Magister Curationis - MCur / Background: Postpartum haemorrhage (PPH) is one of the most preventable causes of maternal death, yet it still ranks as one of the main conditions responsible for maternal mortality. PPH occurs at a stage when a mother is the least likely to receive care, and mothers often do not survive to be referred to a more specialised level of care. This is compounded by the patient not being able to warn healthcare providers timeously about their condition and healthcare providers lacking training resulting in a lack of accuracy in diagnosis, lack of resources, and differing methods of treatment. Due to the lack of consensus in available treatment options, and the paucity of research aimed at clinical interventions for midwives at the primary care level, this research report aimed to investigate the evidence in order to establish the best practices and evidence for clinical interventions to manage postpartum haemorrhage for midwives at the primary care level. This is to ensure that the continuing education for midwives in practice is based on evidence to keep their skill set current and expose practitioners to the latest evidence based care. Aim: To systematically review all available published evidence for the acute non-pharmaceutical, non-surgical, management of PPH for use by midwives at a primary maternity care setting.

A gestão da qualidade do ar é um desafio global, considerando que em muitos países, como no Brasil, a concentração da população em regiões metropolitanas é relevante, assim como sua exposição à poluentes atmosféricos. No estado de São Paulo, ao longo dos anos, as regulações que integraram a gestão da qualidade do ar têm incorporado novos instrumentos, exigências. Porém, identifica-se a ausência de procedimentos oficiais para auxiliar a concepção de políticas públicas. O objetivo deste trabalho foi de analisar metodologias existentes nos Estados Unidos da América e União Europeia, que possam auxiliar o planejamento de políticas públicas de qualidade do ar, em especial, para material particulado na Região Metropolitana de São Paulo (RMSP) e também de análises de viabilidade técnica e econômica de implantação de novas tecnologias, técnicas e práticas, do inglês Best Available Techniques (BAT)/ Best Environmental Practices (BEP). Por meio de pesquisa exploratória, utilizando-se de revisão bibliográfica e documental, este trabalho verificou a ausência sistemática de elementos como: análises de custo-efetividade de políticas públicas, consideração de modelagens integradas para concepção de políticas públicas, envolvimento de partes interessadas no planejamento de medidas. Quanto aos elementos para realizar análise de viabilidade técnica de implementação de BAT/BEP, foi possível identificar aspectos de avaliação de efeitos cruzados ambientais e econômicos, bancos de dados americanos e europeus contendo BAT/BEP e seus custos, que, com a devida adaptação, poderiam ser também uma referência. Trata-se de elementos importantes para subsidiar tomadas de decisão e buscar medidas, para que possam, de fato, levar à melhoria da qualidade do ar, para material particulado (MP10). / Air quality management is a global challenge, considering that in many countries, such as Brazil, the concentration of population in metropolitan regions is relevant and also their exposure to air pollutants. In the state of São Paulo, over the years, regulations that have integrated air quality management have incorporated new instruments, requirements. However, it is identified the absence of official procedures to assist the design of public policies. The objective of this work was to analyze existing methodologies in the United States and the European Union, which can assist in the planning of air quality public policies, especially for particulate matter in the Metropolitan Region of São Paulo (RMSP), as well as technical and economic feasibility analyzes for implementation of new technologies, techniques and practices from Best Available Techniques (BAT) / Best Environmental Practices (BEP). Through an exploratory research, using a bibliographical and documentary review, this work verified the systematic absence of elements such as: cost-effectiveness analysis of public policies, consideration of integrated modeling for public policy design, stakeholder involvement in planning of measures. As for the elements to perform technical feasibility analysis of BAT / BEP implementation, it was possible to identify aspects of environmental and economic cross-effects evaluation, American and European databases containing BAT / BEP and their costs, which, with due adaptation, could also be a reference. Those are important elements to support decision-making and seek measures, so that they can, in fact, lead to improved air quality for particulate matter (PM10).

This thesis aims to investigate and assess the future conditions for Volvo GTO Umeå after the installation of a new pre-treatment facility. The treatment method used is physical-chemical precipitation. Its function is to precipitate contaminants such as nickel, zinc and phosphorus, make them flocculate by adding a coagulant and separate the flocs by sedimentation. An investigation was carried out at the Volvo plant to locate the major inflow of waste water. These major inflows was analyzed and future scenarios was predicted by estimating a lower pre-treatment flow volume. The future scenarios showed that the volume and content will be greatly lowered. This will change many of the treatment plants performance factors, such as residence time, metal ion concentration and how much chemicals needed to treat the contaminants. Volvos physical-chemical precipitation plant was compared to the best available technique document drawn up in the framework of the implementation of the Industrial Emission Directive (2010/75/EU). The findings in the comparison showed that the Volvo plant works at a desirable degree and that the plant itself is considered best available technique when treating the current and future contaminants. Thus the physical-chemical precipitation technique can be used to treat the future waste water flows if the treatment plants performance factors are adjusted for.

