Diss.--Zürich. / Includes bibliographical references.

Inaug.-Diss.--Münster. / Includes bibliographical references.

Bakgrund: Vid bedömning av sjuka barns allmäntillstånd visar tidigare forskning att enbart vitalparametrar, så som puls och andningsfrekvens, är en låg indikator för att upptäcka försämring. Pediatric Early Warning Score (PEWS) är en skala baserad på vitalparametrar tillsammans med fysiologiska faktorer, så som andningsmönster och kapillär återfyllnad, för att tidigt upptäcka försämring i det sjuka barnets allmäntillstånd. Syfte: Beskriva omvårdnadspersonals upplevelser av att använda PEWS som hjälpmedel i omvårdnaden av sjuka barn. Metod: En interventionsstudie med semistrukturerade fokusgruppsintervjuer som bearbetades genom en kvalitativ innehållsanalys med induktiv ansats. Resultat: Omvårdnadspersonalen upplevde PEWS som ett mångfacetterat hjälpmedel i bedömningen av det sjuka barnets allmäntillstånd. Det bidrog till kommunicerbarhet där kommunikationen blev förenklad, tydligare och fördjupad i teamarbetet. Det förändrade arbetssättet som uppstod, i och med implementeringen, ledde till viss osäkerhet då det var ett nytt verktyg att arbeta med. Samtidigt beskrev omvårdnadspersonalen en ökad noggrannhet i bedömningen och i förlängningen omvårdnaden av barnet. Omvårdnadspersonalen upplevde en säkerhet utifrån att objektiviteten ökade och struktur och stabilitet skapades i omvårdnaden. En trygghet uppstod då verktyget fungerade som en stöttepelare i bedömningen och i förlängningen omvårdnaden av barnen. Slutsats: Trots att omvårdnadspersonalen uttryckte en viss osäkerhet i det nya verktyget beskrev de en upplevelse av att PEWS gav dem ett förenklat och gemensamt språk, objektiva referensramar och strategier som skapar säkerhet i omvårdnadspersonalens dagliga arbete. / Background: In assessing general condition of sick children, previous research shows that only vital parameters, such as pulse and respiratory rate, are a low indicator of detecting deterioration. Pediatric Early Warning Score (PEWS) is a scale based on vital parameters along with physiological factors, such as breathing pattern and capillary refill, to detect early deterioration in the general condition of the sick child. Aim: Describe nursing staff experiences using PEWS as an assistance in nursing sick children. Method: An intervention study with semi-structured focus group interviews that were processed through qualitative content analysis with inductive approach. Result: It contributed to communicability where communication was simplified, clearer and deeper in team work. The change of work that occurred during the implementation led to some uncertainty as it was a new tool to work with. At the same time nursing staff described increased accuracy in the assessment and, in the long run, the nursing of the child. Care staff experienced a certainty from the fact that objectivity increased and structure and stability were created in the nursing. A security arose when the tool acts as a pillar in their assessment, and in the long run, in the nursing of the children. Conclusion: Although the nursing staff expressed some uncertainty in the new tool, they described an experience that PEWS gave the nursing staff a simplified and mutual language, objective references and strategies that create safety in the daily nursing.

