oncolytic HSV, Ortataxel; Paclitaxel nanoparticles, Paclitaxel poliglumex, Paliperidone palmitate, Panitumumab, Patupilone, PCV-9, Pegfilgrastim, Peginterferon alfa-2a, Peginterferon alfa-2b, Pertuzumab, Picoplatin, Pimavanserin tartrate, Pimecrolimus, Plerixafor hydrochloride, PM-02734, Poly I:CLC, PR1, Prasugrel, Pregabalin, Progesterone caproate, Prucalopride, Pumosetrag hydrochloride; RAV-12, RB-006, RB-007, Recombinant human erythropoietin alfa, Rimonabant, Romidepsin; SAR-109659, Satraplatin, Sodium butyrate; Tadalafil, Talampanel, Tanespimycin, Tarenflurbil, Tariquidar

  20. Trialing a new clinical clerkship record in Japanese clinical training

    Directory of Open Access Journals (Sweden)

    Nomura S

    2015-09-01

    Full Text Available Shosaku Nomura, Noboru Tanigawa, Yo Kinoshita, Koichi TomodaFirst Department of Internal Medicine, Kansai Medical University, Shinmachi, Hirakata, Osaka, JapanUndergraduate medical education has several problems.1,2 In particular, clinical training, which is the unique feature of medical education, tends to be performed less extensively. In Japan, the current clinical training method is clinical clerkship (CC. CC differs from conventional clinical training, which is study by observation. In CC, the student is a member of the medical team and participates in actual medical care. The student is allowed to practice medical actions in the definite range under the guidance and monitoring of a teaching doctor. Therefore, students can acquire practical clinical abilities. In their study of medical care, students are required to have their own sense of identity and personal responsibility. Clinical training is performed by CC following the original curriculum for diagnoses and treatments in various medical departments.

  1. Emotional dysregulation in non-clinical and clinical subjects

    OpenAIRE

    Maffei, C; Fossati, A.; V. Ponissi; Bertoli, S; Strepparava, MG; Borroni, S.

    2012-01-01

    Emotional dysregulation is a complex pattern of reactivity to reality stimuli that now can be empirically studied. The dysregulation of emotion rating scale (DERS, Gratz and Roamer, 2004 ) seems tobea good instrument to evaluate the components and the phases of the process of emotional dysregulation. In this presentation, the data from Italian clinical and non-clinical population will be discussed. Clinical subjects will be: borderline personality disorder BPD obesity with binge eating obesit...

  2. Children and Clinical Studies: Why Clinical Studies Are Important

    Medline Plus

    Full Text Available ... Systematic Evidence Reviews & Clinical Practice Guidelines Resources Continuing Education Researchers Funding Training & Career Development Division of Intramural Research Research Resources Research Meeting ...

  3. Gateways to clinical trials.

    Science.gov (United States)

    Bayés, M; Rabasseda, X; Prous, J R

    2005-06-01

    Gateways to Clinical Trials is a guide to the most recent clinical trials in current literature and congresses. The data in the following tables have been retrieved from the Clinical Trials Knowledge Area of Prous Science Integrity, the drug discovery and development portal, http://integrity.prous.com. This issue focuses on the following selection of drugs: Abiraterone acetate, acyline, adalimumab, adenosine triphosphate, AEE-788, AIDSVAX gp120 B/B, AK-602, alefacept, alemtuzumab, alendronic acid sodium salt, alicaforsen sodium, alprazolam, amdoxovir, AMG-162, aminolevulinic acid hydrochloride, aminolevulinic acid methyl ester, aminophylline hydrate, anakinra, anecortave acetate, anti-CTLA-4 MAb, APC-8015, aripiprazole, aspirin, atazanavir sulfate, atomoxetine hydrochloride, atorvastatin calcium, atrasentan, AVE-5883, AZD-2171; Betamethasone dipropionate, bevacizumab, bimatoprost, biphasic human insulin (prb), bortezomib, BR-A-657, BRL-55730, budesonide, busulfan; Calcipotriol, calcipotriol/betamethasone dipropionate, calcium folinate, capecitabine, capravirine, carmustine, caspofungin acetate, cefdinir, certolizumab pegol, CG-53135, chlorambucil, ciclesonide, ciclosporin, cisplatin, clofarabine, clopidogrel hydrogensulfate, clozapine, co-trimoxazole, CP-122721, creatine, CY-2301, cyclophosphamide, cypher, cytarabine, cytolin; D0401, darbepoetin alfa, darifenacin hydrobromide, DASB, desipramine hydrochloride, desloratadine, desvenlafaxine succinate, dexamethasone, didanosine, diquafosol tetrasodium, docetaxel, doxorubicin hydrochloride, drotrecogin alfa (activated), duloxetine hydrochloride, dutasteride; Ecallantide, efalizumab, efavirenz, eletriptan, emtricitabine, enfuvirtide, enoxaparin sodium, estramustine phosphate sodium, etanercept, ethinylestradiol, etonogestrel, etonogestrel/ethinylestradiol, etoposide, exenatide; Famciclovir, fampridine, febuxostat, filgrastim, fludarabine phosphate, fluocinolone acetonide, fluorouracil, fluticasone propionate

  4. Demystifying the reflective clinical journal

    International Nuclear Information System (INIS)

    Student learning on clinical placement is a complex issue and cannot be defined solely by just doing things. Reflection during clinical practice is essential if the student is going to learn from the experience. Therefore it is important for educators to include as part of clinical education programs learning strategies that encourage reflection. The reflective clinical journal is an educational tool that is employed by the School of Medical Radiation Sciences at the University of Sydney to encourage reflection of undergraduate radiation therapy students whilst on clinical placement. This discussion paper explores the key concepts of reflection and the reflective clinical journal. Due to the paucity of information about this issue in radiation therapy the literature reviewed is from across all areas of the health sciences

  5. Nontraditional applications in clinical pathology.

    Science.gov (United States)

    Jordan, Holly L; Register, Thomas C; Tripathi, Niraj K; Bolliger, Anne Provencher; Everds, Nancy; Zelmanovic, David; Poitout, Florence; Bounous, Denise I; Wescott, Debra; Ramaiah, Shashi K

    2014-10-01

    Most published reviews of preclinical toxicological clinical pathology focus on the fundamental aspects of hematology, clinical chemistry, coagulation, and urinalysis in routine toxicology animal species, for example, rats, mice, dogs, and nonhuman primates. The objective of this continuing education course was to present and discuss contemporary examples of nonroutine applications of clinical pathology endpoints used in the drug development setting. Area experts discussed bone turnover markers of laboratory animal species, clinical pathology of pregnant and growing laboratory animals, clinical pathology of nonroutine laboratory animal species, and unique applications of the Siemens Advia(®) hematology analyzer. This article is a summary based on a presentation given at the 31st Annual Symposium of the Society of Toxicologic Pathology, during the Continuing Education Course titled "Nontraditional Applications of Clinical Pathology in Drug Discovery and Preclinical Toxicology."

  6. Crown lengthening: a clinical review.

    Science.gov (United States)

    Talbot, T R; Briggs, P F; Gibson, M T

    1993-09-01

    The use of crown lengthening surgery as an adjunct to restorative therapy was first suggested by Rosen and Gitnick. This technique is designed to increase the clinical crown heights of teeth requiring restoration following extensive wear through attrition, abrasion and erosion. This loss of tooth tissue and resulting clinical crown height may be localized to a few teeth or affect the entire dentition. This clinical problem is reflected by the increasing number of reports of treatment of the worn dentition.

  7. Photodynamic therapy in clinical practice

    OpenAIRE

    E. V. Filonenko; L. G. Serova

    2016-01-01

    The review is on opportunities and possibilities of application of photodynamic therapy in clinical practice. The advantages of this method are the targeting of effect on tumor foci and high efficiency along with low systemic toxicity. The results of the set of recent Russian and foreign clinical trials are represented in the review. The method is successfully used in clinical practice with both radical (for early vulvar, cervical cancer and pre-cancer, central early lung cancer, esophageal a...

  8. Turnaround for the Denver Clinic.

    Science.gov (United States)

    Norris, M J

    1981-01-01

    By renovating its facility, the Denver Clinic was able to meet the needs of its present patient population and attract new patients. Marketing techniques were employed to redesign the facility and to capitalize on the clinic's competitive edge in the Denver market. Useful information is offered to other clinics who are considering facility renovation and on the advantages group practices have in the medical market plan. PMID:10252836

  9. Clinical psychology and child protection

    OpenAIRE

    O'Brien, Elaine; Carey, Sean; Carr, Alan.

    2000-01-01

    In this 1998 postal survey of 140 clinical psychologists working in eight Health Boards and Voluntary agencies in the Republic of Ireland, it was found that clinical psychologists from child mental health, adult mental health and services for people with physical and intellectual disabilities were involved in child abuse and protection work. Clinical psychologists' child protection work spanned a number of domains including validation, general assessment, risk assessment, treatment of victims...

  10. Pediatric DXA: clinical applications

    Energy Technology Data Exchange (ETDEWEB)

    Binkovitz, Larry A. [Columbus Children' s Hospital, Department of Radiology, Columbus, OH (United States); Sparke, Paul [Capital University, Department of Chemistry, Columbus, OH (United States); Henwood, Maria J. [Columbus Children' s Hospital, Department of Endocrinology, Columbus, OH (United States)

    2007-07-15

    Normal bone mineral accrual requires adequate dietary intake of calcium, vitamin D and other nutrients; hepatic and renal activation of vitamin D; normal hormone levels (thyroid, parathyroid, reproductive and growth hormones); and neuromuscular functioning with sufficient stress upon the skeleton to induce bone deposition. The presence of genetic or acquired diseases and the therapies that are used to treat them can also impact bone health. Since the introduction of clinical DXA in pediatrics in the early 1990s, there has been considerable investigation into the causes of low bone mineral density (BMD) in children. Pediatricians have also become aware of the role adequate bone mass accrual in childhood has in preventing osteoporotic fractures in late adulthood. Additionally, the availability of medications to improve BMD has increased with the development of bisphosphonates. These factors have led to the increased utilization of DXA in pediatrics. This review summarizes much of the previous research regarding BMD in children and is meant to assist radiologists and clinicians with DXA utilization and interpretation. (orig.)

  11. Clinical definition of sarcopenia.

    Science.gov (United States)

    Santilli, Valter; Bernetti, Andrea; Mangone, Massimiliano; Paoloni, Marco

    2014-09-01

    Sarcopenia is a condition characterized by loss of skeletal muscle mass and function. Although it is primarily a disease of the elderly, its development may be associated with conditions that are not exclusively seen in older persons. Sarcopenia is a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength and it is strictly correlated with physical disability, poor quality of life and death. Risk factors for sarcopenia include age, gender and level of physical activity. In conditions such as malignancy, rheumatoid arthritis and aging, lean body mass is lost while fat mass may be preserved or even increased. The loss in muscle mass may be associated with increased body fat so that despite normal weight there is marked weakness, this is a condition called sarcopenic obesity. There is an important correlation between inactivity and losses of muscle mass and strength, this suggests that physical activity should be a protective factor for the prevention but also the management of sarcopenia. Furthermore one of the first step to be taken for a person with sarcopenia or clinical frailty is to ensure that the sarcopenic patient is receiving correct and sufficient nutrition. Sarcopenia has a greater effect on survival. It should be important to prevent or postpone as much as possible the onset of this condition, to enhance survival and to reduce the demand for long-term care. Interventions for sarcopenia need to be developed with most attention on exercise and nutritional interventions. PMID:25568649

  12. Overview of Clinical Cytogenetics.

    Science.gov (United States)

    Gonzales, Patrick R; Carroll, Andrew J; Korf, Bruce R

    2016-01-01

    Chromosome analysis is one of the first approaches to genetic testing and remains a key component of genetic analysis of constitutional and somatic genetic disorders. Numerical or unbalanced structural chromosome abnormalities usually lead to multiple congenital anomalies. Sometimes these are compatible with live birth, usually resulting in severe cognitive and physical handicaps; other times they result in miscarriage or stillbirth. Chromosome rearrangements also occur as somatic changes in malignancies. Identification of constitutional chromosomal anomalies (anomalies present in most or all cells of the body and/or the germline) can provide important information for genetic counseling. In this unit, we introduce chromosomal microarray analysis (CMA), which is a relatively recent addition to cytogenetic technologies, and has become the recommended first-tier testing method for patients with developmental delay, intellectual disability, autism, and/or multiple congenital anomalies. We also discuss non-invasive prenatal testing/screening (NIPTS), which uses circulating cell-free fetal DNA (cfDNA) from maternal plasma to rapidly screen for autosomal and sex-chromosome aneuploidies. Cytogenetic analysis of tumors is helpful in diagnosis and in monitoring the effects of treatment. The protocols in this chapter cover the clinical study of chromosomes in nonmalignant tissues. © 2016 by John Wiley & Sons, Inc. PMID:27037488

  13. The clinical encounter revisited.

    Science.gov (United States)

    Schattner, Ami

    2014-04-01

    The patient-physician encounter is the pivotal starting point of any healthcare delivery, but it is subject to multiple process breakdowns and prevalent suboptimal performance. An overview of the techniques and components of a successful encounter valid for every setting and readily applicable is presented, stressing 7 rules: (1) ensuring optimal environment, tools, and teamwork; (2) viewing each encounter not only as a cognitive/biomedical challenge, but also as a personal one, and a learning opportunity; (3) adopting an attitude of curiosity, concentration, compassion, and commitment, and maintaining a systematic, orderly approach; (4) "simple is beautiful"-making the most of the basic clinical data and their many unique advantages; (5) minding "the silent dimension"-being attentive to the patient's identity and emotions; (6) following the "Holy Trinity" of gathering all information, consulting databases/colleagues, and tailoring gained knowledge to the individual patient; and (7) using the encounter as a "window of opportunity" to further the patient's health-not just the major problem, by addressing screening and prevention; promoting health literacy and shared decision-making; and establishing proper follow-up. Barriers to implementation identified can be overcome by continuous educational interventions. A high-quality encounter sets a virtuous cycle of patient-provider interaction and results in increasing satisfaction, adherence, and improved health outcomes. PMID:24333201

  14. Clinical Practice. Postmenopausal Osteoporosis.

    Science.gov (United States)

    Black, Dennis M; Rosen, Clifford J

    2016-01-21

    Key Clinical Points Postmenopausal Osteoporosis Fractures and osteoporosis are common, particularly among older women, and hip fractures can be devastating. Treatment is generally recommended in postmenopausal women who have a bone mineral density T score of -2.5 or less, a history of spine or hip fracture, or a Fracture Risk Assessment Tool (FRAX) score indicating increased fracture risk. Bisphosphonates (generic) and denosumab reduce the risk of hip, nonvertebral, and vertebral fractures; bisphosphonates are commonly used as first-line treatment in women who do not have contraindications. Teriparatide reduces the risk of nonvertebral and vertebral fractures. Osteonecrosis of the jaw and atypical femur fractures have been reported with treatment but are rare. The benefit-to-risk ratio for osteoporosis treatment is strongly positive for most women with osteoporosis. Because benefits are retained after discontinuation of alendronate or zoledronic acid, drug holidays after 5 years of alendronate therapy or 3 years of zoledronic acid therapy may be considered for patients at lower risk for fracture.

  15. The Dynamo Clinical Trial

    Science.gov (United States)

    Ayres, Thomas R.

    2016-04-01

    The Dynamo Clinical Trial evaluates long-term stellar magnetic health through periodic X-ray examinations (by the Chandra Observatory). So far, there are only three subjects enrolled in the DTC: Alpha Centauri A (a solar-like G dwarf), Alpha Cen B (an early K dwarf, more active than the Sun), and Alpha Canis Majoris A (Procyon, a mid-F subgiant similar in activity to the Sun). Of these, Procyon is a new candidate, so it is too early to judge how it will fare. Of the other two, Alpha Cen B has responded well, with a steady magnetic heartbeat of about 8 years duration. The sickest of the bunch, Alpha Cen A, was in magnetic cardiac arrest during 2005-2010, but has begun responding to treatment in recent years, and seems to be successfully cycling again, perhaps achieving a new peak of magnetic health in the 2016 time frame. If this is the case, it has been 20 years since A's last healthful peak, significantly longer than the middle-aged Sun's 11-year magnetic heartbeat, but perhaps in line with Alpha Cen A's more senescent state (in terms of "relative evolutionary age," apparently an important driver of activity). (By the way, don't miss the exciting movie of the Alpha Cen stars' 20-year X-ray dance.)

  16. The clinical encounter revisited.

    Science.gov (United States)

    Schattner, Ami

    2014-04-01

    The patient-physician encounter is the pivotal starting point of any healthcare delivery, but it is subject to multiple process breakdowns and prevalent suboptimal performance. An overview of the techniques and components of a successful encounter valid for every setting and readily applicable is presented, stressing 7 rules: (1) ensuring optimal environment, tools, and teamwork; (2) viewing each encounter not only as a cognitive/biomedical challenge, but also as a personal one, and a learning opportunity; (3) adopting an attitude of curiosity, concentration, compassion, and commitment, and maintaining a systematic, orderly approach; (4) "simple is beautiful"-making the most of the basic clinical data and their many unique advantages; (5) minding "the silent dimension"-being attentive to the patient's identity and emotions; (6) following the "Holy Trinity" of gathering all information, consulting databases/colleagues, and tailoring gained knowledge to the individual patient; and (7) using the encounter as a "window of opportunity" to further the patient's health-not just the major problem, by addressing screening and prevention; promoting health literacy and shared decision-making; and establishing proper follow-up. Barriers to implementation identified can be overcome by continuous educational interventions. A high-quality encounter sets a virtuous cycle of patient-provider interaction and results in increasing satisfaction, adherence, and improved health outcomes.

  17. Clinical biochemistry of aluminum

    Energy Technology Data Exchange (ETDEWEB)

    King, S.W.; Savory, J.; Wills, M.R.

    1981-05-01

    Aluminum toxicity has been implicated in the pathogenesis of a number of clinical disorders in patients with chronic renal failure on long-term intermittent hemodialysis treatment. The predominant disorders have been those involving either bone (osteomalacic dialysis osteodystrophy) or brain (dialysis encephalopathy). In nonuremic patients, an increased brain aluminum concentration has been implicated as a neurotoxic agent in the pathogenesis of Alzheimer's disease and was associated with experimental neurofibrillary degeneration in animals. The brain aluminum concentrations of patients dying with the syndrome of dialysis encephalopathy (dialysis dementia) are significantly higher than in dialyzed patients without the syndrome and in nondialyzed patients. Two potential sources for the increased tissue content of aluminum in patients on hemodialysis have been proposed: (1) intestinal absorption from aluminum containing phosphate-binding gels, and (2) transfer across the dialysis membrane from aluminum in the water used to prepare the dialysate. These findings, coupled with our everyday exposure to the ubiquitous occurrence of aluminum in nature, have created concerns over the potential toxicity of this metal.

  18. Clinic Health Awareness Program Subsystem

    Data.gov (United States)

    Department of Transportation — Clinic Health Awareness Program Subystem (CHAPS) is a comprehensive system for recording, reporting, and analyzing a patient’s medical information and managing an...

  19. Clinical governance and external audit.

    Science.gov (United States)

    Glazebrook, S G; Buchanan, J G

    2001-01-01

    This paper describes a model of clinical governance that was developed at South Auckland Health during the period 1995 to 2000. Clinical quality and safety are core objectives. A multidisciplinary Clinical Board is responsible for the development and publicising of sound clinical policies together with monitoring the effects of their implementation on quality and safety. The Clinical Board has several committees, including an organization-wide Continuous Quality Improvement Committee to enhance the explicit nature of the quality system in terms of structure, staff awareness and involvement, and to develop the internal audit system. The second stream stems from the Chief Medical Officer and clinical directors in a clinical management sense. The Audit Committee of the Board of Directors covers both clinical and financial audit. The reporting lines back to that committee are described and the role of the external auditor of clinical standards is explained. The aim has been to create a supportive culture where quality initiatives and innovation can flourish, and where the emphasis is not on censure but improvement. PMID:11422717

  20. In the Clinic. Smoking Cessation.

    Science.gov (United States)

    Patel, Manish S; Steinberg, Michael B

    2016-03-01

    This issue provides a clinical overview of smoking cessation, focusing on health consequences of smoking, prevention of smoking-related disease, treatment, and practice improvement. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including MKSAP (Medical Knowledge and Self-Assessment Program). Annals of Internal Medicine editors develop In the Clinic in collaboration with the ACP's Medical Education and Publishing divisions and with the assistance of additional science writers and physician writers.

  1. Clinical research in allied health.

    Science.gov (United States)

    Selker, L G

    1994-01-01

    Allied health professionals in nutrition and medical dietetics, occupational therapy, physical therapy, and speech-language pathology and audiology play both unique and key cross-cutting roles in the furtherance of clinical research. Clinical research in nutrition and medical dietetics uniquely focuses on food nutrient intake and the metabolic utilization of nutrients. Clinical research in occupational therapy has a special focus on the relationship of impairment to disability, the adaptation to disability and the maximization of function. Physical therapy clinical research uniquely targets movement dysfunction and its evaluation and treatment within the context of quality and effective care. Clinical research in speech-language pathology and audiology is singular in its focus on deafness and hearing disorders, voice, speech, language and related disorders, and intersections among these and other neurological and physical conditions. Thus, all of these disciplines are making unique contributions to clinical research. Clinical research in these allied health professions is much more than the above specific foci. Inasmuch as these disciplines are rooted in practice, their contributions to research are inherently clinical. Many, if not most, of these contributions represent further validations of clinical practice or its underlying knowledge base. This means that, at a macro level, clinical research in allied health is very much "applied" research. Within allied health clinical research, this emphasis is redoubled at the "person," or individual level, where considerable attention is given to concepts of function and effectiveness. Clinical research in allied health has played a key cross-cutting role through its emphasis on collaboration. Possibly due to their professional maturation within multidisciplinary academic units, allied health professionals have demonstrated a level of comfort with multidisciplinary and interdisciplinary collaborations unique within many

  2. Clinical Data Warehousing - A Survey

    DEFF Research Database (Denmark)

    Pedersen, Torben Bach; Jensen, Christian Søndergaard

    1998-01-01

    In this article we present the concept of data warehousing, and its use in the clinical area. Clinical data warehousing will become very important in the near future, as healthcare enterprises need to gain more information from their clinical, administrative, and financial data, in order to improve...... in the area, and providing criteria for comparing clinical data warehouse systems....... quality and reduce costs. Adoption of data warehousing in health care has been slowed by lack of understanding of the benefits offered by the technology. This paper contributes by providing needed understanding, by introducing the opportunities offered by data warehousing, describing current efforts...

