Thesis (Th. D.)--Vrije Universiteit, Amsterdam, 1955. / Bibliography: p. 259-270.

No description available.

Thesis (M.A.)--University of Delaware, 2009. / Principal faculty advisor: Brock W. Jobe, Winterthur Program in Early American Culture. Includes bibliographical references.

Introdução - As práticas obstétricas têm sido determinadas pela noção de risco, resultando em altas taxas de intervenções intraparto e de cesarianas no país. As indicações desta cirurgia não têm seguido um critério clínico-obstétrico fundamentado nos diferentes cenários de assistência, reduzindo o seu potencial protetor. Objetivos - Identificar e comparar as indicações de cesarianas intraparto em mulheres de baixo risco, a partir da assistência e das intercorrências que antecederam o nascimento, em dois modelos de assistência (Centro de Parto Normal e Centro Obstétrico); e caracterizar os locais de estudo quanto à equipe de saúde, às práticas protocolares e à estrutura física para assistência à mulher e ao bebê. Métodos - Estudo transversal, realizado por coleta de dados secundários, em dois hospitais públicos de São Paulo. Foram incluídas no estudo 158 parturientes de baixo risco submetidas à cesariana intraparto, em 2010. Para análise dos dados, estimou-se a Odds Ratio. Resultados - Os achados foram discutidos à luz da Medicina Baseada em Evidências. Os melhores resultados estiveram associados ao Hospital que dispõe de Centro de Parto Normal, com significância estatística na internação oportuna da parturiente, na presença de um acompanhante, no uso de partograma e nos métodos não farmacológicos para alívio das dores. Constataram-se alguns registros de práticas obstétricas realizadas de modo questionável em ambas as instituições, como uso de ocitocina e de amniotomia. Quanto às intercorrências, as mais frequentes foram: sofrimento fetal, presença de mecônio, distocia funcional e desproporção céfalo-pélvica, embora parte dessas indicações tenha divergido dos achados registrados no decorrer do trabalho de parto. Considerações finais: Fragilidades nas práticas obstétricas estiveram presentes em ambas as instituições, embora o Hospital com Centro de Parto Normal tenha demonstrado assistência menos restritiva e mais personalizada às mulheres. Evidenciou-se a presença de intervenções desnecessárias, com vistas à aceleração do trabalho de parto, o que demonstra resistência dos profissionais e das instituições às evidências científicas, bem como às recomendações e diretrizes do Ministério da Saúde e da Organização Mundial da Saúde / Background - The obstetrical practices have been determined by the notion of risk, resulting in high rates of intrapartum interventions and cesarean sections in the country. The recommendations of this surgery have not followed a wellfounded clinical and obstetric criterion in different assistance scenarios, reducing its protective potential. Objectives Identify and compare the recommendations for intrapartum caesarean sections in women with low-risk pregnancies from the assistance and the events that preceded the birth, in two models of care (Center for Childbirth and Obstetric Center); and characterize the study sites regarding the health team, protocol practices and the structure to assist the woman and the baby. Methods - A cross sectional study carried out by secondary data collection in two public hospitals in São Paulo. The study included 158 pregnant women with low-risk pregnancies, submitted to intrapartum cesarean section in 2010. For data analysis, we estimated the Odds Ratio. Results The findings were discussed from the Evidence-Based Medicine. The best results were associated with a hospital that has a Childbirth Center, with statistical significance in the timely admission of the mother, in the presence of a companion, the use of partogram and non-pharmacological methods for pain relief. There were records of obstetrical practices in a way questionable in both institutions, such as use of oxytocin and amniotomy. As for complications, the most frequent were: fetal distress, meconium, functional dystocia and cephalopelvic disproportion, although part of these records have diverged from findings reported in the course of labor. Conclusion: Weaknesses in obstetric practices were present in both institutions, although the Hospital Childbirth Center has demonstrated a more personalized and less restrictive care to women. It was noted the presence of unnecessary interventions, aiming at the acceleration of labor, which shows resistance of professionals and institutions to the evidence-based medicine, and also to the recommendations and guidelines of the Ministry of Health and World Health Organization