Made available in DSpace on 2014-12-17T15:48:10Z (GMT). No. of bitstreams: 1 JoseSL_DISSERT.pdf: 4125269 bytes, checksum: 88052259a19538e206fc0b62be64f6cb (MD5) Previous issue date: 2014-02-28 / Universidade Federal do Rio Grande do Norte / Web services are software units that allow access to one or more resources, supporting the deployment of business processes in the Web. They use well-defined interfaces, using web standard protocols, making possible the communication between entities implemented on different platforms. Due to these features, Web services can be integrated as services compositions to form more robust loose coupling applications. Web services are subject to failures, unwanted situations that may compromise the business process partially or completely. Failures can occur both in the design of compositions as in the execution of compositions. As a result, it is essential to create mechanisms to make the implementation of service compositions more robust and to treat failures. Specifically, we propose the support for fault recovery in service compositions described in PEWS language and executed on PEWS-AM, an graph reduction machine. To support recovery failure on PEWS-AM, we extend the PEWS language specification and adapted the rules of translation and reduction of graphs for this machine. These contributions were made both in the model of abstract machine as at the implementation level / Servi?os Web s?o unidades de software que permitem o acesso a um ou mais recursos, dando suporte ? implanta??o de processos de neg?cios na Web. Eles permitem a intera??o atrav?s de interfaces bem-definidas, utilizando-se de protocolos padr?es da Web, tornando poss?vel a comunica??o entre entidades implementadas em diferentes tipos de plataformas. Em virtude dessas caracter?sticas, Servi?os Web podem ser integrados com o objetivo de formar aplica??es mais robustas, com baixo acoplamento entre servi?os, atrav?s de composi??es. Servi?os Web est?o sujeitos a falhas, situa??es indesejadas que podem comprometer o processo de neg?cio parcialmente ou mesmo totalmente. Falhas podem ocorrer tanto na concep??o de composi??es quanto na execu??o das mesmas. Em virtude disso, ? essencial a cria??o de mecanismos que tornem a execu??o das composi??es de servi?os mais robusta e tratem falhas. Especificamente, propomos o suporte ? recupera??o de falhas em composi??es de servi?os descritas na linguagem PEWS e executadas sobre PEWS-AM, uma implementa??o criada a partir da no??o de grafos. Para o suporte ? recupera??o de falhas em PEWS-AM, estendemos as especifica??es PEWS e adaptamos as regras de tradu??o e redu??o de grafos desta m?quina. Estas contribui??es foram realizadas tanto no modelo da m?quina abstrata quanto no n?vel da implementa??o

Made available in DSpace on 2015-03-03T15:47:47Z (GMT). No. of bitstreams: 1 HandersonBM_DISSERT.pdf: 2503077 bytes, checksum: f08293a045825a9e00bb41506f0ef6e5 (MD5) Previous issue date: 2013-07-17 / Web services are loosely coupled applications that use XML documents as a way of integrating distinct systems on the internet. Such documents are used by in standards such as SOAP, WSDL and UDDI which establish, respectively, integrated patterns for the representation of messages, description, and publication of services, thus facilitating the interoperability between heterogeneous systems. Often one single service does not meet the users needs, therefore new systems can be designed from the composition of two or more services. This which is the design goal behind the of the Service Oriented Architecture. Parallel to this scenario, we have the PEWS (Predicate Path-Expressions for Web Services) language, which speci es behavioural speci cations of composite web service interfaces.. The development of the PEWS language is divided into two parts: front-end and back-end. From a PEWS program, the front-end performs the lexical analysis, syntactic and semantic compositions and nally generate XML code. The function of the back-end is to execute the composition PEWS. This master's dissertation work aims to: (i) reformulate the proposed architecture for the runtime system of the language, (ii) Implement the back-end for PEWS by using .NET Framework tools to execute PEWS programs using the Windows Work ow Foundation / Servi?os web s?o aplica??es de baixo acoplamento que utilizam documentos XML como forma de integra??o de sistemas heterog?neos. Tais documentos s?o usados em especi fica??es como SOAP, WSDL e UDDI que estabelecem, respectivamente, padr?es integrados para a representa??o de mensagens, descri??o e publica??o de servi?os, facilitando assim, a interoperabilidade de sistemas heterog?neos. Muitas vezes um s? servi?o n?o atende ?s necessidades dos usu?rios, portanto, novos sistemas podem ser concebidos a partir da composi??o de dois ou mais servi?os, motivando o desenvolvimento da SOA - arquitetura orientada a servi?os.Paralelo a esse cen?rio, tem-se a linguagem PEWS (Predicate path-Expres-sions for Web Services), que especifi ca o comportamento de como opera??es de servi?os web s?o executadas em uma composi??o de servi?os. O desenvolvimento da linguagem PEWS ? dividido em duas partes: front-end e back-end. A partir de um programa PEWS, o front-end realiza a an?lise l?xica, sint?tica e sem?ntica das composi??es e por m gera c?digo XML. O backend tem como fun??o executar a composi??o PEWS. Este trabalho visa: (i) Implementar o back-end de PEWS mediante o uso de ferramentas do .Net Framework para executar programas PEWS usando a tecnologia Windows Work ow Foundation (ii) reformular a arquitetura proposta para o sistema de tempo de execu??o da linguagem.