  3. Children and Clinical Studies: Why Clinical Studies Are Important

    Medline Plus

    Full Text Available U.S. Department of Health & Human Services National Institutes of Health Contact Us Get Email Alerts Font Size Accessible Search ... Health Topics Education & Awareness Resources Contact The Health Information Center ... Transfer Clinical Trials What Are Clinical Trials? Children & ...

  4. Designing for Anxiety Therapy, Bridging Clinical and Non-Clinical

    DEFF Research Database (Denmark)

    Bertelsen, Olav Wedege; Kramp, Gunnar

    2012-01-01

    In this position paper we discuss, in terms of the concept of boundary objects, how a mobile application, the MIKAT.app, bridge between clinical intervention in anxiety therapy, and life and coping strategies outside the clinic and across phases of being a person suffering from, or having suffered...... from anxiety. Thereby, we hope to provide a counterpoint in the discussion on illness trajectories....

  5. Clinical outcomes in clinical trials of anti-HIV treatment

    DEFF Research Database (Denmark)

    Reekie, J; Mocroft, A; J, Neaton;

    2007-01-01

    Since the introduction of combination antiretroviral therapy, there has been a decrease in both AIDS-defining illnesses and deaths. This decrease meant that performing clinical trials with clinical outcomes in HIV infection became more time consuming and hence costly. Improved understanding...

  6. Integrating Academic and Clinical Learning Using a Clinical Swallowing Assessment

    Science.gov (United States)

    Phillips, Daniel E.

    2013-01-01

    This article describes an experiential learning activity designed to integrate classroom knowledge and a clinical swallowing assessment. Twenty master's-level graduate students in a dysphagia course conducted a clinical swallowing assessment with a resident of an independent retirement community. The exercise was designed to allow students an…

  7. Providing semantic interoperability between clinical care and clinical research domains.

    Science.gov (United States)

    Laleci, Gokce Banu; Yuksel, Mustafa; Dogac, Asuman

    2013-03-01

    Improving the efficiency with which clinical research studies are conducted can lead to faster medication innovation and decreased time to market for new drugs. To increase this efficiency, the parties involved in a regulated clinical research study, namely, the sponsor, the clinical investigator and the regulatory body, each with their own software applications, need to exchange data seamlessly. However, currently, the clinical research and the clinical care domains are quite disconnected because each use different standards and terminology systems. In this article, we describe an initial implementation of the Semantic Framework developed within the scope of SALUS project to achieve interoperability between the clinical research and the clinical care domains. In our Semantic Framework, the core ontology developed for semantic mediation is based on the shared conceptual model of both of these domains provided by the BRIDG initiative. The core ontology is then aligned with the extracted semantic models of the existing clinical care and research standards as well as with the ontological representations of the terminology systems to create a model of meaning for enabling semantic mediation. Although SALUS is a research and development effort rather than a product, the current SALUS knowledge base contains around 4.7 million triples representing BRIDG DAM, HL7 CDA model, CDISC standards and several terminology ontologies. In order to keep the reasoning process within acceptable limits without sacrificing the quality of mediation, we took an engineering approach by developing a number of heuristic mechanisms. The results indicate that it is possible to build a robust and scalable semantic framework with a solid theoretical foundation for achieving interoperability between the clinical research and clinical care domains. PMID:23008263

  8. Clinical mastitis in ewes; bacteriology, epidemiology and clinical features

    Directory of Open Access Journals (Sweden)

    Kvitle Bjørg

    2007-09-01

    Full Text Available Abstract Background Clinical mastitis is an important disease in sheep. The objective of this work was to identify causal bacteria and study certain epidemiological and clinical features of clinical mastitis in ewes kept for meat and wool production. Methods The study included 509 ewes with clinical mastitis from 353 flocks located in 14 of the 19 counties in Norway. Clinical examination and collection of udder secretions were carried out by veterinarians. Pulsed-field gel electrophoresis (PFGE was performed on 92 Staphylococcus aureus isolates from 64 ewes. Results and conclusion S. aureus was recovered from 65.3% of 547 clinically affected mammary glands, coagulase-negative staphylococci from 2.9%, enterobacteria, mainly Escherichia coli, from 7.3%, Streptococcus spp. from 4.6%, Mannheimia haemolytica from 1.8% and various other bacteria from 4.9%, while no bacteria were cultured from 13.2% of the samples. Forty percent of the ewes with unilateral clinical S. aureus mastitis also had a subclinical S. aureus infection in the other mammary gland. Twenty-four of 28 (86% pairs of S. aureus isolates obtained from clinically and subclinically affected mammary glands of the same ewe were indistinguishable by PFGE. The number of identical pairs was significantly greater than expected, based on the distribution of different S. aureus types within the flocks. One-third of the cases occurred during the first week after lambing, while a second peak was observed in the third week of lactation. Gangrene was present in 8.8% of the clinically affected glands; S. aureus was recovered from 72.9%, Clostridium perfringens from 6.3% and E. coli from 6.3% of the secretions from such glands. This study shows that S. aureus predominates as a cause of clinical ovine mastitis in Norway, also in very severe cases. Results also indicate that S. aureus is frequently spread between udder halves of infected ewes.

  9. Clinical management of constipation.

    Science.gov (United States)

    Lennard-Jones, J E

    1993-10-01

    First, it is important to find out whether the patient is complaining of infrequent defaecation, excessive straining at defaecation, abdominal pain or bloating, a general sense of malaise attributed to constipation, soiling, or a combination of more than one symptom. Second, one must decide if there is a definable abnormality as a cause of the symptom(s). Is the colon apparently normal or is its lumen widened (megacolon)? Is the upper gut normal or is there evidence of neuropathy or myopathy? Is the ano-rectum normal or is there evidence of a weak pelvic floor, mucosal prolapse, major rectocele, an internal intussusception or solitary rectal ulcer? Is there any systemic component such as hypothyroidism, hypercalcaemia, neurological or psychiatric disorder or relevant drug therapy? Choice of treatment will depend on this clinical evaluation. The range of treatments available is: Reassurance and stop current treatment: Patients with a bowel obsession may take laxatives or rectal preparations regularly without need. Increase dietary fibre: Most cases of 'simple' constipation respond to increased dietary fibre, possibly with an added supplement of natural bran. Toilet training and altered routine of life: Young people particularly may need to recognise the call to stool and alter their daily routine to permit and encourage regular defaecation. Medicinal bulking agent: Ispaghula, methyl cellulose, concentrated wheat germ or bran, and similar preparations are useful when patients with a normal colon find it difficult to take adequate dietary fibre. These preparations increase the bulk of stool and soften its consistency. They may be useful for those patients with the constipated form of irritable bowel syndrome.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8234432

  10. Liver angioscintigraphy: clinical applications.

    Science.gov (United States)

    Dragoteanu, Mircea; Cotul, Sabin O; Pîgleşan, Cecilia; Tamaş, Stefan

    2004-03-01

    Liver angioscintigraphy (LAS) is a radio-isotope method for the investigation of liver perfusion and its alteration in various hepatic diseases. It measures the arterial and portal venous fractions of total liver blood flow. The percentage of liver blood flow supplied by hepatic artery is estimated mathematically by the hepatic perfusion index (HPI), normally between 25 % and 40 %. The decrease of portal blood flow in liver cirrhosis is compensated ("buffer" mechanisms) by increased arterial supply, with higher HPI value. For a patient with chronic liver disease, HPI over 50% suggests arterialization of hepatic perfusion, guiding the diagnose to liver cirrhosis. Splenic curve is completing the diagnostic information of the hepatic curve. Corroborated with per rectal scintigraphy and liver SPECT, LAS offers a good hemodynamic staging of chronic inflammatory liver diseases. Malignant tumors (primitive or metastases) increase the arterial supply of the liver and decrease the portal flow, HPI being over 50% (currently 65 % - 90 %). Benign tumors do not change portal/arterial liver blood flow ratio. SPECT or non-scintigraphic morphological investigations increase the diagnostic value of LAS for primitive liver tumors. Liver cancer occurring on cirrhosis is a limitative factor for LAS. Hepatic metastases increase the arterial perfusion (and HPI value) very quickly, before their size allows morphologic imaging diagnosis. LAS is therefore an early method to diagnose liver metastases being especially used in colorectal cancer. Other clinical applications of LAS are: follow up of liver toxicity of drugs, evaluation of portal vein permeability, post surgery follow up of the liver tumor patients. PMID:15054528

  11. Clinical pharmacology of homoharringtonine

    Energy Technology Data Exchange (ETDEWEB)

    Savaraj, N.; Lu, K.; Dimery, I.; Feun, L.G.; Burgess, M.; Keating, M.; Loo, T.L.

    1986-12-01

    Clinical pharmacokinetics of homoharringtonine (HHT) were studied in eight patients who received uniformly labeled HHT at 3-4 mg/m2 (150 mu Ci) by continuous 6-hour infusion. The drug and metabolites were quantified by radiochemical and high-performance liquid chromatographic techniques. Computerized nonlinear least-square regression and curve stripping were used to characterize HHT and total (/sup 3/H)HHT equivalent pharmacokinetics. Unchanged HHT in the plasma declined biphasically, with an alpha-half-life of 0.5 +/- 0.1 hours and a beta-half-life of 9.3 +/- 1.4 hours. The total clearance of HHT was 177.4 +/- 27.7 ml X hour-1 X kg-1, and the apparent volume of distribution, estimated from the area under the drug concentration versus time curve, was 2.4 +/- 0.4 L X kg-1. Correspondingly, the total (/sup 3/H)HHT equivalent disappeared from the plasma in a triphasic manner. Compared with the pharmacokinetic parameters of unchanged HHT, the terminal half-life of total /sup 3/H was 67.5 +/- 7.5 hours, 7.4 times longer; the total clearance was 30.9 +/- 3.1 ml X hour-1 X kg-1, 5.5 times slower; but the volume of distribution by area was 2.7 +/- 0.1 L X kg-1, nearly the same. The 72-hour cumulative urinary excretion of total tritium was 28.2% of the administered dose and only 38.3% of this resided in unchanged HHT. Thus, urinary excretion was not a major route of elimination of HHT. Moreover, HHT underwent extensive metabolism; one major and two minor unidentified products were detected in both plasma and urine.

  12. Movement: A Clinical Investigation

    Directory of Open Access Journals (Sweden)

    Kazem Dalaie

    2015-10-01

    Full Text Available Objectives: One major drawback of orthodontic treatment is its long duration due to slow tooth movement and the pain at the onset of treatment following application of forces. There is controversy regarding the efficacy of laser for decreasing the treatment time and pain of orthodontic treatment. The purpose of this study was to investigate the effect of low level diode laser on the rate of orthodontic tooth movement and the associated pain.Materials and Methods: In this double blind randomized controlled clinical trial, 12 or- thodontic patients referring to Shahid Beheshti School of Dentistry for first premolar ex- traction were randomly selected and allocated to gallium aluminum-arsenide laser (Ga,Al,As diode laser, 880 nm, 100 mW, 5 j/cm2, 8 points, 80 seconds, continuous mode or control group. The patients initially underwent leveling and alignment using the sectional system. Force (150 gr was applied to each canine tooth via sectional closing loops. The loops were activated every month. The rate of tooth movement and pain were monitored over the treatment period and recorded on days 1, 3, 7, 30, 33, 37, 60, 63 and 67. Two-way ANOVA was used for comparison of groups.Results: There was no significant difference in terms of tooth movement and pain scores between the irradiated and non-irradiated sides at any time point (P>0.05.Conclusion: Although laser enhanced orthodontic tooth movement in the upper jaw, we failed to provide solid evidence to support the efficacy of laser for expediting tooth move- ment or reducing the associated pain.

  13. Principales consecuencias de los planes de ajuste en Grecia, Irlanda y Portugal

    OpenAIRE

    Tortosa Collado, David

    2014-01-01

    Trabajo acerca de las políticas seguidas por Grecia, Irlanda y Portugal como medida de respuesta a los rescates necesarios que han tenido que recibir por los problemas ocasionados por la crisis actual y por sus situaciones particulares. Grecia, un país con un grave problema de deuda soberana y cuentas falsificadas, Irlanda, cuya situación fue crítica a partir de su rescate bancario y Portugal, un país con un escaso crecimiento y la desconfianza internacional. En él, tras un breve marco teóric...

  14. Teaching Cases in Management - RIPASA: Venda e Ajuste com Minoritários

    Directory of Open Access Journals (Sweden)

    Roberto Borges Kerr

    2009-04-01

    Full Text Available In 2004, the Zogbi, Derani and Zarzur [ZDZ] holding began negotiations to sell control of Ripasa, an attractive growth opportunity for its competitors which would not alter the market equilibrium. National and international competitors will dispute this crown jewel, the smallest of the big cellulose and paper companies. The Ripasa Case is a detailed description of a real business situation, the acquisition of the control of Ripasa by Votorantim Celulose e Papel [VCP] and Suzano Bahia Sul, two competing companies that joined forces in a strategic alliance designed as a consortium to acquire the control of Ripasa. The Case analyzes the acquisition process and the complex agreement with minority stockholders. The main question under discussion is the price to be paid to the minority stockholders. The situation became more complex due to the ambiguity of Ripasa´s Social Statute, which allowed for more than one interpretation on the tag along rights and caused a conflict between agencies. The acquiring companies decided not to take into consideration the best practices of Corporate Governance, aggravating the problem and delaying a final agreement for eighteen months.

  15. AJUSTE A LA CRISIS Y MERCADO LABORAL (PERÚ 2008-2010

    Directory of Open Access Journals (Sweden)

    Norberto E. García

    2011-06-01

    Full Text Available The present paper analyses the adjustment of the Peruvian economy to the external shock caused by the global crisis in 2008-2010, with particular attention to: i the macroeconomic policies adopted to face the external shock; ii the consequences of the adjustment for the labor market; iii the importance of the high rates of economic growth recorded by Peru before the crisis in obtaining a soft adjustment to the external shock; iv the reasons that explained why the Peruvian economy does not suffer a recession and only decelerates growth, which allow us to understand why the adjustment to the external shock does not have a negative effect on the labor market – as a matter of fact there is a reduction of the unemployment rate during the crisis.

  16. Distribution transformer with automatic voltage adjustment - performance; Transformador de distribucion con ajuste automatico de tension - desempeno

    Energy Technology Data Exchange (ETDEWEB)

    Hernandez Ruiz, Gustavo A.; Delgadillo Bocanegra, Alfonso; Betancourt Ramirez, Enrique [PROLEC-GE, Apodaca, Nuevo Leon (Mexico)]. E-mail: gustavo1.hernandez@ge.com; alfonso.delgadillobocanegra@ge.com; enrique.betancourt@ge.com; Ramirez Arredondo, Juan M. [CINVESTAV-Guadalajara, Zapopan, Jalisco (Mexico)]. E-mail: jramirez@gdl.cinvestav.mx

    2010-11-15

    In the electric power distribution systems, the power quality is strongly linked with the service stability voltage. In the radial kind systems, it is virtually impossible to achieve a flat voltage along the lines, so it is desirable to count with transformers that can adjust automatically the turns ratio. In this work, it is described the development and the performance of a transformer with an integrated electronic tap changer, that allows to change the turns ratio along the standard range of +/-5%, and it was identified the application limits of the technology. [Spanish] En los sistemas de distribucion de energia electrica, la calidad del suministro de energia esta fuertemente ligada con la estabilidad del voltaje de servicio. En sistemas de tipo radial, es virtualmente imposible mantener uniforme la tension a lo largo de las lineas, por lo que se hace deseable contar con transformadores que puedan ajustar automaticamente la relacion de transformacion. En este trabajo, se describe el desarrollo y desempeno de un transformador con switch electronico integrado, que permite variar la relacion de transformacion dentro del rango estandarizado de +/-5%, y se identifican los limites de aplicacion de la tecnologia.

  17. PROALCOOL: economic evaluation and adjustments on demand; PROALCOOL: Reavaliacao economica e ajustes de demanda

    Energy Technology Data Exchange (ETDEWEB)

    Motta, R.S. da [Universidade Federal, Rio de Janeiro, RJ (Brazil). Coordenacao dos Programas de Pos-graduacao de Engenharia; Rocha Ferreira, L. da [Universidade do Estado, Rio de Janeiro, RJ (Brazil). Faculdade de Ciencias Economicas

    1987-12-31

    The economic impact on the Brazilian National Alcohol Programme caused by changes in the energy scenery, in view of recent oil price fall in the international market, is discussed. The necessary adjustments of the Programme according to the new Brazilian economic reality are evaluated. The economic analysis concludes that the alcohol production, considering current production capacity and its investments could be economically feasible at international oil prices near US$ 30,00. Excluding investments, its feasibility would be between US$ 18,00 and US$ 20,00 per equivalent oil barrel. Based on these conclusions, proposals for adjusting the PROALCOOL are discussed, including alternative pricing, fiscal and credit policies to control the alcohol-fuel demand. 8 refs., 4 tabs.

  18. Determination of methodology of automatic history matching; Determinacao de metodologia de ajuste automatizado de historico

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Jose Pedro Moura dos

    2000-01-01

    In management of hydrocarbon reservoirs the numeric simulation is a fundamental tool. The validation of a field model with production report is made through history matching which, many times, is done by trial and errors procedures consuming excessive computational time and human efforts. The objective of this work is to present a methodology for automation of the history matching using the program UNIPAR with the modules of parallel computing, sensibility analysis and optimization. Based on an example of an offshore field, analyses of the objective function (water production, oil production and average pressure of the reservoir) behavior were accomplished as function of the variations of reservoir parameters. It was verified that this behavior is very regular. After that, several adjustment situations were tested to define a procedure to be used for a history matching. (author) Ate aqui estao scanned.

  19. La crisis y el ajuste cubano en los noventa: apuntes en torno a lo social

    Directory of Open Access Journals (Sweden)

    María Teresa Valdés Fernández

    1996-01-01

    Full Text Available This paper outlines the role played by the social sector within development strategies designed in Cuba, as well as the effects that the recent economic situation and the adjustment derived therefrom have had on the social sector’s role. This constitutes a necessary antecedent for an understanding of the conditions in which a new model of social policies ought to be formulated in the future, in tune with the transformations already under way in the economy and which will doubtless continue.

  20. Ajuste recursivo con transformaciones invariantes y bootstrapping: El caso de una caminata aleatoria con intercepto

    OpenAIRE

    Eddy Lizarazu Alanez; Jose A. Villasenor Alva

    2010-01-01

    Usamos simulaciones de Monte Carlo para estudiar el desempeno de la prueba de raiz unitaria de Shin-So (DFSS) bajo los enfoques de transformaciones invariantes y el bootstrapping. Si la hipotesis alternativa es un proceso estacionario alrededor de una tendencia lineal, entonces la prueba bootstrap parametrica es la mejor en terminos de la potencia estadistica. Sin embargo, si transformamos las observaciones para construir una prueba invariante, entonces la prueba DFSS es la mejor. Por consigu...

  1. Processamento por ajuste de campo em acústica submarina e aplicações

    OpenAIRE

    C. Soares; Jesus, S.M.

    2004-01-01

    A acústica submarina encontra aplicação em variados problemas tais como detecçãao activa ou passiva e localização de navios e submarinos, comunicações acústicas, tomografia acústica, procura de objectos enterrados e monitorização remota de fenomenos naturais, entre outros. Parte destas aplicações tornaram-se possíveis graças aos avanços tecnológicos da última década, que trouxeram um aumento significativo da capacidade computacional disponível.

  2. Internet au service de la tâche : un travail d’ajustements

    Directory of Open Access Journals (Sweden)

    Thierry Soubrié

    2010-01-01

    Full Text Available [Français] Dans le domaine de l’enseignement/apprentissage des langues, Internet a un rôle important à jouer. Non pas tant en raison des multiples ressources pédagogiques et authentiques que l’on peut y trouver que du fait que son utilisation s’inscrit dans le cadre de nombreuses activités de la vie quotidienne. La transposition de ces activités en classe relève en effet parfaitement de la perspective actionnelle (Conseil de l’Europe, 2001. Cet article montre, à partir de l’analyse de scénarios pédagogiques réalisés dans le cadre du projet Forttice et de l’étude du processus qui a abouti à leur élaboration, quels sont les lieux de résistance à une intégration réussie d’Internet et des tâches en classe de français langue étrangère (FLE. [English] In the field of language teaching and learning, the Internet plays an important role. Not only because of the many teaching resources and authentic documents that can be found there, but because using Internet is an activity which is part of the wider social context of everyday life. Its parallel use in the classroom fits perfectly with the tenets of the action-oriented approach (Council of Europe, 2001. Through the analysis of teaching scenarios, elaborated within the framework of the “Forttice” project, and the study of the process which led to their creation, this article will discuss the areas of resistance to the successful integration of the Internet and tasks in the French foreign language classroom (FFL.

  3. Ajuste de los modelos físicos 802.16 para alta movilidad

    OpenAIRE

    Almagro Carrión, Sergio; Cerdán Cartagena, José Fernando; Luján Fernández, Sergio; Cabrera Lozoya, Andrés

    2009-01-01

    En los útlimos años, la integración de servicios de datos en redes móviles se ha convertido en un objetivo primordial para fabricantes y proveedores de servicios. Dada su robustez y eficiencia, Wimax ha ido ganando protagonismo en dicho mercado, llegando a ser una referencia cuando hablamos de las futuras redes móviles de cuarta generación 4G. Los modelos de simulación para esta tecnología permiten desarrollar nuevas mejoras y conocer su comportamiento. El presente documento se centra en el m...

  4. Diferencias entre universidades privadas y oficiales venezolanas: Algunos ajustes necesarios en el sector privado

    Directory of Open Access Journals (Sweden)

    Luis Fuenmayor Toro

    2003-01-01

    Full Text Available Este trabajo efectúa una caracterización preliminar de la universidad privada venezolana, a medio siglo de sus inicios. Se determinan algunas de sus fallas principales y propone correctivos factibles aprovechando las leyes de educación próximas a ser aprobadas. Los datos demuestran que las universidades privadas, a diferencia de las oficiales, tiene una planta docente mayoritariamente a tiempo convencional, ubicada principalmente en los más bajos escalafones académicos, con estudios de postgrado en una proporción menor que las universidades oficiales y prácticamente sin investigadores. La relación alumno/profesor es el doble de la del sector oficial y los postgrados universitarios que ofrecen son la quinta parte del total y sólo están acreditados el 10%, en contraposición con el 29% acreditado de las instituciones públicas. De estas comparaciones se extrae que la universidad privada está muy limitada para la realización de investigación y para el desarrollo de los postgrados que forman investigadores: maestrías y doctorados. Tiene además limitaciones subsanables en el pregrado, por no disponer de docentes contratados a altas dedicaciones, que dispongan de tiempo dentro de su dedicación para las consultas estudiantiles. Esto se puede resolver a través de un mandato legal que determine que un 33% de los docentes, sin contar autoridades y directivos, deban estar a dedicación exclusiva y repartidos homogéneamente entre todos los programas docentes institucionales. Estos docentes, también por mandato legal, dispondrían de un 30% de su tiempo para hacer investigación en unidades de universidades y otros centros oficiales, a las que serían adscritos formalmente. Ello mejoraría la academia de las instituciones privadas sin costos que hagan imposible estos importantes cambios.