Bakgrund: Som sjukvården ser ut idag är det vanligt att patienter vårdas på flerbäddssal vilket kan upplevas olika av patienterna. Det kan uppstå situationer där det är svårt att bevara patienternas integritet och autonomi vid vård på flerbäddssal. Syfte: Syftet med denna studie är att studera patienters upplevelse av att vårdas på flerbäddssal. Metod: Litteraturstudie med kvalitativa artiklar från databaserna Pubmed och Cinahl. Resultat: En sammanställning av tolv artiklar gjordes. Fyra olika kategorier framkom; sömn, avskildhet, samvaro och välbefinnande. Patienter upplevde dels att de kunde bli störda av sina rumskamrater men vissa upplevde också en oro för att själva störa sina rumskamrater vilket påverkade patienternas sömnkvalitet. Gardinerna mellan sängarna på flerbäddssalen upplevdes ibland inte vara tillräckligt avskärmande eftersom rumskamraterna lätt överhörde privata konversationer. Något som uppskattades av patienterna var när sjuksköterskorna ansträngde sig för att bevara patienternas integritet, genom att exempelvis lägga över en extra filt för att minska kroppslig exponering. Patienterna kunde känna en gemenskap sinsemellan på flerbäddssalarna och kunde därmed finna tröst och trygghet i varandra. Slutsats: Att patienten får känna att hen har ett privat utrymme och möjlighet till avskildhet upplevdes vara mycket viktigt vid vård på flerbäddssal. Emellertid upplevdes flerbäddssalen som hemtrevlig av andra patienter som kände ett behov av ett socialt umgänge och det var ofta positivt att ha sällskap av en rumskamrat eftersom patienterna kände en gemenskap och därmed kunde finna tröst och trygghet hos varandra. Eftersom varje individ är unik och upplever situationer på olika sätt kan inte sjuksköterskan förutsätta att alla vill vårdas på samma sätt. En sjuksköterska bör vårda varje patient på ett individanpassat sätt där sjuksköterskan värnar om patientens integritet. / Background: As medical care looks today it is common for patients to be treated in a multi-bed room, which can be experienced differently by patients. There may be situations where it is difficult to preserve the patient's integrity and autonomy when being treated in a multi-bed room. Purpose: The purpose of this study was to study the patient's experience of being treated in a multi-bed room. Method: A literature study with qualitative articles from the databases Pubmed and Cinahl. Results: A compilation of twelve articles was made. Four different categories emerged; sleep, privacy, fellowship and well-being. These categories describe the patient's experience of care in a multi-bedroom. Some patients experienced that they could be disturbed by their roommates. However, some patients were anxious about interfering with their roommates themselves, which affected the patient's sleep quality. The curtains between the beds in the multi-bed room were sometimes not sufficiently shielded which lead to the roommates easily overheard private conversations. The patients appreciated when the nurses attempted to maintain patient integrity, for example by adding an extra blanket to reduce bodily exposure. Patients could feel a fellowship with each other in the multi-bed rooms, thus finding comfort and security in each other. Conclusion: The feeling of having a private space and the possibility of privacy was very important when getting care in a multi-bedroom. However, other patients felt that the multi-bedroom was homelike because they enjoyed the social interaction. Therefore, it was often positive to have a roommate. The patients felt a fellowship and thus found comfort and security with each other. Because everyone is unique, they experience situations differently and the nurse cannot assume that everyone wants to be cared for in the same way. A nurse should take care of each patient in an individualized manner where the nurse is responsible for the patient's integrity.

abstract: Surgery is one of the most important functions in a hospital with respect to operational cost, patient flow, and resource utilization. Planning and scheduling the Operating Room (OR) is important for hospitals to improve efficiency and achieve high quality of service. At the same time, it is a complex task due to the conflicting objectives and the uncertain nature of surgeries. In this dissertation, three different methodologies are developed to address OR planning and scheduling problem. First, a simulation-based framework is constructed to analyze the factors that affect the utilization of a catheterization lab and provide decision support for improving the efficiency of operations in a hospital with different priorities of patients. Both operational costs and patient satisfaction metrics are considered. Detailed parametric analysis is performed to provide generic recommendations. Overall it is found the 75th percentile of process duration is always on the efficient frontier and is a good compromise of both objectives. Next, the general OR planning and scheduling problem is formulated with a mixed integer program. The objectives include reducing staff overtime, OR idle time and patient waiting time, as well as satisfying surgeon preferences and regulating patient flow from OR to the Post Anesthesia Care Unit (PACU). Exact solutions are obtained using real data. Heuristics and a random keys genetic algorithm (RKGA) are used in the scheduling phase and compared with the optimal solutions. Interacting effects between planning and scheduling are also investigated. Lastly, a multi-objective simulation optimization approach is developed, which relaxes the deterministic assumption in the second study by integrating an optimization module of a RKGA implementation of the Non-dominated Sorting Genetic Algorithm II (NSGA-II) to search for Pareto optimal solutions, and a simulation module to evaluate the performance of a given schedule. It is experimentally shown to be an effective technique for finding Pareto optimal solutions. / Dissertation/Thesis / Ph.D. Industrial Engineering 2010