A gestão por processos de negócio aumenta a qualidade de produtos e serviços e diminui o custo operacional nas organizações. Para realizar gestão por processos é necessário mapear estes processos em modelos de processo de negócio que precisam ter qualidade sintática, semântica e pragmática. A qualidade pragmática, em particular, garante que um modelo é compreensível. Os modelos são criados por analistas de processo, os quais reúnem informações que estão distribuídas pela organização e, a partir do conhecimento dos stakeholders do processo. Esta é uma tarefa complexa, que nem sempre resulta em modelos de processo com boa qualidade pragmática. Processos com baixa qualidade pragmática podem ser de difícil entendimento pelos stakeholders do processo. Para certificar a qualidade pragmática é necessário testar o entendimento do processo com novos usuários. Na maioria das vezes é difícil obter novos usuários para realizar testes. Este trabalho propõe uma abordagem que tem como base uma ontologia para representar modelos de processo e boas práticas de modelagem para auxiliar na identificação de modelos com baixa qualidade pragmática. A abordagem desenvolvida inclui o desenvolvimento de um plug-in para o editor de ontologia Protégé, que a partir de indicadores propostos na literatura automatiza a identificação de problemas na qualidade pragmática da modelagem de processos de negócio. Esta ferramenta pode ser utilizada no contexto acadêmico em cursos de modelagem de processos de negócio, auxiliando alunos no entendimento de boas práticas de modelagem, e no contexto empresarial, para revisar grandes repositórios de processos e selecionar os modelos que possam ter problemas na qualidade pragmática. / Business Process Management (BPM) increases the products and services quality and decreases operational costs in organizations. BPM requires the mapping of such process models that must present synthetic quality, semantic quality and pragmatic quality. Pragmatic quality, in particular, ensures understandability of the model. Models are designed by process analysts, gathering information spread at the organization and the knowledge of stakeholders. The design task is complex and some times does not result in process models with high pragmatic quality. Process model with low pragmatic quality may be difficult to understand by process stakeholders. Pragmatics quality certication tests the understanding of the process with new users. Most of the time it is hard to get new users to run tests. This work proposes an approach based on an ontology to represent process models and modeling practices to identify models with low pragmatic quality. The proposed approach is based on the development of a plug-in for Protégé ontology editor, and uses metrics from the literature to identify pragmatic quality problems in process models. This tool can be aplied in academic context so that students can better understant best practices in business process modeling, and also at business context, to review large process repositories selecting models which may have pragmatic quality problems.

This thesis aims to illuminate how paediatricians in the United Kingdom (UK) make difficult medical decisions when treating severely disabled children with complex health conditions. In particular, it examines the part played, if any, by law, rights, and ethics in those decisions. After drawing on jurisprudence of the English and European Human Rights Court, together with existing scholarship, to analyse the doctors' decision making, this thesis adopts a legal consciousness theoretical approach. Using this it looks at how the paediatricians make sense of and conceptualise law when making these decisions. It examines how decisions are, by the paediatricians' own accounts, commonly made at present and what the paediatricians say about how they and their colleagues make such decisions. This thesis addresses the following research questions: i) Which decisions do UK paediatricians find particularly difficult when working with disabled children and what makes those decisions particularly difficult? ii) What factors do UK paediatricians take into consideration when making difficult decisions for disabled children and what weight do they put on those factors? iii) What formal education in law, rights, and ethics have the doctors received and to what extent, if any, can we discern how this education impacts on their difficult decisions for disabled children? iv) How do UK paediatricians construct and understand the law, rights, and ethics when making their difficult decisions? This thesis makes an original contribution, being the first in-depth socio-legal study examining UK paediatricians' medical decision-making for severely disabled children, by identifying two distinct styles paediatricians adopt when approaching best interest decisions, and by recommending a new category of legal consciousness. It concludes by recommending research and changes both in doctors' training and approach to best interest decision-making to address the current challenges paediatricians describe facing when deciding for severely disabled children.

Excerpt: On July 21, 1956, Pasadena, California-based scholar Joseph Sargent Hall visited the Williams house in Haywood County, North Carolina’s Upper White Oak community, located just outside the Great Smoky Mountains National Park boundary, to make some documentary field recordings of local music.