  5. Factores psicoemocionales y ajuste psicológico asociados al cáncer de mama

    OpenAIRE

    Zayas García, Antonio

    2016-01-01

    Falta palabras clave El cáncer es una enfermedad crónica que provoca un gran número de muertes al año (SEOM, 2014), afectando a quienes lo padecen en su esfera tanto física, como psicológica y social. Concretamente el cáncer de mama es el primer tipo de enfermedad neoplásica que se da en las mujeres en este país, presentando unas peculiaridades específicas que hacen que ejerza una influencia, tanto por el impacto de la enfermedad, por los efectos secundarios derivados de los tratamie...

  6. Ajuste macroeconómico y reformas estructurales en Bolivia, 1985-1994

    Directory of Open Access Journals (Sweden)

    Juan Antonio Morales

    1994-12-01

    Full Text Available El propósito principal de este documento es ofrecer un estado de la situación macroeconómica, una revisión del programa de reformas estructurales, que comenzó con la estabilización de agosto de 1985 (con el Decreto Supremo 21060, y un análisis de las perspectivas de crecimiento. Se hace hincapié en las dificultades que Bolivia confronta para reanudar sostenidamente el crecimiento.

  7. Ajuste psicológico en la infancia: aspectos emocionales y variables asociadas

    OpenAIRE

    Ordóñez López, Ana

    2015-01-01

    La segunda infancia es la etapa evolutiva enmarcada entre los 6 y los 12 años, en la cual los factores físicos, cognitivos y psicosociales se combinan en el desarrollo del individuo. Así, un desarrollo positivo en la infancia es consecuencia de múltiples factores y agentes. Las emociones son un aspecto importante en la vida de las personas, en parte porque tienen un marcado carácter adaptativo y funcional, pero sobretodo porque impregnan toda nuestra vida cotidiana, y mediatizan nuestras rela...

  8. Reseña del libro: Ajuste Cultural de la persona con Discapacidad Intelectual

    Directory of Open Access Journals (Sweden)

    Maira Fernanda Hurtado Abril

    2013-06-01

    Full Text Available El presente trabajo realiza una breve exploración crítica del libro de Verdugo y Gutiérrez (2009, el cual tiene como eje central el análisis de la evolución del término “discapacidad” en los principales sistemas de acción, y la explicación de propuestas de intervención para la adaptabilidad de la persona con discapacidad intelectual. La lectura del libro transcurre de una manera armoniosa, clara y funcional para aquellos interesados en el tema (psicólogos, investigadores, terapeutas, educadores, familiares, buscando así la aplicación conjunta del modelo de una manera práctica y eficaz en la vida cotidiana de estas personas.

  9. Comparación entre varias poblaciones estándar para el ajuste por edades

    OpenAIRE

    Llorca Díaz Javier; Prieto Salceda Dolores; Dierssen Sotos Trinidad; Delgado-Rodríguez Miguel

    2000-01-01

    FUNDAMENTO: Analizar el efecto que tiene la elección de una población de referencia sobre diferentes indicadores derivados de las tasas de mortalidad ajustadas por edad. MÉTODOS: Las tasas de mortalidad por diferentes causas de muerte en España de 1971 a 1992 son ajustadas empleando cuatro poblaciones de referencia: poblaciones españolas de 1971 y 1992, población estándar europea y población estándar mundial. Los resultados obtenidos con las cuatro poblaciones se comparan empleando tres indic...

  10. Ajustes a la arquitectura del sistema general de salud de Colombia: una propuesta

    Directory of Open Access Journals (Sweden)

    Dov Chernichovsky

    2015-01-01

    Full Text Available El modelo de competencia regulada establecido por la Ley 100 de 1993 para el funcionamiento del sis- tema de salud en Colombia presenta fallas de mercado y fallas de gobierno. A la luz del modelo conceptual del « Paradigma Emergente » , este artículo presenta una propuesta de adaptación de la arquitectura del sistema de salud de Colombia a la arquitectura de sistemas internacionales considerados exitosos, identificando instituciones, roles y competencias. Dado lo anterior, las recomendaciones más importantes son: impulsar el sistema dual de competencia regulada en zonas densamente pobladas y monopolios en zonas sin densidad geográfica y regionalizar el sistema. También se sugiere la adopción de instrumentos de regulación de la oferta como el certificado de necesidad.

  11. Balancing mechanism status: March 2009; Bilan du mecanisme d'ajustement: mars 2009

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2009-07-01

    RTE ensures the real-time balance between production and consumption and deals with congestion on the French electricity system. The Balancing Mechanism assists in the accomplishment of this task. As in many countries, and after extensive dialogue with representatives from the market's various players, RTE proposes a Balancing Mechanism in the form of a permanent and transparent system of calls for tender. The system is open to everyone and provides a real-time reserve of power that can be used for balancing either upward or downward. RTE takes advantage of these offers according to economic precedence, taking into account the system's operating conditions. It pays for them at the offer price. There are two types of offer: - Upward offer: increase in production, decrease in consumption, imports, - Downward offer: decrease in production, increase in consumption, exports. For a Balancing Entity, an offer systematically consists of: a balancing direction (upward/downward), a time period, a price that may vary according to six time slots. RTE publishes each month a Balancing Mechanism Report. which includes the following information: - energy volumes activated to ensure the balance of the system and to resolve congestion; - minimum and maximum prices of offers activated to balance the system; - daily trends calculated according to the predominant value of the overall upward or downward trend; - balancing shares by technology (nuclear, thermal, hydraulic); - characteristics of the five most activated balancing entities; - balances/imbalances accounts and production/consumption overcharge; - congestion curbing costs on the French electricity system; - energy volumes activated to ensure the balance of the system according to contracts between RTE and other Balance Responsible entities (UK, Belgium, Italy, Germany, Switzerland); - reliability of the provisional data supplied by RTE about the balancing trend; - availability of RTE's information services (planning, balancing mechanism, block exchange notification, market indicators). This report presents the above information for March 2009. (J.S.)

  12. Balancing mechanism status: September 2009; Bilan du mecanisme d'ajustement: septembre 2009

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2009-07-01

    RTE ensures the real-time balance between production and consumption and deals with congestion on the French electricity system. The Balancing Mechanism assists in the accomplishment of this task. As in many countries, and after extensive dialogue with representatives from the market's various players, RTE proposes a Balancing Mechanism in the form of a permanent and transparent system of calls for tender. The system is open to everyone and provides a real-time reserve of power that can be used for balancing either upward or downward. RTE takes advantage of these offers according to economic precedence, taking into account the system's operating conditions. It pays for them at the offer price. There are two types of offer: - Upward offer: increase in production, decrease in consumption, imports, - Downward offer: decrease in production, increase in consumption, exports. For a Balancing Entity, an offer systematically consists of: a balancing direction (upward/downward), a time period, a price that may vary according to six time slots. RTE publishes each month a Balancing Mechanism Report. which includes the following information: - energy volumes activated to ensure the balance of the system and to resolve congestion; - minimum and maximum prices of offers activated to balance the system; - daily trends calculated according to the predominant value of the overall upward or downward trend; - balancing shares by technology (nuclear, thermal, hydraulic); - characteristics of the five most activated balancing entities; - balances/imbalances accounts and production/consumption overcharge; - congestion curbing costs on the French electricity system; - energy volumes activated to ensure the balance of the system according to contracts between RTE and other Balance Responsible entities (UK, Belgium, Italy, Germany, Switzerland); - reliability of the provisional data supplied by RTE about the balancing trend; - availability of RTE's information services (planning, balancing mechanism, block exchange notification, market indicators). This report presents the above information for September 2009. (J.S.)

  13. Balancing mechanism status: August 2009; Bilan du mecanisme d'ajustement: aout 2009

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2009-07-01

    RTE ensures the real-time balance between production and consumption and deals with congestion on the French electricity system. The Balancing Mechanism assists in the accomplishment of this task. As in many countries, and after extensive dialogue with representatives from the market's various players, RTE proposes a Balancing Mechanism in the form of a permanent and transparent system of calls for tender. The system is open to everyone and provides a real-time reserve of power that can be used for balancing either upward or downward. RTE takes advantage of these offers according to economic precedence, taking into account the system's operating conditions. It pays for them at the offer price. There are two types of offer: - Upward offer: increase in production, decrease in consumption, imports, - Downward offer: decrease in production, increase in consumption, exports. For a Balancing Entity, an offer systematically consists of: a balancing direction (upward/downward), a time period, a price that may vary according to six time slots. RTE publishes each month a Balancing Mechanism Report. which includes the following information: - energy volumes activated to ensure the balance of the system and to resolve congestion; - minimum and maximum prices of offers activated to balance the system; - daily trends calculated according to the predominant value of the overall upward or downward trend; - balancing shares by technology (nuclear, thermal, hydraulic); - characteristics of the five most activated balancing entities; - balances/imbalances accounts and production/consumption overcharge; - congestion curbing costs on the French electricity system; - energy volumes activated to ensure the balance of the system according to contracts between RTE and other Balance Responsible entities (UK, Belgium, Italy, Germany, Switzerland); - reliability of the provisional data supplied by RTE about the balancing trend; - availability of RTE's information services (planning, balancing mechanism, block exchange notification, market indicators). This report presents the above information for August 2009. (J.S.)

  14. Balancing mechanism status: April 2009; Bilan du mecanisme d'ajustement: avril 2009

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2009-07-01

    RTE ensures the real-time balance between production and consumption and deals with congestion on the French electricity system. The Balancing Mechanism assists in the accomplishment of this task. As in many countries, and after extensive dialogue with representatives from the market's various players, RTE proposes a Balancing Mechanism in the form of a permanent and transparent system of calls for tender. The system is open to everyone and provides a real-time reserve of power that can be used for balancing either upward or downward. RTE takes advantage of these offers according to economic precedence, taking into account the system's operating conditions. It pays for them at the offer price. There are two types of offer: - Upward offer: increase in production, decrease in consumption, imports, - Downward offer: decrease in production, increase in consumption, exports. For a Balancing Entity, an offer systematically consists of: a balancing direction (upward/downward), a time period, a price that may vary according to six time slots. RTE publishes each month a Balancing Mechanism Report. which includes the following information: - energy volumes activated to ensure the balance of the system and to resolve congestion; - minimum and maximum prices of offers activated to balance the system; - daily trends calculated according to the predominant value of the overall upward or downward trend; - balancing shares by technology (nuclear, thermal, hydraulic); - characteristics of the five most activated balancing entities; - balances/imbalances accounts and production/consumption overcharge; - congestion curbing costs on the French electricity system; - energy volumes activated to ensure the balance of the system according to contracts between RTE and other Balance Responsible entities (UK, Belgium, Italy, Germany, Switzerland); - reliability of the provisional data supplied by RTE about the balancing trend; - availability of RTE's information services (planning, balancing mechanism, block exchange notification, market indicators). This report presents the above information for April 2009. (J.S.)

  15. Balancing mechanism status: February 2009; Bilan du mecanisme d'ajustement: fevrier 2009

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2009-07-01

    RTE ensures the real-time balance between production and consumption and deals with congestion on the French electricity system. The Balancing Mechanism assists in the accomplishment of this task. As in many countries, and after extensive dialogue with representatives from the market's various players, RTE proposes a Balancing Mechanism in the form of a permanent and transparent system of calls for tender. The system is open to everyone and provides a real-time reserve of power that can be used for balancing either upward or downward. RTE takes advantage of these offers according to economic precedence, taking into account the system's operating conditions. It pays for them at the offer price. There are two types of offer: - Upward offer: increase in production, decrease in consumption, imports, - Downward offer: decrease in production, increase in consumption, exports. For a Balancing Entity, an offer systematically consists of: a balancing direction (upward/downward), a time period, a price that may vary according to six time slots. RTE publishes each month a Balancing Mechanism Report. which includes the following information: - energy volumes activated to ensure the balance of the system and to resolve congestion; - minimum and maximum prices of offers activated to balance the system; - daily trends calculated according to the predominant value of the overall upward or downward trend; - balancing shares by technology (nuclear, thermal, hydraulic); - characteristics of the five most activated balancing entities; - balances/imbalances accounts and production/consumption overcharge; - congestion curbing costs on the French electricity system; - energy volumes activated to ensure the balance of the system according to contracts between RTE and other Balance Responsible entities (UK, Belgium, Italy, Germany, Switzerland); - reliability of the provisional data supplied by RTE about the balancing trend; - availability of RTE's information services (planning, balancing mechanism, block exchange notification, market indicators). This report presents the above information for February 2009. (J.S.)

  16. Balancing mechanism status: November 2009; Bilan du mecanisme d'ajustement: novembre 2009

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2009-07-01

    RTE ensures the real-time balance between production and consumption and deals with congestion on the French electricity system. The Balancing Mechanism assists in the accomplishment of this task. As in many countries, and after extensive dialogue with representatives from the market's various players, RTE proposes a Balancing Mechanism in the form of a permanent and transparent system of calls for tender. The system is open to everyone and provides a real-time reserve of power that can be used for balancing either upward or downward. RTE takes advantage of these offers according to economic precedence, taking into account the system's operating conditions. It pays for them at the offer price. There are two types of offer: - Upward offer: increase in production, decrease in consumption, imports, - Downward offer: decrease in production, increase in consumption, exports. For a Balancing Entity, an offer systematically consists of: a balancing direction (upward/downward), a time period, a price that may vary according to six time slots. RTE publishes each month a Balancing Mechanism Report. which includes the following information: - energy volumes activated to ensure the balance of the system and to resolve congestion; - minimum and maximum prices of offers activated to balance the system; - daily trends calculated according to the predominant value of the overall upward or downward trend; - balancing shares by technology (nuclear, thermal, hydraulic); - characteristics of the five most activated balancing entities; - balances/imbalances accounts and production/consumption overcharge; - congestion curbing costs on the French electricity system; - energy volumes activated to ensure the balance of the system according to contracts between RTE and other Balance Responsible entities (UK, Belgium, Italy, Germany, Switzerland); - reliability of the provisional data supplied by RTE about the balancing trend; - availability of RTE's information services (planning, balancing mechanism, block exchange notification, market indicators). This report presents the above information for November 2009. (J.S.)

  17. Balancing mechanism status: July 2009; Bilan du mecanisme d'ajustement: juillet 2009

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2009-07-01

    RTE ensures the real-time balance between production and consumption and deals with congestion on the French electricity system. The Balancing Mechanism assists in the accomplishment of this task. As in many countries, and after extensive dialogue with representatives from the market's various players, RTE proposes a Balancing Mechanism in the form of a permanent and transparent system of calls for tender. The system is open to everyone and provides a real-time reserve of power that can be used for balancing either upward or downward. RTE takes advantage of these offers according to economic precedence, taking into account the system's operating conditions. It pays for them at the offer price. There are two types of offer: - Upward offer: increase in production, decrease in consumption, imports, - Downward offer: decrease in production, increase in consumption, exports. For a Balancing Entity, an offer systematically consists of: a balancing direction (upward/downward), a time period, a price that may vary according to six time slots. RTE publishes each month a Balancing Mechanism Report. which includes the following information: - energy volumes activated to ensure the balance of the system and to resolve congestion; - minimum and maximum prices of offers activated to balance the system; - daily trends calculated according to the predominant value of the overall upward or downward trend; - balancing shares by technology (nuclear, thermal, hydraulic); - characteristics of the five most activated balancing entities; - balances/imbalances accounts and production/consumption overcharge; - congestion curbing costs on the French electricity system; - energy volumes activated to ensure the balance of the system according to contracts between RTE and other Balance Responsible entities (UK, Belgium, Italy, Germany, Switzerland); - reliability of the provisional data supplied by RTE about the balancing trend; - availability of RTE's information services (planning, balancing mechanism, block exchange notification, market indicators). This report presents the above information for July 2009. (J.S.)

  18. Balancing mechanism status: January 2009; Bilan du mecanisme d'ajustement: janvier 2009

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2009-03-15

    RTE ensures the real-time balance between production and consumption and deals with congestion on the French electricity system. The Balancing Mechanism assists in the accomplishment of this task. As in many countries, and after extensive dialogue with representatives from the market's various players, RTE proposes a Balancing Mechanism in the form of a permanent and transparent system of calls for tender. The system is open to everyone and provides a real-time reserve of power that can be used for balancing either upward or downward. RTE takes advantage of these offers according to economic precedence, taking into account the system's operating conditions. It pays for them at the offer price. There are two types of offer: - Upward offer: increase in production, decrease in consumption, imports, - Downward offer: decrease in production, increase in consumption, exports. For a Balancing Entity, an offer systematically consists of: a balancing direction (upward/downward), a time period, a price that may vary according to six time slots. RTE publishes each month a Balancing Mechanism Report. which includes the following information: - energy volumes activated to ensure the balance of the system and to resolve congestion; - minimum and maximum prices of offers activated to balance the system; - daily trends calculated according to the predominant value of the overall upward or downward trend; - balancing shares by technology (nuclear, thermal, hydraulic); - characteristics of the five most activated balancing entities; - balances/imbalances accounts and production/consumption overcharge; - congestion curbing costs on the French electricity system; - energy volumes activated to ensure the balance of the system according to contracts between RTE and other Balance Responsible entities (UK, Belgium, Italy, Germany, Switzerland); - reliability of the provisional data supplied by RTE about the balancing trend; - availability of RTE's information services (planning, balancing mechanism, block exchange notification, market indicators). This report presents the above information for January 2009. (J.S.)

  19. Balancing mechanism status: May 2009; Bilan du mecanisme d'ajustement: mai 2009

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2009-07-01

    RTE ensures the real-time balance between production and consumption and deals with congestion on the French electricity system. The Balancing Mechanism assists in the accomplishment of this task. As in many countries, and after extensive dialogue with representatives from the market's various players, RTE proposes a Balancing Mechanism in the form of a permanent and transparent system of calls for tender. The system is open to everyone and provides a real-time reserve of power that can be used for balancing either upward or downward. RTE takes advantage of these offers according to economic precedence, taking into account the system's operating conditions. It pays for them at the offer price. There are two types of offer: - Upward offer: increase in production, decrease in consumption, imports, - Downward offer: decrease in production, increase in consumption, exports. For a Balancing Entity, an offer systematically consists of: a balancing direction (upward/downward), a time period, a price that may vary according to six time slots. RTE publishes each month a Balancing Mechanism Report. which includes the following information: - energy volumes activated to ensure the balance of the system and to resolve congestion; - minimum and maximum prices of offers activated to balance the system; - daily trends calculated according to the predominant value of the overall upward or downward trend; - balancing shares by technology (nuclear, thermal, hydraulic); - characteristics of the five most activated balancing entities; - balances/imbalances accounts and production/consumption overcharge; - congestion curbing costs on the French electricity system; - energy volumes activated to ensure the balance of the system according to contracts between RTE and other Balance Responsible entities (UK, Belgium, Italy, Germany, Switzerland); - reliability of the provisional data supplied by RTE about the balancing trend; - availability of RTE's information services (planning, balancing mechanism, block exchange notification, market indicators). This report presents the above information for May 2009. (J.S.)

  20. Balancing mechanism status: June 2009; Bilan du mecanisme d'ajustement: juin 2009

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2009-07-01

    RTE ensures the real-time balance between production and consumption and deals with congestion on the French electricity system. The Balancing Mechanism assists in the accomplishment of this task. As in many countries, and after extensive dialogue with representatives from the market's various players, RTE proposes a Balancing Mechanism in the form of a permanent and transparent system of calls for tender. The system is open to everyone and provides a real-time reserve of power that can be used for balancing either upward or downward. RTE takes advantage of these offers according to economic precedence, taking into account the system's operating conditions. It pays for them at the offer price. There are two types of offer: - Upward offer: increase in production, decrease in consumption, imports, - Downward offer: decrease in production, increase in consumption, exports. For a Balancing Entity, an offer systematically consists of: a balancing direction (upward/downward), a time period, a price that may vary according to six time slots. RTE publishes each month a Balancing Mechanism Report. which includes the following information: - energy volumes activated to ensure the balance of the system and to resolve congestion; - minimum and maximum prices of offers activated to balance the system; - daily trends calculated according to the predominant value of the overall upward or downward trend; - balancing shares by technology (nuclear, thermal, hydraulic); - characteristics of the five most activated balancing entities; - balances/imbalances accounts and production/consumption overcharge; - congestion curbing costs on the French electricity system; - energy volumes activated to ensure the balance of the system according to contracts between RTE and other Balance Responsible entities (UK, Belgium, Italy, Germany, Switzerland); - reliability of the provisional data supplied by RTE about the balancing trend; - availability of RTE's information services (planning, balancing mechanism, block exchange notification, market indicators). This report presents the above information for June 2009. (J.S.)

  1. Balancing mechanism status: October 2009; Bilan du mecanisme d'ajustement: octobre 2009

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2009-07-01

    RTE ensures the real-time balance between production and consumption and deals with congestion on the French electricity system. The Balancing Mechanism assists in the accomplishment of this task. As in many countries, and after extensive dialogue with representatives from the market's various players, RTE proposes a Balancing Mechanism in the form of a permanent and transparent system of calls for tender. The system is open to everyone and provides a real-time reserve of power that can be used for balancing either upward or downward. RTE takes advantage of these offers according to economic precedence, taking into account the system's operating conditions. It pays for them at the offer price. There are two types of offer: - Upward offer: increase in production, decrease in consumption, imports, - Downward offer: decrease in production, increase in consumption, exports. For a Balancing Entity, an offer systematically consists of: a balancing direction (upward/downward), a time period, a price that may vary according to six time slots. RTE publishes each month a Balancing Mechanism Report. which includes the following information: - energy volumes activated to ensure the balance of the system and to resolve congestion; - minimum and maximum prices of offers activated to balance the system; - daily trends calculated according to the predominant value of the overall upward or downward trend; - balancing shares by technology (nuclear, thermal, hydraulic); - characteristics of the five most activated balancing entities; - balances/imbalances accounts and production/consumption overcharge; - congestion curbing costs on the French electricity system; - energy volumes activated to ensure the balance of the system according to contracts between RTE and other Balance Responsible entities (UK, Belgium, Italy, Germany, Switzerland); - reliability of the provisional data supplied by RTE about the balancing trend; - availability of RTE's information services (planning, balancing mechanism, block exchange notification, market indicators). This report presents the above information for October 2009. (J.S.)