Made available in DSpace on 2014-12-17T15:48:07Z (GMT). No. of bitstreams: 1 DanielASC_DISSERT.pdf: 2076393 bytes, checksum: fb34be082f79ab29b3f4ace6f22d195c (MD5) Previous issue date: 2013-01-31 / Universidade Federal do Rio Grande do Norte / Web services are software accessible via the Internet that provide functionality to be used by applications. Today, it is natural to reuse third-party services to compose new services. This process of composition can occur in two styles, called orchestration and choreography. A choreography represents a collaboration between services which know their partners in the composition, to achieve the service s desired functionality. On the other hand, an orchestration have a central process (the orchestrator) that coordinates all application operations. Our work is placed in this latter context, by proposing an abstract model for running service orchestrations. For this purpose, a graph reduction machine will be defined for the implementation of service orchestrations specified in a variant of the PEWS composition language. Moreover, a prototype of this machine (in Java) is built as a proof of concept / Servi?os web s?o software acess?veis atrav?s da Internet que disponibilizam funcionalidades a serem usadas por aplica??es. Hoje, ? natural reutilizar servi?os de terceiros para compor novos servi?os. Este processo de composi??o pode acontecer em dois estilos, denominados orquestra??o e coreografia. A coreografia representa uma colabora??o entre servi?os os quais conhecem a aplica??o ? qual pertencem e o momento exato para executarem. J? a orquestra??o possui um processo central, o orquestrador, que coordena todas as opera??es da aplica??o. ? neste contexto que este trabalho se encaixa, propondo um modelo abstrato para a execu??o de orquestra??es de servi?os. Com esta finalidade, ser? definida uma m?quina de redu??o de grafos para a implementa??o de orquestra??es de servi?os especificadas em uma variante da linguagem de composi??o PEWS. Ademais, um prot?tipo desta m?quina (em Java) ser? constru?do como prova de conceito

The nursing culture of an inpatient pediatric unit was resistant to activating pediatric rapid response team (PRRT) alerts despite guidelines for activation. Nurses routinely assessed patients and assigned a pediatric early warning score (PEWS); however, the level of illness severity was not interpreted consistently among nurses and a PEWS action algorithm did not exist to guide nurses' minimal actions based on the PEWS score. Guided by 3 adult learning theories (Knowles, Kolb, and Bandura) and 1 evaluation model (Kirkpatrick), this staff education project sought to educate pediatric nurses on a PEWS action algorithm and determine whether this project improved nurses' knowledge, situational awareness, and attitude toward activating PRRT alerts. A convenience sample of 30 pediatric nurses completed a preeducation knowledge survey (EKS), attended an interactive PEWS education class, and completed a postEKS. After participating in the class, correct responses on the EKS increased from 43% to 82% and, using the Wilcoxon-signed rank test, a significant increase was noted in nurses' responses to questions related to self-efficacy, factual knowledge, and application. The overall increase in the nurses' self-efficacy and knowledge about the PEWS might enhance critical-thinking skills, foster identification of patients at risk for clinical deterioration, and empower nurses to follow the PEWS action algorithm including activation of PRRT alerts when indicated. This project has the potential to effect positive social change by supporting nurses' actions designed to improve pediatric patient outcomes.