Submitted by Maria Creuza Silva (mariakreuza@yahoo.com.br) on 2014-01-30T19:38:56Z No. of bitstreams: 1 Matary Brito. Diss. MP. 2010.pdf: 949426 bytes, checksum: 6f11495889083fdc2769290e0343efea (MD5) / Approved for entry into archive by Maria Creuza Silva (mariakreuza@yahoo.com.br) on 2014-01-30T19:39:12Z (GMT) No. of bitstreams: 1 Matary Brito. Diss. MP. 2010.pdf: 949426 bytes, checksum: 6f11495889083fdc2769290e0343efea (MD5) / Made available in DSpace on 2014-01-30T19:39:12Z (GMT). No. of bitstreams: 1 Matary Brito. Diss. MP. 2010.pdf: 949426 bytes, checksum: 6f11495889083fdc2769290e0343efea (MD5) / A Secretaria de Saúde do Estado da Bahia (SESAB) visando, de um lado, a humanização e a melhoria do atendimento nas emergências de grandes hospitais da Rede Própria do Estado, e de outro, o estímulo à melhoria da formação dos profissionais da saúde, implanta o programa Permanecer SUS como uma estratégia da Política Estadual de Humanização. O Permanecer SUS traz no seu escopo a integração entre educação e trabalho numa proposta de inclusão social contribuindo, por um lado, para implantação/implementação do acolhimento mediante escuta qualificada e acionamento das redes interna e externa nas urgências/emergências e por outro lado, o estímulo da permanência na universidade de estudantes de medicina, enfermagem, psicologia e serviço social, em vulnerabilidade socioeconômica. Neste sentido, o objetivo do presente estudo é analisar a contribuição do Programa Permanecer-SUS, para a formação dos estudantes envolvidos na proposta. O lócus da pesquisa foi em uma Unidade de Urgência e Emergência de um dos maiores Hospitais Públicos do Estado da Bahia. Caracterizado como estudo de caso, utilizou como fontes primárias entrevistas semi-estruturadas (com os estudantes inseridos no Programa, coordenadores de cursos da área da saúde das universidades participantes e gestores da SESAB) e observação participante durante um período de três meses. Como fonte secundária realizou-se análise documental. Os resultados apontam os ganhos identificados pelos diversos atores para o processo da formação e identificam desafios a serem enfrentados no processo de implementação do Permanecer SUS Bahia.

Windows provide building occupants with important physiological and psychological benefits but are absent from many indoor spaces. It is argued that most existing attempts at compensating for an absence of windows fall short because they lack either outdoor environmental information or sensory stimulation. A wind-animated digital-tree shadow was used to test this hypothesis. The work concludes that the following strategies are likely to help most to compensate for an absence of windows: (1) establishing a live connection with the outdoors; (2) introducing controllable sensory variation into a space; (3) making such change a source of natural environmental information. It is suggested that these approaches could be helpful used either separately or in combinations but that a live connection with the outdoors that introduces controllable naturally-generated change into a space would likely be most effective. The video files that accompany this thesis show the digital shadow with wind and computer generated movement.

Thesis (MTech (Design))--Cape Peninsula University of Technology, 2015. / Whether one is fascinated by the night sky as a child, or as a professional astronomer looking back to the beginning of time solving life’s big questions; at some point in our lives we have curiously looked up at the heavens above. The desire to explore the universe has lead us to constructing larger and more advanced telescopes, with the sole focus of observing deeper into the cosmos in an attempt to unravel its secrets. Like with most other technological advances, it has created advanced and technically complex control rooms. Based on a design ethnographic study this thesis will focus on the exploration of the effects of complex interfaces of a control room environment and its users, where one of the leading twenty first century telescopes of its kind, Southern Africa Largest Telescope (SALT), is studied. While the STS framework and policy debates concerning the rapid development and integration of complex human and non-human systems into larger systems become common practice. The design ethnographic study revealed that the operation of the SALT telescope and the research being conducted by the astronomers is clearly hindered by poor control room design. The study identified relationships between the framework and the empirical findings, which was used to frame a design pilot study to determine if further design intervention would have a positive impact on the interaction of a control room system. This project will consist of: a literature review, an ethnographic study and the analysis of the findings, design framing of a pilot study, a design pilot study, and an evaluation of the study. The results from the design pilot study clearly show that the application of a design intervention to a control room environment could potentially impact the space positively and reduced frustration, improve comfort, increased efficiency in the users work practices, and ultimately amplified productivity. Providing an appropriate starting point for the exploration of possible solutions for identified challenges experienced in complex control room environments, more importantly it contributed to narrowing the socio-technical gap, between the mechanical and research departments of a leading international optical telescope, SALT.