  2. Balancing mechanism status: December 2009; Bilan du mecanisme d'ajustement: decembre 2009

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2009-07-01

    RTE ensures the real-time balance between production and consumption and deals with congestion on the French electricity system. The Balancing Mechanism assists in the accomplishment of this task. As in many countries, and after extensive dialogue with representatives from the market's various players, RTE proposes a Balancing Mechanism in the form of a permanent and transparent system of calls for tender. The system is open to everyone and provides a real-time reserve of power that can be used for balancing either upward or downward. RTE takes advantage of these offers according to economic precedence, taking into account the system's operating conditions. It pays for them at the offer price. There are two types of offer: - Upward offer: increase in production, decrease in consumption, imports, - Downward offer: decrease in production, increase in consumption, exports. For a Balancing Entity, an offer systematically consists of: a balancing direction (upward/downward), a time period, a price that may vary according to six time slots. RTE publishes each month a Balancing Mechanism Report. which includes the following information: - energy volumes activated to ensure the balance of the system and to resolve congestion; - minimum and maximum prices of offers activated to balance the system; - daily trends calculated according to the predominant value of the overall upward or downward trend; - balancing shares by technology (nuclear, thermal, hydraulic); - characteristics of the five most activated balancing entities; - balances/imbalances accounts and production/consumption overcharge; - congestion curbing costs on the French electricity system; - energy volumes activated to ensure the balance of the system according to contracts between RTE and other Balance Responsible entities (UK, Belgium, Italy, Germany, Switzerland); - reliability of the provisional data supplied by RTE about the balancing trend; - availability of RTE's information services (planning, balancing mechanism, block exchange notification, market indicators). This report presents the above information for December 2009. (J.S.)

  3. Balancing mechanism status: January 2010; Bilan du mecanisme d'ajustement: janvier 2010

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2010-07-01

    RTE ensures the real-time balance between production and consumption and deals with congestion on the French electricity system. The Balancing Mechanism assists in the accomplishment of this task. As in many countries, and after extensive dialogue with representatives from the market's various players, RTE proposes a Balancing Mechanism in the form of a permanent and transparent system of calls for tender. The system is open to everyone and provides a real-time reserve of power that can be used for balancing either upward or downward. RTE takes advantage of these offers according to economic precedence, taking into account the system's operating conditions. It pays for them at the offer price. There are two types of offer: - Upward offer: increase in production, decrease in consumption, imports, - Downward offer: decrease in production, increase in consumption, exports. For a Balancing Entity, an offer systematically consists of: a balancing direction (upward/downward), a time period, a price that may vary according to six time slots. RTE publishes each month a Balancing Mechanism Report. which includes the following information: - energy volumes activated to ensure the balance of the system and to resolve congestion; - minimum and maximum prices of offers activated to balance the system; - daily trends calculated according to the predominant value of the overall upward or downward trend; - balancing shares by technology (nuclear, thermal, hydraulic); - characteristics of the five most activated balancing entities; - balances/imbalances accounts and production/consumption overcharge; - congestion curbing costs on the French electricity system; - energy volumes activated to ensure the balance of the system according to contracts between RTE and other Balance Responsible entities (UK, Belgium, Italy, Germany, Switzerland); - reliability of the provisional data supplied by RTE about the balancing trend; - availability of RTE's information services (planning, balancing mechanism, block exchange notification, market indicators). This report presents the above information for January 2010. (J.S.)

  4. Política social e ajuste macroeconômico Social policy and macroeconomic adjustment

    Directory of Open Access Journals (Sweden)

    Nilson do Rosário Costa

    2002-01-01

    Full Text Available O objetivo do texto é fazer um balanço das respostas dos Estados de bem-estar social às mudanças provocadas pelo globalização nas décadas de 1980-1990. O texto mostra que a hipótese sobre o desmantelamento dos sistemas de bem-estar social não pode ser comprovada por falta de evidências de mudanças substanciais nos mecanismos de financiamento e eleição de beneficiários. O texto focaliza também os efeitos do processo de internacionalização da economia brasileira sobre o sistema de proteção social do país. Conclui que as restrições impostas aos gastos públicos limitou severamente a capacidade em promover políticas sociais abrangentes. Verificou-se na década, a opção por políticas sociais focalizadas e seletivas pela adoção do diagnóstico da baixa efetividade do sistema de proteção social brasileiro. O caso da política de saúde foi uma exceção em razão da capacidade de intermediação de interesses na arena setorial.This paper analyzes responses by welfare states to globalization in some OECD countries in the 1980s and 90s, demonstrating that the hypothesis concerning the dismantling of social welfare systems cannot be proven due to lack of evidence of substantial changes in the funding and selection of beneficiaries. The paper also focuses on the effects of internationalization of the Brazilian economy on the country's social protection system. The conclusion is that restrictions imposed on public expenditures severely limited the capacity to promote broad coverage in social policies. During the decade the option was made for targeted, selective social policies based on the adoption of a diagnosis of low effectiveness in the Brazilian social protection system. The case of health policy was an exception, due to capacity for interest mediation in the social arena.

  5. Determinantes del ahorro interno y ajuste estructural en el Perú, 1990-1995

    OpenAIRE

    Efraín Gonzales de Olarte; Cecilia Lévano Castro; Pedro Llontop Ledesma

    1998-01-01

    La economía peruana creció sostenida y establemente desde los años cincuenta hasta mediados de los años setenta; a partir de entonces tuvo un decaimiento que duró hasta fines de los años ochenta, época en la cual el PBI por persona decayó a niveles del año sesenta. Una de las principales causas del crecimiento y crisis fue la inversión, cuya evolución explica lo que sucedió con el producto. A partir de 1991 se ha observado una recuperación del crecimiento, sostenido nuevamente por el aumento ...

  6. Ajustes en la plantilla de la empresa a través del despido colectivo

    OpenAIRE

    Regueras Sánchez, María

    2015-01-01

    El despido colectivo ha sido objeto de importantes modificaciones legales en los últimos años, las cuales han constituido un nuevo modelo de despido colectivo. Por primera vez en nuestro país, esta forma de extinguir contratos de trabajo depende de la decisión empresarial, sin precisar de autorización administrativa. Estas modificaciones persiguen flexibilizar la utilización de esta vía extintiva por parte del empresario. El despido colectivo se encuentra regulado principalmente por e...

  7. La crisis y el ajuste estructural en el sector de la salud

    OpenAIRE

    1985-01-01

    Es preciso distinguir entre la producción de salud y la producción de asistencia sanitaria. La salud es el bien final al que se llega por una combinación de factores y productos intermedios, entre los cuales se cuenta la asistencia sanitaria. Muchas veces las condiciones de vivienda, nutrición, estilo de vida son, en efecto, mucho más importantes para mejorar la salud que la asistencia sanitaria. No mucho más que esta última es, sin embargo, recogido por nuestros limitados sistemas de contabi...

  8. Evidence-based clinical practice

    DEFF Research Database (Denmark)

    Gluud, Christian

    2002-01-01

    Evidence-based medicine combines the patient's preferences with clinical experience and the best research evidence. Randomized clinical trials are considered the most valid research design for evaluating health-care interventions. However, empirical research shows that intervention effects may be...

  9. Clinical Wisdom among Proficient Nurses

    DEFF Research Database (Denmark)

    Uhrenfeldt, Lisbeth; Hall, Elisabeth

    2007-01-01

    This paperexamines clinical wisdom which has emerged from a broader study anout nurse managers´influence on proficient registered nurse turnover and retention. The purpose of the study was to increase understanding of proficient nurses´experience and clinical practice by giving voice to the nurses...

  10. Toward a Naturalized Clinical Ethics

    NARCIS (Netherlands)

    Verkerk, Marian; Lindemann, Hilde

    2012-01-01

    Clinical ethicists tend to see themselves as moral experts to be called in when clinicians encounter a particularly difficult moral problem. Drawing on a naturalized moral epistemology, we argue that clinicians already have the moral knowledge they need the norms and values that guide clinical pract

  11. American Association for Clinical Chemistry

    Science.gov (United States)

    ... The Journal of Applied Laboratory Medicine Clinical and Forensic Toxicology News Clinical Laboratory Marketplace Books and Multimedia ... Global Health Outreach Global Lab Quality Initiative Lab Tests Online Harmonization Membership Grants Travel Grants International Travelers ... On the Path to Improved Blood Glucose Monitoring A new mathematical model uses hemoglobin ...

  12. Two Approaches to Clinical Supervision.

    Science.gov (United States)

    Anderson, Eugene M.

    Criteria are established for a definition of "clinical supervision" and the effectiveness of such supervisory programs in a student teaching context are considered. Two differing genres of clinical supervision are constructed: "supervision by pattern analysis" is contrasted with "supervision by performance objectives." An outline of procedural…

  13. Clinical Service of Chinese Medicine

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    @@ The clinical practice of traditional Chinese medicine (TCM) faces three major challenges:(1)How to enhance its contribution on overall medical service quality? (2) How to best address the unmet medical needs in the contemporary society? (3)How to guarantee that the traditional perspective for disease diagnosis and treatment not be neglected in clinical practice?

  14. Mindfulness Meditation in Clinical Practice

    Science.gov (United States)

    Salmon, Paul; Sephton, Sandra; Weissbecker, Inka; Hoover, Katherine; Ulmer, Christi; Studts, Jamie L.

    2004-01-01

    The practice of mindfulness is increasingly being integrated into contemporary clinical psychology. Based in Buddhist philosophy and subsequently integrated into Western health care in the contexts of psychotherapy and stress management, mindfulness meditation is evolving as a systematic clinical intervention. This article describes…

  15. Clinical reasoning as social deliberation

    DEFF Research Database (Denmark)

    2014-01-01

    In this paper I will challenge the individualistic model of clinical reasoning. I will argue that sometimes clinical practice is rather machine-like, and information is called to mind and weighed, but the clinician is not just calculating how to use particular means to reach fixed ends. Often the...

  16. Clinical Governance: Costs and Benefits

    Directory of Open Access Journals (Sweden)

    Kieran Walsh

    2014-04-01

    Full Text Available Dear Editor, Ravaghi et al. should be congratulated for offering a fascinating insight into the views of senior managers on the implementation of clinical governance (1. Clearly many had experience of challenges in implementation and there were different types of challenges. However, a common theme ran through many of the challenges, and that theme is one of cost. The managers did not mention cost explicitly but the issue was clearly implicit. They spoke of the need for more resources, support and staff engagement—all of which are associated with costs. We would do well to ask outright: what are the costs of implementing clinical governance? Such costs are likely to be significant, and are likely to be made up of all the components of clinical governance including, as the authors outline, “clinical effectiveness, clinical audit, risk management, patient and public involvement, education and training, staff management, and use of information” (2.

  17. Clinical polymorphism of endocrine ophthalmopathy

    Directory of Open Access Journals (Sweden)

    V. G. Likhvantseva

    2014-07-01

    Full Text Available Purpose: to analyze clinical polymorphism of endocrine ophthalmopathy in patients with Graves’ disease.Methods: Clinical and radiological data of 18 cases with clinical manifestations of lacrimal gland increase were analyzed and compared with data retrieved from 50 patients without increasing of lacrimal gland.Results: the characteristics of clinical manifestations of endocrine ophthalmopathy with lacrimal gland increase were presented. this form differs, as the organ of the target, along with orbital fat and/or eye muscles becomes the glandula lacrimalis. A correlation between fact involving, on the one hand, and the intensity and severity of the autoimmune process in orbit, on the other hand were identified.Conclusion: Involvement of this secretion organ in the autoimmune process makes the clinical course of endocrine ophthalmopa-thy more complicated, and leads to eye dry syndrome creation.

  18. Clinical polymorphism of endocrine ophthalmopathy

    Directory of Open Access Journals (Sweden)

    V. G. Likhvantseva

    2012-01-01

    Full Text Available Purpose: to analyze clinical polymorphism of endocrine ophthalmopathy in patients with Graves’ disease.Methods: Clinical and radiological data of 18 cases with clinical manifestations of lacrimal gland increase were analyzed and compared with data retrieved from 50 patients without increasing of lacrimal gland.Results: the characteristics of clinical manifestations of endocrine ophthalmopathy with lacrimal gland increase were presented. this form differs, as the organ of the target, along with orbital fat and/or eye muscles becomes the glandula lacrimalis. A correlation between fact involving, on the one hand, and the intensity and severity of the autoimmune process in orbit, on the other hand were identified.Conclusion: Involvement of this secretion organ in the autoimmune process makes the clinical course of endocrine ophthalmopa-thy more complicated, and leads to eye dry syndrome creation.

  19. Towards clinical bioethics (or a return to clinical ethics?).

    Science.gov (United States)

    Petrini, C

    2013-01-01

    Medical ethics has traditionally been oriented towards the clinical setting. Since the middle of the last century, however, various circumstances (associated mainly, though not exclusively, with rapid advances in technology and knowledge) have considerably broadened both the field of enquiry and the scope of this discipline. This is due partly to the overlap between medical ethics and bioethics, which in recent decades has acquired its own identity and concerns a multitude of ethical aspects in the biomedical field. Clinical ethics taps into the vast wealth of deontology, so that it has no need for additional criteria or principles, or for the definition of new values: rather, it recognizes the need to apply existing criteria, principles and values to contingent circumstances and contexts. A special role is reserved for ethics committees and, above all, for clinical ethics consultants, although in some countries the former are concerned mainly with authorisations for clinical trials. Clinical ethics consultants, however, may have a more incisive influence in clinical decisions: the special requisites and skills they need have been defined and discussed in various documents which are mentioned briefly in the present article. The presence of these consultants does not exonerate clinical physicians from their responsibilities or from liability for their decisions, in the formation of which they must refer constantly to codes of professional ethics. PMID:24424236

  20. Clinical neurophysiology of fatigue.

    Science.gov (United States)

    Zwarts, M J; Bleijenberg, G; van Engelen, B G M

    2008-01-01

    reliability of the psychological and clinical neurophysiological assessment techniques available today allows a multidisciplinary approach to fatigue in neurological patients, which may contribute to the elucidation of the pathophysiological mechanisms of chronic fatigue, with the ultimate goal to develop tailored treatments for fatigue in neurological patients. The present report discusses the different manifestations of fatigue and the available tools to assess peripheral and central fatigue. PMID:18039594

  1. [Hospital clinical ethics committees].

    Science.gov (United States)

    Gómez Velásquez, Luis; Gómez Espinosa, Luis Néstor

    2007-01-01

    The scientific and technological advances have been surprising, more in the two last decades, but they don't go united with to the ethical values of the medical professional practice, it has been totally escaped, specially when the biological subsistence, the maintenance of the life through apparatuses and the mechanisms that prolong the existence are who undergoes an alteration that until recently time was mortal shortly lapse. It is common listening that exist a crisis in the medical profession, but what really is it of human values, which as soon and taken into nowadays, actually professional account, which gives rise to a dehumanization towards the life, the health, the disease, the suffering and the death. The ideal of the doctor to give to service to the man in its life and health, as well to be conscious that the last biological process that must fulfill is the death, and when it appears, does not have considered as a actually professional failure. It has protect to the patient as the extreme cruelty therapeutic, that it has right a worthy death. It's taking to the birth of the hospital ethics committees, they have like function to analyze, to advise and to think about the ethical dilemmas that appear actually clinical or in the biomedical investigation. In 1982 in the UEA only 1% of its hospitals had a ethics committees; by 1988, it was 67% and the 100% in 2000. In Mexico the process of the formation by these committees begins, only in the Military Central Hospital, to count the ethics committee on 1983, also the Hospital no. 14 of the IMSS in Guadalajara, it works with regularity from 1995, with internal teaching of bioethic. The Secretariat of Health has asked the formation of the bioethical committees in each hospital, and order the it was be coordinated by the National Committee of Bioética. The integration of these committees is indispensable that their members have the knowledge necessary of bioética. The Mexican Society of Ortopedia, conscious of

  2. Clinical application of pet

    Directory of Open Access Journals (Sweden)

    Francisco Lomeña

    2005-10-01

    Full Text Available Positron emission tomography (PET is an imaging modality that gives information on tissue metabolism and functionalism, different from other imaging techniques like computed tomography (CT and magnetic resonance imaging (MRI, which provide anatomical or structural information. PET has reached its development in biomedical research because of its capacity to use analogous compounds of many endogenous substance as tracers, and to measure, in vivo and in a non-invasive way, their consumption by the different organs and tissues of the mammalian body. Fluordeoxyglucose-F18 (FDG PET has been proven to be a tracer adequate for clinical use in oncology and in many neurological diseases, with an excellent cost-efficiency ratio. The current PET-CT scanners can come to be the best tools for exploring patients who suffer from cancer.A tomografia por emissão de pósitrons (PET é uma técnica de diagnóstico por imagem que fornece informação sobre o metabolismo e funcionamento dos tecidos, diferente de outras técnicas de imagens como tomografia computadorizada (TC e ressonância magnética (RM, as quais fornecem informações estruturais ou anatômicas. O PET alcançou seu desenvolvimento em investigação biomédica devido à sua capacidade de usar traçadores análogos a muitas substâncias endógenas e de medir in vivo e de forma não invasiva seu consumo em diferentes órgãos e tecidos dos mamíferos 18Fluordesoxiglicose (FDG PET tem provado ser uma exploração de uso clínico com excelente relação custo benefício em oncologia e em muitas doenças neurológicas. Os atuais tomógrafos por PET-CT podem chegar a ser a melhor ferramenta de diagnóstico nos pacientes que sofrem de câncer.

  3. Biodegradable polymers in clinical use and clinical development

    CERN Document Server

    Domb, Abraham J

    2011-01-01

    The definitive guide to biodegradable polymer science-where we are and what's to come The most comprehensive review of biodegradable polymers already utilized or under development for clinical use, Biodegradable Polymers in Clinical Use and Clinical Development looks at the state of biodegradable polymers now and over the next five years. Implantable molecules that break down within the body over a predetermined period of time, biodegradable polymers have been employed as drug carriers, orthopedic fixation devices, and absorbable sutures. Yet while hundreds of such polymers have been deve

  4. ESR Perspective on Clinical Audit

    Directory of Open Access Journals (Sweden)

    Maurizio Centonze

    2011-05-01

    Full Text Available In October 2009, the European Commission published"nguidelines (Radiation Protection No. 159 on Clinical"nAudit for medical radiology-including Diagnostic"nRadiology, Nuclear Medicine and Radiotherapy-in"norder to improve the implementation of article 6.4 of"nthe Council Directive 97/43/ EURATOM, on health"nprotection of individuals against the dangers of ionizing"nradiation in relation to medical exposure. In article 6.4"nit is stated that "Clinical Audits shall be carried out"nin accordance with national procedures". However,"nthere is a wide variation in the understanding and"nimplementation of Clinical Audit in Europe and"nworldwide. The interpretation of the term audit and"nits differentiation from regulation, quality assurance,"naccreditation and research also differs across Europe."nIn January 2010, the Audit & Standards Subcommittee"nof the European Society of Radiology (ESR published"na document on the ESR perspective on Clinical Audit"nin an effort to define the scope of Clinical Audit in a"nway applicable across the European member states and"nradiological organizations."nThe aim of the presentation is to provide a"ncomprehensive outline of ESR perspective on the"naudit process for clinical radiologists and clinical"nradiology departments. The philosophy discussed is"nequally appropriate for interventional and diagnostic"nradiologists.

  5. Social media in clinical trials.

    Science.gov (United States)

    Thompson, Michael A

    2014-01-01

    Social media has potential in clinical trials for pointing out trial issues, addressing barriers, educating, and engaging multiple groups involved in cancer clinical research. Social media is being used in clinical trials to highlight issues such as poor accrual and barriers; educate potential participants and physicians about clinical trial options; and is a potential indirect or direct method to improve accrual. We are moving from a passive "push" of information to patients to a "pull" of patients requesting information. Patients and advocates are often driving an otherwise reluctant health care system into communication. Online patient communities are creating new information repositories. Potential clinical trial participants are using the Twittersphere and other sources to learn about potential clinical trial options. We are seeing more organized patient-centric and patient-engaged forums with the potential to crowd source to improve clinical trial accrual and design. This is an evolving process that will meet many individual, institutional, and regulatory obstacles as we move forward in a changed research landscape.

  6. Children and Clinical Studies: Why Clinical Studies Are Important

    Medline Plus

    Full Text Available ... Clinical Studies Children have often had to accept medicines and treatments based on what is known to ... children's health with the goal to develop treatments, drugs, and devices specific to children. Resources for a ...

  7. Children and Clinical Studies: Why Clinical Studies Are Important

    Medline Plus

    Full Text Available ... NHLBI Entire Site Health Topics News & Resources Intramural Research Public Health Topics Education & Awareness Resources Contact The ... Researchers Funding Training & Career Development Division of Intramural Research Research Resources Research Meeting Summaries Technology Transfer Clinical ...

  8. Children and Clinical Studies: Why Clinical Studies Are Important

    Medline Plus

    Full Text Available ... Topics News & Resources Intramural Research Public Health Topics Education & Awareness Resources Contact The Health Information Center Health ... Systematic Evidence Reviews & Clinical Practice Guidelines Resources Continuing Education Researchers Funding Training & Career Development Division of Intramural ...

  9. How GPs implement clinical guidelines in everyday clinical practice

    DEFF Research Database (Denmark)

    Videbæk Le, Jette; Hansen, Helle P; Riisgaard, Helle;

    2015-01-01

    . Interviews were recorded, transcribed verbatim and then analysed using systematic text condensation. RESULTS: Analysis of the interviews revealed three different approaches to the implementation of guidelines in clinical practice. In some practices the GPs prioritized time and resources on collective...

  10. Children and Clinical Studies: Why Clinical Studies Are Important

    Medline Plus

    Full Text Available ... children's health with the goal to develop treatments, drugs, and devices specific to children. Resources for a Wide Range of Audiences The Children and Clinical ... and Postcards ...

