In practice, this sample of patients live almost daily with the consequences of the disease, among which pain occupies a central position, contribu- ting to a physical discomfort with implications in social and professional activities. Furthermore, this situation is clearly visible in the way patients ex- press their wants as to the management and treat- ment of rheumatoid arthritis: 81.2% of individuals said that they would like to have less joint pain, 73.1% would like to feel a general improvement of arthritis, 59.2% wanted to have less joint swelling and 57.4% would aim to achieve lasting relief of rheumatoid arthritis symptoms (Table V).
The new product concept was analyzed through the HoQ tool as a way to define which product characteristics can be improved according to the “voice of customers”. After the identification of customer and technical requirements, an interrelationship matrix was constructed and this allowed understanding how each technical requirement affects customer wants. Also, the relationships among technical properties were evaluated in order to identify which features conflict and which features potentiate others. According to customers’ feedback received, target values for each design requirement were established, which will constitute concrete goals for the game’s development phase. Alongside, the current AB games were compared with AB Music, as a way to perceive the value added by the new game. HoQ allows weighting technical requirements according to their importance, which ultimately leads to better decisions and coordination between the stages of a new product development and allows assuring that product features are aligned with customers’ needsand requirements. There were found minimal negative relationships between the “availability of songs” and the “smaller player”. Besides these technical specifications , none of the listed requirements seems to be damaged by the existence of the other requirements. However it is important to take into account that the construction of this HoQ was made at an early phase of the development path. Most likely, some of these characteristics have an impact on general requirements of any digital game, namely, the cost of production, and will require tradeoffs.
In the health sector, one of the most discussed topics is primary health care. It is considered by many a central pillar of the health system. In order to increase efficiency, quality and equity in this area, countries have increased the complexity of the strategies to provide services in health system. Particularly in Portugal we have seen a lot of changes in the organizations, the largest one having started in 2005. This reform in primary care wants to improve the performance of the health care centres by decentralizing power, increasing team work and giving an active voice to the community. It is within this reform that the Primary Care Trust (namely in Portuguese as Agrupamentos de Centros de Saúde) emerged.
Buskirk (1982) opined that the total caloric need is influenced by the body weight, the frequency of repetition of the event, category of sport taken and the length of practice during training. Training itself increases the daily caloric need by 5-40% depending on the nature of the exercise and the length of practice. Women athletes require 10% fewer calories to cover the energy need for each type of sport or during training. As per the guidelines for Nutrition and Hydration for excellence in sports and Nutrition (2005), athletes especially females and participants in endurance and aesthetic sports are chronically energy deficient. This energy deficiency impairs performance growth and health. Reproductive disorders in female athletes are caused by the low energy availability perhaps specifically by low carbohydrate availability and lot by the stress of exercise. Focus should be given on wholesome unrefined complex carbohydrates in the menu planning for athletes as they are rich in fiber, vitamins, minerals, phytochemicals, have essential fatty acid, antioxidants and promote satiety. These disorders can be prevented by dietary supplementation in compensation for exercise energy expenditure.
The interviewees show preoccupation with self- care. However, as the own nomenclature indicates, to be effective it is indispensable the action of each individual, considering his health and well-being. The results of study made it clearer that primary healthcare services cannot handle such necessity in isolation, as it is something related to daily life, either to eat, take a bath, cut the nails, etc. Any of those situations can be rather complex for those who do not empower themselves, therefore the importance of autonomy for people with diabetes.
Objective: To characterize the profile of children with special health care needsand analyze their demands for care after discharge from a pediatric hospital in Rio de Janeiro. Method: this is a quantitative study, exploratory and descriptive. The sample consisted of 23 children who met the eligibility criteria of the study. Results: built the health profile of children who revealed that they suffer from repeated and lengthy hospitalizations, which added the severity of each situation interfere with their growth and development and can enhance your special needs. Conclusion: We found children dependent on medical, technological and other children with typical care demands of development and activities of daily living needs to be adapted. The implications for nursing care involving the reorganization of education in health for the families of these children through a care package home safely, effectively and conscientiously. Descriptors: Chile, Pediatric nursing, Health education.
