Adolescent (14-17 year-olds) and young adult (18-20 year-olds) women account for a disproportionate 20% of the total number of unintended pregnancies that occur among women of all reproductive ages (14-55 year-olds) each year in the US. Nearly half (41%) of all unintended pregnancies result from the 18% of women who report inconsistent, incorrect, or no use of their contraceptive method. Evidence shows that a large proportion of these young women, especially those who are sexually active, come to the emergency department for their core sexual and reproductive health care needs. By obtaining a better understanding of the sexual and reproductive health needs and preferences of an urban population that is disproportionately low income and ethnically and racially diverse, our hope is to maximize adolescent and young adult accessibility to contraceptive services most feasible in the PED environment such as Nexplanon, in addition to the provision of comprehensive contraceptive counseling and education. OBJECTIVES: The first objective of this subgroup analysis is to determine the percentage of adolescent and young adult females presenting to an urban PED who are familiar with Nexplanon and to describe the demographic, sexual health, and contraceptive use characteristics of these young women. The second main objective of our study is to evaluate the sources of Nexplanon-related information reported by respondents familiar with Nexplanon. In addition to the main objectives, we also determine participant willingness to initiate or switch to Nexplanon® and receptivity to learning about contraceptive methods during a related or nonrelated visit to the PED. METHODS: This is a cross-sectional descriptive study using a paper-based anonymous questionnaire distributed to female patients, ages 16-21 years, presenting to a Boston urban pediatric emergency department (PED). This is a sub-group analysis of a larger study aimed at describing the contraceptive use history of young women who present to the PED. To identify if any statistically significant categorical variables existed between the two assigned groups, univariate analysis was performed using Chi-squared tests. Odds ratios with 95% confidence intervals (CIs) were obtained for the relationship between participants who have heard of Nexplanon and the three statistically significant variables: history of STDs, gravidity, and prior sexual intercourse with a male. Mean and Standard Deviation were used to describe the one continuous variable, age, followed by univariate analysis using independent t-test. Statistical significance was indicated using p-values for the categorical variables and odds ratio with 95% CI for the continuous variable—age. RESULTS: Of the 366 adolescent and young adult females included in our subgroup analysis, 230 (62.8%) indicated they were familiar with Nexplanon. We found that female participants familiar with Nexplanon were 1.3 times more likely to have had a prior STI, twice as likely to have had one or more previous pregnancies, and 3.5 times more likely to have previously engaged in sexual intercourse with a male compared to those female participants unfamiliar with Nexplanon. We also found that most (42.2%) female participants familiar with Nexplanon obtained their contraceptive information from their family and friends only, while about a third obtained their contraceptive information from medical professionals only. Among our total population of respondents, 6% (22/366) of our sub-group participants identified the contraceptive implant as their current method of contraception. Lastly, approximately 21% of female participants familiar with Nexplanon indicated current use of a long-acting reversible contraceptive method at the time of the survey. CONCLUSION: Overall, our study findings are supportive of and consistent with the provision and education of Nexplanon in the PED. This would be a crucial opportunity to provide comprehensive contraceptive counseling and convenient access to the most effective method of contraception among a population that disproportionately affected by unintended pregnancy. This can be made possible by enabling PED health care providers with the proper access to and training in Nexplanon. By adapting these patient-centered practices and techniques, the PED setting can contribute to the notable reduction in teen pregnancy seen in a variety of similar clinic-based interventions. The PED atmosphere has enormous potential to serve young women as an additional venue for contraception education and access.