  11. Creating clinical trial designs that incorporate clinical outcome assessments.

    Science.gov (United States)

    Gilbert, Mark R; Rubinstein, Lawrence; Lesser, Glenn

    2016-03-01

    Clinical outcome assessments (COAs) are increasingly being used in determining the efficacy of new treatment regimens. This was typified in the recent use of a symptom-based instrument combined with an organ-based measure of response for the approval of ruxolitinib in myelofibrosis. There are challenges in incorporating these COAs into clinical trials, including designating the level of priority, incorporating these measures into a combined or composite endpoint, and dealing with issues related to compliance and interpretation of results accounting for missing data. This article describes the results of a recent panel discussion that attempted to address these issues and provide guidance to the incorporation of COAs into clinical trials, including novel statistical designs, so that the testing of new treatments in patients with cancers of the central nervous system can incorporate these important clinical endpoints. PMID:26989129

  12. Clinical audit of a specialist symptomatic breast clinic.

    OpenAIRE

    Gui, G. P.; Allum, W. H.; Perry, N. M.; Wells, C.A.; Curling, O. M.; McLean, A; Oommen, R.; Sullivan, M.; Denton, S; Carpenter, R.

    1995-01-01

    The efficient delivery of health care requires vigilant quality assurance. We describe the audit of our symptomatic breast clinic, which includes the option of a one-stop diagnostic service. A total of 134 new and 386 follow-up patients attended over four consecutive clinics. The majority of new referrals (68%) were seen by a consultant surgeon. Urgent referrals were seen significantly sooner than routine referrals (P < 0.001, chi 2-test), and the mean wait from designated appointment to seei...

  13. Trichinella infection and clinical disease

    DEFF Research Database (Denmark)

    Clausen, M R; Meyer, C N; Krantz, T;

    1996-01-01

    Trichinellosis is caused by ingestion of insufficiently cooked meat contaminated with infective larvae of Trichinella species. The clinical course is highly variable, ranging from no apparent infection to severe and even fatal disease. We report two illustrative cases of trichinellosis. Returning....... Life-threatening cardiopulmonary, renal and central nervous system complications developed. The patient recovered after several months. Her husband, who also ate the pork, did not have clinical symptoms, but an increased eosinophil count and a single larva in a muscle biopsy confirmed infection....... The epidemiology, clinical manifestations, diagnosis, treatment and prevention of trichinellosis are reviewed....

  14. Clinical Genetic Testing in Gastroenterology

    Science.gov (United States)

    Goodman, Russell P; Chung, Daniel C

    2016-01-01

    Rapid advances in genetics have led to an increased understanding of the genetic determinants of human disease, including many gastrointestinal (GI) disorders. Coupled with a proliferation of genetic testing services, this has resulted in a clinical landscape where commercially available genetic tests for GI disorders are now widely available. In this review, we discuss the current status of clinical genetic testing for GI illnesses, review the available testing options, and briefly discuss indications for and practical aspects of such testing. Our goal is to familiarize the practicing gastroenterologist with this rapidly changing and important aspect of clinical care. PMID:27124700

  15. Developing clinical piano improvisation skills

    DEFF Research Database (Denmark)

    Wigram, Anthony Lewis

    2003-01-01

    Teaching piano improvisation skills for use in clinical work relies on the development of a range of musical techniques and therapeutic methods that are combined and integrated. Simple musical styles of playing such as melody dialogues, two chord accompaniments, walking basses (tonal and atonal), 6...... in a new direction. Structure and lack of structure play a balanced role in the clinical process, and reflects the skills of the therapist to musically meet the needs of the client. This workshop will provide teaching and practice tools for the participants that are intended to sustain the creativity...... of improvisation while adding some clear structure and method to it’s clinical application...

  16. Family therapy and clinical psychology

    OpenAIRE

    Carr, Alan

    1995-01-01

    The results of a survey of 111 clinical psychologists in the Republic of Ireland along with some comparable data from US and UK surveys were used to address a series of questions about the link between family therapy and clinical psychology. Family therapy was not a clearly identifiable sub-specialty within clinical psychology in Ireland. Family therapy theoretical models were used by more than a quarter of the Irish sample to conceptualize their work but by less than a tenth of US and UK res...

  17. Clinical photoacoustic imaging of cancer

    Science.gov (United States)

    2016-01-01

    Photoacoustic imaging is a hybrid technique that shines laser light on tissue and measures optically induced ultrasound signal. There is growing interest in the clinical community over this new technique and its possible clinical applications. One of the most prominent features of photoacoustic imaging is its ability to characterize tissue, leveraging differences in the optical absorption of underlying tissue components such as hemoglobin, lipids, melanin, collagen and water among many others. In this review, the state-of-the-art photoacoustic imaging techniques and some of the key outcomes pertaining to different cancer applications in the clinic are presented. PMID:27669961

  18. Modern Management of Clinical Chorioamnionitis

    Directory of Open Access Journals (Sweden)

    Thomas Westover

    1995-01-01

    Full Text Available Clinical chorioamnionitis continues to contribute to fetal and maternal morbidity and mortality. Significant advances have been made in the last 20 years in understanding the pathophysiologic processes leading to chorioamnionitis. This review addresses the history, incidence, pathophysiology, host defenses, risk factors, diagnosis, and maternal and neonatal management of clinically evident chorioamnionitis. After a detailed review of the physiologic processes leading to clinical chorioamnionitis and sepsis, we present a modern management scheme designed to optimize perinatal outcome for both mother and fetus.

  19. Patient records and clinical overview

    DEFF Research Database (Denmark)

    Jensen, Lotte Groth

    2016-01-01

    Summary This PhD dissertation contributes with a sociological perspective on the creation of clinical overview in daily clinical practice among physicians at hospitals. The issue about creating clinical overview originated from a change in media, when one of the five Danish regions decided...... involved in the process of creating clinical overview and Distributed Cognition render visible that cognition is not just something that takes place in the mind of individuals but is distributed in a socio-technical system. In an iterative analysis process, the theoretical framework and the empirical data...... the possibilities to mark up pages in personal ways and add personal notes to it. On the other hand, the EPR provides quick and easy access to lot of information and once information is entered in the EPR they stay in place. Information in the EPR is often updated due to real time entry, which avoid...

  20. Clinical Information Support System (CISS)

    Data.gov (United States)

    Department of Veterans Affairs — Clinical Information Support System (CISS) is a web-based portal application that provides a framework of services for the VA enterprise and supplies an integration...

  1. The clinical management of hyponatraemia.

    Science.gov (United States)

    Williams, David M; Gallagher, Maire; Handley, Joel; Stephens, Jeffrey W

    2016-07-01

    Hyponatraemia is the most common electrolyte disorder seen in clinical practice and the consequences can range from minor symptoms to life-threatening complications including seizures and cardiorespiratory distress. These effects occur as a result of fluid shifts due to deranged serum tonicity and subsequent cerebral oedema. The appropriate assessment and management of patients with hyponatraemia is not always achieved in clinical practice, which is partly related to challenges in teaching with limited clinical guidance. Recently, the European Society of Endocrinology, European Society of Intensive Care Medicine and European Renal Association-European Dialysis and Transplant Association produced clinical practice guidelines to focus on appropriate investigation and management of these patients. Within this manuscript, we highlight the key points from these guidelines, which are most pertinent to doctors of all specialties to improve the care of patients with this common electrolyte disorder. PMID:27044859

  2. [Research activity in clinical biochemistry

    DEFF Research Database (Denmark)

    Jorgensen, H.L.; Larsen, B.; Ingwersen, P.;

    2008-01-01

    BACKGROUND: Quantitative bibliometric measurements of research activity are frequently used, e.g. for evaluating applicants for academic positions. The purpose of this investigation is to assess research activity within the medical speciality of Clinical Biochemistry by comparing it with a matched...... Clinical Biochemistry, 57 fulfilled the inclusion criteria. Each of these 57 was matched according to medical title with two randomly chosen specialists from other specialities, totaling 114. Using Medline and the Web of Science, the number of publications and the number of citations were then ascertained....... RESULTS: 25% of the 11,691 specialists held a PhD degree or doctoral degree, DMSci, (Clinical Biochemistry: 61%). The 171 specialists included in the study had 9,823 papers in Medline and 10,140 papers in the Web of Science. The number of Medline papers per specialist was 71 for Clinical Biochemistry...

  3. Neurofibromatosis: part 2--clinical management.

    Science.gov (United States)

    Batista, Pollyanna Barros; Bertollo, Eny Maria Goloni; Costa, Danielle de Souza; Eliam, Lucas; Cunha, Karin Soares Gonçalves; Cunha-Melo, José Renan; Darrigo Junior, Luiz Guilherme; Geller, Mauro; Gianordoli-Nascimento, Ingrid Faria; Madeira, Luciana Gonçalves; Mendes, Hérika Martins; Miranda, Débora Marques de; Mata-Machado, Nikolas Andre; Morato, Eric Grossi; Pavarino, Érika Cristina; Pereira, Luciana Baptista; Rezende, Nilton Alves de; Rodrigues, Luíza de Oliveira; Sette, Jorge Bezerra Cavalcanti

    2015-06-01

    Part 1 of this guideline addressed the differential diagnosis of the neurofibromatoses (NF): neurofibromatosis type 1 (NF1), neurofibromatosis type 2 (NF2) and schwannomatosis (SCH). NF shares some features such as the genetic origin of the neural tumors and cutaneous manifestations, and affects nearly 80 thousand Brazilians. Increasing scientific knowledge on NF has allowed better clinical management and reduced rate of complications and morbidity, resulting in higher quality of life for NF patients. Most medical doctors are able to perform NF diagnosis, but the wide range of clinical manifestations and the inability to predict the onset or severity of new features, consequences, or complications make NF management a real clinical challenge, requiring the support of different specialists for proper treatment and genetic counseling, especially in NF2 and SCH. The present text suggests guidelines for the clinical management of NF, with emphasis on NF1. PMID:26083891

  4. Clinical Decision Support (CDS) Inventory

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Clinical Decision Support (CDS) Inventory contains descriptions of past and present CDS projects across the Federal Government. It includes Federal projects,...

  5. A review of clinical guidelines.

    LENUS (Irish Health Repository)

    Andrews, E J

    2012-02-03

    BACKGROUND: Clinical guidelines are increasingly used in patient management but few clinicians are familiar with their origin or appropriate application. METHODS: A Medline search using the terms \\'clinical guidelines\\' and \\'practice guidelines\\' was conducted. Additional references were sourced by manual searching from the bibliographies of articles located. RESULTS AND CONCLUSION: Clinical guidelines originated in the USA in the early 1980s, initially as a cost containment exercise. Significant improvements in the process and outcomes of care have been demonstrated following their introduction, although the extent of improvement varies considerably. The principles for the development of guidelines are well established but many published guidelines fall short of these basic quality criteria. Guidelines are only one aspect of improving quality and should be used within a wider framework of promoting clinical effectiveness. Understanding their limitations as well as their potential benefits should enable clinicians to have a clearer view of their place in everyday practice.

  6. Quality assurance in clinical trials.

    NARCIS (Netherlands)

    Ottevanger, P.B.; Therasse, P.; Veld, C.J.H. van de; Bernier, J.; Krieken, J.H.J.M. van; Grol, R.P.T.M.; Mulder, P.H.M. de

    2003-01-01

    From the literature that was initially searched by electronic databases using the keywords quality, quality control and quality assurance in combination with clinical trials, surgery, pathology, radiotherapy, chemotherapy and data management, a comprehensive review is given on what quality assurance

  7. Clinical leaders of the future.

    Science.gov (United States)

    Pearce, Lynne

    2016-08-10

    Putting ideas for management improvement into practice is one of the core tenets of the RCN's clinical leadership programme It's a transformational experience,' says RCN interim head of education Anne Corrin. 'The change is personal and professional.' PMID:27507391

  8. Responsibility of the clinical physicist

    International Nuclear Information System (INIS)

    The author discusses the various aspects of the responsibilities of physicians and clinical physicists with regard to radiation protection in medical applications of ionizing radiation. He annotates that in the Netherlands only 4 registered clinical physicists find a full-time task in x-ray diagnostics. Much more often it concerns a part-time task. the Dutch Society for Nuclear Medicine therefore recommends a legal basis for responsibilities of the clinical physicists and for taking up the appropriate discipline in the BIG-law. Also in this respect the society pleads for bringing into level of the number of qualified clinical physicists needed. The institutes involved should be obliged legally to acquire the necessary experts and should therefore dispose of the proper financial resources. (author)

  9. Inquiry Teaching in Clinical Periodontics.

    Science.gov (United States)

    Heins, Paul J.; Mackenzie, Richard S.

    1987-01-01

    An adaptation of the inquiry method of teaching, which develops skills of information retrieval and reasoning through systematic questioning by the teacher, is proposed for instruction in clinical periodontics. (MSE)

  10. The Evaluation Of Clinical Competence

    OpenAIRE

    Boucher, François-Gilles; Palmer, Wilfred H.; Page, Gordon; Barriault, Ronald; Seely, Janet

    1980-01-01

    During a workshop on the evaluation of clinical competence, the participants identified the process skills that comprise clinical competence and examined the techniques available for evaluating these skills. No single technique allows satisfactory evaluation of all the process skills; the most commonly used methods (chart review and case presentation) evaluate few process skills. An adequate performance profile in all the process skills requires a combination of evaluation techniques. Medical...

  11. Data integration for clinical genomics

    OpenAIRE

    Calabria,, C.

    2011-01-01

    Genetics and Molecular Biology are keys for the understanding the mechanisms of many of the human diseases that have strong harmful effects. The empirical mission of Genetics is to translate these mechanisms into Clinical benefits, thus bridging in-silico findings to patient bed side: approaching this goal means achieving what is commonly referred as clinical genomics or personalized medicine. In this process, technologies are assuming an increasing role. With the introduction of new expe...

  12. [Clinical gait analysis: user guide].

    Science.gov (United States)

    Armand, Stéphane; Bonnefoy-Mazure, Alice; Hoffmeyer, Pierre; De Coulon, Geraldo

    2015-10-14

    Clinical gait analysis has become an indispensable medical examination for the management of patients with complex gait disorders. As its name suggests, the purpose of this examination is to assess patients whilst they are walking in a laboratory setting. Measurements include: 3 dimensional joint motion, forces applied to joints, and electromyographic muscle activity. This quantitative data allows identification of walking deviations and to deduce the likely causes of these deviations thanks to the clinical data available for each patient.

  13. Recombinant erythropoietin in clinical practice

    OpenAIRE

    Ng, T; Marx, G.; Littlewood, T; Macdougall, I

    2003-01-01

    The introduction of recombinant human erythropoietin (RHuEPO) has revolutionised the treatment of patients with anaemia of chronic renal disease. Clinical studies have demonstrated that RHuEPO is also useful in various non-uraemic conditions including haematological and oncological disorders, prematurity, HIV infection, and perioperative therapies. Besides highlighting both the historical and functional aspects of RHuEPO, this review discusses the applications of RHuEPO in clinical practice a...

  14. Oral cysticercosis: a clinical dilemma

    OpenAIRE

    Wanjari, Sangeeta Panjab; Patidar, Kalpana A; Parwani, Rajkumar N; Satyajitraje A Tekade

    2013-01-01

    Cysticercosis is a potentially fatal parasitic disease caused by cysticercus cellulosae, the larval stage of Taenia solium. Oral cysticercosis is a rare entity and represents difficulty in clinical diagnosis. This article reports two cases of oral cysticercosis involving buccal and labial mucosa. Both the cases presented with solitary, nodular swelling that had been clinically diagnosed as a mucocele. Histopathology of excisional biopsy revealed it to be cysticercosis. Single, cystic nodular ...

  15. Clinical case of toxocariasis chorioretinitis

    Directory of Open Access Journals (Sweden)

    I. G. Pikhovskaia

    2013-01-01

    Full Text Available The clinical case of a toxocariasis chorioretinitis which is of interest for ophthalmologists is described. Insufficient knowledge of clinic and diagnostics of a lesion of eyes by Toxocara canis, their infrequent occurrence, similarity of the ophthalmologic picture with inflammatory diseases and eye neoplasms can be at the bottom of gross diagnostic mistake and wrong choice of treatment tactics.

  16. Clinical case of toxocariasis chorioretinitis

    Directory of Open Access Journals (Sweden)

    I. G. Pikhovskaia

    2014-07-01

    Full Text Available The clinical case of a toxocariasis chorioretinitis which is of interest for ophthalmologists is described. Insufficient knowledge of clinic and diagnostics of a lesion of eyes by Toxocara canis, their infrequent occurrence, similarity of the ophthalmologic picture with inflammatory diseases and eye neoplasms can be at the bottom of gross diagnostic mistake and wrong choice of treatment tactics.

  17. Clinical relevance in anesthesia journals

    DEFF Research Database (Denmark)

    Lauritsen, Jakob; Møller, Ann M

    2006-01-01

    The purpose of this review is to present the latest knowledge and research on the definition and distribution of clinically relevant articles in anesthesia journals. It will also discuss the importance of the chosen methodology and outcome of articles.......The purpose of this review is to present the latest knowledge and research on the definition and distribution of clinically relevant articles in anesthesia journals. It will also discuss the importance of the chosen methodology and outcome of articles....

  18. Clinical Biomarkers for Hypoxia Targeting

    OpenAIRE

    Le, Quynh-Thu; Courter, Don

    2008-01-01

    Tumor hypoxia or a reduction of the tissue oxygen tension is a key microenvironmental factor for tumor progression and treatment resistance in solid tumors. Because hypoxic tumor cells have been demonstrated to be more resistant to ionizing radiation, hypoxia has been a focus of laboratory and clinical research in radiation therapy for many decades. It is believed that proper detection of hypoxic regions would guide treatment options and ultimately improve tumor response. To date, most clinic...

  19. OBSTRUCTIVE JAUNDICE: A CLINICAL STUDY

    OpenAIRE

    Antony,; Rasool Syed

    2016-01-01

    BACKGROUND Jaundice is a frequent manifestation of biliary tract disorders and evaluation of obstructive jaundice is a common problem faced by general surgeons. Obstructive jaundice of varied aetiology is one of the main cause of hospital admissions. Hence, comprehensive study of aetiology, clinical presentation, management of obstructive jaundice is important in management of these patients. AIMS AND OBJECTIVES  Study the clinical history and presentation of obstructiv...

  20. ¿Puede asociarse el sedentarismo con hallazgos clínicos de alarma de enfermedad crónica en adultos jóvenes?. Un análisis en el proyecto CHICAMOCHA / Can Sedentarism be Associated with Alarm Clinical Findings of Chronic Diseases in Young Adults?. An Analysis in CHICAMOCHA Project / Poderia associar-se o sedentarismo às conclusões clínicas de alarme de doenças crônicas em adultos jovens?. Análise no projeto CHICAMOCHA

    Directory of Open Access Journals (Sweden)

    Juan Carlos Villar-Centeno, MD., Esp., MsC., PhD.

    2015-07-01

    Full Text Available Introducción: La asociación entre sedentarismo y enfermedades crónicas no transmisibles (ECNT requiere décadas de exposición. Es posible que esta se manifieste más tempranamente, por algunos hallazgos clínicos en adultos jóvenes. Objetivo: Probar la hipótesis de que en adultos jóvenes el sedentarismo se asocia con algunos signos o síntomas de alarma para el desarrollo posterior de ECNT. Metodología: Usando la evaluación inicial (años 2000-2003 del proyecto CHICAMOCHA, en 1539 donantes de sangre clínicamente saludables con pruebas de tamización negativas (edad media 36, DE 8,3 años, 66% hombres se estudió la asociación entre sedentarismo y una serie de hallazgos clínicos. Se definió sedentarismo como reportar actividad física moderada-intensa ≤150 minutos/semana (incluyendo el trabajo. El desenlace primario fue el compuesto de 11 hallazgos (5 síntomas y 6 signos de alarma encontrados en la valoración médica. La asociación fue estimada usando un modelo regresión logística ajustado por covariables. Resultados: Se encontró que 56.9% (IC95% 54.3 – 59.3 de los participantes eran sedentarios. En el análisis multivariado, el sedentarismo se asoció positivamente con el estado civil soltero y negativamente con estar empleado. No se encontraron asociaciones significativas en el compuesto agregado de 5 síntomas (OR ajustado 1.07, IC95% 0.90 – 1.26, 6 signos (OR ajustado 1.01, IC95% 0.79 – 1.28. Sin embargo, se observó un gradiente positivo no significativo por el número de hallazgos presentes (1 hallazgo OR=0.91, IC95% 0.61 – 1.35, 2 hallazgos (OR=1.20, IC95% 0.84 – 1.73, 3 o más hallazgos (OR=1.31, IC95% 0.91 – 1.89. Conclusiones: Más de la mitad de la población estudiada se encontró sedentaria. Aunque este factor no se encontró asociado con signos o síntomas individualmente, se identificó un gradiente no significativo con el número de estos hallazgos, posiblemente relacionado con el tiempo de

  1. Epidemiology for the clinical neurologist.

    Science.gov (United States)

    Jacob, M E; Ganguli, M

    2016-01-01

    Epidemiology is a foundation of all clinical and public health research and practice. Epidemiology serves seven important uses for the advancement of medicine and public health. It enables community diagnosis by quantifying risk factors and diseases in the community; completes the clinical picture of disease by revealing the entire distribution of disease and presenting meaningful population averages from representative samples; identifies risk factors for disease by detecting and quantifying associations between exposures and disease and evaluating causal hypotheses; computes individual risk to identify high-risk groups to whom preventive interventions can be targeted; evaluates historic trends that monitor disease over time and provide clues to etiology; delineates new syndromes and disease subtypes not previously apparent in clinical settings, helping to streamline effective disease management; and investigates the effects of health services on population health to identify effective public health interventions. The clinician with a grasp of epidemiologic principles is in a position to critically evaluate the research literature, to apply it to clinical practice, and to undertake valid clinical epidemiology research with patients in clinical settings. PMID:27637949

  2. Ubiquitous Multicriteria Clinic Recommendation System.

    Science.gov (United States)

    Chen, Toly

    2016-05-01

    Advancements in information, communication, and sensor technologies have led to new opportunities in medical care and education. Patients in general prefer visiting the nearest clinic, attempt to avoid waiting for treatment, and have unequal preferences for different clinics and doctors. Therefore, to enable patients to compare multiple clinics, this study proposes a ubiquitous multicriteria clinic recommendation system. In this system, patients can send requests through their cell phones to the system server to obtain a clinic recommendation. Once the patient sends this information to the system, the system server first estimates the patient's speed according to the detection results of a global positioning system. It then applies a fuzzy integer nonlinear programming-ordered weighted average approach to assess four criteria and finally recommends a clinic with maximal utility to the patient. The proposed methodology was tested in a field experiment, and the experimental results showed that it is advantageous over two existing methods in elevating the utilities of recommendations. In addition, such an advantage was shown to be statistically significant.