Methods: The study design was qualitative. Nine EOD caregivers (7 women) were recruited at a service for Alzheimer’s disease and assessed using semi-structured interviews. Interpretative phenomenological analysis was used to analyze caregivers’ reports. Results: Five themes emerged from the narratives: psychological and emotional impact; physical impact; inancial and professional impact; social impact and need for support services. The majority of the caregivers of people with EOD perceived their emotional wellbeing as poor or extremely poor. Carers reported poor physical health, which tends to be longer-lasting than mental health problems. Two caregivers had to retire after the disclosure of the dementia diagnosis, and seven reduced their work loads because they had to look after PWD. Preserving the abilities of PWD is essential to maintain their self-esteem, dignity and sense of utility. For the caregivers, interventions and stimulating activities make PWD feel worthwhile and contribute to improving life.
It is now recognised that the volume of nocturnal urine produced is a critical aetiological factor in many individuals with nocturia. Global polyuria (GPu) is the overproduction of urine occurring over 24 hours (>2.8 litres of urine/24 hr or >40 ml/ kg). A common cause is diabetes mellitus, where high circulating glucose levels lead to an osmotic diuresis. In diabetes insipidus (DI) the kidneys are unable to suiciently concentrate the urine due to a lack of arginine vasopressin (AVP) (or anti-diuretic hormone) production in the posterior pituitary gland (cranial DI), or loss of renal sensitivity to the hormone (renal DI). Other causes include excessive drinking (either habitual or due to psychiatric causes) and an excessive intake of protein drinks, causing an osmotic diuresis.
1995). Further studies characterized flagellin and evaluated its protective activity by using a recombinant flagellin protein (KOJIMA et al., 1999; 2000). These authors reported poor protective immunity induced by the recombinant flagellin in mice, suggesting that a conformation-dependent epitope plays an important role in the development of immunity against blackleg. The poor protective activity of the recombinant flagellin protein observed previously (KOJIMA et al., 2000) can be attributed to the fact that these authors did not considered that there are a minimum of two copies of fliC gene on the chromosome of C. chauvoei (SASAKI et al., 2002). RYCHENER et al., (2017) found three copies of the allelic variants fliC1, fliC2, and fliC3 of flagellin in most strains studied, thus showing 91.8% amino acid identity with each other in a given strain and 82-96% identity between the paralogues of different strains. THOMAS and collaborators (2017) also revealed the presence of three fliC genes.
(1969) on the information requirements of engineering design are perhaps the only analyses of this sort where both tasks and information inputs are visible together. Some of the information inputs to research are shown in an appendix to Slater and Fisher (19). White (1973) and others list inputs to product development, but in both cases they are unrelated to a task analysis.
In a study of Information needs at a new levei, task analysis of basic research and the product development process are presented, with Information inputs indicated for the separate tasks. These are based on interviews with research and product development workers on how they put Information to use In their work. Information input analysis has managerial significance for Information systems. The inputs show where to look for the Information required in research and they can also be used to show a benefit from the expenditure on materials and people which is involved in an Information service.
Much qualitative research is still too generic. General studies of the ‘‘life experience’’ of key populations may have been useful and relevant 15 or 20 year ago. However, when studies exam- ining such experiences occur and are published in large volumes without any further attempts to discover nuances of either what is being experienced or the people involved, the research risks lacking focus and may miss vital areas where new knowledge is needed. For example, a series of qualitative systematic reviews (Clark, King-Shier, Duncan, et al., 2013; Clark, King-Shier, Spaling, et al., 2013; Clark et al., 2012) examined almost 100 qualitative studies over 30 years into patient decisions about participating in cardiac rehabilitation programs. For three decades, it has also been known from quantitative research that being female was associated with lower attendance. Yet, examining the 90þ qualitative studies into referral, attendance, and completion of these health ser- vices, only three studies actually examined the influence of sex or gender on participants’ accounts and only one of these studies had an adequate theorization of gender (Angus et al., 2015). How, despite decades of research showing sex-based inequalities in access to cardiac rehabilitation, did we end up doing so much undifferentiated qualitative work that ignored sex and gender?
Investments represent the build up through which the humanity reached the actual development stage, being also, the way through which it succeeded in accumulating the means for satisfying its necessities. In almost all the economic theories , investments appear as an integrant part of the development theory in which the investment policy determines the economic growth trend , and their structure , influence the reaching of different production ascendant trends in economic sectors , ultimately sustaining shifts in the economic structure of the system ; investments are being influenced by several growth and development hypostases.(Huru 2007 ) The paradigmatic analyze on investment quality in this sense would be useless , through the investment act , we can naturally create the premises for material and spiritual growth. But , the paradigmatic analyze in Kuhn’s view does not solve the problem , the Popper view ( Fuller 2003 ) , leads us to a critic of an implicit argument , leads us to a question : Can economic growth be a mean of destructing the development potential , through an inefficient distribution of resources to the present economic growth?