Fundação Carlos Chagas Filho de Amparo a Pesquisa do Estado do Rio de Janeiro / Esta dissertação é parte integrante da linha de pesquisa Currículo: sujeitos, conhecimentos e cultura e do grupo de pesquisa Currículo, cultura e diferença coordenado pela professora doutora Elizabeth Fernandes de Macedo. Em minha pesquisa, investiguei os currículos destinados às Salas de Leitura, espaços destinados à promoção de leitura existentes nas escolas regulares do Município do Rio de Janeiro desde 1985. A partir de análise de documentos curriculares que orientam este programa e do contato com professores que lá atuam ou atuaram, a presente pesquisa visou buscar uma melhor compreensão do que é hoje o programa Sala de Leitura. Para tanto, busquei retratar como estas Salas de Leitura nasceram nos Centro Integrados de Educação Pública (CIEP), como se expandiu a toda Rede Municipal de Ensino e como se apresentam no Núcleo Curricular Básico Multieducação (proposta curricular que esteve vigente na Rede Municipal de Ensino do Rio de Janeiro de 1996 a 2009). Para então entender e retratar os movimentos de sua construção, a pesquisa foi organizada com base na análise documental das resoluções e portarias que a Sala de Leitura recebeu ao longo de sua história. Neste sentido, voltei minha atenção para algumas das mudanças pelas quais as Salas de Leitura passaram, buscando a partir dos documentos citados, investigar tais modificações a fim de evidenciar as articulações políticas que a constituíram e como tais modificações mexeram e mexem nas atuações docentes que modelam estes mesmos espaços. A partir do que foi pesquisado, busquei então enunciar a produção e vivência dos currículos da Sala de Leitura. Embasada em discussões pós-estruturais do campo do currículo, interpretei e analisei tais currículos enquanto criações e enunciações contínuas de sentidos. Com esta perspectiva, operei com a idéia de um currículo que se constitui continuamente, o que possibilitou a problematização acerca da tão cara dicotomia currículo vivido e escrito, que embora pareça uma distinção superada, esta se fez presente nos cotidianos escolares com os quais tive contato durante a pesquisa de campo. Após a discussão teórica e análise dos currículos que norteiam o funcionamento da Sala de Leitura, optei por entrevistar atores envolvidos com tal espaço a fim de entender suas leituras a cerca dos movimentos vivenciados em sua constituição. Neste sentido, realizei observação em uma Sala de Leitura por quase dois anos, com o intuito de estar presente em tal universo. Em meio a tantas vivências e experiências que modificaram e nortearam a escrita desta dissertação, trago por fim os dados da empiria que sustentam minhas análises e que evidenciam que os docentes da Sala de Leitura, ainda que não reconheçam, produzem currículos outros para além dos currículos prontos que chegam às suas salas de aula. / This work is part of the research "Curriculum: subject, knowledge and culture" and the research group "Curriculum, culture and difference," coordinated by Professor Dr. Elizabeth Fernandes de Macedo. In my research, I investigated the curricula for the Reading Rooms, spaces for the promotion of reading existing mainstream schools in the city of Rio de Janeiro since 1985. From analysis of curriculum documents that guide this program and contact with teachers who work or worked there, this research aimed to seek a better understanding of what is today the program 'Reading Room'. To do so, sought to portray as they were born in Reading Rooms Integrated Center of Public Education (CIEP), as expanded to all municipal schools and how to present the Basic Curricular Nucleus Multieducation (curriculum that was in effect at the Municipal School of Rio de Janeiro from 1996 to 2009). To understand and then portray the movements of its construction, the research was organized on the basis of documentary analysis of the resolutions and ordinances that Reading Room has received throughout its history. In this sense, I turned my attention to some of the changes by which the Reading Rooms now, looking from the documents cited, to investigate such changes in order to highlight the political alliances that formed and how these changes stirred and stir in the proceedings that shape teachers these same spaces. From what has been searched, then sought state the production and experience of the curriculum in the Reading Room. Based on post-structural discussions of the curriculum field, interpreted and analyzed creations such as curricula and continuous utterances senses. With this perspective, operated on with the idea of a curriculum that is continuously, which allowed the questioning regarding the dichotomy so expensive curriculum "experienced" and "writing", although it seems that a distinction overcome, this was present in everyday school with who had contact during the field survey. After the theoretical discussion and analysis of the curricula that guide the operation of the Reading Room, I chose to interview people involved with this space in order to understand their readings about the movements experienced in its constitution. In this sense, I made a note in the Reading Room for almost two years, in order to be present in this universe. Amidst all these experiences and experiences that changed and guided the writing of this dissertation, and finally bring the empirical data that support my analyzes and show that teachers in the Reading Room, although it does not recognize, others produce curricula beyond the curriculum "ready" to come to their classrooms.