  3. Ubiquitous Multicriteria Clinic Recommendation System.

    Science.gov (United States)

    Chen, Toly

    2016-05-01

    Advancements in information, communication, and sensor technologies have led to new opportunities in medical care and education. Patients in general prefer visiting the nearest clinic, attempt to avoid waiting for treatment, and have unequal preferences for different clinics and doctors. Therefore, to enable patients to compare multiple clinics, this study proposes a ubiquitous multicriteria clinic recommendation system. In this system, patients can send requests through their cell phones to the system server to obtain a clinic recommendation. Once the patient sends this information to the system, the system server first estimates the patient's speed according to the detection results of a global positioning system. It then applies a fuzzy integer nonlinear programming-ordered weighted average approach to assess four criteria and finally recommends a clinic with maximal utility to the patient. The proposed methodology was tested in a field experiment, and the experimental results showed that it is advantageous over two existing methods in elevating the utilities of recommendations. In addition, such an advantage was shown to be statistically significant. PMID:26984357

  4. Estimativa da relação hipsométrica em clones de Eucalyptus sp. com o modelo de curtis ajustado por métodos bayesianos empíricos

    Directory of Open Access Journals (Sweden)

    Cláudio Roberto Thiersch

    2013-02-01

    Full Text Available Neste trabalho foi considerado o modelo de Curtis para a relação hipsométrica em clones de Eucalyptus sp. com os parâmetros sujeitos a restrições. Para fazer a inferência dos parâmetros do modelo com restrições, utilizou-se uma abordagem bayesiana com densidade a priori construída empiricamente. As estimativas bayesianas são calculadas com a técnica de simulação de Monte Carlo em Cadeia de Markov (MCMC. O método proposto foi aplicado a diferentes conjuntos de dados reais, dos quais foram selecionados cinco para exemplificar os resultados. Estes foram comparados com os resultados obtidos pelo método de mínimos quadrados, destacando-se a superioridade da abordagem bayesiana proposta.

  5. Planejamento do balanço bancário: desenvolvimento de um modelo matemático de otimização do retorno econômico ajustado ao risco

    Directory of Open Access Journals (Sweden)

    Solange Garcia dos Reis

    2001-08-01

    Full Text Available Este trabalho consiste na concepção de um modelo matemático de otimização para auxiliar a escolha das categorias de ativos e passivos que comporão a estrutura patrimonial de uma instituição bancária em períodos futuros. O modelo de decisão dos gestores bancários, o qual é traduzido pelo modelo matemático, considera a necessidade de um processo de planejamento estruturado, no qual são escolhidas as alternativas que proporcionarão o maior retorno econômico e, simultaneamente, considera a necessidade de atendimento às limitações do ambiente operacional dos bancos: suas políticas internas em relação ao risco e liquidez, os relacionamentos contábeis do balanço a cada período do horizonte de planejamento, os requisitos normativos exigidos pelos reguladores bancários e as restrições relativas aos volumes de negociação suportáveis pelo mercado. A principal restrição abordada no modelo é a limitação de capital próprio para cobertura de riscos do portfólio. Esse aspecto é contemplado da perspectiva dos reguladores, por meio da modelagem dos requerimentos normativos de capital, e da perspectiva dos gestores, por meio da proposta de utilização de um modelo estatístico para mensuração do risco. O modelo matemático construído é caracterizado como um modelo de programação não-linear, multiperiódico e probabilístico.This paper is concerned with the construction of a mathematical optimization model that helps to choose the categories of assets and liabilities that will form the balance sheet of a bank in future periods. The mathematical model herein represents a decision model for bank managers. In its assumptions, it considers the necessity of a structural planning, in which there some alternatives have to be chosen to provide a better economic return. In addition, it also considers the necessity of meeting the constraints of a bank's operational environment: politics established by the Company regarding risk and liquidity, the accounting relations in the balance sheet from each period in the planning scope, the regulatory requirements defined by banking regulators, as well as the restrictions on acceptable volumes of trade. The major constraint in the model is the capital adequacy towards the coverage of portfolio risks.This aspect is considered not only from the regulators' perspective, which provides a formula to calculate the capital requirements, but also from the managers' perspective, represented by a suggested statistical model to measure risk. The present mathematical model is considered to be a non-linear programming, multi-periodic and probabilistic one.

  6. Risco nutricional em cirurgia avaliado pelo índice de massa corporal ajustado ou não para pacientes idosos Nutritional risk in surgery evaluated by body mass index adjusted or not to elderly patients

    Directory of Open Access Journals (Sweden)

    Alberto Bicudo-Salomão

    2006-09-01

    Full Text Available RACIONAL: O índice de massa corporal vem sendo usado indistintamente entre idosos ou não para a avaliação do estado nutricional. A hipótese deste trabalho é a de que em pacientes idosos um ponto de corte mais alto para o índice de massa corporal pode ter maior validade na aferição do risco nutricional em cirurgia. OBJETIVO: Avaliar a morbimortalidade em pacientes cirúrgicos idosos comparada a pacientes mais jovens e sua associação com valores baixos de índice de massa corporal utilizando-se um ponto de corte convencional (18,5 kg/m² e outro adaptado para pacientes com idade avançada (24 kg/m². PACIENTES E MÉTODOS: Um mil e novecentos e doze pacientes foram divididos em dois grupos: 65 anos (n = 285. Comparou-se nos dois grupos o tempo de internação e a morbimortalidade. Pacientes com idade >65 anos foram estratificados segundo o índice de massa corporal 65 anos (6 [1-75] dias vs. 4 [1-137] dias, assim como as complicações pós-operatórias (37/285; 13,0% vs. 109/1627; 6,7%; OR 2,1; IC95% 1,40-3,09 e óbitos (15/285; 5,3% vs. 34/1627; 2,1%; OR 2,6; IC95% 1,40-4,84. Em pacientes com índice de massa corporal BACKGROUND: Standard body mass index cut-off points for malnutrition are routinely used for adults independently of their age. The hypothesis of this study was that a cut-off point higher than the usual for the diagnosis of malnutrition might be more precise to access the nutritional risk of aged surgical patients. AIM: To evaluate the morbimortality in aged surgical patients and its association with nutritional status assessed by body mass index using either the standard and a higher cut-off point for malnutrition. PATIENTS AND METHODS: All patients admitted for operative procedures (n = 1,912 were allocated to either two groups: 65 years old (n = 285. The body mass index was used to access the nutritional status. Two different cut-off points for malnutrition (18.5 or 24 kg/m² were used in the group of older patients. Endpoints of the study were length of stay, morbidity and mortality. RESULTS: Length of stay was higher in patients over 65 years (6 [1-75] days vs. 4 [1-137] days. Both postoperative complications (37/285; 13.0% vs. 109/1627; 6,7%; OR 2,1; IC95% 1,40-3,09 and deaths (15/285; 5.3% vs. 34/1627; 2,1%; OR 2,6; IC95% 1,40-4,84 were most common in the older group. Using a higher cut-off (24 kg/m², the length of stay (8 [1-75] days vs. 4 [1-43] days, postoperative complications (28/152; 18.4% versus 9/133; 6.8%; OR 3,1; IC95% 1.41-6.86 and re-operations (16/152; 10.5% versus 3/133; 2.2%; OR 5.1; IC95% 1.45-17.91 were greater in malnourished patients. However these correlations were not statistically significant with the cut-off point for malnutrition in 18.5 kg/m². CONCLUSIONS: Morbimortality is higher in surgical patients over 65 years old. In these, the cut-off point set in 24 kg/m² was most associated with the occurrence of postoperative complications, re-operations and length of stay.

  7. Bracket/wire play: what to expect from tipping prescription on pre-adjusted appliances Folga braquete/fio: o que esperar da prescrição para inclinação nos aparelhos pré-ajustados

    OpenAIRE

    Leopoldino Capelozza Filho; Fabricio Monteiro de Castro Machado; Terumi Okada Ozawa; Arlete de Oliveira Cavassan; Mauricio de Almeida Cardoso

    2012-01-01

    INTRODUCTION: The opinion on the 'straight-wire' concept has been evolving since its origin, characterized by faithful followers or absolute skepticism. Currently, it seems reasonable to state that most professionals have a more realistic and critical viewpoint, with an attitude that reveals Orthodontics' maturity and greater knowledge on the technique. The most relevant criticisms refer to the impossibility of the both the Straight-Wire and the Standard systems to completely express the char...

  8. Bracket/wire play: what to expect from tipping prescription on pre-adjusted appliances Folga braquete/fio: o que esperar da prescrição para inclinação nos aparelhos pré-ajustados

    Directory of Open Access Journals (Sweden)

    Leopoldino Capelozza Filho

    2012-08-01

    Full Text Available INTRODUCTION: The opinion on the 'straight-wire' concept has been evolving since its origin, characterized by faithful followers or absolute skepticism. Currently, it seems reasonable to state that most professionals have a more realistic and critical viewpoint, with an attitude that reveals Orthodontics' maturity and greater knowledge on the technique. The most relevant criticisms refer to the impossibility of the both the Straight-Wire and the Standard systems to completely express the characteristics related to the brackets due to mechanical deficiencies, such as bracket/wire play. OBJECTIVES: A critical analysis of this relationship, which is unclear due to lack of studies, was the scope of this paper. METHODS: The compensatory treatment of two patients, using Capelozza's individualized brackets, works as the scenery for cephalometric evaluation of changes in incisor inclination produced by different dimensions of leveling archwires. RESULTS: The evaluation of these cases showed that, while the introduction of a 0.019 x 0.025-in stainless steel archwire in a 0.022 x 0.030-in slot did not produce significant changes in incisor inclination, the 0.021 x 0.025-in archwire was capable of changing it, mainly in mandibular incisors, and in the opposite direction to the compensation. CONCLUSION: Considering compensatory treatments, even when using an individualized prescription according to the malocclusion, the bracket/wire play seems to be a positive factor for malocclusion correction, without undesirable movements. Therefore, it seems reasonable to admit that, until a bracket system can have absolute individualization, the use of rectangular wires that still have a certain play with the bracket slot is advisable.INTRODUÇÃO: a opinião sobre o conceito Straight-Wire tem evoluído desde sua origem, caracterizada por seguidores fiéis ou ceticismo absoluto. Atualmente, parece razoável acreditar que a maioria dos profissionais tem uma visão mais realista e crítica, com uma postura que revela maturidade da Ortodontia e maior conhecimento sobre a técnica. As maiores críticas, e com fundamento, referem-se à impossibilidade do sistema, seja Straight-Wire ou Edgewise, expressar totalmente as características embutidas nos braquetes, devido a deficiências mecânicas como folga entre braquetes e fios. OBJETIVOS: uma análise crítica dessa relação mal explicada, pela carência de estudos, foi o escopo desse artigo. MÉTODOS: o tratamento compensatório de dois pacientes, realizados com braquetes individualizados Capelozza, serve de cenário para uma avaliação cefalométrica das alterações nas inclinações dos incisivos produzidas por diferentes calibres de arcos de nivelamento. Resultados: a avaliação dos casos mostrou que, enquanto a introdução do arco de nivelamento de aço 0,019" X 0,025" em canaleta 0,022" X 0,030" não produziu alterações significativas nas inclinações dos incisivos, o arco 0,021" X 0,025"foi capaz de alterá-las, principalmente nos incisivos inferiores, e em direção contrária ao sentido da compensação. CONCLUSÃO: em tratamentos compensatórios, mesmo buscando-se utilizar prescrição individualizada de acordo com a má oclusão, a folga entre braquete e fio parece ser um fator positivo para que ocorra a correção da oclusão, sem que movimentos indesejáveis aconteçam. Assim, parece razoável admitir que, até que um sistema de braquetes permita ter uma individualização absoluta, é recomendável a utilização de fios retangulares que preservem uma folga com a canaleta do braquete.

  9. Avaliação de um modelo de distribuição diamétrica ajustado para povoamentos de Tectona grandis submetidos a desbaste Evaluation of a diametric distribution model adjusted for thinned Tectona grandis stands

    Directory of Open Access Journals (Sweden)

    Gilciano Saraiva Nogueira

    2006-06-01

    Full Text Available Este estudo teve como objetivo avaliar, do ponto de vista do realismo biológico, um modelo de distribuição diamétrica, bem como a eficiência do método dos ingressos porcentuais para determinação da idade técnica do primeiro e do segundo desbaste de povoamentos de teca (Tectona grandis L. f.. A avaliação consistiu em comparar as idades técnicas de desbaste obtidas pelo método dos ingressos porcentuais, as distribuições diamétricas projetadas para idades futuras e o comportamento da distribuição remanescente, após algumas simulações de desbaste, com a tendência lógica esperada. Pôde-se concluir que o modelo de distribuição diamétrica proposto gera estimativas que seguem uma tendência lógica do ponto de vista biológico e que o método dos ingressos porcentuais é adequado para determinar a idade técnica do primeiro e do segundo desbaste.The objective of this study was to evaluate, under the biological point of view, a diametric distribution model. Another objective was to evaluate the efficiency of the percentage of entries method to determine the technical age for the first and second thinning in teak (Tectona grandis L. f. stands. This evaluation was carried out by comparing the technical thinning ages obtained by the percentage of entries method, the diametric distributions projected for future ages and the behavior of the remaining distribution, after some thinning simulations, with the expected logical tendency. It was be concluded that the proposed diametric distribution model generates estimates which follow a logical tendency, biologically speaking and that the percentage of entries method is suitable to determine the technical age of the first and second thinning.

  10. Early Learner Engagement in the Clinical Workplace

    NARCIS (Netherlands)

    Chen, H.C.

    2015-01-01

    Introduction Recent calls for medical education reform advocate for the integration of knowledge with clinical experience through early clinical immersion. Yet, early learners rarely are invited to participate in workplace activities and early clinical experiences remain largely observational. We

  11. Clinical Leadership: A Call to Action.

    Science.gov (United States)

    Grindel, Cecelia Gatson

    2016-01-01

    Clinical nurses are expected to assume leadership roles to enhance patient care and assure efficient work processes. Dimensions of clinical leadership and the essential knowledge and skills of the clinical leader are described.

  12. 75 FR 57472 - Clinical Investigator Training Course

    Science.gov (United States)

    2010-09-21

    ... investigational medicine; Promote communication between clinical investigators and FDA; Enhance investigators... days in advance. SUPPLEMENTARY INFORMATION: Clinical trial investigators play a critical role in the... HUMAN SERVICES Food and Drug Administration Clinical Investigator Training Course AGENCY: Food and...

  13. Clinical Leadership: A Call to Action.

    Science.gov (United States)

    Grindel, Cecelia Gatson

    2016-01-01

    Clinical nurses are expected to assume leadership roles to enhance patient care and assure efficient work processes. Dimensions of clinical leadership and the essential knowledge and skills of the clinical leader are described. PMID:27044123

  14. Clinical Pearls in pediatric infections.

    Science.gov (United States)

    Singhi, Sunit; Mathew, Joseph; Jindal, Atul; Verma, Sanjay

    2011-12-01

    This series of Clinical Pearls presents four cases presenting with infection. Each of these cases had clinical clues to the correct diagnosis, which could be picked up on meticulous history, clinical examination, or basic laboratory investigations. The authors highlight the important lessons to be learnt from each case. The first is a 7 year old boy with recurrent respiratory tract infections since early life. Clinical examination revealed the presence of dextrocardia and situs inversus and bronchiectasis leading to a diagnosis of Primary Ciliary Dyskinesia. The second case is a 1.5-month-old infant who presented with meningitis and increasing head size since birth. CSF examination and CT scanning led to the correct diagnosis of congenital Toxoplasmosis. The next case is an infant with high grade fever and neck swelling. He had the rare Lemierre's syndrome comprising of oro-pharyngeal infection, suppurative thrompbophlebitis of the internal jugular vein and systemic dissemination of septic emboli. The fourth case is a 2-year-old infant with recurrent respiratory tract infections and discharging neck swellings from early life. Repeated testing for tuberculosis was negative. The diagnosis was Chronic granulomatous disease. The authors describe the clinical approach and investigations in these cases; along with an outline of the management.

  15. Clinical Epidemiology Unit - overview of research areas

    Science.gov (United States)

    Clinical Epidemiology Unit (CEU) conducts etiologic research with potential clinical and public health applications, and leads studies evaluating population-based early detection and cancer prevention strategies

  16. Clinical development of Ebola vaccines.

    Science.gov (United States)

    Sridhar, Saranya

    2015-09-01

    The ongoing outbreak of Ebola virus disease in West Africa highlighted the lack of a licensed drug or vaccine to combat the disease and has renewed the urgency to develop a pipeline of Ebola vaccines. A number of different vaccine platforms are being developed by assessing preclinical efficacy in animal models and expediting clinical development. Over 15 different vaccines are in preclinical development and 8 vaccines are now in different stages of clinical evaluation. These vaccines include DNA vaccines, virus-like particles and viral vectors such as live replicating vesicular stomatitis virus (rVSV), human and chimpanzee adenovirus, and vaccinia virus. Recently, in preliminary results reported from the first phase III trial of an Ebola vaccine, the rVSV-vectored vaccine showed promising efficacy. This review charts this rapidly advancing area of research focusing on vaccines in clinical development and discusses the future opportunities and challenges faced in the licensure and deployment of Ebola vaccines.

  17. Unusual clinical manifestations of leptospirosis

    Directory of Open Access Journals (Sweden)

    Bal A

    2005-01-01

    Full Text Available Leptospirosis has protean clinical manifestations. The classical presentation of the disease is an acute biphasic febrile illness with or without jaundice. Unusual clinical manifestations may result from involvement of pulmonary, cardiovascular, neural, gastrointestinal, ocular and other systems. Immunological phenomena secondary to antigenic mimicry may also be an important component of many clinical features and may be responsible for reactive arthritis. Leptospirosis in early pregnancy may lead to fetal loss. There are a few reports of leptospirosis in HIV- infected individuals but no generalisation can be made due to paucity of data. It is important to bear in mind that leptospiral illness may be a significant component in cases of dual infections or in simultaneous infections with more than two pathogens.

  18. AMELOGENESIS IMPERFECTA: A CLINICAL REPORT

    Directory of Open Access Journals (Sweden)

    Veena

    2015-01-01

    Full Text Available AIM: This clinical case report describes the oral rehabilitation of a young adult female patient diagnosed with hypoplastic Amelogenesis imperfecta. SUMMARY : Amelogenesis Imperfecta is a hereditary condition that affects the formation of the enamel mineralization process of both the primary and secondary dentition. It is clinically and genetically heterogeneous grou p of condition that affects both the quantity and quality of the enamel structure resulting in extensive loss of tooth tissue , poor esthetics and tooth sensitivity. The main objective for the selected treatment was to enhance the esthetics , and restoring m asticatory function. Treatment was divided into phases which included removal of impacted canine , lengthening of the maxillary and mandibular clinical crowns , and placement of anterior and posterior crowns.

  19. Clinical development of Ebola vaccines.

    Science.gov (United States)

    Sridhar, Saranya

    2015-09-01

    The ongoing outbreak of Ebola virus disease in West Africa highlighted the lack of a licensed drug or vaccine to combat the disease and has renewed the urgency to develop a pipeline of Ebola vaccines. A number of different vaccine platforms are being developed by assessing preclinical efficacy in animal models and expediting clinical development. Over 15 different vaccines are in preclinical development and 8 vaccines are now in different stages of clinical evaluation. These vaccines include DNA vaccines, virus-like particles and viral vectors such as live replicating vesicular stomatitis virus (rVSV), human and chimpanzee adenovirus, and vaccinia virus. Recently, in preliminary results reported from the first phase III trial of an Ebola vaccine, the rVSV-vectored vaccine showed promising efficacy. This review charts this rapidly advancing area of research focusing on vaccines in clinical development and discusses the future opportunities and challenges faced in the licensure and deployment of Ebola vaccines. PMID:26668751

  20. Pain assessment in clinical Rheumatology

    Directory of Open Access Journals (Sweden)

    L. Sinigaglia

    2011-09-01

    Full Text Available The diagnostic approach in clinical practice in Rheumatology is mainly based on the recognition of pain origin. Patient’s experience of pain may be similar in different diseases involving bones, joints, tendons, muscles or peripheral nervous system. The analysis of some characteristics of pain may be helpful in the diagnostic approach. In this perspective pain must be analyzed according to the type, localization, occurrence, elicitation and concomitant clinical signs. In the majority of cases this analysis allows a preliminary differential diagnosis which is essential to drive further assessments. The diagnostic approach to arthropaties is based on a group of indicative criteria which include diffusion of the arthropathy, the involved sites, the course of the joint disease, the joint damage, the history of preceding events and the presence of extra-articular features which accompany joint disease. This kind of clinical approach helps the clinician in saving time and reducing costs of diagnosis by driving any further investigation.

  1. Clinical applications of bacterial glycoproteins.

    Science.gov (United States)

    Fulton, Kelly M; Smith, Jeffrey C; Twine, Susan M

    2016-01-01

    There is an ongoing race between bacterial evolution and medical advances. Pathogens have the advantages of short generation times and horizontal gene transfer that enable rapid adaptation to new host environments and therapeutics that currently outpaces clinical research. Antibiotic resistance, the growing impact of nosocomial infections, cancer-causing bacteria, the risk of zoonosis, and the possibility of biowarfare all emphasize the increasingly urgent need for medical research focussed on bacterial pathogens. Bacterial glycoproteins are promising targets for alternative therapeutic intervention since they are often surface exposed, involved in host-pathogen interactions, required for virulence, and contain distinctive glycan structures. The potential exists to exploit these unique structures to improve clinical prevention, diagnosis, and treatment strategies. Translation of the potential in this field to actual clinical impact is an exciting prospect for fighting infectious diseases. PMID:26971465

  2. On writing from clinical experience.

    Science.gov (United States)

    Scharff, J S

    2000-01-01

    Papers that present the life of the analytic session offer material through which analysts can together study analytic process and therapeutic action and arrive at consensus on how to improve psychoanalytic theory and practice. But some analysts have been deterred from publishing clinical material of that kind because of concerns about preserving confidentiality, protecting the therapeutic relationship, reporting accurately, being scrutinized, worrying about losing their colleagues' support, and not feeling authorized to present their views. Here conscious, preconscious, and unconscious constraints against writing and publishing are explored, and an example is given of successful self-analysis of a writing inhibition. The debate over the ethics of writing is reviewed and an argument made that detailed clinical description is useful in advancing analytic understanding. Finally, a clinical example shows how the analysand usefully analyzes the experience of reading what the analyst has written, and how the analyst's self-analysis may be promoted in resonance with the analysand's experience.