Excerpt: In an interview published in the February 1992 issue of The Banjo Newsletter and conducted by bluegrass historian Neil Rosenberg and banjo player and instruction book author Tony Trischka, Carroll Best conveyed the depth of his connections to the instrument he had mastered: “When I was old enough to pick up a banjo I wanted to play.”

No description available.

In this dissertation I consider the problem of external world skepticism and attempts at providing an argument to the best explanation against it. In chapter one I consider several different ways of formulating the crucial skeptical argument, settling on an argument that centers on the question of whether we're justified in believing propositions about the external world. I then consider and reject several options for getting around this issue which I take to be inadequate. I finally conclude that the best option available to us at the moment is to argue that the antiskeptical view is the best explanation of our ordinary experiences In chapter two I argue that, if we hope to ground what counts as defending antiskepticism in common sense, there is an argument against the possibility of ever knowing one has succeeded in defending antiskepticism. After showing that common sense is no place to look in setting a goal for our antiskeptical project, I present the view that what will be crucial to settling on our antiskeptical goal is coming to a successful analysis of the nature of physical objects. I suggest some minimal criteria that must be met by a view in order to be antiskeptical based on our intuitions about core skeptical cases, but acknowledge that a fully successful response to external world skepticism will require the antiskeptic to engage in some much more difficult analysis. In chapter three I consider various views of the nature of explanation and conclude, tentatively, that explanation as it interests the antiskeptic is fundamentally causal. In chapter four I consider and reject some of the core views on which best explanation facts are so fundamental that a project of attempting to vindicate probabilistically the virtues which make explanations epistemically good. In this chapter I show that views which analyze justification in terms of best explanation factors fail. In chapter five I attempt to vindicate the various explanatory virtues probabilistically. In doing so I attempt to express or translate the various explanatory virtues in terms of probabilities in order to show that having those virtues makes a view at least prima facie more probable. In chapters six and seven I explain and evaluate the various arguments to the best explanation against skepticism present in current philosophical literature. I attempt to show that extant arguments fail to appreciate the virtues possessed by classical (and some new) skeptical scenarios. In chapter eight I briefly consider some options that may be open to the antiskeptic moving forward. All routes forward contain considerable obstacles, but there are some fruitful areas of research to pursue.

Ingeniero Civil Industrial / Seguros Falabella es una Corredora de Seguros Grandes Tiendas perteneciente al grupo Falabella. Tiene participación en algunos países de Latinoamérica, en particular en Chile, donde se realiza este trabajo de memoria. El objetivo general de esta memoria consiste en diseñar un modelo predictivo basado en las características individuales de los clientes, que entregue la propensión de compra para los seis productos principales de la compañía, con el fin de incrementar el stock de estas pólizas. Se realizan modelos de propensión para todos los ramos principales de seguros, correspondientes a automotrices, vida, vida con bonificación, salud, hogar y transaccionales. En particular se utilizan dos metodologías distintas de clasificación binaria: Árbol de Decisión y Logit Binario. Dada la naturaleza de los datos y la diferencia de información para los clientes con y sin la tarjeta de crédito del holding, es necesario calcular modelos independientes para ambos tipos de clientes. Así, se generan 12 modelos distintos tanto para Árbol de Decisión como también para Logit Binario. La empresa cuenta con un total de 3 millones de registros de clientes entre los periodos 2015 y 2016. Debido a la metodología elegida, sólo se utiliza un 40% de la base resultante para obtener resultados consistentes y en un tiempo de ejecución razonable. En base a los resultados, se elige el método Logit Binario puesto que tuvo un mejor desempeño en las métricas más significativas para el negocio. Éste, en promedio, logró recuperar un 60% de las ventas generadas con sólo un 20% de la base de datos, en comparación con el 53,3% del árbol de decisión. Para elegir el producto más adecuado para cada cliente, se propone un modelo de Next Best Offer . Se realiza una simulación de esta metodología versus la actual, obteniendo un beneficio estimado 11% mayor y un aumento de 22% en pólizas vendidas. Para validar este método, se plantean dos experimentos de igualdad de proporciones. El primero busca comprobar que la elección mayor decil de propensión genera más ventas cuando existe un único máximo decil. El segundo busca verificar que la ponderación por el beneficio de la compañía genera más ventas cuando existe más de un producto que compartan el máximo decil. Finalmente, para estudios futuros, se propone la realización de un modelo que determine, para cada cliente, el canal más propenso para la contratación de un producto. Además, se plantea una idea de mejora del método Next Best Offer mediante la optimización según una ponderación tanto del decil de propensión como también del beneficio esperado para la compañía. / 13/11/2022