In the context of urban buildings, architectural floor plans describe a building's structure and spatial distribution. These digital documents are usually shared in file formats that discard the semantic information related to walls and rooms. This work proposes a new method to recover the structural information by extracting walls and detecting rooms in 2D floor plan images, aimed at multi-unit floor plans which present challenges of higher complexity than previous works. Our proposed approach is able to handle overlapped floor plan elements, notation variations and defects in the input image, and its speed makes it suitable for real applications on both desktop and mobile devices. We evaluate our methods in terms of precision and recall against our own annotated dataset of multi-unit floor plans. / Graduate

abstract: The physical environment influences the physiology, psychology, and the societal interactions of those who experience it. The environment can also influence human behavior. Critical care nurses are in constant interaction with the physical environment surrounding their patients. High acuity ICU patients are vulnerable and at risk for harm, infection, and poor outcomes while the physical and cognitive workload of nurses presents a demanding and continuous challenge. The goal of this qualitative study was to explore and understand the way critical care nurses navigate within the patient room and interact with its features. The study of critical care nurses interacting with the patient room environment was conducted in five critical care units at three tertiary care institutions in the Eastern United States, along with another unit in the pilot study at a community hospital in the Southwest United States. Nurses were observed in their typical work environment as they performed normal tasks and patient care activities for entire day and night shifts. The study involved ethnographic field observations, individual semi-structured participant interviews, and examination of photographs and floor plans. The exploratory study resulted in a comprehensive model for nurse navigation that includes both cognitive and action components, along with a conceptual framework for nurse behavioral activity. Repetitive patterns of nurse movement were identified and named. The findings produced recommendations for nurses’ effective use of space and architectural design of ICU patient rooms to improve patient outcomes. / Dissertation/Thesis / Doctoral Dissertation Nursing and Healthcare Innovation 2017

Fundação Carlos Chagas Filho de Amparo a Pesquisa do Estado do Rio de Janeiro / Esta dissertação é parte integrante da linha de pesquisa Currículo: sujeitos, conhecimentos e cultura e do grupo de pesquisa Currículo, cultura e diferença coordenado pela professora doutora Elizabeth Fernandes de Macedo. Em minha pesquisa, investiguei os currículos destinados às Salas de Leitura, espaços destinados à promoção de leitura existentes nas escolas regulares do Município do Rio de Janeiro desde 1985. A partir de análise de documentos curriculares que orientam este programa e do contato com professores que lá atuam ou atuaram, a presente pesquisa visou buscar uma melhor compreensão do que é hoje o programa Sala de Leitura. Para tanto, busquei retratar como estas Salas de Leitura nasceram nos Centro Integrados de Educação Pública (CIEP), como se expandiu a toda Rede Municipal de Ensino e como se apresentam no Núcleo Curricular Básico Multieducação (proposta curricular que esteve vigente na Rede Municipal de Ensino do Rio de Janeiro de 1996 a 2009). Para então entender e retratar os movimentos de sua construção, a pesquisa foi organizada com base na análise documental das resoluções e portarias que a Sala de Leitura recebeu ao longo de sua história. Neste sentido, voltei minha atenção para algumas das mudanças pelas quais as Salas de Leitura passaram, buscando a partir dos documentos citados, investigar tais modificações a fim de evidenciar as articulações políticas que a constituíram e como tais modificações mexeram e mexem nas atuações docentes que modelam estes mesmos espaços. A partir do que foi pesquisado, busquei então enunciar a produção e vivência dos currículos da Sala de Leitura. Embasada em discussões pós-estruturais do campo do currículo, interpretei e analisei tais currículos enquanto criações e enunciações contínuas de sentidos. Com esta perspectiva, operei com a idéia de um currículo que se constitui continuamente, o que possibilitou a problematização acerca da tão cara dicotomia currículo vivido e escrito, que embora pareça uma distinção superada, esta se fez presente nos cotidianos escolares com os quais tive contato durante a pesquisa de campo. Após a discussão teórica e análise dos currículos que norteiam o funcionamento da Sala de Leitura, optei por entrevistar atores envolvidos com tal espaço a fim de entender suas leituras a cerca dos movimentos vivenciados em sua constituição. Neste sentido, realizei observação em uma Sala de Leitura por quase dois anos, com o intuito de estar presente em tal universo. Em meio a tantas vivências e experiências que modificaram e nortearam a escrita desta dissertação, trago por fim os dados da empiria que sustentam minhas análises e que evidenciam que os docentes da Sala de Leitura, ainda que não reconheçam, produzem currículos outros para além dos currículos prontos que chegam às suas salas de aula. / This work is part of the research "Curriculum: subject, knowledge and culture" and the research group "Curriculum, culture and difference," coordinated by Professor Dr. Elizabeth Fernandes de Macedo. In my research, I investigated the curricula for the Reading Rooms, spaces for the promotion of reading existing mainstream schools in the city of Rio de Janeiro since 1985. From analysis of curriculum documents that guide this program and contact with teachers who work or worked there, this research aimed to seek a better understanding of what is today the program 'Reading Room'. To do so, sought to portray as they were born in Reading Rooms Integrated Center of Public Education (CIEP), as expanded to all municipal schools and how to present the Basic Curricular Nucleus Multieducation (curriculum that was in effect at the Municipal School of Rio de Janeiro from 1996 to 2009). To understand and then portray the movements of its construction, the research was organized on the basis of documentary analysis of the resolutions and ordinances that Reading Room has received throughout its history. In this sense, I turned my attention to some of the changes by which the Reading Rooms now, looking from the documents cited, to investigate such changes in order to highlight the political alliances that formed and how these changes stirred and stir in the proceedings that shape teachers these same spaces. From what has been searched, then sought state the production and experience of the curriculum in the Reading Room. Based on post-structural discussions of the curriculum field, interpreted and analyzed creations such as curricula and continuous utterances senses. With this perspective, operated on with the idea of a curriculum that is continuously, which allowed the questioning regarding the dichotomy so expensive curriculum "experienced" and "writing", although it seems that a distinction overcome, this was present in everyday school with who had contact during the field survey. After the theoretical discussion and analysis of the curricula that guide the operation of the Reading Room, I chose to interview people involved with this space in order to understand their readings about the movements experienced in its constitution. In this sense, I made a note in the Reading Room for almost two years, in order to be present in this universe. Amidst all these experiences and experiences that changed and guided the writing of this dissertation, and finally bring the empirical data that support my analyzes and show that teachers in the Reading Room, although it does not recognize, others produce curricula beyond the curriculum "ready" to come to their classrooms.