  3. Clinical Decision Support Systems: A Useful Tool in Clinical Practice

    Directory of Open Access Journals (Sweden)

    Kolostoumpis G.

    2012-01-01

    Full Text Available The possibility of supporting in decision – making shows an increase in recent years. Based on mathematic simulation tools, knowledge databases, processing methods, medical data and methods, artificial intelligence for coding of the available knowledge and for resolving complex problems arising into clinical practice. Aim: the aim of this review is to present the development of new methods and modern services, in clinical practice and the emergence in their implementation. Data and methods: the methodology that was followed included research of articles that referred to health sector and modern technologies, at the electronic data bases “pubmed” and “medline”. Results: Is a useful tool for medical experts using characteristics and medical data used by the doctors. Constitute innovation for the medical community, and ensure the support of clinical decisions with an overall way by providing a comprehensive solution in the light of the integration of computational decision support systems into clinical practice. Conclusions: Decision Support Systems contribute to improving the quality of health services with simultaneous impoundment of costs (i.e. avoid medical errors

  4. Clinical features of dysthymia and age: a clinical investigation.

    Science.gov (United States)

    Bellino, S; Patria, L; Ziero, S; Rocca, G; Bogetto, F

    2001-09-20

    A few authors have described the clinical picture of dysthymia in groups of elderly patients and pointed out differences from literature reports of dysthymia in younger adults. The present study, an attempt to analyze age effects on clinical characteristics of dysthymia throughout a lifetime, was performed in a sample of 106 patients, all aged > or =18 years, who were diagnosed according to DSM-IV. The patients were evaluated using: (1) a semistructured interview to assess clinical features, family history and previous treatments; (2) the Hamilton Depression Rating Scale; (3) the Interview for Recent Life Events; and (4) the Structured Clinical Interview for DSM-IV Disorders. Statistical analysis with stepwise logistic regression revealed that age was positively related to concomitant medical illnesses and to the total score of recent life events, but negatively related to the presence of avoidant or dependent personality disorders. The data suggested different etiologic pathways in older and younger patients. Dysthymia appeared to be associated in younger adults with abnormalities of personality; in the elderly, with a history of health problems and life losses.

  5. Children and Clinical Studies: Why Clinical Studies Are Important

    Medline Plus

    Full Text Available ... E-Newsletters About NHLBI Organization NHLBI Director Budget, Planning, & Legislative Advisory Committees Contact Us FAQs Home » Clinical ... the general public. Last Updated: August 3, 2015 Resources Educational Website - English / Spanish Paper Kingdom Video ... and Postcards Facebook Page

  6. Gatekeepers for pragmatic clinical trials.

    Science.gov (United States)

    Whicher, Danielle M; Miller, Jennifer E; Dunham, Kelly M; Joffe, Steven

    2015-10-01

    To successfully implement a pragmatic clinical trial, investigators need access to numerous resources, including financial support, institutional infrastructure (e.g. clinics, facilities, staff), eligible patients, and patient data. Gatekeepers are people or entities who have the ability to allow or deny access to the resources required to support the conduct of clinical research. Based on this definition, gatekeepers relevant to the US clinical research enterprise include research sponsors, regulatory agencies, payers, health system and other organizational leadership, research team leadership, human research protections programs, advocacy and community groups, and clinicians. This article provides a framework to help guide gatekeepers' decision-making related to the use of resources for pragmatic clinical trials. Relevant ethical considerations for gatekeepers include (1) concern for the interests of individuals, groups, and communities affected by the gatekeepers' decisions, including protection from harm and maximization of benefits; (2) advancement of organizational mission and values; and (3) stewardship of financial, human, and other organizational resources. Separate from these ethical considerations, gatekeepers' actions will be guided by relevant federal, state, and local regulations. This framework also suggests that to further enhance the legitimacy of their decision-making, gatekeepers should adopt transparent processes that engage relevant stakeholders when feasible and appropriate. We apply this framework to the set of gatekeepers responsible for making decisions about resources necessary for pragmatic clinical trials in the United States, describing the relevance of the criteria in different situations and pointing out where conflicts among the criteria and relevant regulations may affect decision-making. Recognition of the complex set of considerations that should inform decision-making will guide gatekeepers in making justifiable choices regarding

  7. Positron emission tomography clinical practice

    CERN Document Server

    Valk, Peter E; Bailey, Dale L; Townsend, David W; Maisey, Michael N

    2006-01-01

    This book provides a contemporary reference to the science, technology and clinical applications of PET and PET/CT. The opening chapters summarize the scientific aspects of PET and PET/CT including physics, instrumentation, radiation dosimetry and radiation protection. A chapter on normal variants in FDG PET imaging serves as an introduction to the clinical chapters, which cover oncology applications and have been updated to include the impact of FDG PET/CT imaging in oncology. The book concludes with chapters on the use of PET and PET/CT in cardiology and neurology and PET imaging of infectio

  8. New developments in clinical CARS

    Science.gov (United States)

    Weinigel, Martin; Breunig, Hans Georg; Kellner-Höfer, Marcel; Bückle, Rainer; Darvin, Maxim; Lademann, Juergen; König, Karsten

    2013-02-01

    We combined two-photon fluorescence and coherent anti-Stokes Raman scattering (CARS) imaging in a clinical hybrid multiphoton tomograph for in vivo imaging of human skin. The clinically approved TPEF/CARS system provides simultaneous imaging of endogenous fluorophores and non-fluorescent lipids. The Stokes laser for the two-beam configuration of CARS is based on spectral broadening of femtosecond laser pulses in a photonic crystal fiber (PCF). We report on the highly flexible medical TPEF/CARS tomograph MPTflex®-CARS with an articulated arm and first in vivo measurements on human skin.

  9. Electrochemical Sensors for Clinic Analysis

    Directory of Open Access Journals (Sweden)

    Guang Li

    2008-03-01

    Full Text Available Demanded by modern medical diagnosis, advances in microfabrication technology have led to the development of fast, sensitive and selective electrochemical sensors for clinic analysis. This review addresses the principles behind electrochemical sensor design and fabrication, and introduces recent progress in the application of electrochemical sensors to analysis of clinical chemicals such as blood gases, electrolytes, metabolites, DNA and antibodies, including basic and applied research. Miniaturized commercial electrochemical biosensors will form the basis of inexpensive and easy to use devices for acquiring chemical information to bring sophisticated analytical capabilities to the non-specialist and general public alike in the future.

  10. Handbook of clinical nursing practice

    Energy Technology Data Exchange (ETDEWEB)

    Asheervath, J.; Blevins, D.R.

    1986-01-01

    Written in outline format, this reference will help nurses further their understanding of advanced nursing procedures. Information is provided on the physiological, psychological, environmental, and safety considerations of nursing activities associated with diagnostic and therapeutic procedures. Special consideration is given to the areas of pediatric nursing, nursing assessment, and selected radiologic and nuclear medicine procedures for each system. Contents: Clinical Introduction. Clinical Nursing Practice: Focus on Basics. Focus on Cardiovascular Function. Focus on Respiratory Function. Focus on Gastrointestinal Function. Focus on Renal and Genito-Urological Function. Focus on Neuro-Skeletal and Muscular Function. Appendices.

  11. Clinical applications of cells labelling

    International Nuclear Information System (INIS)

    Blood cells labelled with radionuclides are reviewed and main applications are described. Red blood cell labelling by both random and specific principle. A table with most important clinical uses, 99mTc labelling of RBC are described pre tinning and in vivo reduction of Tc, in vitro labelling and administration of labelled RBC and in vivo modified technique. Labelled leucocytes with several 99mTc-complex radiopharmaceuticals by in vitro technique and specific monoclonal s for white cells(neutrofiles). Labelled platelets for clinical use and research by in vitro technique and in vivo labelling

  12. Optimal use of MRI in clinical trials, clinical care and clinical registries of patients with rheumatoid arthritis

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Møller-Bisgaard, Signe

    2014-01-01

    with rheumatoid arthritis (RA). The question is when and how MRI should be used. The present article reviews our knowledge about, and provides suggestions for, the use of MRI in clinical trials, clinical care and clinical registries. In clinical trials, the OMERACT RA MRI scoring system (RAMRIS) is a thoroughly...

  13. [Clinical decision-making support systems in renal failure].

    Science.gov (United States)

    Martínez Bernabé, E; Paluzie-Ávila, G; Terre Ohme, S; Ruiz Poza, D; Parada Aradilla, M A; González Martínez, J; Albertí Valmaña, R; Castellvi Gordo, M

    2014-05-01

    Introducción: Los sistemas de soporte a la toma de decisiones clínicas utilizan característicasindividuales del paciente para generar recomendaciones a los clínicos.Objetivo: Evaluar el impacto de una herramienta de ajuste de fármacos en insuficienciarenal como sistema de soporte en la toma de decisiones clínicas encuanto al grado de aceptación de las intervenciones y el tiempo invertido por elfarmacéutico.Método: Estudio cuasi-experimental del tipo antes y después realizado en dos hospitalescomarcales. La intervención consistía en la incorporación de una alerta automatizadade función renal en la orden médica. Antes de la intervención (2007) semonitorizaron 40 fármacos. Se revisaron las analíticas de pacientes cuyo tratamientocontenía alguno de ellos. En caso de función renal alterada, se insertabauna recomendación de ajuste en la orden médica. Si el médico aceptaba, se considerabaéxito. El tiempo medio empleado fue 1 minuto/analítica consultada y 3minutos/recomendación. En 2008 se incorporó un sistema de recomendación automáticade ajuste según función renal de 100 fármacos con mensajes emergentes.En una fase posterior (2009) se evaluó y comparó el número de intervenciones y elporcentaje de éxito con la herramienta.Resultados: Fase previa: Se validaron 28.234 Ordenes Médicas Electrónicas, correspondientesa un promedio de 205 pacientes hospitalizados/día, y se revisaron 4.035analíticas. Se realizaron 121 intervenciones farmacéuticas (0,43% del total de órdenesmédicas). Se obtuvo éxito en el 33,06% de las intervenciones. El tiempo invertidopor el farmacéutico en consultar analíticas y realizar recomendaciones fue 73,3horas (67,25 horas correspondían a pacientes sin alteración de la función renal y enlos que no se realizó ninguna intervención). Fase posterior: Se validaron 26.584Ordenes Médicas Electrónicas, correspondientes a un promedio de 193 pacienteshospitalizados/día, y se realizaron 1.737 intervenciones

  14. Using Disguised Clinical Case Material

    Science.gov (United States)

    Kantrowitz, Judy L.

    2010-01-01

    When, why, and how clinicians decide to write about clients are ethical concerns. There are risks and potential clinical ramifications as well as responsibilities for how these decisions are made. On the basis of 141 interviews with psychoanalysts who have published in 3 major national and international psychoanalytic journals, the author explores…

  15. Age and Clinical Dengue Illness

    OpenAIRE

    Egger, Joseph R.; Paul G Coleman

    2007-01-01

    The relationship between age and risk for classic dengue fever has never been quantified. We use data from clinical patients to show that the relative risk of having classical disease after primary dengue virus infection increases with age. This relationship has implications for strategies aimed at controlling dengue fever.

  16. Clinical Spectrum of Propionic Acidaemia

    Directory of Open Access Journals (Sweden)

    Muhammad Rafique

    2013-01-01

    Full Text Available Objectives. To evaluate the clinical features, physical findings, diagnosis, and laboratory parameters of the patients with propionic acidaemia (PA. Methods. The records of diagnosed cases of propionic acidaemia were reviewed, retrospectively. Results. Twenty-six patients with PA had 133 admissions. The majority (85% of the patients exhibited clinical manifestations in the 1st week of life. Regarding clinical features, lethargy, fever, poor feeding, vomiting, dehydration, muscular hypotonia, respiratory symptoms, encephalopathy, disturbance of tone and reflexes, and malnutrition were observed in 51–92% admissions. Metabolic crises, respiratory diseases, hyperammonaemia, metabolic acidosis, hypoalbuminaemia, and hypocalcaemia were observed in 30–96% admissions. Pancytopenia, ketonuria, hypoproteinemia, hypoglycaemia, and mildly disturbed liver enzymes were found in 12–41% admissions. Generalised brain oedema was detected in 17% and cerebral atrophy in 25% admissions. Gender-wise odd ratio analysis showed value of 1.9 for lethargy, 1.99 for respiratory diseases, 0.55 for anaemia, and 1.82 for hypocalcaemia. Conclusion. Propionic acidaemia usually presents with wide spectrum of clinical features and disturbances of laboratory parameters in early neonatal age. It is associated with significant complications which deteriorate the patients’ quality of life. Perhaps with early diagnosis of the disease and in time intervention, these may be preventable.

  17. Topics in clinical oncology. 14

    International Nuclear Information System (INIS)

    The symposium proceedings contain 39 papers. All papers were inputted in INIS. The subjects of the papers were the use of computers in radiotherapy planning, and clinical dosimetry, equipment and quality assurance, biological radiation effects and radiation protection problems in radiotherapy. (J.P.)

  18. Ocular Syphilis: a Clinical Review.

    Science.gov (United States)

    Woolston, Sophie L; Dhanireddy, Shireesha; Marrazzo, Jeanne

    2016-11-01

    While ocular syphilis is not a new phenomenon, recent increased rates of new diagnoses, especially in human immunodeficiency virus (HIV)-infected persons and men who have sex with men, have sparked a new interest in an old disease. This article will review the clinical presentation, diagnosis, and treatment of ocular syphilis, and provide guidance on management. PMID:27686678

  19. Current clinical approach to achalasia

    Institute of Scientific and Technical Information of China (English)

    Alexander J Eckardt; Volker F Eckardt

    2009-01-01

    Idiopathic achalasia is a rare primary motility disorder of the esophagus.The classical features are incomplete relaxation of a frequently hypertensive lower esophageal sphincter (LES) and a lack of peristalsis in the tubular esophagus.These motor abnormalities lead to dysphagia,stasis,regurgitation,weight loss,or secondary respiratory complications.Although major strides have been made in understanding the pathogenesis of this rare disorder,including a probable autoimmune mediated destruction of inhibitory neurons in response to an unknown insult in genetically susceptible individuals,a definite trigger has not been identified.The diagnosis of achalasia is suggested by clinical features and confirmed by further diagnostic tests,such as esophagogastroduodenoscopy (EGD),manometry or barium swallow.These studies are not only used to exclude pseudoachalasia,but also might help to categorize the disease by severity or clinical subtype.Recent advances in diagnostic methods,including high resolution manometry (HRM),might allow prediction of treatment responses.The primary treatments for achieving long-term symptom relief are surgery and endoscopic methods.Although limited high-quality data exist,it appears that laparoscopic Heller myotomy with partial fundoplication is superior to endoscopic methods in achieving long-term relief of symptoms in the majority of patients.However,the current clinical approach to achalasia will depend not only on patients' characteristics and clinical subtypes of the disease,but also on local expertise and patient preferences.

  20. Teaching Techniques in Clinical Chemistry.

    Science.gov (United States)

    Wilson, Diane

    This master's thesis presents several instructional methods and techniques developed for each of eleven topics or subject areas in clinical chemistry: carbohydrate metabolism, lipid metabolism, diagnostic enzymology, endocrinology, toxicology, quality control, electrolytes, acid base balance, hepatic function, nonprotein nitrogenous compounds, and…

  1. Clinical cytogenetics and molecular cytogenetics

    Institute of Scientific and Technical Information of China (English)

    LI Marilyn; PINKEL Daniel

    2006-01-01

    The short report will be focused on helping our students to understand commonly used conventional and cutting edge cytogenetic techniques and their clinical applications, the advances and drawbacks of each technique, and how to pick the right test(s) for a specific patient in order to achieve a proper diagnosis efficiently and economically.

  2. Pulse Pressure in Clinical Practice

    Directory of Open Access Journals (Sweden)

    Jiri Parenica

    2012-02-01

    Full Text Available The review presents basic information about the pulse pressure. The variables related to pulse pressure are briefly explained - arterial stiffness, arterial compliance, pulse wave velocity, pulse pressure amplification and augmentation index. We present some recent trials and observational studies that show the importance of pulse pressure in clinical practice. Briefly the possibilities of influencing the pulse pressure are discussed.

  3. Radon in caves: clinical aspects

    OpenAIRE

    Craven Stephen A.; Smit Berend J.

    2006-01-01

    Historical, experimental and clinical evidence is presented to suggest that radon constitutes a relatively small carcinogenic risk for casual visitors to caves. The risk is dependent on radon levels and the smoking of tobacco. Show cave guides, chronically exposed to radon, may be at increased risk for lung cancer due to the effects of radon, especially if they are smokers of tobacco.

  4. Supervisees' Perception of Clinical Supervision

    Science.gov (United States)

    Willis, Lisa

    2010-01-01

    Supervisors must become aware of the possible conflicts that could arise during clinical supervision. It is important that supervisors communicate their roles and expectations effectively with their supervisees. This paper supports the notion that supervision is a mutual agreement between the supervisee and the supervisor and the roles of…

  5. Clinical Application of Point Diji

    Institute of Scientific and Technical Information of China (English)

    栾继萍

    2004-01-01

    @@ Diji (SP 8) is a cleft point of the Spleen Channel of Foot-Taiyang. Its indications include abdominal pain, diarrhea, edema, dysmenorrhea and certain other symptoms caused by incoordination between the liver and the spleen. Either taking the point alone or together with some other adjunct points in clinical practice, the author has obtained satisfactory curative effects.

  6. Reestablishing Clinical Psychology's Subjective Core

    Science.gov (United States)

    Hunsberger, Peter Hume

    2007-01-01

    Comments on the report by the APA Presidential Task Force on Evidence-Based Practice (see record 2006-05893-001) entitled Evidence-based practice in psychology. The Task Force is to be commended for their report valuing evidence from "clinical expertise" on a par with "research data" (p. 272) in guiding psychological practices. The current author…

  7. Improvisation skills for clinical work

    DEFF Research Database (Denmark)

    Wigram, Anthony Lewis

    based on a short theme or ‘leit-motif’ will all be included in the workshop activities, using both piano, and other instruments. While interventions utilising improvisational music therapy should never be driven by clinical procedures, applying therapeutic method, and also recognising method...

  8. MR spectroscopy in clinical research

    DEFF Research Database (Denmark)

    Henriksen, O

    1994-01-01

    MR spectroscopy (MRS) offers unique possibilities for non-invasive evaluation of biochemistry in vivo. During recent years there has been a growing body of evidence from clinical research studies on human beings using 31P and 1H MRS. The results indicate that it is possible to evaluate phosphorous...

  9. Nonverbal Interventions in Clinical Groups.

    Science.gov (United States)

    Shadish, William R., Jr.

    1980-01-01

    A comparison of nonverbal with verbal clinical group interventions suggested that some traditional self-report devices show less differentiation between these two interventions than do measures of group cohesion. A strong, replicable manipulation tested these findings, which were consistent with previous research. (Author/BEF)

  10. Registration of randomized clinical trials

    DEFF Research Database (Denmark)

    Østervig, R M; Sonne, A; Rasmussen, L S

    2015-01-01

    starting enrolment before 2010 to 63.2% after 2010 (24/38, P clinical trials were registered at clinicaltrials.gov. CONCLUSION: Many published randomized controlled trials from Acta Anaesthesiologica Scandinavica were not adequately registered but the requirement of trial registration has...

  11. Randomized clinical trials in HEPATOLOGY

    DEFF Research Database (Denmark)

    Kjaergard, L L; Nikolova, D; Gluud, C

    1999-01-01

    Evidence shows that the quality of randomized clinical trials (RCTs) affects estimates of intervention efficacy, which is significantly exaggerated in low-quality trials. The present study examines the quality of all 235 RCTs published in HEPATOLOGY from the initiation in 1981 through August 1998...

  12. The Future of Clinical Dentistry.

    Science.gov (United States)

    Slavkin, Harold C.

    1998-01-01

    Discussion of the future of clinical dentistry looks at a variety of influences, including historical development factors; demographic trends; the role of the Human Genome Project in the development of scientific knowledge; a paradigm shift in approaches to oral infection and systemic disease; advancing technology; and reforms resulting from these…

  13. Ethical dilemmas in clinical genetics.

    OpenAIRE

    Young, I D

    1984-01-01

    This paper discusses the results of a survey of medical and paramedical opinion relating to various difficult ethical issues in clinical genetics. These include the confidentiality of the doctor-patient relationship, prenatal diagnosis and termination, and Huntington's chorea. It is suggested that this method provides a useful means of assessing what is ethically acceptable in contemporary society.

  14. Clinical Judgment and Affective Disorders.

    Science.gov (United States)

    Strohmer, Douglas C.; And Others

    1984-01-01

    Addressed the limitations of previous work on counselor clinical judgment in a study involving 20 counselors who were asked to make a series of judgments. Results suggested the judgment processes of experienced counselors making diagnoses of affective disorders differs depending on the type of judgment. (JAC)

  15. CLINICAL STUDY OF ANORECTAL MALFORMATIONS

    OpenAIRE

    Umesh; Sowmya,

    2015-01-01

    BACKGROUND: A norectal malformations are relatively encountered anomalies. Presentations may vary from mild to severe and bowel control is t he main concern. AIM: To study the modes of presentation , types of anomalies , associated anomalies , reliability of clinical signs and radiological investigations in the diagnosis and the prognosis and continence in the post - operative in relation to type of anomaly and associated anomaly (s)...

  16. Bias in clinical intervention research

    DEFF Research Database (Denmark)

    Gluud, Lise Lotte

    2006-01-01

    Research on bias in clinical trials may help identify some of the reasons why investigators sometimes reach the wrong conclusions about intervention effects. Several quality components for the assessment of bias control have been suggested, but although they seem intrinsically valid, empirical...

  17. Topics in clinical trial management

    NARCIS (Netherlands)

    B.A. Kirwan (Bridget Anne)

    2004-01-01

    textabstractThe aim of this thesis is to show how clinical trial conduct can be managed while respecting the underlying scientific principles. Chapter 2 describes the main results of PICO (PImobendan in COngestive heart failure), a trial which investigated a positive inotropic agent in patients with

  18. Positive reinforcement in clinical teaching.

    Science.gov (United States)

    Gallagher, L M

    1992-01-01

    Contrary to the idea that nursing students are intrinsically motivated, findings in research studies show that students repeatedly report the significance of positive feedback to them. Delivery of positive reinforcement by clinical instructors can be developed so that the reinforcement is more meaningful to students and more effective in promoting or maintaining desired student behaviors.