The main issue for Transport en OR, which is also valid for any industrial company, consists of optimizing the use of the trucks and of the human resources. This is even truer for this company since it is headquartered in an area which is remote from the large cities. In this area, it is the delivery of goods to big centers which causes troubles. Actually, there is a great amount of goods which comes from the big centers to this area such as groceries, clothes, materials, motor vehicles, etc., but very few products leave the area. As far as moving is concerned, one should have an excellent sense of logistics in order to arrange the appointments so as to limit the waste of time.
Parents reported that during the journey of educating a child with CP they often felt the need for more information about the clinical condition. All participants had premature children with CP and the diagnosis communication was reported as a relevant steppingstone to the task of parenting their child. Participants stressed that the birth of a premature child with a clinical diagnosis unleashes a mix of emotions, thoughts, and questions that were difficult to deal with. For example, surprise, doubts about the disability in itself, uncertainty about the prognostics, fear about the future, doubts about their ability to educate a child with a long term health condition and general questions about the process, such as “why did this has happened to my child?” (M1e0), “why this happened to us?” (L6l8). These questions have a different nature: those mostly about the reasons why their child had born with CP, and, the others about daily life management (e.g., what to do? how can we promote his/her autonomy? what to expect?). The latter increase the need for information to help parents cope with educating a child with CP. The need for information was referred by participants as something that is always present in their lives due to the fact that CP is a long-term health condition with a lifelong impact. “In the beginning, everything was scary, I didn't know what was going to happen, I didn’t understand anything, I didn’t know the purposes and how to use some medical devices […], but today we have more knowledge about the process, we feel a little less threatened [...]” (B1s6).
The study wants understand the extent REDD+ project (Reducing Emissions from Deforestation and Forest Degradation) implemented in the Brazilian Amazonia, started in 2013, can to reduce carbon emissions and provide social inclusion populations impacted. Carbontrack software was used to estimate the amount of carbon from data previously categorized in SIMAMAZONIA. Human dimensions were stipulated for ethnography, social context and application of subjective scale well-being. In the simulation of deforestation, potential changes are present in the central area, by the presence of farms and urban areas. In the scope of human dimensions, there has been an unbalance in the analysis of the processes of reducing social inequality. Key words: REDD+ Mechanism; Social inequality; Brazilian Amazonia
The data analyses were performed using SPSS software version 13, SPSS Inc., Chicago, IL, USA. Descriptive statistics including frequency, percentage, mean and median were used to analysis the demographic characteristics, cancer related information, and unmet supportive care needs of participant. Binary logistic regression (LR) was used for analysis of un-adjusted and adjusted Odds Ratios (ORs) for patients needsand analysis of study variables based on Backward LR procedure. According to backward strategy, at first, all of the independent variables imported in to the model, thus the less important variables considering correlation were removed until the criteria were met (considering P<0 .01).
encouraged to bring Patients’ Own Medications (PODs) into the hospital to be used throughout their stay and relabelled when necessary. Using PODs provides a reduction in medication wastage and expenditure. Furthermore, during the process of medication reconciliation at admission patients are asked about their supply at home and the information given are documented on the drug chart so medicines are not re-dispensed at discharge in case the patient has the adequate amount at home. Medicines prescribed during admission are supplied and labelled in a ‘ready for discharge’ format to facilitate the discharge process and to decrease delays in discharge. Nevertheless, the medicines that are expected to be discontinued (e.g. analgesics) on discharge or to suffer dose amendment (e.g. beta blockers and ACE inhibitors) are provided from the ward stock of previously defined commonly-used- medicines’ list in each clinical area. The stock list should include the names and forms of all medicines needed, and the minimum stock level that must be maintained. When a required medicine is not contained within the stock list and when the POD is not available or appropriate for use, it is ordered at the time it is needed. To support the administration process, all medicines used throughout admission including PODs are stored in a bedside locker, which must remain locked when not in use. These lockers help to eliminate the need for pushing a ‘medicines trolley’ around the ward.