A sala de recurso multifuncional (SRM) é o serviço designado para desenvolver o atendimento educacional especializado, com vistas a prover apoio em caráter complementar ou suplementar, no contraturno, aos alunos/as com deficiência, transtornos globais do desenvolvimento (TGD) e altas habilidades/superdotação (AH/SD), matriculados/as na classe comum. Utilizando-se de referenciais teóricos do currículo, que compreendem a escola como um espaço dotado de significados, que sofre influências sociais, culturais, políticas, ideológicas etc., em um processo dinâmico que perpassa prescrições ditadas pelo Estado, produções didáticas e as relações dos sujeitos (FORQUIN, 1993; LOPES, 2002; YOUNG, 2007; GIMENO SACRISTÁN, 2000) questiona-se: existem orientações curriculares previstas para o trabalho pedagógico nas SRM? Que interfaces existem entre o currículo da classe comum e o que é desenvolvido nas SRM? Quais conhecimentos são priorizados nessas salas? Desse modo, estabeleceu-se como objetivo de pesquisa investigar as orientações curriculares para o atendimento educacional especializado, nas SRM, a partir da análise da política de educação especial de um município paulista, a saber, a cidade de Franca/SP. Para tanto, a abordagem qualitativa foi a opção adotada, com o uso de um conjunto de técnicas: levantamento e análise documental (legislação nacional, referenciais curriculares nacionais e municipais, projetos políticos-pedagógicos e planos de aulas das SRM); entrevistas semiestruturadas com cinco professoras especializadas das SRM, de três escolas municipais; e observação in loco das práticas das mesmas profissionais, utilizando como forma de registro, caderno de campo. Dentre os resultados da pesquisa, identificou-se que Franca produziu, em 2008, um referencial curricular que contempla aspectos da educação desse alunado, subsidiado pelos Parâmetros Curriculares Nacionais Adaptações curriculares, estratégias para a educação do aluno com necessidades educacionais especiais (BRASIL, 1999), mas, pouco se faz uso do documento municipal nas práticas na SRM. Nesse serviço de educação especial, prevalecia o uso da Coleção A educação especial na perspectiva da inclusão escolar (BRASIL, 2010), que fundamentava um trabalho com materiais concretos e simbólicos e o aprendizado de linguagem, códigos e recursos tecnológicos para garantir a comunicação e o acesso ao currículo da classe comum. E, em meio às práticas que priorizavam atividades de leitura e escrita, poucos foram os registros e questionamentos sobre quais conteúdos deveriam ou não ser contemplados, em relação ao estabelecido no referencial municipal para a idade/série dos alunos, o que pode vir a justificar atividades de diferenciação e/ou minimização de conteúdos. / The multifunctional resource rooms (MMR) is the designated service for development the specialized education attendance to provide assistance in a complementary or supplementary nature, on double-shift, for students with disabilities, Pervasive Developmental Disorders (PDD) and High Abilities / Giftedness (HA/GD), enrolled in regular classes. Using theoretical curriculum referentials, which include the school as a space endowed with meaning, suffering cultural, social, political, ideological, methodological influences etc., in a dynamic process that runs through prescriptions dictated by the state, educational productions and relations of subjects (MOREIRA, 2011; YOUNG, 2007; LOPES, 2002; GIMENO SACRISTÁN, 2000; FORQUIN, 1993) is questioned: are there curriculum orientations to pedagogical work in MMR? Which are the interfaces between the curriculum of the regular class and the which is developed in MMR? Which knowledges are prioritized in this rooms? Thus, it was established as the objective of the research to investigate the curriculum guidelines for specialized educational services, in MRR, from the analysis of special education policy of São Paulo municipality, namely the city of Franca. To fulfill this goal, the qualitative approach was the adopted option, using a set of interpretative techniques: survey and document analysis (national legislation, national and local curriculum frameworks, political-pedagogical projects and MRR lesson plans); semi-structured interviews with five specialized teachers from MRR, of the three municipal schools; and on-site observation of the same professionals practices, using a field notebook as a way of recording. Among the research results, was identified that Franca produced, in 2008, a curriculum referential which contemplate aspects of education of students with disabilities, PDD and HA/GD subsidized by the \"National Curriculum Standards - curriculum adaptations, strategies for the education of students with special educational needs\" (BRAZIL, 1999), but, that municipal document is few used in practices in SRM. In that special education service, prevailed the use of the Collection \"Special education in the perspective of school inclusion\" (BRAZIL, 2010), which have underlain a work with concrete materials (games) and symbolic materials (jokes) and the language learning, codes learning and technological resources to ensure communication and access to the curriculum of the regular class. And, among the practices were prioritized reading and writing activities, there were few questions about \"what\" content should or should not be included, in relation to the established in municipal referential for the age / grade students, can justify activities with features of differentiation and / or minimization of content.