  19. HIV/AIDS Clinical Trials Fact Sheet

    Science.gov (United States)

    HIV Prevention HIV/AIDS Clinical Trials (Last updated 9/15/2015; last reviewed 9/15/2015) Key Points HIV/AIDS clinical ... safe and effective in people. What is an HIV/AIDS clinical trial? HIV/AIDS clinical trials help ...

  20. MDS clinical diagnostic criteria for Parkinson's disease

    NARCIS (Netherlands)

    Postuma, R.B.; Berg, D; Stern, M.; Poewe, W.; Olanow, C.W.; Oertel, W.; Obeso, J.; Marek, K.; Litvan, I.; Lang, A.E.; Halliday, G.; Goetz, C.G.; Gasser, T.; Dubois, B.; Chan, P.; Bloem, B.R.; Adler, C.H.; Deuschl, G.

    2015-01-01

    This document presents the Movement Disorder Society Clinical Diagnostic Criteria for Parkinson's disease (PD). The Movement Disorder Society PD Criteria are intended for use in clinical research but also may be used to guide clinical diagnosis. The benchmark for these criteria is expert clinical di

  1. Clamping down on clinic violence.

    Science.gov (United States)

    1993-11-16

    The editorial remarked that anti abortion groups using violence must be stopped through legislation currently under consideration by the House and Senate of the US Congress. An important distinction is made between expressing freedom of speech on a deeply held belief and intimidation and violence that directly impacts on the rights of others. Women's health clinics where abortions are performed have repeatedly been the setting for intimidation and violence. There have been over 1000 reports of violence against these facilities and the people working at abortion centers since 1977. The most extreme act was the March 1993 murder of Dr. David Gunn outside a Pensacola, Florida, clinic and the wounding in August 1993 of a doctor in Wichita, Kansas. Unfortunately, the clinic violence not only interfere with abortion seekers, but also interferes with normal routine procedures such as Pap smears, prenatal care, well baby visits, and contraceptive counseling. Politically motivated violence antagonizes many women who rely on these clinics as the only source of care. The House and Senate bills would make it a federal criminal act to use force or physical obstruction to prevent a woman from getting an abortion or to damage a medical facility that provides abortion-related services. The Senate voted November 16, 1993 and the House vote will follow within the week. Anti abortion activists have cited the change to a pro-choice president as one of the reasons for the increase in violence against clinics, which amounted to a tripling of acts between 1990 and 1992. It is quixotic that movement to protect life would use extreme acts such as murder to protect life. Persuasion and appeals to hearts and minds would serve the abortion foes better as a viable strategy in the exercise of their right of free speech.

  2. Clinical evaluation of Graves ophthalmopathy

    Directory of Open Access Journals (Sweden)

    Janićijević-Petrović Mirjana A.

    2012-01-01

    Full Text Available Introduction. Graves ophthalmopathy is an autoimmune disease, which is the consequence of thyroid dysfunction. Ocular manifestations occur in 50% of patients with Graves disease. The changes occur due to the inflammatory cell infiltration of retrobulbar fat tissue and extraocular muscles. Ultrasonography of eye orbit provides important information about the condition of retrobulbar adipose tissue and the thickness of extraocular muscles. Objective. The aim of our study was to show the clinical significance of orbital ultrasonography in the diagnostics and follow-up of patients with Graves disease. Methods. The authors examined 154 patients with Graves ophthalmopathy at the Clinic of Ophthalmology of the Clinical Centre in Kragujevac during the period 2008–2010. Ophthalmological examination included visual acuity testing (Snellen chart, biomicroscopy and applanation tonometry, direct and indirect ophthalmoscopy, dry eye testing and exophthalmometry (Hertel. Orbital ultrasonography examination and extraorbital muscle measurement was done by ultrasound B-scan. Results. The disease was more frequent in women (79.87% aged from 36–45 years. Most patients had hyperthyreoidism (54.55%. In relation to the duration of the disease, the most frequent clinical signs were bilateral ptosis, conjunctival chemosis and periorbital edema. According to our data the highest number of patients had enlarged medial straight muscle. Conclusion. Graves ophthalmopathy is the most frequent sign of thyroid disease. By orbital ultrasonography we detected extended echogram and measured the thickness of the extraocular muscle. Computerized tomography and magnetic resonance scan were utilized for cases of insufficiently manifested clinical signs of the disease. The advantages of ultrasonography lie in easy handling, patients’ comfort, short time of examination and possibilities of repetition.

  3. Mortalidade hospitalar como indicador de qualidade: uma revisão Hospital mortality as an indicator of clinical performance: a review

    Directory of Open Access Journals (Sweden)

    Claudia Travassos

    1999-01-01

    Full Text Available Este artigo visa a discutir as principais questões metodológicas relacionadas à mortalidade hospitalar como indicador de qualidade. Variações nos valores deste indicador se devem a inúmeros fatores, associados ao doente e à doença, que devem ser examinados para que possamos utilizá-lo como medida de desempenho. Presença de comorbidades e a gravidade do caso estão associadas à chance de morrer . Aspectos metodológicos, relevantes para a construção deste indicador, incluem a qualidade das fontes de dados, o intervalo de tempo no qual elas são calculadas e os diferentes tipos de agregação. São discutidos diversos modelos, tanto para classificação da gravidade, quanto para o ajuste das taxas de mortalidade entre serviços. São examinados ainda modelos explicativos para a variação de mortalidade. Conclui-se que nas condições em que a morte não é um evento raro, o emprego de taxas de mortalidade hospitalar representa uma ferramenta útil para indicar serviços com eventuais problemas de qualidade.This article discusses the principal methodological problems related to hospital mortality as an indicator of clinical performance. Hospital mortality rates variation are due to various factors associated with patients' characteristics and to the specific diseases they are suffering. Socio-demographic variables, presence of comorbidity and severity may define case-mixes were chances of dying are not associated to technology deployed or quality of care. Relevant methodological aspects for calculating the rates include the quality of the source of data, time period and aggregation criteria. Various models that exist both for classifying severity of cases and for risk adjustment are presented and discussed. Explanatory models for mortality rates variation are also examined. The authors conclude that outcome indicators can be used as tool for health care service evaluation. For those conditions which death is not a rare event hospital

  4. Future clinical trials in DIPG: bringing epigenetics to the clinic

    Directory of Open Access Journals (Sweden)

    Andres E. Morales La Madrid

    2015-07-01

    Full Text Available In spite of major recent advances in DIPG molecular characterization, this body of knowledge has not yet translated into better treatments.To date,more than 250 clinical trials evaluating radiotherapy along with conventional cytotoxic chemotherapy as well as newer biologic agents,have failed to improve the dismal outcome when compared to palliative radiation alone.The biology of DIPG remained unknown until recently when the neurosurgical expertise along with the recognition by the scientific and clinical community of the importance of tissue sampling at diagnosis;ideally in the context of a clinical trial and by trained neurosurgical teams to maximize patient safety.These pre-treatment tumor samples,and others coming from tissue obtained post-mortem,have yielded new insights into DIPG molecular biology.We now know that DIPG comprises a heterogeneous disease with variable molecular phenotypes, different from adult high grade glioma,other non-pontine pediatric high grade gliomas and even between pontine gliomas.The discovery of histone H3.3 or H3.1 mutations has been an important step forward in understanding tumor formation,maintenance and progression.Pharmacologic reversal of DIPG histone demethylation therefore offers an important potential intervention strategy for the treatment of DIPG.To date,clinical trials of newly diagnosed or progressive DIPG with epigenetic modifiers have been unsuccessful.Whether this failure represents limited activity of the agents used,their CNS penetration,redundant pathways within the tumor,or the possibility that histone mutations are necessary only to initiate DIPGs but not maintain their growth,suggest that a great deal still needs to be elucidated in both the underlying biology of these pathways,and the drugs designed to target them.In this review, we discuss the role of both epigenetic and genetic mutations within DIPG and the development of treatment strategies directed against the unique abnormalities

  5. Electronic health records improve clinical note quality

    OpenAIRE

    Burke, Harry B; SESSUMS, LAURA L; Hoang, Albert; Becher, Dorothy A; Fontelo, Paul; Liu, Fang; Stephens, Mark; Pangaro, Louis N; O'Malley, Patrick G; Baxi, Nancy S; Bunt, Christopher W; Capaldi, Vincent F; Chen, Julie M; Cooper, Barbara A; Djuric, David A

    2014-01-01

    Background and objective The clinical note documents the clinician's information collection, problem assessment, clinical management, and its used for administrative purposes. Electronic health records (EHRs) are being implemented in clinical practices throughout the USA yet it is not known whether they improve the quality of clinical notes. The goal in this study was to determine if EHRs improve the quality of outpatient clinical notes. Materials and methods A five and a half year longitudin...

  6. Clinical Legal Education Models: Recommended Assessment Regimes

    OpenAIRE

    Riette (MA) du Plessis

    2015-01-01

    Clinical legal education (CLE) forms part of the LLB curriculum at most South African Universities. There are many similarities in the approach to CLE, but often also many differences. The clinical models of four South African university law clinics are reviewed in an effort to find suitable models. It is indicated that formulating a mission for the law clinic will have a direct impact on the clinical model chosen. The integration of CLE courses into the core curriculum of the law school will...

  7. Clinical Practice Guidelines and Industry

    Directory of Open Access Journals (Sweden)

    Ajai R. Singh

    2007-01-01

    Full Text Available In this section we shall see what Clinical Practice Guidelines (CPGs should be and what they are, the recent case of Xigris and a thriller-like manipulation by the concerned company to enter a performance 'bundle', CPG effectiveness/cost effectiveness and other considerations, how they serve Industry needs, and what methods can possibly assist them actualise their enormous potential.Introduction From the early nineties, a number of Clinical Practice Guidelines (CPGs have been created and published by many different associations and organizations at considerable expense. CPGs are supposed to serve an important purpose. They offer objective consensus of expert opinion on treatment and hence are trusted by hospitals and practicing physicians alike. They can reduce the possibility of inappropriate care being delivered, while helping introduce new knowledge into clinical practice (Grimshaw and Russell, 1993; Merritt et al. , 1997; Woolf et al. , 1999. They are a distillate of biomedical wisdom at a certain point of time applied to better and more efficient patient care. Hence, rigorously developed guidelines can translate complicated research findings into actionable recommendations of clinical care (Shiffman et al. , 2003; Haines and Jones, 1994. Clinical practice guidelines have generally been accepted as an objective consensus on evidence (Baird, 2003. Practice guidelines approved by expert panels are intended to standardize care in such a way as to improve health outcomes (Eichacker et al. , 2006. Major hospitals and knowledge updated physicians feel reassured they are doing the very best by following CPGs. State of the art, and such other fancy labels, can be justifiably applied to them.McMaster et al., (2007 have talked recently of getting guidelines to work in practice. In an effort to make CPGs more effective, developers of such guidelines have started grouping evidence-based interventions into what are called 'bundles'. The justification for

  8. Hyperthermia: Rational and clinical applications

    International Nuclear Information System (INIS)

    Over the past 20 years, research in the application of hyperthermia (HT), primarily as an adjuvant to radiation therapy (XRT), for the management of locally-advanced or recurrent malignancies, has waxed and waned in interest in the United States. Initial enthusiasm based on in vitro and murine tumor studies, was severely dampened by the results of early clinical trails. One initial clinical Phase III trial, however, employed applicators which were frequently unable to obtain adequate tumor heating, failed to sufficiently monitor tumor and normal tissue temperatures, and selected inappropriate tumors (based on size and depth) for therapy. Fortunately, subsequent clinical trials have benefited from the lessons learned in earlier attempts. Recently, three European-based, Phase III randomized trials enrolling large numbers of patients have demonstrated significantly improved local control rates for superficially-located metastatic melanomas, chest wall recurrences from breast cancer, and deep-seated locally-advanced tumors of the uterine cervix and urinary bladder. In addition, continued improvements in HT applicators and a better understanding of thermal dosimetry should permit further advances in trial design for the clinical use of HT as an adjuvant to XRT. This refresher course will focus on four areas: (1) a review of progress made in thermal dose descriptors with emphasis on their use in prescribing HT treatments and on the correlation of thermal and thermal dose parameters with clinical outcome, (2) tumor site-specific selection for HT studies based on sites that can be heated with currently available equipment, and tumors where improved local control will result in increased chance of patient cure or significant palliation, (3) site-specific results and examples of responses to XRT-HT, and (4) an overview of the results of eleven randomized Phase III clinical studies comparing XRT alone to XRT plus HT. It is hoped that those attending the refresher course will

  9. Statistical literacy for clinical practitioners

    CERN Document Server

    Holmes, William H

    2014-01-01

    This textbook on statistics is written for students in medicine, epidemiology, and public health. It builds on the important role evidence-based medicine now plays in the clinical practice of physicians, physician assistants and allied health practitioners. By bringing research design and statistics to the fore, this book can integrate these skills into the curricula of professional programs. Students, particularly practitioners-in-training, will learn statistical skills that are required of today’s clinicians. Practice problems at the end of each chapter and downloadable data sets provided by the authors ensure readers get practical experience that they can then apply to their own work.  Topics covered include:   Functions of Statistics in Clinical Research Common Study Designs Describing Distributions of Categorical and Quantitative Variables Confidence Intervals and Hypothesis Testing Documenting Relationships in Categorical and Quantitative Data Assessing Screening and Diagnostic Tests Comparing Mean...

  10. CLINICAL EVALUATION OF THYROID SWELLINGS

    Directory of Open Access Journals (Sweden)

    Vikrant

    2016-05-01

    Full Text Available BACKGROUND Thyroid nodule is the most common entity and presentation of underlying thyroid pathology. Term goitre is generalized enlargement of thyroid gland. The management of thyroid swelling depends on clinical examination, battery of tests to reach correct diagnosis. METHODS This is prospective study of clinical evaluation of thyroid swellings done on 100 patients presented with palpable thyroid swellings in Department of Otorhinolaryngology and Head and Neck Surgery, Government Medical College and Hospital, Haldwani, Nainital, Uttarakhand. The time period of study was from November 2013 to November 2015. RESULTS Thyroid swellings is more common in females (M:F ratio 1:5.66. Majority of the patients are in the age group of 31-40 years. Swelling in the anterior neck was the commonest mode of presentation. In majority of the patients, duration of swelling prior to presentation was between 6 months and 3 years

  11. Career opportunities in clinical engineering.

    Science.gov (United States)

    Morse, W A

    1992-01-01

    The varied career opportunities open to clinical engineers are described in this paper. Many of these opportunities are within the medical device industry in research, development, manufacturing design, regulatory activities, production, operations, sales, marketing, service, and management. Additional opportunities are available in hospitals, with the Veterans Administration, or working as an entrepreneur or a consultant. Each of these careers requires specific training and skills, and they all require a fundamental scientific knowledge of physical principles and mathematics. Research and management, however, require different educational preparation. The research emphasis should be on theoretical principles and creativity; the management emphasis should be on financial and labor problems. In all clinical engineering careers, the individual is a problem solver. PMID:10120058

  12. Loop Diuretics in Clinical Practice.

    Science.gov (United States)

    Oh, Se Won; Han, Sang Youb

    2015-06-01

    Diuretics are commonly used to control edema across various clinical fields. Diuretics inhibit sodium reabsorption in specific renal tubules, resulting in increased urinary sodium and water excretion. Loop diuretics are the most potent diuretics. In this article, we review five important aspects of loop diuretics, in particular furosemide, which must be considered when prescribing this medicine: (1) oral versus intravenous treatment, (2) dosage, (3) continuous versus bolus infusion, (4) application in chronic kidney disease patients, and (5) side effects. The bioavailability of furosemide differs between oral and intravenous therapy. Additionally, the threshold and ceiling doses of furosemide differ according to the particular clinical condition of the patient, for example in patients with severe edema or chronic kidney disease. To maximize the efficiency of furosemide, a clear understanding of how the mode of delivery will impact bioavailability and the required dosage is necessary.

  13. Clinical application of fast neutrons

    International Nuclear Information System (INIS)

    The results of treatments and clinical experiments with neutrons (from a medical d+T neutron generator with an output of 1012 neutrons per second) are reported and discussed. Data on RBE values are presented after single doses and multiple fractions of neutrons and 60Co-gamma rays on pulmonary metastases. The results of pilot studies on head and neck tumours, brain tumours and pelvic tumours are discussed. The accuracy of the calculated dose is tested with some in-vivo experiments during neutron irradiation of the pelvis. Estimations of RBE values for tumour control, skin damage and intestinal damage after fractionated neutron therapy are dealt with and the results obtained in treatment of sarcomas are discussed. The preliminary results are given of some clinical trials in Amsterdam. Also some data from other centres are reviewed. From these data some remarks about the future of neutron therapy are made. (Auth.)

  14. Positive interventions in clinical practice.

    Science.gov (United States)

    Rashid, Tayyab

    2009-05-01

    Mainstream psychotherapy has made huge strides in treating symptoms and disorders, but it has largely overlooked happiness as a therapeutic goal despite frequently hearing from clients, "Doctor, I want to be happy." This issue of Journal of Clinical Psychology: In Session describes a number of positive interventions for specific clinical problems, such as depression, anxiety, schizophrenia, loss, grief, and relationship distress. Although the name may suggest it, positive interventions do not imply that rest of psychotherapies are negative. Neither are negatives denied nor minimized. Distinct from self-help recipes proffering instant changes, positive psychology interventions refer to systematic approaches to overcome challenges by using clients' strengths and assets. A hybrid psychotherapy-coaching model and strength-based assessment can ask a client "What is right with you?" All articles are supplemented with rich case illustrations. PMID:19294745

  15. Responsiveness of Clinical Outcome Measures

    DEFF Research Database (Denmark)

    Lauridsen, Henrik Hein

    Rating Scale is recommended. The MCID was more or less stable across subgroups for most instruments and increased monotonously with baseline condition severity in PrS and LBP patients only. The clinical question: “how are you now compared to when you started the treatment” seems to be most sensitive......Background The Oswestry Disability Index (ODI) is one of two standardised functional health measurement scales (HMS) recommended. Despite extensive psychometric testing, little is known about HMS behaviour and the minimal clinically important difference (MCID) in subgroups of LBP patients. Moreover...... subgroups of patients with LBP. In addition, we explored whether low back pain patients were able to determine an acceptable treatment outcome before it began. Methods The responsiveness in subgroups study. An extensive cross-cultural adaptation and validation of the ODI was carried out on patients seen...

  16. [Thoracic nocardiosis - a clinical report].

    Science.gov (United States)

    Vale, Artur; Guerra, Miguel; Martins, Daniel; Lameiras, Angelina; Miranda, José; Vouga, Luís

    2014-01-01

    Nocardia genus microorganisms are ubiquitous, Gram positive aerobic bacterias, responsible for disease mainly in immunocompromised hosts, with cellular immune response commitment. Inhalation is the main form of transmition and pulmonary disease is the most frequent presentation. Dissemination may occur by contiguity and also via hematogenous. The clinical and imaging presentation is not specific, and diagnosis is obtained after identification of Nocardia bacteria in biological samples. Since there are no reliable studies that indicate the best therapeutic option, treatment should be individualized and based on antimicrobial susceptibility testing. Surgical drainage should also be considered in all patients. The authors present a clinical case of a patient with thoracic nocardiosis, and make a short literature review on the theme. PMID:25596394

  17. Proton therapy in clinical practice

    Institute of Scientific and Technical Information of China (English)

    Hui Liu; Joe Y. Chang

    2011-01-01

    Radiation dose escalation and acceleration improves local control but also increases toxicity. Proton radiation is an emerging therapy for localized cancers that is being sought with increasing frequency by patients. Compared with photon therapy, proton therapy spares more critical structures due to its unique physics. The physical properties of a proton beam make it ideal for clinical applications. By modulating the Bragg peak of protons in energy and time, a conformal radiation dose with or without intensity modulation can be delivered to the target while sparing the surrounding normal tissues. Thus, proton therapy is ideal when organ preservation is a priority. However, protons are more sensitive to organ motion and anatomy changes compared with photons. In this article, we review practical issues of proton therapy, describe its image-guided treatment planning and delivery, discuss clinical outcome for cancer patients, and suggest challenges and the future development of proton therapy.

  18. Raman Spectroscopy for Clinical Oncology

    Directory of Open Access Journals (Sweden)

    Michael B. Fenn

    2011-01-01

    Full Text Available Cancer is one of the leading causes of death throughout the world. Advancements in early and improved diagnosis could help prevent a significant number of these deaths. Raman spectroscopy is a vibrational spectroscopic technique which has received considerable attention recently with regards to applications in clinical oncology. Raman spectroscopy has the potential not only to improve diagnosis of cancer but also to advance the treatment of cancer. A number of studies have investigated Raman spectroscopy for its potential to improve diagnosis and treatment of a wide variety of cancers. In this paper the most recent advances in dispersive Raman spectroscopy, which have demonstrated promising leads to real world application for clinical oncology are reviewed. The application of Raman spectroscopy to breast, brain, skin, cervical, gastrointestinal, oral, and lung cancers is reviewed as well as a special focus on the data analysis techniques, which have been employed in the studies.

  19. Loneliness: Clinical Import and Interventions

    OpenAIRE

    Cacioppo, Stephanie; Grippo, Angela J.; London, Sarah; Goossens, Luc; Cacioppo, John T.

    2015-01-01

    In 1978, when the Task Panel report to the US President’s Commission on Mental Health emphasized the importance of improving health care and easing the pain of those suffering from emotional distress syndromes including loneliness, few anticipated that this issue would still need to be addressed 40 years later. A meta-analysis (Masi et al., 2011) on the efficacy of treatments to reduce loneliness identified a need for well-controlled randomized clinical trials focusing on the rehabilitation o...

  20. Clinical violence in nursing students

    OpenAIRE

    Aghajanloo, Ali; Nirumand-Zandi, Kianoosh; Safavi-Bayat, Zahra; Alavi-Majd, Hamid

    2011-01-01

    BACKGROUND: One of the significant issues in health studies is violence. Although violence against nurses has been recognized as a major occupational problem, its magnitude and extent is not clearly defined. The aim of this study was to determine the extent and types of violence during clinical training of nursing students. METHODS: In this descriptive and cross-sectional study, 180 sophomores, juniors and seniors of Shahid Beheshti, Tehran and Iran Medical Universities were selected by quota...