Multi-touch technology and digital tabletops have been used in different fields. They provide a natural way of interaction with computers through gestures. In this report, we present a digital desk for power plant control rooms aimed at visualizing the power grid status. The thesis reports about the development of this desk that comprised field studies, use cases and requirements identification, low fidelity prototyping, and software development. A final evaluation of the design indicated that digital tabletops can be valuable for control room operators since they can enhance learning and communication among the collaborating operators. The work was done at ABB Corporate Research in Sweden.

No description available.

Operating room nursing skills are some of the most demanding skills in the nursing profession. At the moment nurses trained in operating room technique are in very short supply in Ethiopia, due to the exodus of nurses to better working environments with more reasonable payment. This is especially noticeable in one of the state hospitals in Addis Ababa, Ethiopia, as emerged in conversations with the head nurse of the operating room in this hospital about the high turnover rate, as well as the high absenteeism rate amongst the nurses working in the operating room. Nurses working in the operating room also expressed unhappiness in their work environment which could cause them to look for other jobs or to be absent from duty. The nurses were facing numerous problems in their work environment such as work overload due to staff shortage, stress due to shortage of supplies because they are not able to do their job as much as the need requires. The researcher identified the need to explore the challenges that the operating room nurses are experiencing in their work environment. The researcher used the following questions to meet the research objectives: What are the experiences of the operating room nurses in their work environment?; What potential assistance would such nurses need to better cope with the problems they experience in their work environment? The research study aimed to explore and describe the experience of operating room nurses in their work environment and on the basis of the findings to develop guidelines to assist the operating room nurses in coping more effectively with their work environment. The researcher used a qualitative approach with an explorative, descriptive and contextual design. Fifteen registered nurses were selected using purposive sampling. Informed consent was obtained from the participants and permission from the Ethics Committee of the Nelson Mandela Metropolitan University, as well as Yekatit 12 Hospital. Data were gathered using face to face interviews and field notes were taken to determine the experiences of the participants. Data were analyzed using Tesch's method of descriptive data analysis (in Creswell, 2003:13). Two main themes with two sub-themes related to the experience of the registered nurses working in the operating room of the state hospital were identified. Main theme one focused on the non-conducive work environment and it focused on the lack of support from management and the problems experienced in the environment. It was found that OR nurses had good working relationships among the nursing staff. Main theme two focused on the limited training opportunities in OR techniques. The sub-themes described the limited exposure to new technology and the quality of nursing education which the participants felt was not taken seriously in Ethiopia. Based on the identified themes guidelines were formulated to assist the registered nurses working in the operating room of a state hospital in Ethiopia. Utilization of these guidelines should assist the registered nurses to cope more effectively with their work environment. Recommendation were made, further research and limitations identified.

ABSTRACTStudying patients' reduced autonomy in acute care is complicated. There are few studies describing the patient's perspective in acute intubations. This was a quantitative literature study, where the primary purpose was to examine if there were evidence based plans of action to improve patient safety with intubations at the emergency room. The main question was if an empathetic approach was included. The theoretical framework is based on Jean Watson and her philosophy of care and basic human needs, in this study concentrating on breathing. The method used was literature searches in the database PubMed/Medline and Cinahl, main search words were patient safety, intubation, checklists complications and nursing. Criteria for inclusion in this study: adult patients in need of acute intubation related to respiratory failure caused by various causes. Children under the age of 18 and intubations that were performed pre-hospital were excluded. 14 studies were included, four randomized intervention studies, five intervention studies without randomization and five observational studies. All studies were rated reasonably strong to very strong on the GRADE review template. The main group of results centered around patient safety that generated three subcategories in the form of checklists, preventive measures and structured work methods. No studies described guidelines that included empathetic approach.The literature identified 7 common factors for increasing patient security during intubation: teamwork, communication, simulation training, body position, pre-oxygenating, medication and experience/technique. Secondarily, results showed that checklists were good for patient security, when combined with a structured way of working.Conclusion: Guidelines were available concerning complications in emergency intubations and patient safety may increase if checklist is used. However, the literature study shows that the checklists lacked an empathetic approach in emergency situations with acute intubation. The literature study may be important as a basis for further research but another study design is proposed / SAMMANFATTNING Studera patienters nedsatta autonomi vid akuta omhändertaganden är komplicerat. Det finns få studier som beskriver patientens perspektiv vid akuta intubationer. Forskningsdesignen var en kvantitativ litteraturstudie, där det primära syftet var att undersöka om det fanns evidensbaserade riktlinjer för att förbättra patientsäkerheten vid akuta intubationer på akutrummet. Den viktigaste frågeställningen var om empatiskt förhållningssätt fanns inkluderat i riktlinjer. Det teoretiska ramverket knöts till Jean Watson och hennes filosofi kring omvårdnad och fundamentala mänskliga behov, i detta arbete ligger tyngdpunkten på andningen. Metoden var litteratursökning i databaserna PubMed/Medline och Cinahl, huvudsökorden var patient safety, intubation, checklist, complications och nursing. Inklusionkriterier var vuxna patienter i behov av akut intubation relaterat till respiratorisk svikt av olika orsaker. Barn under 18 år och prehospitala intubationer exkluderades. Totalt inkluderades 14 studier, varav fyra randomiserade interventionsstudier, fem interventionsstudier utan randomisering samt fem observationsstudier. Samtliga studier bedömdes ha måttligt starkt till starkt vetenskapligt underlag enligt GRADE granskningsmall. Resultatet visade en huvudgrupp med patientsäkerhet som genererade tre undergrupper i form av checklista, förebyggande metoder och strukturerat arbetsätt. Inga studier beskrev riktlinjer som inkluderade empatiskt förhållningssätt. I litteraturstudien identifierades sju gemensamma faktorer för att öka patientsäkerheten vid akuta intubationer; teamwork, kommunikation, simuleringsövningar, kroppsposition, preoxygenerering, läkemedel och erfarenhet/teknik. Sekundärt visade resultatet att checklistor var bra för patientsäkerheten, men att dessa bör kombineras med ett strukturerat arbetsätt. Slutsats: Riktlinjer finns gällande komplikationer vid akuta intuberingar och patientsäkerheten verkar kunna öka om checklista används. Litteraturstudien visar dock att checklistorna saknade ett empatiskt förhållningssätt i vårdsituationer med akut intubering. Litteraturstudien kan få betydelse som grund för vidare forskning men en annan studiedesign föreslås.

The aim of this master's thesis is to draw up a business plan for founding a small tea room and review its feasibility and viability in practice. The thesis is divided into theoretical and practical part and includes three chapters. The first theoretical chapter deals with a business environment in the Czech Republic. Basic business terms, Czech legal forms and legislative requirements for food business are explained, specified and outlined here. The second theoretical chapter is focused on the purpose, principles of processing and structure of business plan. Practical part of thesis is based on this chapter and contains the real business plan for founding the tea room "Čajovna U plné konvičky" in the Prague's district Nusle.